800-pound man thrown out of Rhode Island hospital for ordering a pizza

[Miles Archer]

A Rhode Island man's weight is a death sentence, and his father says he's now nearing that fate after the hospital that was treating the 33-year-old kicked him out. Steven Assanti says he spent nearly 3 months at Rhode Island Hospital, during which time he lost 20 pounds. He weights 778 pounds, and the intention was to "stay there and lose all my weight and get down to 550 to get the gastric bypass," Assanti tells WJAR. But the Cranston man, who says he suffers from an eating addiction, reports being given the boot by the hospital after ordering pizza in violation of the strict plan he was to be following.

ABC6 reports Assanti decided to order the pizza as a "cheat meal" to "reward himself for that small (weight loss) victory."

"If he comes home and I do get him up the stairs somehow, someway he's going to go right back to his eating habits," says his dad.

As of Wednesday night, Assanti was staying at Kent County Hospital in a short-term arrangement; his social worker is trying to secure a permanent location. The only way to transport Assanti, per his father, is to have several people place him in the rear of an SUV.

http://www.wcnc.com/story/news/nation/2015/10/09/newser-morbidly-obese-pizza/73663206/

[Fumesucker]

1. Put him up the stairs, only bring him what he's supposed to eat

When he can get downstairs on his own he can fix his own food.

[alphafemale]

3. Sounds about right.

But I would imagine the father has been the enabler.

He is the one that will go right back to trotting all that food up the stairs.

Nobody is able to get to that kind of weight on their own. They are basically immobile past a certain point.

[restorefreedom]

16. seems like a plan

but he clearly has had a number of people enabling. he won't stop unless they stop.

[TheBlackAdder]

35. Losing only 20 pounds in 3 months shows that he was gaming the hospital system for a long while.

.

The amount of calories to sustain that weight level, must have been over 5,000 or more per day.

Cutting 1,000 calories would result in about .5 pound drop per day, and those are the easy pounds to lose.


.

[MillennialDem]

73. Your math is off, but your point still stands. I lost 0.5 pounds a day by burning 1750 more

than I took in. 1 pound = 3500 half of 3500 = 1750

I only weighed 225 at my max and I'm 6'2". Granted this guy can't exercise, but yes his daily expenditure of calories is enormous compared to mine.

From this I get that he could eat 5,000 calories and still lose almost 1.5 pounds per week. To lose half a pound a day, he'd have to eat ~3700 calories.

http://www.caloriecount.com/tools/calories-goal

[pnwmom]

86. You're assuming he has a normal metabolism. nt

[LisaL]

98. We know he ordered pizza to "reward" himself.

This guy is close to 800 lb. It doesn't take a genius to figure out he shouldn't be ordering pizza to reward himself for anything. Unless he can lose at least some weight, there is no point of doing surgery on him. People on this type of surgery don't always lose weight. They can stretch the stomach back up again if they keep on overeating. Doesn't seem like this guy can stop overeating.

[LuvNewcastle]

2. How is he able to care for himself

financially and physically? He wouldn't be able to do what he does without enablers. Looks like time for some tough love when the hospital kicks you out. I'm not in favor of abandoning family or friends, but some people close to Mr. Assanti need to think about what he really needs versus what makes everyone happy for the moment. Maybe a hospital that specializes in mental disorders is the right way to go. The people who love him shouldn't have to stand by and watch him kill himself. If they can't deny meals to him, they need to find people who will.

[LisaL]

11. Presumably he is on disability at this point.

[get the red out]

154. Buying liquor for an alcoholic

I agree, his family has to be enabling him, this is like continuously buying liquor for an alcoholic.

They were probably enabling him while he was in the hospital since he lost so little weight. I gained about 30 lbs over the past few years and got serious about losing it over the summer and did. Someone that large should have lost a lot of weight on a managed diet in the hospital.

[Erich Bloodaxe BSN]

4. 20 lbs in 3 months?

I don't believe that pizza could have been the only 'cheat' he ate, unless the hospital dietician is incompetent. From that starting weight, I'd expect at least a pound a day weight loss simply from cutting down on the MANY thousands of calories a day your body burns to try and maintain with that much weight. He was wasting hospital resources. At that rate, he would have had to stay in the hospital for 4 years or so just to get down to where he could have the gastric bypass. And at that weight, his heart is likely to give out before that 4 years ever comes.

[LisaL]

9. I agree. 20 lb in 3 month with his kind of weight is very little.

They are keeping him in the hospital so he can lose weight. He isn't going to lose a lot of weight if he eats pizza.

[MADem]

53. My lazy fat ass could manage that amount of loss with a step-up in activity and cutting back on

sweets and second helpings. Isn't the paradigm for people on a diet and exercise program one to three pounds a WEEK for people who are just "overweight?" You'd be dropping a lot more weight if you were maintaining the body mass of four hefty people.

[MillennialDem]

74. Hey now, 200 pounds is not hefty for people over 6 feet tall. But I'm glad you said

1-3 pounds rather than off quoted 1-2. For someone tall they can definitely lose more than 2 pounds a week. Whereas for someone very short 2 pounds might be borderline too much.

A better number is probably 1-2% of your total weight per week.

[MADem]

76. I am no expert but what you are saying sounds right on the money.

Now I'm thinking I really need to get off my lazy behind and exercise more.

[TexasBushwhacker]

117. Yes, and at his size he should have been able to lose

1% a week, which would be 7 to 8 pounds per week. In 90 days he should have lost at least 80 pounds. Even so, if he needs to get down to 550 for the surgery, that would mean staying in the hospital over 8 months if he lost a pound a day.

That being said, he really isn't a candidate for WLS until he us willing to take SOME control if his eating and apparently he isn't. Sad to see such a young person so messed up.

[Rex]

83. He was not trying at all.

I lost 60 pounds by dropping sodas and fastfood and some mild exercise. Not that I was anywhere near his weight, but I was unhealthy and doing the same thing he was doing. Thankfully I fell down and hurt myself and realized I had a huge problem.

