1000-lb Sisters: Season 4, Episode 1 Recap: “The Sweet and Sour Life” Deals with Tammy’s Brush with Death

“This is my last chance. I just don’t understand why God saved me again.”

The Thousand Pound Sisters Tammy and Amy are back for a fourth season of their TLC televised weight loss journeys.

“The Sweet and Sour Life” starts the new season off with a recap of season three, reminding viewers of the last season’s drama, ending with Tammy’s childish partying behavior after failing to make progress towards her weight loss goals. “I’m aware that I’m doing damage to my body,” she confesses before clips show the rest of the family worrying about her being too far gone once she hits rock bottom to be healthy enough to even recover.

As season three ended, Tammy decided to check herself into a rehab facility after becoming tired of being constantly sick and unable to be independent. One day after checking in, Tammy was rushed to the hospital where she had quit breathing. Miraculously, Tammy survived and the fourth season opens at her rebab center where Tammy is on a vent with a trach. Despite being unable to speak well, she’s in good spirits and smiling as her nurse attends to her.

Sitting down for an interview proves harder than ever for Tammy this season, as she’s shown struggling and confined to a wheelchair and hooked up to her medical equipment while the producers talk to her. Tammy remarks that she blacked out before being rushed to the hospital, and only remembers waking up a week later on life support.

When arriving at the rehab facility, Tammy weighed in at her highest weight to date: 717lbs. With all that she has been through, it’s not surprising that Tammy seems very somber and like she is taking her health and weight issues seriously for the first time in the series’ four seasons. This is the closest brush with death Tammy has had thus far — being put into a medically induced coma and turning septic.

Tammy is extremely worse for wear, but it’s a relief to see her in good spirits as she cracks jokes with Marina, her registered nurse about how she remembers the “cute nurses.” Tammy’s new life with her trach has been full of adjustments, with her learning to live and breath with the new airway and all that comes with it.

“This is my last chance. I just don’t understand why God saved me again,” Tammy confesses in tears.

Meanwhile, things are looking cheery for Amy, who’s visiting a salon with her husband Michael and their child, Gage. With how successful Amy’s story has been, it’s a nice relief from the tension surrounding Tammy’s condition to see Amy enjoying life and keeping the show 1000-lb Sisters rather than just focusing on one of them.

Amy also happily announces she and Michael are expecting another child, lovingly named ‘Beanie’ for now.

On a whim, Amy decides to let little Gage decide what hair color she should try out. Amy reveals that how close she and Tammy are in age has often led to the two of them being confused as twins, which has led her to seek out her own identity through changing her hair color. In the end, Gage chose blue hair for Amy, which is revealed as she, Gage and Michael meet up with family for a day out, including Chris and Amanda. The family, as expected, make jokes about Amy’s blue hair — comparing her to a Teletubby and Troll doll.

Chris shares that he’s lost 95 pounds after having his surgery at the end of the third season. Chris chooses not to bring up conflict as the rest of the family goes for an unhealthy meal together in the evening. While eating, Amy and Amanda butt heads over Amy’s unwillingness to visit Tammy. Amy is apprehensive to see Tammy despite her declining health; she confesses that she feels like Tammy has never taken things seriously enough, and compares her situation to the Boy Who Cried Wolf.

Amanda, always the no-nonsense voice that both sisters need, is blunt with Amy, reminding her that at the end of the day, she needs to let her problems with Tammy go — the two are still sisters, after all. Nonetheless, Amy breaks the news to Tammy that she, Michael and Gage will not be making the trip to see her with the rest of the family over a video call, frustrating Tammy, who feels like Amy does not ‘give a shit.’

The two sisters have definitely grown and gone down separate paths over the course of the series, with them being most noticeably codependent on each other in the show’s first few seasons. Once Amy had her son, she’s been markedly less willing to put up with Tammy’s drama, and while it feels a bit bad for her to be neglecting Tammy now that she’s in rehab, it’s also easy to see things from Amy’s perspective.

Chris and Amanda go to visit Tammy together, reminding her of how many times she’s cheated death. Tammy promises she is ready to take things seriously and make a change, ready to do what it takes to get her surgery. Getting home so she can be closer to see Amy’s son is one of her driving factors as she does physical therapy, walking over ten feet with her walker.

Tammy checks in with her doctor, Dr. Eric Smith, where she’s down to 620 pounds, likely due to a lot of retained water from her respiratory issues. Dr. Smith encourages Tammy to make proper dietary and lifestyle changes so that her weight loss can continue in the right direction, rather than stagnate and be only a result of her hospitalization. Tammy’s weight goal is 550, and Tammy is invigorated to reach the goal.

In the past, Tammy’s motivation and drive for the weight loss has alway seemed half-hearted, but her recent hospitalization seems to have changed her outlook this time. Tammy says she’s tired of being sick and having difficulty breathing, and even talks about wanting to start a career. Little things like this seem genuine, and hopefully are indicative that Tammy will finally reach the goal set for her in this upcoming season.

Things look more risky for Amy this season, though, as she battles pregnancy hunger cravings that Michael willingly obliges. Amy encourages him to exchange the chips he got her for a bigger bag of Doritos, along with canned cheese and sodas. With how far Amy has come on her journey, it would be very disappointing to see her stumble, especially with how cavalier her attitude appears to be in this episode, as she downs a can of string cheese directly into her mouth as soon as Michael returns to the car with it while laughing. Even more concerning is her attitude that she will worry about not being morbidly obese “when the time comes.”

As the season premiere draws to a close, Tammy’s patient monitor goes off in the middle of the night, signaling a life-threatening emergency. Tammy had stopped breathing due to a blockage in her trach. With another brush with death so soon, it’s looking like this will be the toughest season of 1000-lb Sisters yet for Tammy.

Watch 1000-lb Sisters on TLC and streaming on Discovery+.



Written by Sam

Sam is the Managing Editor of POParazzi. He works primarily in Washington, DC. You can contact him at

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