Amy faces the judge for the final time. Tammy addresses Amy about her weight gain. The family heads to Pittsburgh for Tammy's skin removal surgery but while Tammy goes under the knife, the siblings go head-to-head in the waiting room.

Amy and Tammy revisit the junkyard with their siblings. After 6 years of dieting, significant weight loss and surgery, they are encouraged for what they've achieved. After encouragement from Tammy, Amy agrees to get back on track and lose weight.