Season 4

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.

Tammy's seemingly good progress inspires Amy to visit, reuniting the siblings for the first time in months; Amanda begins a new chapter in her life; Amy learns she's at risk of serious complications if she doesn't get her eating under control.

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.

After finding out Tammy's been robbed, Misty and Amanda visit to break the news in person; while Chris pushes ahead toward his surgery goal, Amy has a setback and is rushed to the ER; with her sisters by her side, Tammy faces the results of her weigh in.

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.

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.

After years of struggling, Tammy finally has her weight loss surgery, but things are not as straightforward as expected.

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

Tammy announces her engagement to the family and reveals that her big day is only two weeks away; Amy takes up maid of honor duties; the family wonders if there's another reason Tammy is rushing down the aisle.