Amy and Tammy eagerly begin their weight loss journey. Sticking to their diets is a matter of life or death but proves to be a real struggle. The pressure to reach their goals culminates in a huge fight that threatens their diets and relationship.

Amy decides to have a real wedding ceremony because if she gets approved for surgery, she's afraid she may not survive. After the wedding, the sisters head to Atlanta hoping for a life-changing final weigh-in.