lol is that guys neck really the same width as his skull?
I had a friend who went over 400 pounds from pregnancy drugs. She went to Duke's Rice House for about a year and you would never know she was over 140. No surgery. No stretch marks. It can be done.
about a decade ago i was almost 300, dropped to 100, then gained to 130 and the only sign that ever happened is a slight stretch mark on the back of one of my calves, which you can now get removed. even long before i trooned, nobody believed my fat pictures were me. the key to not fucking your skin up is to pace out your weight loss and don't go too fast unless your goal is to transition into a twinky stretch armstrong doll.
overdoing the cardio, doing no strength training, and trying to lose weight too quick = stretch marks, loose skin, and eventually a meth/runner's face in the end. the only way to fix that is fillers or getting fat again.
one of my friends fucked this up recently and he looks like a holocaust victim with silver-dollar nipples and a smiley face of skin-flap on his gut.