Siblings Carlton and Shantel have always been close, but with their eating habits enabling each other, they need to make a change; Shantel is sad to grow apart from her little brother, but it might be the one thing they both need the most.
Thederick has lost enough weight to get the giant lymphedema mass removed from his leg, in one of Dr. Now's biggest removals ever.
Paul made a promise to his girlfriend that he intends to keep; to ask her to marry him within a year's time. Now he just has to lose about 300 pounds. Carrie needs surgery badly, but she prefers not to change her eating habits.
Mike has an unusually tough decision to make, when moving to Houston, Texas, for weight loss surgery might mean forfeiting custody of his kids; Chrystal finally gets her surgery and takes a big leap towards being the mom her kids deserve.
Michael has a new lease on life post-surgery and a return to martial is arts is just the beginning, now that he has lost upwards of 300 pounds; Lucas was doing great, when a bit of backsliding proves difficult to overcome.
Nathan is shedding pounds and heading back to work as a teacher following his weight-loss surgery; however, his wife Amber can't seem to do the same as she struggles to qualify for a second surgery to update one she had years ago.
Ontreon hopes that surgery can make him a better husband to his wife Musa, but he struggles to move past the grief that's blocked him for years; Wess is doing great post-surgery, but his next goal is crucial to his success.
Weight loss leads to exciting things when Julian and his wife Irma adopt a baby, but fatherhood might distract Julian from his goals; Cindy needs to change her attitude to lose some weight.
After getting his surgery canceled and living in his van by the beach, surgery may be the break David has been waiting for his whole life; Syreeta suffers a devastating personal tragedy that only strengthens her desire to become a mother.
Margaret succeeds in getting surgery, but Dr. Now is dismayed when a few months later she and her mom revert to their old ways; Megan grows impatient with her slow weight loss, and if Dr. Now doesn't approve her for surgery soon, she might quit.
Maja struggles to get approval for surgery. Justin may be an ideal patient.
Angie enters the most-trying stretch of her weight-loss journey. She finds herself on the brink of homelessness after Dr. Now refuses to keep her in his program unless she submits to drug rehab for substance abuse.
Jeanne struggles to care for herself in the aftermath of her dad's death. Brandon strives to get his weight down in order to feel confident when proposing to his girlfriend Tayler and be the man she deserves.
Cillas must face difficulties from his childhood in order to progress to his goal weight and set an example for his children. Tiffany struggles to lose weight when financial hardships place a strain on her relationship with her boyfriend Aaron.
As Steven heals from his weight-loss surgery, his brother Justin finally decides to come to Texas to get the same procedure, but his feelings toward Steven immediately begin to sabotage his hopes of surgery.
A year since her weight-loss journey began, Janine is still in the 500s and mostly immobile, and now, Dr. Nowzaradan is running out of options for how to treat her if she can't find a way to control her eating habit and start walking again.
For Milla Clark, after three years and five surgeries, success would mean beating the odds and becoming one of Dr. Nowzaradan's most impressive weight-loss patients, but failure would mean slipping back to the bedbound life.
Over 11 years, Melissa has lost 500 pounds and saw her weight drop to 137 pounds; now facing marital problems, three pregnancies, and life as a single mom, Melissa is struggling with a 150-pound weight gain and finds herself at a crossroads.
After successful sleeve gastrectomy procedures, the Dreier twins collectively lose more than 400 pounds and work toward skin surgeries when a major life event disrupts their world and threatens their progress.
Ashley lost over 200 pounds in Houston, but a family of enablers threatens her progress; Diana has shed 300 pounds but knee damage may cause her to regain weight.
Back on Dr. Nowzaradan's program, James is suspected of cheating as he continues to gain weight and suffers a series of life-threatening illnesses; Cynthia continues to lose weight but seems satisfied to do so at her own pace.
Kirsten must gain independence to get a full gastric bypass; Michael struggles to lose and battles anger issues; Michael's wife, Roni, wants surgery too.
Doug has lost over 200 pounds and is more involved with his family life. He is now an example of healthy habits, but eating disorders threaten to derail his progress.
Ashley hits an emotional wall and is desperate for skin surgery, but she's not losing any weight; after being evicted, Nicole is forced to move back to Ohio, which could impact her weight loss journey.
Brittani has lost over 400 pounds in two years, so she and husband Bill think about expanding their family; Lupe has struggled since surgery, but, having left her husband, may finally start to make the permanent changes she needs.
Sean must overcome recent tragedies in his life before he loses all the progress he made over the last two years; Dottie struggles to stay on track while maintaining her family life.
Zsalynn's 360-body lift procedure proves to be more challenging than expected; lonely and depressed since her gastric surgery, Olivia wants skin removal surgery but struggles to lose the weight to qualify.
Despite having lost 378 pounds, Angel's crippling knee pain and history of extreme obesity threatens everything for which she's worked; Charity finds the strength to return to a normal life after post surgery complications.
With her weight loss, Laura is much less dependent on her husband Joey, who is now having trouble finding his place in their relationship; challenging patient Marla returns and the fireworks begin once again.
Pauline must keep her weight loss on track after a medical emergency; Chay admits to being a transgender woman, and the resulting stress may threaten his weight loss journey.
Zsalynn struggles between fighting her weight and fighting for her marriage; Christina releases the negativity in her life and finally begins to live.
Penny returns to Maryland believing she can lose weight; Tara continues to lose weight and is dating for the first time.
Chuck's second year of weight loss and a new relationship; Paula struggles with juggling many responsibilities along with her weight-loss.