Olivia strives to weigh-in under 200-lbs as she lives by herself for the first time and suffers an unexpected loss. Battling a series of let downs, James fights to reach his goal of skin surgery and to live a fulfilling relationship for the first time.

Away from Dr. Nowzaradan's care, Penny has returned to Maryland believing she can make the choices to lose weight, but has she truly changed? Dating for the first time in her life, Tara continues to lose weight and is learning to balance new roles.

Chuck starts from scratch during his second year of weight-loss, discovering a promising new relationship. Paula juggles many responsibilities at once, but is it too much to stay on track for her weight-loss goal?