I don't think he realizes how close to death he is if he ordered a pizza. I feel most sorry for his dad.

[MADem]

84. I think you are entirely correct.

He is certainly not obligated to follow medical advice, but if he doesn't, doctors are free to dismiss him as a patient.

Wow, I admire you!! That is just so cool that you did that. I hope you pat yourself on the back regularly, and smile at yourself in the mirror. That's an accomplishment!

[Rex]

139. Thanks!

I don't do any of that stuff, but my bones THANK me all the time by not hurting from carrying around so much weight. I still need to lose another 40 and this will be the hard part, because now I am down to a weight that will only be lost by working out.

[MADem]

142. Give yourself some credit--you really do deserve it!

I have a feeling you'll get where you want to be!

[pnwmom]

87. No, no more than 2 pounds a week, and they usually say 1 is best, if you want to keep it off.

Keeping weight off is the hardest part, because losing weight itself changes your metabolism. Also, muscle is lost, not just fat.

[MADem]

88. I am not an expert, so I bow to those with more technical knowledge.

I guess the three pound limit has to do with very big people who exercise vigorously in addition to dieting.

I remember when I was young...I could eat like a damn farmhand! Those were the days!

[pnwmom]

90. Sadly, most of the research now says that it is extremely difficult

to maintain weight loss over the long term -- most people who lose weight gain it back, and then some.

This 800 lb. guy sounds like a jerk, but some of the posters here are unrealistic about how easy it is to lose weight.

[LisaL]

95. It's not that easy to lose weight, because most people eat a lot more calories than

needed to lose weight. But this guy is near 800 lb and was in the hospital on what was supposed to have been a restricted meal plan. He should have been losing a lot of weight.

[pnwmom]

102. Even on weight loss programs, it's considered a success if the person succeeds

long term in maintaining a 5% weight loss. Which is his case would be 40 pounds.

[LisaL]

103. You are forgetting he is nearly 800 lb.

So he is at least 500-600 pound overweight. 5% is nothing with that kind of starting weight.

[pnwmom]

104. The most effective treatment for hugely obese is surgery, but that's not an option for him.

5% is a tiny amount for him. But that doesn't mean it would be easy to lose. It all depends on his personal metabolism, and how it has evolved over the years. The more attempts at weight loss, the more rebounds, the harder it can be to lose.

We don't know how many previous attempts he's had, do we?

http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-fat-trap.html

While researchers have known for decades that the body undergoes various metabolic and hormonal changes while it’s losing weight, the Australian team detected something new. A full year after significant weight loss, these men and women remained in what could be described as a biologically altered state. Their still-plump bodies were acting as if they were starving and were working overtime to regain the pounds they lost. For instance, a gastric hormone called ghrelin, often dubbed the “hunger hormone,” was about 20 percent higher than at the start of the study. Another hormone associated with suppressing hunger, peptide YY, was also abnormally low. Levels of leptin, a hormone that suppresses hunger and increases metabolism, also remained lower than expected. A cocktail of other hormones associated with hunger and metabolism all remained significantly changed compared to pre-dieting levels. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.


“What we see here is a coordinated defense mechanism with multiple components all directed toward making us put on weight,” Proietto says. “This, I think, explains the high failure rate in obesity treatment.”

While the findings from Proietto and colleagues, published this fall in The New England Journal of Medicine, are not conclusive — the study was small and the findings need to be replicated — the research has nonetheless caused a stir in the weight-loss community, adding to a growing body of evidence that challenges conventional thinking about obesity, weight loss and willpower. For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into a sobering reality: once we become fat, most of us, despite our best efforts, will probably stay fat.

[LisaL]

106. Surgery is an option for him if he loses some of the weight.

He was in the hospital to get to 550 lb, after which he could have the surgery.

[pnwmom]

109. Right. Surgery, which is the most effective treatment for the morbidly obese,

isn't an option for him yet.

[LisaL]

126. The way he is going, I find it hard to believe it's ever going to be an option for him.

He needs to stop overeating for him to get to 550 lb at which surgery is going to be possible. I haven't seen anything to suggest he can do so.

[Ghost in the Machine]

100. I lost 8 pounds in one week just by switching from sugar to Splenda in my sweet tea! No extra diet,

no exercising, no other change in my routine. Splenda, which the only ingredient is sucralose, is a no calorie sweetener. I actually liked the taste better, plus it didn't get that sour, or rotten, taste like sugar does if you leave it out too long. I also went from being borderline diabetic to having normal, to almost low, blood sugar. All together, I have lost about 90 pounds since last November, too. Went from size 42-44 pants to 36-38, depending on the maker. They all size their stuff differently. I actually got into a pair of size 34's the other day, but they were justthismuch too tight, lol. Luckily I have been finding some great deals at yard sales and on our local Facebook Yard Sale group. I just got 2 large bags of clothes that had 9 pairs of pants and around 40 shirts in them for $20! I sure got my money's worth, as their were name brands like Duck Head, Tommy Hilfiger and Levi's, just to name few.

I just recently found some Mayfield's brand that is really good, plus a store brand. The labels say "No Calorie Sweet Tea". I was never a fan of store bought jugs of tea, as most of them tasted like tobacco juice to me, but the Mayfield's and the "Laura Lynn" (Ingle's store brand) are very good... and between $1.79 to $2.29/gallon, you can't beat it!

Yeah, this guy definitely ordered more than one pizza though.

Peace,

Ghost

[pnwmom]

110. Congrats!

You've accomplished a great deal with a huge weight loss. But I bet that first 8 pound loss was largely water. And you're not saying you lost all 90 pounds merely by switching to Splenda, are you?

[Ghost in the Machine]

119. Thank you! No, not all due to splenda... I have been eating healthier some, and have been a little

more active. I am disabled, but got into pain management where they don't just keep me doped up all the time. I can actually do some yard work and things around the house now, and when I get to hurting too much, the meds are just enough to take the edge off and let me relax and rest.

