pra1785 wrote:
Can someone explain all the options? I did not have good enough reason to eliminate any options
Quote:
Alfred lost more than 180 pounds since having an operation truncating his stomach three years ago.
(A) lost more than 180 pounds since having
(B) lost more than 180 pounds since having had
(C) has lost more than 180 pounds since
(D) has lost more than 180 pounds after
(E) has lost more than 180 pounds subsequently to
With "since" we use the present perfect or present perfect continuous. So A and B out.
With "after" we would use simple past in D.
The phrase is "subsequent to = after, following" in E, not "subsequently to".
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57% (00:51) correct 
