Tammy has her heart set on skin removal but is met with a roadblock.

The family takes a trip down memory lane and revisits the important people and places who have made them who they are today, but not without jokes and hilarity along the way.

The family preps for their very first beach vacation, and Tammy hits some major milestones. While everyone flies, Amy opts for a nine-hour car ride which leaves her and the boys cranky. Then, Chris gives Amy some tough love.

Amanda and Misty get big news and take a major step in their health journey; Amy and Tammy blow off some steam; Amy gets some devastating news from her lawyer that sends her reeling.

Tammy hosts a housewarming party and has a few choice words for her mom; Amy's world is turned upside down when she finally confronts Michael over his lack of help with raising their two boys; meanwhile, Caleb hasn't been honest with Tammy.

Tammy wants to come home, but a setback causes a major blowup between her and the family.

The family deals with the aftermath of Amy's meltdown. Back home, Chris gets skin removal surgery. Amy has a risqué photoshoot. Tammy finds doctors who can do her skin removal surgery but some test results force Tammy to confess a long-held secret.

Tammy addresses Amy about her weight gain and the family heads to Pittsburgh for Tammy's skin removal surgery.

Amy is ashamed of her behavior in Florida and wants to make amends, but she worries Amanda won't accept her apology; when Tammy gets some devastating news, her whole world is turned upside down, and her family rallies behind her in support.

After the blowout with Michael, Amy makes the hardest decision of her life; Chris and Tammy have a long-overdue appointment with Dr. Smith; worried about surgery, Amanda and Misty do a last-minute cleanse to sweat out nicotine.

As Tammy heads home after 14 months in rehab, she's forced to make the most difficult decision of her life. Fed up with not having help, Amy feels her marriage is starting to unravel. Amanda and Misty reveal they're getting bariatric surgery.

Tammy's skin removal surgery is still up in the air as she struggles to kick bad habits. Amy's got a new roommate and a new man. Chris' plays referee between Brittany and their new neighbor. Tammy is keeping a secret from her family.

When the siblings react to Amy's proposal, relationships are fractured.

The family arrives in London for their first international vacation and learns even more surprising news about their ancestry.

Tammy struggles to cope after surviving a near-death experience; Amy realizes being an overweight mom may prove to be too much; Chris is desperate to get rid of excess skin; Amanda offloads some dead weight of her own.

A missing tool in the operating room causes delays to Tammy's extreme skin removal and Amy decides she's had enough and makes a bold move.

Tammy, Amy and their siblings sit down to watch their most memorable clips.

Amanda reels after leaving dinner; Chris crosses something off his bucket list; Tammy tries to have fun but misses Caleb; fed up with her siblings critiquing her, Amy reaches her boiling point and explodes.

Amy faces Michael in court at their first divorce hearing. Chris finds an unusual way to get healthy food. Tammy explores the possibility of having kids. Later, Tammy heads to rehab for a recon mission after learning some information about Caleb.

Tammy reveals to her sisters that she's dating a woman and their reaction surprises her. Chris and Tammy check-in on their skin removal progress, and a harrowing moment at the petting zoo sees Amy's life turned upside down.

Chris comes down on Amy for enabling Tammy.

Chris faces the ultimate weigh-in to get approved for bariatric surgery. With Tammy's weight at a standstill, Amy and Michael make a life-altering decision. The family's fears about Tammy's choice in partners are realized.

The Slaton's are larger-than-life sisters who have always relied on each other and food for support. Amy, age 31, is desperate to have children, but hasn't been able to due to her weight. While Tammy, age 32, is one step away from being bedridden.

Tammy must see a new therapist, but things don't go the way she'd hoped; Amy wants to lose her excess skin, but she gets bad news at the plastic surgeon's office; Chris faces the scale; if he's below 400 pounds, his surgery is on.

Tammy struggles to get back on the weight-loss wagon in order get approved for surgery, but this time, her brother, Chris, joins her on the journey. Amy must deal with one very big life-altering repercussion of having had her surgery

Tammy hits a tipping point at rehab, and more bad news from back home sends her into a downward spiral; Chris gets a reality check during a check in with Dr. Smith; the family says goodbye to a beloved family member.

Tammy is back from rehab, and Amy makes a decision regarding her sister.

After a stressful first month of dieting, the sisters head back to Atlanta for their one-month check in with Dr. Procter to find out if they are on the right path to their weight goals. The results force Amy to make a difficult decision.

Amy undergoes gastric bypass surgery to change her life, but endangers herself by not sticking to the post-op diet. Tammy seeks support from her love interest, Jerry. Two months later, the sisters reveal the changes they've made.

After a rift on the family vacation, Amy returns home and drops a bomb on Tammy. While Amy focuses on her new life, Tammy makes a decision that takes her even further away from her weight-loss goals.

Amy and Michael finally move out of the duplex, while Tammy's partying phase takes a turn for the worse. Amanda tries to get through to her sister before it's too late, and Amy's in for a rude awakening at her annual check up with Dr. Procter.

Amy gets unsettling news about the birth of her baby as her high-risk pregnancy has last-minute complications; with their next weigh-in ahead of them, Chris and Tammy are cautiously optimistic until Tammy steps on the scale.

Having survived yet another brush with death, Tammy recovers at rehab, but a new scare threatens her life; the family adjusts to life without Tammy; Amy's big surprise stuns everyone.

Amy and Tammy eagerly begin their weight loss journey. Sticking to their diets is a matter of life and death but proves to be a real struggle. The pressure to reach their goals culminates in a huge fight that threatens their diets and relationship.

The Slatons are shocked by the cause of Amy's trip to the emergency room. Chris and Tammy see a new doctor, where Tammy must step on the scale again after a month of not sticking to her diet.

The family vacation starts off terribly when Tammy refuses to enter the cabin. Chris hopes he's lost enough weight to fulfill a life-long dream. A last attempt to save the vacation ends in another confrontation. The siblings discover Tammy's secret.

Amy reels emotionally and physically from her camel bite and arrest. Chris explores a passion project, and Tammy expands her circle and fulfills a childhood dream.

While Chris makes progress after his surgery, Tammy gets discouraging news. Amy plans a unique bash for Tammy's 35th birthday. The family excitedly plans their first vacation together with all five siblings, but concerns rise about Tammy's mobility.

Amy and Tammy go to Atlanta to meet Dr. Procter to discuss weight loss surgery. When they arrive, Dr. Procter gives Tammy a hefty weight loss goal before he will approve her for surgery, meanwhile the dietician has more bad news for Amy.

Amy feels from giving birth and finding out Michael has COVID-19; after 20 years, Chris gets back on the horse; Tammy is almost at the finish line for surgery approval, but worries she won't pass her final assessments.