"I feel like I'm sitting in an old shell," says 19-year-old Kaitlyn Smith

By Stephanie Emma Pfeffer
Updated December 24, 2014 09:45 PM
Larsen & Talbert

Growing up, Kaitlyn Smith was always bigger than her five siblings. “I was constantly going to the doctor and being put on workout plans,” she tells PEOPLE. By sixth grade, the Portland, Tennessee, tween weighed 200 lbs.

Her diet consisted mostly of home-cooked Southern meals like pork chops and mashed potatoes with butter and salt. Plus she “spent summers at the local ballpark” because all of her siblings played sports. “Dinner would be nachos, cheese fries or mozzarella sticks,” says Smith, now 19.

When she hit 414 lbs. in high school, “I felt like a burden to my family,” she recalls. “I had given up.” A visit to a gastric surgeon who told her she would never be “normal” made her spiral further into shameful despair. “I left his office in tears. I was like, wow – if a doctor can’t even help me, then I’m truly helpless.”

Everything changed in January 2013, when her mom found her a Beachbody coach who had helped others in her community lose weight. “She taught me how to eat healthy and how to exercise,” says Smith, a Walmart cashier. “I made no excuses.” She borrowed a Beachbody P90x workout DVD, replaced high-fat foods with grilled chicken, salads and “lots of veggies” and started losing 20 lbs. a month.

She was finally able to succeed after so many false starts, Smith says, because she changed her lifestyle for good and didn’t go back to her old habits. She also credits her exercise routine. “I work out hard,” she says.

Smith has dropped 208 lbs. from her 5’5″ frame. As proud as she is to weigh 206 lbs. and fit into regular clothes, one thing still bugs her: the loose skin on her body.

“It’s the only thing keeping me from feeling completely beautiful,” she says. And it’s not only about appearances. Her skin gets caught in zippers and infected easily. It rubs on her clothes and causes blood blisters. “My skin skirt hangs down and causes pain in my back and hips,” she explains.

After meeting with a doctor who recommended three skin surgeries – chest and stomach, arms, legs – Smith started a crowdfunding campaign to pay for them. She raised $12,000 for her first surgery, which is coming up on Jan. 21, through GoFundMe, as well as a rummage sale and a benefit dinner organized by her hometown. She still has to raise $11,000 for the other two surgeries.

“When patients lose that much weight, nothing they can do will change that extra skin except surgery,” says Smith’s plastic surgeon, Kevin F. Hagan, at Nashville’s Vanderbilt University. “We can tighten things up and make them feel good about themselves,” he says, adding that the skin itself usually only weighs an extra 10-15 lbs.

Smith has been chronicling her weight loss on Instagram and Facebook. “I was hesitant at first, but people started thanking me for being so courageous,” she says. “I realized I could help others. I finally know why I was chosen for this journey.”

For more amazing transformations, diet tips that really work and the hottest Hollywood slimdowns, check out PEOPLE’s Half Their Size issue, on newsstands Tuesday