1000-lb Sisters: Season 4, Episode 2 Recap: “Can’t Have Your Cake and Eat It Too”

With season 4 of 1000-lb Sisters kicking off last week with a bang showing Tammy Slaton’s closest brush with death yet, the new season also introduced tension between the titular sisters. Newly pregnant Amy just didn’t have the time or energy to visit Tammy in her rehabilitation center, citing that she finds it hard to trust that Tammy is truly committed to losing the weight that’s endangering her life.

Factoring in how many times Tammy has jumped on and off the weight-loss bandwagon — and an argument could easily be made that over the first three seasons of the show she never really committed herself fully — Amy’s logic is pretty reasonable. But is it really 1000-lb Sisters if someone isn’t soon made out to be a hypocrite? As the first episode ended, Amy was feasting on piles of junk food, blaming her slip up on pregnancy cravings, while Tammy was making steady progress.

This week’s episode, ‘Can’t Have Your Cake and Eat It Too’ opens with Amy visiting her OBGYN, Dr. Cindy Basinki, who explains the risks of Amy getting pregnant while not being at her target weight. Amy faced a similar high risk pregnancy with her son Gage, when she unexpectedly got pregnant very quickly after getting her bariatric surgery.

Yearning for a baby girl, Amy is visibly disappointed to see she’s having another boy. (…Hopefully the child won’t watch this episode.) Dr. Basinki consults Amy about trying to having a healthier diet, limiting carbs and fat to keep her blood pressure under control for the health of Amy and the fetus. “If you don’t take care of yourself, you won’t be around to take care of him,” the doctor warns. Amy seemingly takes this seriously, saying “You’re about to see a whole new Amy.”

Meanwhile, it’s been three months since Tammy’s health scare with her trach, and four months total that she’s been at the rehab center. She’s up and walking more than ever. Walking has been something that’s been difficult for Tammy throughout most of the show, and seeing her walking steadily and doing other forms of exercise, despite all her newfound health issues and the trach, is a promising sign for her.

Adjusting to the trach has been difficult for Tammy, but she’s stayed in high spirits about it. “My throat farts,” she jokes, “I can’t control that!” In another promising sign, Tammy is quick to point out something she can control: what she eats. It’s hard for her to stick to a healthy diet in the rehab center, where they offer her foods like lasagna and hot dogs. There’s little variety for her to choose from, but hopefully appropriate portions can keep things under control for Tammy’s weight loss goals.

As for the Tammy and Amy’s other family members, Amanda and Misty go to the gym for the first time in years. While watching a dance class, they wonder aloud, “Where are all the big people?”, too intimidated to join the class and choosing to go to the machine equipment instead.

After Amy already successfully reached her goals and had the surgery she wanted, the show shifted focus to include more of the sister’s family to add to the drama and fill the series runtime. This felt natural when it came to their brother, Chris, who also shared the goal of the sisters when the show premiered — he wanted to lose weight to have the surgery to better his life.

But when it comes to other family members, like Amanda who already had the surgery, 1000lb Sisters often feels a bit bloated when profiling these members of the Slaton clan too closely. Obviously weight issues are something the entire family deals with, but when season four starts out with Tammy going through one of the most frightening things to happen to her, these detours from the stars of the show feel a little unnecessary. Especially when you factor in the amount of growth Tammy’s shown in her attitude and drive since last season, there’s surely a more detailed story and narrative that the show could tell while focusing more on its two main stars. As Amanda meets an attractive man at the gym and discusses her divorce, the show is likely beginning to start a storyline for her juggling dating and weight loss, something that will only further detract from what the show is actually supposed to be about.

Meanwhile at rehab, Tammy has a heartfelt, emotional breakdown over the pain of missing family functions and especially the growth of young Gage while she’s focusing on her own health at the facility, far from the family. “I’ve never really been away from my family this long,” she admits, sending the family a video recording showing her appreciation for them.

Back at Amy’s home, she’s focusing on her health and diet, finding the desire to eat healthier in the fact that she wants to be a better role model for Gage. Amy, Michael, and Gage snack on some peaches and give Tammy a Facetime call to tell her that Amy is having another boy.

In a sit down interview, Amy cracks a joke about how she will be chasing two kids while the only thing Tammy has chased is a sandwich. It’s a funny joke, but it does showcase one of the issues the show is having this season: the separation of Tammy and Amy. Earlier seasons benefitted from the sisters being close friends as well as in close proximity to each other. As Amy makes this joke, one can only imagine what the quick-witted Tammy would fire back, were the two doing their interviews together like in earlier seasons.

Luckily, Amy also breaks the news that she has had a change of heart after seeing Tammy’s change in attitude, and she plans to bring Gage and come visit. It’s been months since the last episode where Chris and Amanda went to visit Tammy, and upon hearing the news, Tammy is instantly happier and excited for everyone to see the progress she’s made.

Tammy’s fast progress seems promising, especially in comparison to the progress of some of the friends she’s made at the rehabilitation facility, who have been there for seven years and are stuck at a standstill.

When the family comes to visit Tammy, she’s noticeably lost weight — down to 573 from over 700 when she arrived. But seeing her family has made Tammy miss them more, and she’s ready to be near to them and come home. Tammy turns to her counselor, who is proud of the progress Tammy has made, especially in her attitude and self-respect.

When asked to confront her past decisions of drinking and partying, Tammy shuts down, refusing to talk about the time in her life that led up to her brush with death. The counselor wants Tammy to reflect on what made her develop a food addiction and turn to alcohol in times of trouble, warning that until she takes those actions of reflection, she’s likely to relapse into such behaviors in the future. The two discuss working on a relapse prevention plan for Tammy to avoid falling back into bad habits when she leaves rehab.

This week’s episode winds down with Amy and Gage going for a swimming lesson, and Tammy going in for a new weigh-in. Tammy needs to get to 550 to be approved for the bariatric surgery, and she hopes to be at 560 from the last weigh-in at 573. Unfortunately, she’s gained ten pounds, and is back up to 583—the first time she’s gained weight since being in the hospital.

Next week’s episode teases Chris seeing what his waist size would be if he had his leftover fat taken off a year after his surgery, and the family attends a funeral — complete with Tammy attending via video call. Also at the rehab center, Tammy and her counselor clash heads, as Tammy’s newly defeated attitude following her weigh-in kicks back into high gear. Amanda also discovers that Tammy’s apartment has been broken into during Tammy’s absence.

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