Cousins Casey, Amanda, Amy and Ed are morbidly obese; when Amanda decides to have bariatric surgery, the family considers doing the same.

Amanda undergoes bariatric surgery in the hopes of losing enough weight to treat her cancer; Casey meets with Dr. Procter and is told he'll die if he doesn't lose weight; the family has a pool party and Casey confronts Ed over his name-calling.

Casey reaches a boiling point with his parents when they blame his morbid obesity on video games; Amanda starts having pains post-surgery that send her to the E.R.; Amy makes major lifestyle changes in the hopes of being approved for surgery.

The family comes together to support Amy on her tough road to recovery; as Ed's surgery rapidly approaches, his daughters start expressing their concerns; Casey starts questioning surgery more than ever after watching Amy go through post-op.

It's the moment of truth as Casey learns if he has been approved for life-saving surgery. Amanda has huge news regarding her cancer. Amy attempts a hellacious Spartan Race. The King family throws a party to reveal their shocking new looks.

A year after the Anderson family started their weight loss journey, they find that the honeymoon period is over as they begin to struggle. Their 600 lb cousin Shavonne wants to follow in their footsteps, but can they motivate her?

Shavonne calls out the family for not losing weight; Naomi gets devastating news that might derail her goals for good; Drew attempts to re-enter the dating world for the first time in a decade; Chitoka tries to get back on track.

The members of the Anderson family work through their issues in group therapy; Chitoka and Shavonne face the painful memories that have kept them from losing more weight.

Shavonne undergoes high-risk bariatric surgery. Chitoka struggles to lose enough weight to be approved for skin tightening surgery. Drew works up the courage to go on another date. The family throws a party for Shavonne to reveal her weight loss.