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Tammy hits a tipping point at rehab, and more bad news from back home sends her into a downward spiral; Chris gets a reality check during a check in with Dr. Smith; the family says goodbye to a beloved family member.
Tammy's seemingly good progress inspires Amy to visit, reuniting the siblings for the first time in months; Amanda begins a new chapter in her life; Amy learns she's at risk of serious complications if she doesn't get her eating under control.
After finding out Tammy's been robbed, Misty and Amanda visit to break the news in person; while Chris pushes ahead toward his surgery goal, Amy has a setback and is rushed to the ER; with her sisters by her side, Tammy faces the results of her weigh in.
After surviving a near-death experience, Tammy struggles to cope with her new reality. Then, she makes a life-altering decision, one that no one saw coming. With baby number two on the way, Amy feels her family is complete, but she soon realizes being an overweight mom may prove to be too much. Chris is desperate to get rid of excess skin and qualify for skin removal surgery, while Amanda offloads some dead weight of her own.