Georgia Davis, known as "Britain's fattest teenager," was the center of attention when she lost half her body weight at a camp in North Carolina in 2009.
But 16 months later, she has regained even more -- 224 pounds -- much to the ridicule of her countrymen.
Today, 17-year-old Davis is 5-foot-6 and weighs in at nearly 460 pounds. She lost 202 pounds at Wellspring Academy of the Carolinas in the Blue Ridge Mountains.
"Unbelievable," said one commenter on the story that appeared in Britain's Daily Mail newspaper. "By the way, who paid for her attendance at fat camp?"
"Where is she getting the money from to buy all this much food," said another. "Surely, even benefits won't cover the cost of what she is eating every day."
"If you don't put food in your mouth, you don't get fat -- end of story," said a third commenter.
But doctors say that the morbidly obese face psychological and physiological problems that prevent them not only from keeping weight off, but losing it in the first place.
"The poor kid," said Dr. David L. Katz, director of the Yale Griffin Prevention Research Center. "The proximal cause of obesity is bad use of feet and forks -- too many calories and not enough exercise, an energy balance issue. The root cause for most of us is everything about modern living -- the availability of tasty, glow-in-the-dark foods, the marketing of food, every device so you don't use your muscles.
"Sometimes, it's psychological -- trauma in childhood, major self-esteem issues and depression -- when food is a Band Aid," Katz said. "Unless you treat those problems, the dependency on food doesn't go away."
Davis, who is from Aberdare in South Wales and has Type 2 diabetes, was told in 2008 that she would die if she did not lose more than 200 pounds. At her current weight, doctors say she might not live past 20.
She paid nearly $6,000 to attend the North Carolina camp where she was treated by behavioral coaches, food psychologists and fitness trainers, and encouraged to walk 10,000 steps on a treadmill every day.
Davis said she began to gain weight after using food to comfort herself after the death of her father when she was 5.
From the age of 10, she cared for her sick mother and also was bullied at school by peers who called her lazy and said it was her own fault she was fat.
"I'd eat to comfort myself, and afterwards I'd feel worse and I'd eat again," said Davis.
Georgia Davis Was Bullied and Turned to Food
Davis' daily diet included three bowls of sugared cereal, sausage rolls and pies, six packets of potato chips, a stack of sandwiches, a chocolate cake, French fries, 21 cookies, KFC chicken, chunks of cheese and a liter of coke.
Her pattern was typical of those who are obese: They are teased, turn to food for comfort, feel ashamed, eat more and get heavier.
"The damage is done," said Katz. 'It's reward and punishment at the same time."
There also are genetic vulnerabilities with the morbidly obese, but they are escalated by psychological problems.
"We see a cascade play out.," he said.
But schoolyard taunts didn't help Davis to lose weight.
"What motivated me was my friends and my family, and me thinking that if I keep going the way that I am I am going to die soon," she said in an interview with ABC News' "Good Morning America" in 2009.
After losing 202 pounds, Davis said she was optimistic about chances of success and vowed to lose even more weight.
After returning to Britain, she told the media, "I used to look at myself in the mirror and cry. Now I smile and say, 'Yeah, I like myself. I like my face and I like the way my body is shaped.' The world is my oyster and I feel I can achieve anything."
But back home she felt isolated, as neither her family nor her friends were sticking to a healthy eating plan. Davis wants more help from Britain's National Health Service because her problem is no different from drug or alcohol addiction.
"I know I'm probably eating myself to death again, but at the moment I can't face up to it," she told the Daily Mail.
"I think it's unfair she got lambasted," said Keith Ayoob, director of the nutrition clinic at the Rose R. Kennedy Center at Albert Einstein College of Medicine. " It just underscores a very, very difficult problem. And it's more than addiction, because you can't quit cold turkey -- you have to eat."
"It's like someone telling you that you have to limit yourself to two drinks a day, but you have to take some," he said. "And unlike many other conditions, in obesity everybody's got an opinion they want to share with you."
Gaining and losing weight can be a "vicious cycle," according to Manuel Villacorta, a registered dietician and spokesman for the American Dietetic Association.
His Eating Free program emphasizes eating all foods, but learning how to balance food types, manage portions and to lose weight slowly.
"I don't know what [Davis'] situation was," he said. "You try to figure out what is wrong -- the environment she lives in, the lack of knowledge and confusion, lack of support, medical reasons and the big one -- the emotional component of food and its draw for her."
Hormones in the brain keep the body in a "calm, alert state" throughout the day and are inextricably tied to eating, according to Villacorta. Carbohydrates raise serotonin, which induces calm; protein raises dopamine, which triggers pleasure; and fat lowers the stress hormone cortisol, raising endorphins in the brain.
Stress and eating can cause all those hormones to kick in.
"She was getting high eating," he said.
Food Addiction Is Hard to Lick
Many Americans face the same issues with an abundance of food -- "every flavor, whatever you want in a matter of seconds," Villacorta said.
Scientists are learning that the hormone ghrelin, which stimulates appetite, helps defeat most dieters, according to Villacourta. It slows down the metabolism just when the body starts to cut back calories and begins to store fat, especially in women.
"The second you delay meals, skip meals, the body starts producing the hormone naturally," he said.
At camp, Davis was prescribed a strict 1,500-calorie diet, but may not have learned sufficiently to make better food choices.
"Sometimes, knowledge does change behavior, but someone needs to work with her on coping mechanisms so she doesn't go back to eating the drug," said Villacorta.
Wellspring Academy says that students enrolled for at least two semesters lose an average of 81 pounds.
But according to Yale University's Katz, 85 to 90 percent of all diets fail, especially among the morbidly obese.
"We are quick-fix society and people want a silver bullet," he said. "They go and sign up for the pickle juice diet, but they haven't fundamentally changed their skill power. You deprive yourself for six weeks to get to look good in the black dress for the wedding, but you can't stay lean for the long haul.
"Extreme obesity has more issues, and you have to get at the source," said Katz. "I suspect that what we are talking about in this story is self-esteem, and that may be just the tip of the iceberg."
Many who are obese need to take responsibility for themselves -- with social and emotional support.
"No one can eat and exercise for you," said Katz. "But before you ask people to take responsibility, make sure they are empowered to do it or often they fail."