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suyashjhawar
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siyer
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I go with C.

a verb is needed so between choices c,d and e. since in c conveys the meaning - from that time.
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Must be "has lost" rather than "lost" since George is still losing those pounds. Eliminate:
a) lost more than 180 pounds since having
b) lost more than 180 pounds since having had
"subsequently to (a noun)" is non-idiomatic I think. Eliminate:
e) has lost more than 180 pounds subsequently to
The sentence is describing something that happened from that point on until the present. "Since" is more appropriate than "after". Eliminate:
d) has lost more than 180 pounds after

Ans
c) has lost more than 180 pounds since
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For anyone wondering why OA is C and not D, take a look at

https://www.manhattanprep.com/gmat/forums/usage-of-since-after-and-following-source-self-made-t4478.html

It is about usage of "since" and "after".
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George Brown lost more than 180 pounds since having an operation truncating his stomach three years ago.

a) lost more than 180 pounds since having
having is continuous . wrong.

b) lost more than 180 pounds since having had
having had is wrong construction.

c) has lost more than 180 pounds since
straight forward. simple. CORRECT

d) has lost more than 180 pounds after
has..since.
he has not lost that weight immediately after the operation.
it has been an ongoing process. so, has lost....since
.
e) has lost more than 180 pounds subsequently to
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