Season 4

Nikki's life and career are threatened by her 650-pound weight. Determined to make a change, she undergoes weight-loss surgery.

Brittani has reached almost 600 pounds at just 32 years old. Though her husband loves large women, she lives in constant pain and hides her body from him for fear of rejection. In hopes of better health and a better marriage, she undergoes weight-loss surgery.

At over 700 pounds, Chad's weight is out of control and gastric bypass surgery is his last resort. He sells his house to be able to afford the surgery, but his recovery is complicated when he faces a medical crisis and fails to follow doctor's orders.

June, at almost 600 pounds, has coped with the tragic death of her son by eating. Confined to her house and unable to care for her three children, she must make a change and pursues gastric bypass surgery. Her girlfriend and primary caretaker Sadi supports her efforts.

At over 600 pounds, Dottie agrees to a drastic new diet and gastric bypass surgery in hopes of reclaiming her health and ability to care for her children. Her child's life-threatening emergency and her own self-sabotage threaten to derail her efforts.

At over 600 pounds, Gideon's is unable to work and completely dependent on his exhausted wife. Fearing an early demise and desperate for change, he uproots his family to undergo weight-loss surgery in hopes of reclaiming his life and health.

Ashley is just 26 years old and over 700 pounds. Her 5-year-old son is one of her primary caregivers and a motivating factor in making a major change. Knowing her life is on the line, she pursues weight loss surgery but faces medical setbacks and various struggles in the process.

At over 700 pounds, Teretha's life is confined to a bed -- a far cry from her former job representing Detroit's healthy eating program. Her adoring family fears losing her and hopes bariatric surgery will help save her life.

At 650 pounds, Randy's weight has led to the loss of his marriage and custody of his daughter. In a last ditch effort to save his life, he begins a rigorous diet to undergo weight loss surgery. He battles the temptation of fast food, as well as lingering depression, and struggles to keep his job.

At about 700 pounds, Milla is bedridden and unable to feed or bathe herself -- her five children care for her every need. She knows she must make a change for their sake as well as hers and in an attempt to reclaim her health, she moves to Texas to undergo weight-loss surgery.

Sean weighs almost 1,000 pounds at just 26 years old. His skin is so stretched it is tearing apart, and a massive growth protrudes from his side. With the support of his mother, he attempts weight-loss surgery to save his life.

Lupe, at almost 600 pounds, has been bedridden for 10 years and depends on her husband for all her needs. A cross-country move to Texas for weight-loss surgery is her last chance for change, but it may be too late.