Losing over 200 pounds, Doug is now an active part of his family's lives and inspires a healthier lifestyle for them all. However, Doug's eating disorder and trouble finding his own identity threaten to derail his progress.
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 finally become independent to get the full gastric bypass surgery she feels she needs; Michael struggles to lose and still battles anger issues; and Michael's wife, Roni, wants her own surgery.
Ashley lost over 200 lbs. in Houston, but she faces the fact of regaining independence and struggling to lose weight back in California with her family of enablers; and Diana has embraced her new life and shed 300 lbs., but her knee damage might threaten her progress.