Before leaving Meridian, Oprah meets with Karen, Claudia, Susan and Jeff, residents who have decided to take the Best Life Challenge.
Karen, a 42-year-old mother of two, weighs 512 pounds—and she knows how it happened. "I put other things and other people, other issues, ahead of taking care of myself," she says.
One painful side effect of Karen's weight problem is the reactions of her 6- and 8-year-old children. "It really hurts when they say, 'Mom, you're fat. Mom, why are you fat?'" she says. "It hurts when my little boy…plays ball, and Mom can't go because she can't get to the field."
After several attempts to lose those extra pounds, Karen has realized her health could be at stake. "After my second child, my last child, I acquired high blood pressure, and my health has been going downhill ever since," she says. "It's to the point where I either lose it or I'm going to die."
Karen plans to reprioritize her life in order to take control of her health. "I'm going to take care of me," she says. "I'm going to make myself healthy."