When Nathan's weight gets in the way of the only healthy thing in his life - his job as a drama teacher - it's a wake-up call for him. But changing his life might mean a falling out with his wife, Amber, who is also overweight, unless she can lose, too.

For Julian and his wife, Irma, it was love at first sight. But in order to grow old together, Julian will have to overcome the food addiction that made him more than 800 pounds, and Irma will have to hold on no matter how difficult the journey may become.

Bianca is all in for a move to Houston with her boyfriend and two young kids to get Dr. Now's help with a second weight-loss surgery. But just when the coast is clear, her boyfriend's change of mind could undermine her progress.

Mike was born with a talent for sports -- and an omnivorous appetite to match. After his football dreams were dashed by multiple concussions, he packed on over 700 pounds. Now he must find a new purpose in life to avoid succumbing to pain and regret.

Lacey is so big from overeating that she can barely leave the house, but that hasn't stopped her from finding love with Ricky. Her weight isn't the only thing between her and a happy husband, however, with Ricky's sister Sharon in the picture.

Paul weighs in at 700 pounds, and his girlfriend struggles with how this limits their ability to live a normal life; he thinks their relationship won't survive if he moves to work with Dr. Now, but prioritizing his own health is the only option.

For James B, food means family. He grew up eating rich Haitian food and loves it with a passion. Now, James needs Dr. Now's help to diminish that love in order to survive, but a death in the family sends James retreating back to the comforts he knows.

Living on a homestead with his family, Lucas wants to spread his wings and fly, but at 600 pounds, he can't take off. All he does is eat and game, and if he wants to leave the nest and live a normal life, he needs Dr. Now's help to lose over 400 pounds.

Margaret's life at 700 pounds is in need of a jump start. At age 35, she is a mama's girl. Now, it's time for Margaret to get out of bed, overcome her food addiction and break away from the comfort of her mother so she can finally live her life.

At 700 pounds, Ontreon has managed to keep going thanks to his faith in God, and he's training to become a minister. But if he can't find a way to believe in himself, he'll never be able to stop eating.

Dolly has gotten too comfortable at 600 pounds. There's physical pain all over, and the skin apron pulling on her abdomen is miserable, but with her mom and others waiting on her hand and foot, she manages to avoid ever taking responsibility for her life.

For Larry, a second weight loss surgery would mean a second chance at a career as a gospel recording artist. But a beautiful singing voice doesn't pair well with a 600-pound eating habit. If Larry can't make the choice to change, then no one can help him.

Lisa wouldn't have made it this far without the help of her chief enabler, her boyfriend Randy. But Randy falls ill, and Lisa is about to find out if she has the will and determination she needs in order to turn her life around.

Growing up in foster care, David suffered from a lack of attention and didn't develop a sense of self-worth. Now he weighs 800 pounds, and he's relying on his favorite foster mom to support him as he finds the motivation to change and save his own life.