At 650 lbs., Amanda Johnson’s weight is a major health concern. And two years ago her situation became even more complicated when she was diagnosed with endometrial cancer.

The 37-year-old can’t start cancer treatments until she loses weight, and now she must decide whether to get weight loss surgery or continue living as long as possible at this size.

“Every day that I don’t do something about my weight is one second and step closer to the grave for me,” she says in this exclusive clip from Wednesday’s premiere of Family by the Ton. “Now it’s either surgery or death.”

Johnson says she started binging on food in sixth grade, when she was 12 or 13.

“My dad wouldn’t let me eat at the table, because I was disgusting,” she says, crying. “So instead I would wait until he went to bed and then eat whatever I could find. He would lock the refrigerator. And because he’s passed, I can’t really close that chapter.”

Johnson’s weight problems further “skyrocketed” as a high school senior.

“I went to my first period class and I didn’t see a chair, so I told the teacher, ‘Can I go get a chair?’ and he says, so everyone can hear, ‘If you can’t sit in a desk like a normal person you can sit on the floor for today.’ I just left the school and didn’t come back,” she says.

These days, Johnson lives at home with her mom and spends the day trying unsuccessfully to make healthy food choices.

“Usually when I wake up, I’m already thinking about ordering pizza,” she says. “But I try to tell myself not to do that, so I’ll eat something like cheese and crackers or something else to snack on, and eventually I end up ordering the pizza. I get a large pizza and then I have the plate of brownies. And I’ll eat all of it until it’s gone, and then my mom comes home from work for dinner, and then I’ll eat regular dinner with her. And who knows how many calories that is.”

“You just have that moment, like, ‘What happened? How did I get here?’ “

Since being diagnosed with cancer in Oct. 2016, she hasn’t been able to start treatment because of her size.

“I have no idea if it’s growing; I have no idea if it has spread. I don’t know,” she says, through tears. “Endometrial cancer is caused in some part by being obese. So I feel like I did it to myself. Or maybe it’s my punishment for abusing my body.”

Now Johnson, along with three of her cousins who are also overweight, is considering weight loss surgery so she can start healing.

Family by the Ton premieres Wed. Jan 2 at 10 p.m. Eastern, 9 p.m. Central on TLC.