When Travis gets too big to walk down the aisle, he promises to give his wife a proper wedding; he gains more weight, leaving Dr Now as Travis' only hope to lose weight and get the life he and his wife dreamed of having together.

Shantel's brother Carlton lives downstairs but she hardly ever sees him because at 600 lbs each, neither can do the stairs safely; to break free from a death spiral of codependent eating they need Dr. Now's help to reforge their sibling relationship.