Family By the Ton is back and bigger than ever.
The weight loss show, along with My 600-Lb. Life, returns to TLC on Jan. 2 with new family members struggling to manage their weight. The King family, four cousins, weigh a combined 2,200 lbs. Each one is considering weight loss surgery.
Casey is the largest at over 700 lbs., and he lives at his parents’ house where he spends his days playing video games and eating.
“Because of my weight, my family is taking care of me,” he says in this exclusive clip from the new season.
And his cousin Amanda is in a tougher situation — along with weighing 650 lbs., she has endometrial cancer, and has to lose half her weight before she can even start treatment.
“This is serious for me, if I don’t lose weight I’m going to die from cancer,” Amanda says.
Cousins Ed and Amy, weighing 450 lbs. and just under 400 lbs., respectively, join in with Casey and Amanda on a weight-loss pact in the hopes of saving their lives.
Their surgeon, Dr. Charles Procter, says they’re at risk of harming themselves if they don’t get their eating on track.
“My concern is the rest of the family is not taking this seriously and they could all go back to the weight they were when I first met them, and even more,” he says.
My 600-Lb. Life premieres Jan. 2 at 8 p.m./7 p.m. central time, followed by the premiere of Family By the Ton at 10 p.m./9 p.m.
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This article originally appeared on People.com