S04.E12: Sean's Story

[Cherrio]

"Imagine a 1000 pound man bowels movements who eats 30,000 calories a day of fastfood?"

 

Operalover,

      If I have a nightmare of being chased by what you described, I am going to come find you.    :)

[operalover]

It was a volatile combination- the manipulating whiny and demanding child with the downright stupid mother who wanted to keep him a baby and dependent for her won reasons. This is the "dynamic" (Dr. Na) that leads someone to become 913 pounds before they seek help. He was a mess at 500 pounds! He couldn't move at 700 pounds! This is such a vivid example of co-depenency. Had she wanted him better she would have gotten him medical attention for his foot in the first place. But she allowed and condoned it and HELPED him to kill himself. His body is ruined, even if he gets his weight down. His body, his social development, his mental development, his lack of education= everything is permanently ruined. 

Edited March 17, 2016 by operalover

[ClareWalks]

I just really cannot believe that whiny fucker gained 100 lb in one month and claimed he was "trying" to follow the diet. That being said, I agree with others here that 800 calories is a bit of a shock to the system. THAT being said, I honestly think Dr. Now was trying to save this kid's life. He was in very, very immediate danger of dying if he didn't lose weight fast. I laughed a few times when Sean said he was starving. It would take him months to starve to death, and even then it would be malnutrition that did him in, not a lack of fat stores. When the mom said that Sean just wants to eat constantly, I said from my couch, "buy a ton of heads of iceburg lettuce and let him eat THAT."

 

I don't know if anyone watched Fat Chance afterward, but it was like an Immaturity Marathon on TLC. First Sean, then TaTiana, who was so childish and dramatic it drove me nuts.

[Azubah]

I wonder how many of these people have problems that are more directly related to lipidema and lymphedema than to primary obesity? Sean's flesh was tearing because of the lymphedema. Some other folks have lipidema that never goes away. 

[operalover]

We often say here that we would like to see the fit the person throws when they don't get their way. Can you imagine listening to this guy whine if you didn't bring him his burger? I would probably just give him whatever he wanted to just to shut him up. 

[Cherrio]

We often say here that we would like to see the fit the person throws when they don't get their way. Can you imagine listening to this guy whine if you didn't bring him his burger? I would probably just give him whatever he wanted to just to shut him up. 

I have a feeling that it goes much further than just verbal tantrums too.        

[ChristmasJones]

I'm sort of questioning Dr. Now's speculation that it would take 30K calories per day to gain weight (or did he say 20K? I can't remember).  The calculator I linked above said just over 6K calories per day are needed to maintain 550lbs, completely sedentary.  I'm thinking its more in the 12-16K range to gain weight at 800 lbs.

[aliya]

And this is why I could never be a health care worker--I honestly didn't care if Sean made it.  When he kept crying and complaining about how it was so unfair of everyone to make him cut calories, and that he should be allowed to enjoy his food, all I thought was "go ahead, keep eating all that shit".  I was almost hoping Dr. Now would stop trying and let this whiny manipulative jerk eat himself into oblivion.

Save the surgery for someone who really wants to change.  My reservation in hell now confirmed.

I'm gonna be right there with you. I thought the same thing. It seemed the music was different, sadder and slower. On 'Fat Doctor' from the UK, they showed one patient who died and I kept thinking this is the one Dr Now is gonna lose. Strangely, I wasn't too choked up about it.

 

I missed the poop and foot thing. Something to look forward to in the re-run...

 

Re mom in the wheelchair, I wonder if she has arthritis or something. Yes, she was big, but we've seen bigger. I have a little arthritis in my hip and sometimes have to sit down on walks and deal with the pain for a bit, then start again. If she hasn't pushed herself to keep moving, she might have become dependent on the chair. Also, lots of people's knees give out. They're OK for awhile, but when they need to sit down, they need to sit down.

 

When he said he needed a snack, I thought she was going to go in the kitchen and get some ice cream, a small sandwich, you know...a snack.  But no, she goes out and gets him a full meal and dessert. This is where it's hard to feel bad for the caregiver. Considering that he can't/won't get up, she could have brought him some fruit, even a turkey sandwich, but she not only gets him a full meal, but an unhealthy one at that. And she gets in the car and drives who knows where to get it. Nope. No sympathy. 

[Linnee]

 

Yes, all us parents are responsible to some degree for what happens to our kids but we can't control all of it.

When your kid is 26 and completely dependent on you for everything you eat, you can control that. Refuse to feed him whatever he demands. If he whines and cries, leave the house. It's not as if Sean could run after his mother and continue his tantrum.

