Zsalynn struggles between fighting her weight and fighting for her marriage; Christina releases the negativity in her life and finally begins to live.

Olivia suffers an unexpected loss; James strives to reach his goal of skin surgery and have a fulfilling relationship.

Dr. Nowzaradan is worried Lupe's emotional issues are blocking her weight loss journey since she's shed over 300-lbs but still can't walk; when Ashley is struck with sudden paralysis, her own emotional stability is thrown into peril.

Gastric surgery freed Brittani from her housebound life, but to achieve her ideal body she'll have to endure two more painful surgeries; Sean's super-obesity nearly killed him.

Surgery enables Teretha to return to family in Detroit, but it soon threatens to undo all her progress; Chad is back on the road, but his old diet is a risk.

After losing 250lbs, Nikki is on her way to skin surgery, but when a close friend dies from weight loss surgery, Nikki's progress is derailed by fears.