As an Italian American, Geno was raised with lots of love, family and food. Now, he's still living with his mom and eating himself to death, and it's time to make a change. Geno's cousin, Nico, joins the cause, and they pledge to lose weight together.

Latonya found the man she wants to marry. The only problem is that, at almost 700 pounds, she can't walk down the aisle. Latonya doesn't want to give up the food that she's used to, but will she do it for love?

Wess gets off to a great start in Dr. Now's program, but when the cravings continue after surgery, Dr. Now sends him to therapy to confront his demons. Now, Wess must ask himself whether he is ready to live his truth as a gay man in small town Texas.

Syreeta thinks that anyone trying to help has an ulterior motive, but now she's gotten so big she desperately needs help. She's learning to let down her guard for her husband, but weight loss surgery will be tough if she can't learn to trust the surgeon.

Mark sets out with a goal for weight loss surgery, but as weight loss gets easier, he turns down medical advice and decides to do it on his own. Now, Mark thinks he can lose 500 pounds by himself, but Dr. Now sees this as another excuse not to change.

With her weight spiraling, Stephanie needs her mom's help to care for her three kids. Now, she's at the point where she'll have to lose weight or risk not having the chance to see her kids grow up.

Nothing means more to Chris than his relationship with his daughter, Zoey, but now he feels he is failing her as his weight gain begins to limit his mobility. Chris turns to his mother, whom he hasn't seen in seven years, to help get his life on track.

Patrick's weight has never been a bother -- not to him, nor to his wife, Amanda. Now, however, he's so big that it's getting in the way of his relationship with his daughter. If he wants to see her graduate high school, he'll have to reverse course.