There *are* times, though, when I go 2 or 3 days without eating because I just have no appetite at all. When I do eat, I have to force myself to. I don't know what happened, but I just lost my appetite one day and never got it back. Most times just the thought of eating turns my stomach. I'm figuring it's just something that happens as you get older... I could be wrong... but doctors have checked me out, done blood work and stuff, and everything seems normal inside.

Peace,

Ghost

[pnwmom]

123. There are a number of drugs that can cause weight gain too,

like steroids, SSRI's, and others.

Lack of appetite can be caused by depression -- which would be understandable in your situation. I hope that you're taking care of yourself emotionally, too.

[MADem]

113. Good for you! Wow! nt

[Ghost in the Machine]

120. Thank you! n/t

[clamshells]

156. congrats, Ghost!

I am really struggling. I am down 20 pounds from my worse weight, but have 50 to go, and I am stuck with no exercising until ortho problems clear up. I just eat too much. I am not sure why I have been able to keep the 20 off for a couple of years. No ice cream, maybe.

[Ghost in the Machine]

165. Congrats to you too, clamshells. Keep on trying and don't give up. The first 50 are the hardest..

I was stuck for a while after the first 25, but finally made it past it and kept going...

Peace,

Ghost

[Monk06]

61. Probably just lost 20 lbs from reduced salt intake. I bet all his visitors showed up at meal time

with back packs full of air food

[jwirr]

135. Or he started drinking water instead of carbonated drinks

with sugar.

This is one man who weighs 800 pounds. Think of all the people we know or see who are on their way to weights that are way too high. Do gastric bypasses really work with someone who does not intend to change their habits?

[Ms. Toad]

5. 20 lbs in nearly 3 months -

Something is not right, here.

At home, living with someone who is obviously feeding you enough to sustain that weight, I can believe 20 lbs in 3 months. In a hospital where people are paid to monitor every bite he eats, his weight should be dropping much more quickly than .22 lb a day.

[LisaL]

10. I agree. Seems like he should have lost a lot more.

[Gloria]

149. But you have to move, too...and he really

can't move that much...

Very hard situation...

[Yo_Mama]

26. Yes, but some people have mutations that allow their bodies to shut down the metabolism

if they are on a restricted calorie regimen for very long. I have a brother who can easily maintain his weight on 1,200 calories a day, unless he exercises a lot. And he is quite overweight, still. But his body temperature stays below 95.7 degrees!

Obviously at 800 lbs this guy isn't able to exercise. Yoga breathing practice is about all he can handle. He is being strangled by his own bulk.

But he was cheating - it wasn't just this pizza. I guess they caught him with the pizza. The reason they are throwing him out is because he isn't following the plan, not because he got this one pizza.

[Ms. Toad]

64. 3 months is not "very long"

And at around 800 lbs, he should be losing more than a quarter pound a day on any restricted diet for quite a while. Since he was rewarding himself for a small loss, it sounds as if he just managed to start losing. My body is very efficient, so I can sustain my weight fairly easily on not very many calories - particularly after I have been eating a restricted diet for a while. But the early stages are another story. I'm down 6 lbs in a week - in the early stages of a newly restricted diet. It will definitely slow - but not to the rate of a quarter pound a day over an extended period - and I'm not carrying anywhere near his weight.

As for exercise, it really doesn't make much difference for weight loss. Swimming or biking vigorously for an hour is about the equivalent of a single cookie. About the only significant value exercise has is that people who exercise tend to be less hungry and eat less as a consequence.

If being in the hospital was to lose weight (and not for other medical reason), he should have been on an access restricted ward so that he couldn't just order pizza (or have family bring it). Since they kicked him out, it is pretty clear it wasn't for other health reasons. I'd call this a hospital failure.

[Yo_Mama]

97. Exercise matters hugely for those with these particular genetic traits.

It forces their body to ramp back up. Otherwise their bodies literally shut down the circulation when they start losing weight, and it can happen in less than a month.

By experiment, I verified that three intervals of exercise over a day consisting of ten minutes of walking twice daily, and one about 6 minute set of exercises with arm weights shifted my brother from gaining on average about a quarter of a pound a week over eight weeks to losing an average of more than a pound and a half over eight weeks on the medical 1,200 calorie a day diet. And that has nothing to do whatever with the caloric expenditure. Nor was that fluid balance, because the idiots at the hospital had already put my brother on 80 mg of furosemide a day because they thought he simply must be retaining fluid.

Human beings are astonishingly similar, but there are certain mutations that make some people's bodies work differently. I think that this particular mutation is very associated with Type II and CVD.

My other brother, who is normal weight but with slightly elevated cholesterol didn't want to take statins, so he went on a low-fat high vegetable diet for a month and then was repeat-tested after 32 days. He shouldn't have lost much weight at all, but he did. He had lost ten pounds, his blood sugar had elevated, his HDL's fell from the 50s to the 30s, his triglycerides raised more than 75 points and his VLDLs shot up to over 60. There was a notable loss of circulation in his hands and feet. He then tried to continue it, developed an H1AC of nearly 6 and acute reactive hypoglycemia after meals if he ate as much as 40 carbs. Then he began to gain cardiac profile weight, concentrated on the belly and around the neck and throat. He has always been quite physically active.

Before I would censure the hospital, I would have to know more.

I have two patients with Type II and CVD whom I manage at the clinic who appear to have something similar. Whether they lose or gain weight seems to have little to do with what they eat. I don't manage their sugar levels by standard means - I manage them by controlling their lipids and mineral levels, and I do that primarily by managing their physical activity and making sure they eat enough fat and protein. After two years one dropped from an H1AC of 10 to 5.8 without (now) any sort of medication except an ARB and daily aspirin. He still has poor peripheral circulation, though. His first symptom, after which he developed peripheral neuropathy in his mid 30s followed by acute Type II less than two years later, was disturbed digestion. He had been on a very controlled and healthy diet since his early 20s.

