While Chris makes progress after his surgery, Tammy gets discouraging news; Amy plans a unique bash for Tammy's 35th birthday; the family excitedly plan their first vacation together with all five siblings, but concerns rise about Tammy's mobility.

After a rift on the family vacation, Amy returns home and drops a bomb on Tammy. While Amy focuses on her new life, Tammy makes a decision that takes her even further away from her weight-loss goals.