An obese 10-year-old girl presents with a heart attack. At first thinking it's an adverse reaction to diet pills, they ultimately uncover a much more deadly source of her illness. Also, House is also faced with a woman who will not accept a surgery for a 30 lb. tumor because she actually wants to remain overweight. Meanwhile, House is under orders from Vogler to fire one of his team. He finally makes a decision but Vogler doesn't accept it and demands he pick someone else, it leads House to suspect one of his own team members is giving inside information to Vogler.