Dr. Nowzaradan tells Tara that if she doesn't change her eating habits immediately, she'll only live five more years. Tara is reduced to tears when her mother delivers an ultimatum on top of that.

Chuck is surprised to discover that surgery didn't take away his cravings. He's still getting meals from the drive-thru.

Moving to Texas wasn't easy for Christina, but she's kept a brave face. Daunted by getting into her temporary home, though, she breaks down into tears.

Christina is shocked to discover how little weight she's lost after surgery. Her family offers her some excuses, but she tells them it's simply not good enough and she has to work harder.

Zsalynn is scared going into surgery, but she puts on a brave face for her daughter Hannah. She confesses that she wishes her husband were there to support her.

Zsalynn fights -- and wins -- the battle over tortilla chips at a Mexican restaurant, but she later falls prey to another food craving.

Paula mentally prepares for gastric bypass surgery by drastically altering her look with bright green hair dye.

James comes from a long line of family obesity and at 706lbs, is determined not to die in the same hospital bed that his father and sister did.

Penny is transported from her home in Maryland to see Dr. Nowzaradan in a Texas hospital. Once she's there, he shares some grim facts about her weight and BMI.

These individuals transform their bodies -- and their lives -- over an intense seven-year journey.

Olivia is placed in the hospital for 48 hours to assess her preparedness for gastric bypass surgery.

Olivia travels from Chicago to Texas to see Dr. Nowzaradan, but the 18-hour car trip is grueling for someone in her condition.

Post surgery Zsalynn enjoys the next step in her battle with obesity, but her victory is short lived with the arrival of her unsupportive husband.

Paula is motivated to work out with a personal trainer at her gym, but it's still going to take some time before Dr. Nowzaradan's diet advice really sinks in.

Chuck weighs almost 700lbs and it has hindered every aspect of his life. He's had to downsize his business and his wife feels like a single-parent, who is ready to leave him.

Christina's husband and mother are enabling her to eat 7,000 calories a day. She learns a tough lesson from Dr. Nowzaradan: When they put food in front of her, she must simply say no.

Tanisha struggles with her weight loss commitment after she and her husband separate.

Charity must find the strength to return to her goals of getting healthy and living a normal life after post-surgery complications.

Renee tells us about her rough childhood that led to her being overweight.

Charity must find the strength to return to her goals of getting healthy and living a normal life after post-surgery complications.

Renee has an emergency on the way to Houston.

James describes his difficult childhood.

Marla, one of Dr. Now's most challenging patients returns and the fireworks begin all over again.

Sarah describes her early childhood and what led her to gain all the weight.

As James got older, his life took a turn for the better when he met his current girlfriend, Lisa.

Laura has lost 300lbs+ and is much less dependent on her husband Joey who now he's having trouble finding his way in the relationship

Sarah moves in with her grandmother who is helping her stay on track to lose weight.

James’ father stops by to visit and suffers a health scare, leaving James frustrated by his own immobility and inability to help.

Tensions rise as Sarah and her mom move into their new apartment in Houston. Within minutes, Sarah's mother finds several hidden bags of candy and cookies which instantly makes her worried about Sarah's level of seriousness concerning this process.

Tracey begins the journey to Houston for treatment.

Chay's finally admitting what he's long known, that he's a transgender woman. However, the emotional stress of coming out could threaten his weight loss journey.

Chay's Aunt and Uncle who supported his weightloss journey, aren't as supportive of him coming out as transgender.