[vinny9698]

6. I had a hernia operation and lost 40 lbs in weeks.

I lost my appetite and had to force myself to eat. The pain and nausea made me lose that weight.

[clamshells]

157. more than once

I have thought that if BigPharma smartened up, they would make a weight loss pill that produces nausea. How simple is that

[TheCowsCameHome]

7. 90 days and 20 pounds

That doesn't add up. He must be eating the furniture or bedding when no one is looking.

[LisaL]

13. Somehow I doubt this is the first pizza he ordered while in the hospital.

A guy who weighs this much shouldn't be ordering pizza to reward himself for losing 20 lbs in 3 months.

[gollygee]

8. It seems like the hospital would have some control over what food goes into his room

When I've been in the hospital and I haven't been allowed to eat, no food has entered my room. When I could only have liquid, only liquid entered my foom.

[pinboy3niner]

12. I was on a liquid diet a number of times and always was able to sneak in the pizza delivery guy

My jaw was wired at those times and I had to wear wirecutters around my neck in case of emergency, but I had a space where I could slip in solids. And they were soooo good!

[catnhatnh]

17. My brother had his jaw wired...

He lived on KFC mashed potatoes and gravy and occasionally cheated and stuffed tiny chunks of pepperoni through a gap in his teeth...speaking of which, I bet wiring this guys jaws would get him down to gastric bypass weight pretty quickly I'd guess.

[LiberalElite]

21. Assuming someone doesn't secretly

give him chocolate malteds.

[pinboy3niner]

23. When I was on a liquid diet the dieticians allowed me to order a triple serving of every meal

And it still wasn't enough. My injuries involved both my jaw AND my teeth, so like your brother I had that lovely gap to receive solid foods. When my family came to see me they snuck me out of the hospital and I made them stop at a burger joint.

But I don't want to minimize the issue of the obese patient. In his case it was the hospital's responsibility to control his intake and prevent unauthorized food being delivered to him. Your brother and I wouldn't blame the guy.

[clamshells]

30. not hospital's responsibility

The hospital is a busy place and likely understaffed. They can't station an employee at this guy's door 24/7 for months to stop delivery people or his friends and relatives who are smuggling in food.

[pinboy3niner]

40. If they accept a patient with special needs, it is their responsbility

It's not hard for the ward nursing station to stop somebody from bringing in a pizza box. And when they admit a long-term patient like that, it is the hospital's responsibility to take whatever extra measures are necessary for his care, and not blame him for their laxity.

[Marrah_G]

56. How long does the staff have to suffer his abusive mouth?

[pinboy3niner]

59. As long as it takes

It's not their job to judge him. It's their job to treat him.

Hug a nurse.

[Marrah_G]

91. Might not be their job to judge him, but niether is it their job to take his shit.

He abuses staff, laughs at the taxpayers and spends him time posting nasty ranting videos. In return he expects everyone to k iss his ass. Fat or not, you can't be an asshole and expect people to just keep taking it.

[LisaL]

99. Is that in their job description?

[clamshells]

65. you haven't been in a hospital lately

People can walk right in and out and never see a nurse. The last time I was in, the nursing station in my area was usually empty because the nurses were run off their feet dealing with problems.

The only way to keep someone like this from eating extra is to put him in the equivalent of jail or in some situation where no enablers can get to him,.

[pinboy3niner]

69. Preventing access to outside food is the hospital's responsibility in this kind of case

Attempts to smuggle in food are predictable and the hospital should be prepared to prevent it if they're going to accept this kind of patient.

[LisaL]

81. Sounds like the hospital decided they are not prepared to keep that kind of patient.

[clamshells]

133. the hospital maybe should not have accepted him

but I suspect he was in some sort of medical crisis which they dealt with, and then they erroneously assumed they were dealing with someone who wanted to get better. He should be in Butler or fending on his own - if he were an alcoholic, which is a similar situation, no one would be castigating a hospital.

[SheilaT]

77. It depends on how the unit is laid out.

I worked in a hospital not very long ago where about half of the patient rooms were before the nurse's station. And often whatever staff was there at any given time was too busy to stop and question every single delivery person who shows up. Although, usually -- at least at my hospital -- the pizza guy passed off the food at the information desk at the front of the hospital.

[mythology]

94. And where is the responsibility of not only the patient but also his family?

He didn't get to be 800 lbs because he ate an extra large serving of ice cream last night. They and he should have cut himself off sooner.

The hospital gave it a shot, but he's obviously not serious about taking care of himself. If he was unwilling to put in the work and to be cooperative, then tough shit for him. His actions have consequences.

[Ms. Toad]

67. If the purpose for being in the hospital is to lose weight, it is their responsibility

to put him in an access restricted ward so they can strictly control what he eats.

Since they kicked him out, it sounds as if that was the sole reason he was hospitalized - in which case it is their failure.

[LisaL]

101. Hospital is not a prison.

[Ms. Toad]

118. If treatment requires it, they can be.

When people are a danger to themselves or others because of mental health issues, hospitals use locked wards.
When people are at extreme risk for disease because of a compromised immune system, the room isn't locked - but entrance and exit are very restricted enough that a pizza delivery wouldn't be able to make it through.
When people have a highly contagious disease, they are kept in isolation to keep others safe.
When people are in critical condition, they are kept in intensive care units to which visitors are severely restricted - and they are within sight of the nurse's station..

In this case, he was apparently hospitalized solely to lose weight (since they kicked him out when he snuck the pizza in - and it would be malpractice to kick him out if he really needed to be hospitalized to treat another condition). For purposes of losing weight, he needs to cared for in a way that his diet is strictly controlled - and the hospital is at fault if that is what he was being treated for and they failed to set up a restricted environment. That failure is every bit as deadly as permitting - for example - free access to the bedside of someone who is severely immune compromised.

[LisaL]

130. Seems like such a hospital for weight loss only exists in your imagination.

Do you know of any secure facilities where they lock up obese patients for weight loss and guard them from ordering food? Because I am not aware of such a facility existing anywhere in the US.
And what would be the point? Would he have to stay in such an (imaginary) hospital for the end of his life? Because if he has no will power to not order fast food, he will get all this weight back as soon as he leaves the lock up.

