Seana's mind is ready for surgery, but her body still has a conflict with the scale. Once almost 900 pounds, J.T. Clark is finally ready to have his massive leg surgically downsized.

Margaret succeds in getting surgery, but Dr. Now is dismayed when she and her mom revert to their old ways just a few months later; Megan grows impatient with her slow weight loss, and if Dr. Now doesn't approve her for surgery soon, she might quit.

After getting surgery canceled and living in his van by the beach, surgery might be the break David has been waiting for his whole life. Syreeta suffers a devastating personal tragedy that only strengthens her desire to become a mother.

Weight loss leads to exciting things when Julian and his wife Irma adopt a baby, but fatherhood might distract Julian from his goals; Cindy needs to change her attitude to lose some weight.

Ontreon hopes that surgery can make him a better husband to his wife Musa, but he struggles to move past the grief that's blocked him for years. Wess is doing great post-surgery, but his next goal is crucial to his success: lymphedema removal.

With bonus scenes; Nathan is shedding pounds and heading back to work as a teacher following his weight-loss surgery; however, his wife Amber can't seem to do the same as she struggles to qualify for a second surgery to update one she had years ago.