At his heaviest, Hector Garcia, Jr. weighed 636 pounds.
After being ridiculed for being overweight as a kid, he began dieting in high school, but the weight kept coming back due to poor eating habits and, likely, a genetic predisposition to obesity. At times confined to his home, Garcia told the San Antonio Express-News he couldn't remember a time when he was truly happy.
"It's hard to fight for my life when I feel that my life is not a life," he said. "It's existence. Existence is not enough for me."
Sixty-nine percent of Americans over the age of 20 are overweight, and 35.1 percent are obese, according to the CDC. Obesity increases a person's risk for numerous health conditions, including heart disease, stroke, Type 2 diabetes, sleep apnea and certain cancers. Roughly 3.4 million adults die each year around the world as a result of being overweight or obese.
Garcia allowed Express-News photographer Lisa Krantz and health and fitness reporter Jessica Belasco to follow him for four years starting in 2010 to capture the toll obesity takes on individuals and their families. "My life is a cautionary tale," he told the paper.
Around the year 2000, Garcia elected to have gastric bypass surgery, according to the Express-News. After the operation he lost close to 400 pounds, but he slowly gained all the weight back. "It helps you lose weight, but it doesn't teach you how to eat," he told the paper. "People think it's the miracle pill. I got news for ya. You still have to work at it."
In 2012, Garcia had surgery to replace both knees, which had been severely damaged by his weight. In order to undergo the procedure, he lost nearly 350 pounds. But complications of the surgeries led to disappointment and depression, a lack of exercise and return to seeking comfort in food, and by 2014, his weight was back to nearly 500 pounds.
"I overeat because food never rejects me," Garcia told the Express-News. "But the truth is, it's actually rejecting me now, because it's killing me. It's going to reject me up to the point where it takes my life if I'm not careful."
On Dec. 8, Garcia struggled to breathe and collapsed into a chair. Paramedics were called to the house, but it was too late. The exact cause of death is unknown, according to the paper.
A few of the powerful moments from Garcia's life as captured on camera by Krantz are below. Visit the Express-News to read the whole series.