[Ms. Toad]

143. If he was hospitalized solely for weight loss, as it appears he was since they kicked him out,

It is their responsibility to provide the treatment associated with the condition they admitted him for. Just as it would be for any other condition - like the ones I mentioned which require special restrictions.

I didn't invent that he was hospitalized for the purpose of losing enough weight so he was eligible for surgery. That is part of the article. So - taking the article at face value, apparently this particular facility agreed to treat him. If they were not capable of covering the most elementary part of his care (controlling his intake of food), they should not have agreed to treat him - any more than they should agree to treat an Ebola patient if they do not have the ability to maintain the controlled atmosphere that is necessary to safely provide care, or critically ill patients, or patients who are severely immune compromised.

The point is that hospitals know how to provide isolation and restrict access. When it agreed to treat him, they accepted that responsibility.

I agree that he likely has issues beyond what they can treat, and I am not saying there are or should be hospitals that provide weight loss treatment (as opposed to medical care for the conditions associated with weight so high it prevents independent movement). BUT this facility apparently does or he wouldn't have been hospitalized for 3 months solely to lose weight. Once it made that choice, it had the obligation to provide safe and competent treatment. It failed that at the most basic level: by failing to provide the the kind of restricted access necessary to care for him safely and competently for the the condition for which they agreed to provide care.

[alphafemale]

41. It's his responsibility to decide whether he wants to live or not. nt

[pinboy3niner]

46. It's also the responsibility of professional caregivers to try to save his life

The guy may be a complete jerk and total asshole, but the imperative of medical professionals is preserving life, whether or not the patient is cooperative.

But, as you say, his choices will affect the outcome.

[LisaL]

47. They tried, but if he is ordering pizza, what is the point of keeping him in the hospital?

He can be ordering pizza in his home.

[pinboy3niner]

49. Why is the hospital not controlling that for a long-term patient with his affliction?

Sounds like they were happy to take him in and bill for it without without having the ability to deal with the obvious.

[MADem]

60. Because ... freedom?

I will say, I've been able to sleep by the bedside of ill relatives, beyond visiting hours, for those who were hospitalized for long periods and needed a great deal of care. I've taken over some of the nurses' basic duties without any complaint from them--they're horribly understaffed, even at 'premiere' hospitals. They do rely on the honor system with food restricted patients. And they don't have the staff to sit there and force non-compliant patients to bend to their will.

People do have the right to refuse medical advice in this country, and by ordering pizza when the doctor says NO, this guy is basically saying "I'll do what I want, screw you, doc." Refusing medical advice is fine, but you don't get the bed if you don't work the program.


The only way this guy can be "controlled" in terms of what he eats by nurses and doctors is if he is admitted as a mental hospital patient, against his will--"committed" in effect. Then someone else can make decisions for him. Beyond that, doctors and nurses cannot do a thing if he proceeds on a course of action 'against medical advice' save make the determination that he is uninterested in listening to them and freeing up the bed for someone who will listen.

[pinboy3niner]

62. This was no ordinary patient

He obviously had special needs about his food intake, and noncompliance should have been foreseen and prevented.

[LisaL]

131. He is an adult. As such who is supposed to babysit him?

[alphafemale]

134. Bullshit.

There comes a point where the hospital needs to protect their workers against constant abuse and a potential lawsuit and bring a person who actually wants help into the program rather than a full blown asshole who is just using this for a stunt and attention.

[MADem]

144. You can't lock him up and prevent him from having visitors.

And that's where he was getting his chow. He wasn't wandering down to the cafeteria and chowing down--people were bringing him stuff.

Hospitals don't have the personnel to put a guard at his door. He can either follow the doctor's recommendations, or do his own thing.

He was a patient, not a prisoner. And, sadly, he was noncompliant. It's like lung cancer patients who won't stop smoking, or people who need liver transplants who won't stop drinking. No one "puts a guard" on those people to stop them from killing themselves. Those folks just aren't going to get the transplants...they'll go to the people who are going to follow the doctor's protocols.

[Glassunion]

71. I once had liquid enter my foom.

It was curiously refreshing.

[Marr]

14. Isn't his father in complete control of his eating habits until the man

can move himself around?

[LisaL]

15. You would think that.

[Monk06]

63. From what I have seen morbidly obese people always have a caregiver that willingly brings excess

food

In the case of the Mexican lady her husband was feeding her 20 tacos and 10 cheese cakes at a single sitting.

[hifiguy]

72. TEN cheesecakes?!?!?

Blurgh.

[Monk06]

122. Yeah it sounds unbelieveable but allowing eight hours sleep and sixteen hours of eating it is

probably possible in a days eating

basically the morbidly obese are eating thanks to enablers as often as they breath. All day every day

This could only happen in the first world where neurosis meets lotsa money and cheap high calorie food

[LisaL]

82. That's pretty much a given.

Once somebody reaches that kind of weight, they are not mobile, so someone has to bring food to them.

[Monk06]

124. I think at a certain point the enablers should be removed from the nutrition regimen. Hygene

maintenance only

[Prism]

18. 20 lbs . . .

Even people who don't need to lose much weight could do that through some minor adjustments and exercise in 3 months.

A hospital couldn't take more than that off an 800lbs person in 3 months?

Something about this story isn't right. I'd guess he was chronically breaking the rules and this particular pizza incident was the last straw. They probably figured it was a waste of everyone's time and resources. Food addiction can be like alcoholism. You can't help someone who doesn't want it.

[Ms. Toad]

68. In some ways it is worse.

You can avoid all drinking.

But if you avoid all food, you don't last long. So you are always dealing with eating triggering the desire for more food.

[Prism]

75. This is very true

I'm a former pudgy type, and I can't keep what I shouldn't be eating in the house. If it's there, I will eat it. If I'm entertaining guests, everything gets bought right before they come over, and anything left goes out the door with them. Restaurants are trickier, but I'll usually zero in on whatever grilled chickenish dish is happening on the menu.

