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In 2021, my half son #Daddy_A, who was over 300lb / 136kg, lost 75lb / 34kg in 90 days due to a previously unsuspected genetic mutation.
He had a mild form of skin cancer, so they prescribed a topical chemotherapy drug. For most people, this has no side effects because the tiny bit that gets into the bloodstream gets broken down in the liver pretty quickly. For him, it was like he was on traditional chemo ... nausea and vomiting, diarrhea.
By the time they tested for the genetic issue, they already knew from the symptoms that it was there. The weight loss meant that his back injury symptoms lessened, so his next two surgeries are postponed.
He has been hospitalized multiple times this year for yet another issue, but he's home and says he's looking forward to a better 2023.
(It does mean that if he gets another form of cancer, chemotherapy is probably not an option.)