I watch The Learning Channel (and other similar channels) where they have show documentaries on the super obese (more than 200 lbs over ideal body weight). It can be a very emotional show as it usually focuses around medical procedures to help them lose weight as a matter of life or death. In some instances, even sitting up too fast can cause cardiac arrest. I feel sympathy as I try to understand the long, painful process they will have to endure to reshape their bodies and their health. Some, do not make it as the various complications brings on death. Again, there's sympathy to be had but it's always overshadowed by the question "How did their weight get so out of control?"

If you're an 800 pound woman, what was going on with you at 300 or 400 pounds? I mean, why did it take another 4 or 5 hundred pounds before the decision was made to get help? If you're a 1000 lb man who cannot even move from the bed, why wasn't the decision made at half of that weight (while he could still walk), that continuing his current lifestyle would be self defeating?

The other question is at a certain point, the super-super obese cannot take care of themselves. They need someone to bring them food. The problem is the food served is such that it sustains or actually cause weight gain. That's not such an easy task when the food consumed in one day is the equivalent to the amount an average weight person eats in 5 to 7 days. I don't understand completely why loved ones help to create or continue the unhealthy and many times deadly habits on the super-super obese. Of course, enabling is often an emotional issue. I just don't completely understand it.

On another note, the documentary "The 650 Pound Virgin" follows a young man who lost 410 without gastric bypass surgery. He did it the old fashion way of diet and exercise and it all started with a decision, his decision, to change.