Olivia works toward her goal weight, and James hopes to have skin surgery.

Penny struggles while Tara continues to lose weight and enjoys dating.

Brianne gains independence. Annjeanette chooses love over health.

The lives of obese cousins Naomi, Drew and Chitoka are in danger.

Drew wants to have the weight loss surgery, and Chitoka asks for help.

Chitoka tries to become more mobile, starting by leaving her bedroom.

Drew's surgery is on the brink of being canceled if he doesn't lose weight.

The family anxiously wait while Drew undergoes surgery.

At a birthday party, the cousins reveal their startling transformations.

Cousins Casey, Amanda, Amy and Ed are morbidly obese.

Amanda has surgery in the hopes of losing enough to treat her cancer.

Casey reaches a boiling point with his parents, and Amy makes changes.

Casey starts questioning surgery after watching Amy go through post-op.

Casey questions whether he should go through with the surgery.

Casey learns if he has been approved for life-saving surgery.

A year later, the Andersons begin to struggle in their weight-loss journey.