Even minor healthy things I do have around like nuts can present a problem. "Eh, I ran a bunch this morning. I can have a bit more." No brain! You cannot! Knock it off.

I keep waiting for that part of the brain to give up and understand the old days of sitting around and eating a bag of chips are long gone. But at least once a day, there's that evil rationalizing voice explaining why we should go have a milkshake. Buh!

[KittyWampus]

19. Gastric Bypass is not a magic panacea. It requires total commitment to weight loss.

Unless you are prepared to do what it takes, bypass surgery will ultimately not work.

There are ways around eating as I was told by a friend whose sister had the surgery and couldn't eat properly and stay in limits.

For some, food really is an addiction.

[clamshells]

33. Chris Christie - bypass surgery

I was expecting for some time to see dramatic photos before and after of Chris Christie, but so far nope. He seems to have lost a small percentage of his weight only.

[alphafemale]

45. I think it is pretty dramatic.

He was well past morbidly obese before. I don't know how much he weighed but that looks to be nudging into the 400lb area in the first photo.

I'd say he is within 50 lbs or so healthy weight now.

And really...really needs some new suits. And....is that the same tie?

[clamshells]

66. looking much better, Chris

[LisaL]

96. I agree. That's at least a 100 lb weight loss.

I would say that's dramatic.

[romanic]

115. Holyee crap

that is a huge difference in Chris, especially around the neck/jaw area.

[spinbaby]

107. I seem to recall he had a lap band

A lot less drastic than a gastric bypass. He seems to have done pretty well with it but will probably never be a "normal" weight.

[marlakay]

108. I know someone who lost a lot

Then gained it all back drinking, milkshakes and booze.

It makes your stomach little to hold less food but drinking bypasses that.

[TexasBushwhacker]

114. No, he got a gastric sleeve

It reduces the stomach permanently. There is no possivbilty if adjustment or like there us with a lap band. But, depending on the surgeon and what the patient wants, it can be as small as 2 ounces or as large as 8 ounces.

[Docreed2003]

111. He's not a candidate

He's not a candidate for surgery at his current weight...he's been evaluated by bariatric surgeons in the past who have told him this.

[LiberalElite]

20. I'm thinking this is just the first time

he was caught. Losing 20 lbs. in 3 months when you're in that hospital to lose weight- something is very fishy, and they should have figured it out sooner.

[WillowTree]

28. I'm thinking it *wasn't* the first time he was caught. More like the last straw.

[LiberalElite]

43. That may be more probable nt

[Hortensis]

138. Yes. Their program is for people like him, so they must be up to

all the tricks and committed to helping patients make it through to success. Undoubtedly they are able to document his breaking his contract more than just a couple of times -- including losing only 20 pounds in all that time -- and felt they couldn't justify keeping him in the program.

Poor guy. 33 years old. He must be aware he's courting death and very unhappy. Maybe this will be the beginning of a real turning point.

Like getting him away from whoever is bringing him all that excess food. If I were his parents, I would live in the car and let him scream abuse all he wanted in the apartment. IF the neighbors didn't object, of course....

[LisaL]

140. He needs to be able to control his cravings.

Unless somebody is going to keep him locked up for the rest of his life.

[Hortensis]

141. For sure, but maybe that'll come later? When he has enough success

that he can actually believe he will be able to live a normal life? Go for walks? Hold a job? Date? It doesn't for everyone, of course. I'm not a bariatric specialist, but 800 pounds sounds like a really bad prognosticator to me. He gave up and has been killing himself for a long time.

ITM, his bed will go to someone else.

[RedRocco]

22. the first thing that went through my mind, seeing as how it was RI

[B2G]

24. I don't think it was just the pizza...

The REAL 800lb man: Morbidly obese man who claimed he was a victim after being thrown out of hospital for ordering pizza is caught on camera harassing a nurse and mocking taxpayers who pay for his treatment


http://www.dailymail.co.uk/news/article-3267280/The-REAL-800lb-man-Morbidly-obese-man-claimed-victim-thrown-hospital-ordering-pizza-caught-camera-harassing-nurse-mocking-taxpayers-pay-treatment.html

[ronnie624]

25. Clearly an attempt to vilify.

I would never allow myself to be influenced on an issue like this, by that sort of emotionalism.

[jen63]

31. He also needs mental and emotional

help. He's not going to lose weight or get serious about it, until he's ready to. In the meantime, he's taking up a bed and abusing hospital staff, when there are actually desperate, obese people out there who want the help. Rhode Island isn't exactly a large state and facilities are probably at a premium.

[ronnie624]

38. "actually desperate, obese people"

He is one of them, and he is clearly in no position to help himself. That responsibility lies with the medical professionals who are in a far better position to do so. At this point, I have little confidence in his chance for long term survival, either way.

Some posters up-thread commented on the enablers in his life, and I think the hospital, through its negligence, is the one that bears the most responsibility.

[LisaL]

48. Pardon me, but he is an adult. If he wants to eat pizza, what right does a hospital have to

forbid him? It's his right to eat himself to death, if that's what he wants.

[ronnie624]

50. I'm skeptical of the assumption

that the hospital is under some legal obligation to allow pizza to be delivered in its building. They restrict visitors to patients' rooms, on a regular basis. And again, the hospital staff are in a much better position than he is, to get him the help that he needs.

[LisaL]

80. Since his problem is overeating, he is the only one in the position to help himself.

[alphafemale]

70. They do have the right to dismiss him from the program so he can do just that

He does not have the right to take the spot of a person who actually wants help rather than a free bed and people he assaults and treats like slaves.

[Yo_Mama]

162. Anyone has the right to decline medical treatment at any time. That's why rehab centers

have their patients sign contracts, and eject them if they don't follow the contract.

So do pain management (really prescription pill addiction) centers, etc.

