Ashley lost over 200 lbs. in Houston, but can she regain independence & continue to lose back in California with her enabling family? No longer a shut-in, Diana has embraced her new life and shed 300 lbs., but will knee damage threaten her progress?

Back on Dr. Nowzaradan's program, James is suspected of cheating as he continues to gain weight and suffers a series of life-threatening illnesses. Cynthia continues to lose weight but seems satisfied to do so at her own pace.