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 towards Steven immediately begin to sabotage his hopes of surgery.

A year since her weight loss journey began, Janine is still in the 500 and mostly immobile, and now, Dr. Nowzaradan is running out of options to treat her if she can't find a way to control her eating habit and start walking again.

Lee's anger issues continue to jeopardize his relationship with Rena and threaten to derail both of their weight loss journeys; a major life event sends Sarah into depression, and she must pull herself out of it if she wants to keep losing weight.

In the 4th year of his weight loss journey, Sean struggles to get past the loss of his mother and live on his own. Dr. Now intervenes to control his eating for a time, but if Sean can't learn to control himself, he will face dire consequences.

Liz has gone from being bedbound with lymphedemas on both legs, to standing and walking, but old fears are about to threaten her progress. And if Jenn and Marissa can't get along as mother and daughter to lose weight, they'll have to proceed apart.

For Milla Clark, after 3 years & 5 surgeries, success would mean beating the odds, and becoming one of Dr. Nowzaradan's most impressive weight-loss patients ever. Failure would mean slipping back to the bedbound life she swore she'd never return to.

Pauline's self-destructive behavior continues to be a problem. Chad strives to be a better father and husband as he continues his journey. June's progress stalls when frequent travel and wedding plans cause her to slip back into bad habits.

Tamy faces a tough choice when her husband wants her back but only if she moves away from Houston and Dr. Now's program. Karina's weight loss begins to slow, but she finds happiness dating a guy Dr. Now is surprised to see in his clinic again.

In year three Erica is succeeding on her weight-loss journey with romantic misfortune send her spiraling backwards; Benji Bolton must reach his goal weight without the support of his brother David after a disagreement leaves the brothers estranged.

Alicia’s relationship with her boyfriend comes under the microscope in the second year of her weight loss journey; now in her fourth year, Pauline must beg her way back onto the program after quitting when her last weight in didnt go so well.

Dottie faces an unexpected challenge to her weight-loss when her husband's drinking problem becomes intolerable for her and her son. Cynthia starts to wonder if being there for her kids at her current weight is more important than losing more.

In order to keep pace with her daughter Charly’s weight loss, Charity must do something she’s never done: find a way to go it alone; try as she might, Teretha finds one too many obstacles in the way of continuing with Dr. Nowzaradan’s program.

Together weighing more than a ton, the Perrio siblings Roshanda, Brandie and Clarence set out to lose weight as a family; the all-for-one approach may be hurting more than it helps when each of them shows signs of heading in the wrong direction after surgery.

If Steven Sr. thought getting weight loss surgery for his sons would help bring them together, the 3rd year of their weight loss journey will prove him wrong, as Justin returns to Rhode Island with every intention to never speak to Steven again.

Holly has come a long way in her weight loss journey, but now she's trying to balance a wedding and skin surgery. Lashanta struggles to lose any weight at all. When a car drives through a wall in her living room, her weight loss is curtailed even more.

Robin and Garrett started their weight-loss journeys together as aunt and nephew. Now almost four years later, they continue to support each other to reach their target weights by shedding pounds and having skin removal surgeries.

Vianey and Allen have been on a weight loss journey together. But after Allen's surgery is a success and Vianey's is not, the couple struggles to get back on the same page to save their lives.

After regaining her mobility, Octavia is determined never to be stuck in the bed again, but difficult life circumstances threaten her ability to eat right and stay on track. Aaron is laid low by the death of his father, but true love saves him.

Even after surgery, Lacey's weight loss moves at a glacial pace. She says she wants skin removal surgery, but Dr. Now begins to wonder if she even wants to lose weight. Meanwhile, abandoned in Houston by her cousin, Mercedes and her kids face destitution.

Maja needs weight-loss surgery so she can lose weight, but Dr. Now won't approve her for surgery if she can't overcome getting dumped by her boyfriend Christian without using food to cope. Justin charts a course to be one of Dr. Now's best patients ever.

There is much to be gained -- and lost -- for Brianne in year two of her journey, in which she both loses weight and gains independence. Getting back with Erica becomes the top priority for Annjeanette, who chooses love over even her own

Right when Angie starts to succeed in Dr. Now's program, her marriage falls apart and her life is thrown into chaos. Angie moves ahead despite dire difficulties, but when her body starts to break down, Angie fears the worst ... and faces it alone.

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.

The brothers shock Dr. Now with their staggering collective weight loss.

Holly has come a long way in her weight loss journey, but now she's trying to balance a wedding and skin surgery. Lashanta struggles to lose any weight at all. When a car drives through a wall in her living room, her weight loss is curtailed even more.

Robin and Garrett started their weight-loss journeys together as aunt and nephew. Now almost four years later, they continue to support each other to reach their target weights by shedding pounds and having skin removal surgeries.

Vianey and Allen have been on a weight loss journey together. But after Allen's surgery is a success and Vianey's is not, the couple struggles to get back on the same page to save their lives.

After regaining her mobility, Octavia is determined never to be stuck in the bed again, but difficult life circumstances threaten her ability to eat right and stay on track. Aaron is laid low by the death of his father, but true love saves him.

Even after surgery, Lacey's weight loss moves at a glacial pace. She says she wants skin removal surgery, but Dr. Now begins to wonder if she even wants to lose weight. Meanwhile, abandoned in Houston by her cousin, Mercedes and her kids face destitution.

Nathan is shedding pounds and heading back to work as a drama teacher following his weight loss surgery. However, wife and colleague 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: lymphedema removal.

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 might 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 succeeded in getting surgery, but Dr. Now is dismayed when she and her mom are back to their old ways just a few months later. Megan grows impatient with her own slow, steady weight loss, and if Dr. Now doesn't approve her for surgery soon, she might just quit.

Seana's mind is ready for surgery, but her body still has a conflict with the scale. Once almost 900 pounds, J.T. Clark is finally ready to have his massive leg surgically downsized.

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 for the best.

Thederick has lost enough weight to get the giant lymphedema mass removed from his leg, in one of Dr. Now's biggest removals ever. Will he even bother to pursue weight loss surgery after that? Lindsey loses more than weight when she loses her husband to another woman.

Mike has an unusually tough decision to make, when moving to Houston for weight loss surgery might mean forfeiting custody of his kids. Chrystal finally gets her surgery and makes a big leap towards being the mom her kids deserve.

Isaac has been close to getting surgery many times, but putting family first keeps him from getting the help he needs. Irene's slow-and-steady approach finally pays off.

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.

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.