Is the hospital supposed to pay for an aide to stand at his door 24 hours a day and stop the pizza guy, the relatives, etc?

I don't know what you expect the hospital to do, and I think until he can accept some responsibility for himself all treatment will be futile.

He needs help. He also must accept the help.

[ronnie624]

164. He didn't refuse treatment.

Last edited Wed Oct 14, 2015, 12:43 AM - Edit history (1)

According to the article, he was thrown out, because the hospital 'cannot' monitor his diet.

He suffers from a severe obsessive compulsive disorder, no doubt accompanied by plenty of emotional issues. His road to wellness, if it's even possible, would be long and arduous. The hospital doesn't want to deal with him anymore because he has an unpleasant personality. They've weighed his life in their cost/benefit analysis and made their decision.

Oh well.

[jwirr]

136. He is in the hospital on a treatment plan. Other addicts who

are in treatment for alcohol or drugs also get kicked out if the refuse to follow the plan. Hence drug testing.

[backscatter712]

27. This is clear physical and psychological illness...

How about the hospital do what it's fucking supposed to do and treat sick people instead of throwing them out on the street.

How about instead of throwing him out, giving him the services of a psychiatrist. Surely they have one on staff.

[Marrah_G]

32. He is abusive and nasty, there is a mental hospital nearby

He could go to Butler Hospital, but he can't be forced to go. Watch all the videos he made of himself. I feel badly for the nurses who had to care for him. He was there 90 days, they put up with his shit for 90 days.

[Docreed2003]

112. Spot on...

And he did a Skype interview last night from Kent for Inside edition. He's an addict and his personality seems to be no different than a drug or alcohol addict

[artislife]

132. Food can be addictive

Lets face it, addiction is when certain chemical reactions happen in the brain...from booze, gambling, sex, ciggies, food, internet, porn...etc.

He has an addictive brain. He needs help with the chemical reaction going on.

This doesn't mean he isn't an ass, it just may explain in some part why he is an ass.

[clamshells]

34. the hospital is not an insane asylum.

[backscatter712]

54. Is not mental illness an illness?

Is not a hospital a place for treating people with illnesses?

Get that man a fucking shrink.

[Marrah_G]

57. You cannot make anyone see a shrink

RI hospital is an excellent Hospital and trauma center and close by is Butler Hospital, also a first class mental health hospital. Watch the videos this man made of himself. He is a self centered, spoiled, nasty little man who spits in the faces of people who try and help him.

[backscatter712]

58. Then his physical and mental illnesses are likely to kill him.

His physical obesity, and the 10,000 serious medical conditions that result from being that large, are all intertangled with his mental health issues that make him behave badly. They all need to be treated together, or he's going to die.

[Marrah_G]

89. Yes it will, but no one can make him accept help.

[Nevernose]

93. If you sneak drugs into rehab

They throw you out. Sad, but that seems to be the situation here. What's sadder is that clearly someone is helping this man kill himself.

[lunasun]

128. Same with alchohol . I had a relative got thrown out of a rehab program. This sounds like the same

set of rules here. Not following the rules agreed upon means you are not participating in the program
If you are seeking to get better you need to accept and follow what they are prescribing otherwise everyone involved is wasting time and resources including the patient.

[Marrah_G]

29. The guy is a fucking asshole

A spoiled, nasty, vicious little man.

[Heeeeers Johnny]

36. An older video of his.

Stuff like this doesn't help him get much encouragement and support from others

[ronnie624]

42. That's no excuse for denying him the help he needs.

Similar rationalizations can be produced to justify police brutality.

[pinboy3niner]

55. What a fucked-up world if med professionals judge patients who deserve/don't deserve help. nt

[jwirr]

137. I don't think that it is so much judging them as the rules

that come with the insurance that pays for the plan. Most plans know that if the client does not want change there will be no cure. In this case ordering a pizza or pizzas seems to indicate that the client is not interested.

It would be interesting to know how he got into the hospital in the first place.

One thing for sure is that the medical industry needs to put some real research into the issue of obesity. We now treat it as just a problem of over eating and lack of activity. I think there is a lot more to it than that. I think food addiction may be part of it also.

But I come from a family that has had over 7 generations some real body differences that continue to appear. We have many men who were over 6' 6" tall and women who were over 6'. On the other hand we had women who were just over 4'. And we have had women who were very overweight and others who are pretty normal. And this is over generations as I said. My sister was tested for thyroid problems and was diagnosed as borderline. When an over large baby is born we all just cringe. Can this be genetic?

We need more research. And we need to start taking this seriously. There are a lot of kids setting behind a computer with a pizza and pop beside them and they are already heading toward diabetes.

[B2G]

44. Makes me want to punch him. nt

[ronnie624]

51. Which is why it is important

that trained professionals are the ones caring for the sick and emotionally disturbed.

[immoderate]

52. That's the response he is looking for.

He welcomes your abuse.

--imm

[Quantess]

153. I bet you are right.

[LanternWaste]

155. Quite the lack of self-discipline on your part if mere words compel you to violence.

Quite the lack of self-discipline on your part if mere words compel you to violence.

[Monk06]

166. His problem is his mother who has obviously spoiled and pampered him to the point

that he is completely narcissistic and incapable of functioning as an independent human being.

He's nasty and someone only a mother could love

Happy Birthday, a candy covered marble cheesecake followed by ice cream meanwhile his bedside table has three plastic gallon containers of piss sitting there for who knows how long.

If he was in pain psychologically there might be room for sympathy but the guy is nasty and makes it hard for obese people that want to change their lives

He doesn't want to change he just wants to abuse and disgust people as some kind of revenge narrative.

[Vinca]

37. While I'm sympathetic to this guy's situation,

he will get nowhere unless he takes some responsibility for himself. I don't blame the hospital for giving him the boot. He needs to grow up, lose the weight at home on his own and then go in for his bariatric surgery.

[Deadshot]

39. 20 pounds in three months is nothing.

He was cheating. My money is the family was helping him get the food he wanted.

[auntAgonist]

78. Clearly this man child is mentally disturbed and needs more medical help than just weight loss

surgery.
He is abusive to his caregivers which must seem 'normal' to him because he's been abusing himself for a very long time. Obviously not caring a whit about his health.
He has someone (father?) enabling him.
He will die if not convinced to be treated.
I think he needs to be committed to an institution where he'll get the mental and physical help he needs.
Weight loss surgery isn't a magic bullet and depending on what surgery they choose to perform it might not even be successful.
Lap band will allow him to eat around the configuration and will probably not even come close to working for him.
RNY is restrictive but not restrictive enough. He'll still be able to abuse his body, eat too much and puke it all out. He won't learn anything from it at all.
Bileopancreatic Diversion w/ Duodenal Switch is the most successful radical, dangerous surgery there is and requires the most discipline from the patient.
I don't hold out much hope for this man child if he doesn't get his mental issues dealt with first.

Yes, the hospital had an obligation to care for him and restrict all and everything going into his room. Nurses are overworked and underpaid and shouldn't have to take the abuse that he and many like him hand out.

There's no easy answer here.
The onus is on him and he needs to be convinced of this. The people in his life need to be taught that they are killing him by enabling his behaviour.

He's not long for this world if a lot of things don't change.


aA
kesha

[Bucky]

160. Exactly right. Sadly, he seems to have turned vicious on those who tried to help

I doubt he'd be any more cooperative with psychiatric assistance. But someone really needs to try.

[SheilaT]

79. Wow. All of the posters who

keep on saying it's the hospital's responsibility to lock him up so thoroughly no unwanted food can get to him.

How many of you have ever worked in a medical setting directly with patients? Do you understand that most are not set up to be prisons? And that if this man's family and friends are bringing him food, which I strongly suspect, they can't do an awful lot about that, other than perhaps to imprison him in a solitary confinement with no visitors whatsoever.

Taking a glance at what this jerk has posted on youtube, he's a selfish monster who doesn't give a flying fuck about anyone else. What a shame his dad hasn't learned to say no to him by now.

I understand being overweight, but no one gets up to 800 pounds and essentially bed ridden if the people around him aren't bringing him plenty of food.

[lunasun]

129. +1 !! exactly Its like bringing drugs or alchohol to rehab . The enabalers are usually with issues

also. Often will feel unneeded if they cant enable the addict. A twisted form of caretaking that wont exist if the addict gets healed

No a hospital can not imprison him

Same posters would be howling if they did lock him up to keep food away against his will I suspect

[NaturalHigh]

85. This guy is an ass. If he truly wants help he needs to work on his attitude.

Sorry, but I'm not chalking up his behavior to mental illness. He's an overgrown brat who hasn't learned what "no" means. If he wants to eat himself into the ground, that's his business.

[bettyellen]

92. I'm wondering how much the internet instant fame culture is influencing this crap?

his videos, Dr Phil, etc.... like does he feel he can make a money out of this?
I got the same vibe reading about Randy Quaid's wife. She definitely has problems, but one of them seems to be wanting to get paid for being a self indulgent, drug addled asshole. It seems she was trying to shop around a reality show, so who knows how much of the outrageous behavior is an act.

[Warpy]

105. It's called noncompliance

I've seen heart patients get discharged for going out to smoke, monitor and all. Patients have a right to do these things to themselves, but not a right to waste the time and resources of a hospital and staff.

Besides, being sent home to die might be just the wakeup call they need. It has been for some of the people who went home, lit up, got severe chest pain, and went to another hospital.

With only a 20 pound weight loss in three months in the hospital, they knew he was managing to cheat, probably supplied by his enabling family. Ordering a pizza was just the final proof they needed.

It's sad he and his family thought they could game the system and it's sad he's probably going to die and it's sad that his family is so locked into the enabling pattern that they will help him do it. However, it's his choice.

[Laffy Kat]

116. He probably signed a contract with the care center.

And he broke that contract. It's a two-way street.

[Reter]

121. It took 3 months to lose 20 pounds?

I did 10 in my first week and I was 174. At 800 pounds, you can lose a lot quicker than I could.

[B Calm]

125. I agree, he should of lost 50 to 60 lbs in three months. He's probably

been smuggling in food all along. I can see why the hospital got rid of him.

[chillfactor]

127. suicide eating....n/t

[GreatGazoo]

145. He lost 20 pounds, the headline writer added 22 back. n/t

[dembotoz]

146. my father was quite overweight which he maintained for a couple years in a nursing home

exercise was not possible for him
the home controlled his diet and he was on a diet the entire time....
he just did not fricken loose weight.

it was the strangest thing

[Gloria]

148. I wonder if the man has ever gotten any psychological support...

We all binge....in this case, with an eating addiction, as they report, there should be some leeway here...

Even just placing calls FOR him would control the situation...

[BainsBane]

150. My heart breaks for people like this

I think of the terrible mental pain he must be in to do that to himself.

Seems to me the problem is the hospitals for enabling him to have access to pizza delivery. It's like a rehab center letting drug dealers come in.

[Ex Lurker]

151. Difficult to stop it unless he's on a locked ward

Hospitals don't have the staff to monitor everyone 24/7. Patients ordinarily have someone look in on them ever couple of hours, and a lot can happen in the meantime. There's an implied contract with the patient that they will follow medical instructions and do what is necessary to get well. If they and/or their families refuse to do so, they're wasting their own and the hospital's time and resources.

[Quantess]

152. The gastric bypass will be a temporary solution for him.

A person like that will always return to obesity, until they get over their eating disorder.

[KamaAina]

158. Rhode Island hospital? Was it Quahog Hospital?

[KamaAina]

159. Did the delivery guy get there in 30 minutes or less?

[geek tragedy]

161. suicide by food, this guy is trying to kill himself

some serious pathology at play here

[pediatricmedic]

163. Liveleak video of the guy

http://www.liveleak.com/view?i=d1c_1444512422

Draw your own conclusions, but mine is the hospital was justified in discharging him.