Edited March 17, 2016 by Linnee

[OhioMom]

I'm sort of questioning Dr. Now's speculation that it would take 30K calories per day to gain weight (or did he say 20K? I can't remember).  The calculator I linked above said just over 6K calories per day are needed to maintain 550lbs, completely sedentary.  I'm thinking its more in the 12-16K range to gain weight at 800 lbs.

What I heard him say (and maybe I'm confusing this show with Dottie's) is that "you are eating 3x the calories you need, if you were at your ideal weight.  Come to think of it, I do think he said that to Dottie. I don't recall him saying this to Sean, unless it was to say, "to gain as much weight as you have, you would need to eat _____ calories."

[Armchair Critic]

This was the first episode where I wanted to retch watching it, Sean was gross.

[Minivanessa]

Wow. I watched the opening scenes of this episode, and had it on in the background while doing other things. I finally turned it off, I think after Sean had gained a staggering amount of weight between his first and second visits to Dr. Now.

 

I heard him say, in that time between visits, about his eating habits to lose weight, "I'm down to just one fast food meal a day now." Color me unsurprised that he gained another adult person's worth of weight between those doctor visits. Holy french fries!! I assume that his "one fast food meal a day" was more like two meals, neither of which was a salad with a bottle of water. 

 

My take on Sean's back story is that he didn't get love and support from his dad, may have not fit in well with his peers, and learned when very young to soothe his feelings with food. Then his parents got divorced, and maybe that's when his mom went to work, and Sean came home from school to an empty house where he could soothe and soothe himself with food. Maybe when he got hurt and laid up, it was Mom's excuse to quit her job. And however it came about, she got to stay home and "care" for Sean, with both of them getting enough benefits (SSI, whatever) to get by. 

 

When (ok, if) Sean loses weight and gets enough of his physical issues dealt with, that he's no longer eligible for disability benefits? Mom, unless she develops her own disabilities, also loses benefits. And - has to get a job. She's been out of the work force for at least 8 years by now, and may not have liked working anyway.

 

Just my opinion based on the bits we learned at the start of the episode of Sean's history.

 

I'm afraid he'll never get well, though, so Mom may be OK with that caregiver gig. Unless the poor guy dies - which could be damned soon if he farts around and doesn't lose more weight. 

[Armchair Critic]

Can't somebody make some underwear for these people? I have noticed that most of them don't wear underwear and then when they are moved their shirt/dress lifts up and they are exposed. When the church people moved Sean out of the wheelchair he totally mooned them. eeeewww

[OSM Mom]

In regards to where he was going to the bathroom, towards the end when he got off the bed at home, I saw one of those portable toilets with the rails on it in the background. An oversized one. Apparently they do make the for obese people.

[operalover]

Yes none of them wear underwear and they flash whoever is helping them. 

 

I am speculating that to move to Houston from whereever you live, the show pays for the move, and maybe 2 years of rent and all the medical care and also a stipend. It must be a VERY sweet deal to get these lazy ass people to move across country. Financially it must seem lucrative to them. And when they get there and were offered all that money, free medical care, and free housing and they don't even try it is a real slap in the face. 

Even if they become able to work having lost sons of weight, they can still collect SSI based on being poor. Once they make too much money though, by working, they can't collect anymore- you have to stay poor and not work and not accumulate any assets. This is why not too many people are on it just because they are poor, because you are usually capable of working. The mother, however, might claim permanent disability with her weight and god knows she probably has major health issues. With his deformed foot and lack of HS diploma, his options for work will be limited - and Im sure he will have excess skin that will take another year of rehab after getting it all cut off. 

[OSM Mom]

And as far as underwear goes, if your bedbound and doing it all in a bed pan or a bucket, underwear is very inconvenient to use. Just a thought.

[Armchair Critic]

I am thinking a guy of that size loses the sexual urge (yes I went there). I admit I love food too, but not to the point where it's all I have in life.

[Minivanessa]

 

Even if they become able to work having lost sons of weight, they can still collect SSI based on being poor. Once they make too much money though, by working, they can't collect anymore- you have to stay poor and not work and not accumulate any assets. This is why not too many people are on it just because they are poor, because you are usually capable of working. The mother, however, might claim permanent disability with her weight and god knows she probably has major health issues. With his deformed foot and lack of HS diploma, his options for work will be limited - and Im sure he will have excess skin that will take another year of rehab after getting it all cut off. 

 

My understanding that as to SSI, if you're under age 65, you must be blind or disabled to receive it. While I doubt that Sean is going to be able to hold a job anytime soon, he can't keep getting SSI just because he's "still poor" if he ever does become able to hold a job. There may be some other kind of assistance they can collect if they "stay poor," but I don't think it's SSI.

[ChristmasJones]

I think 100 years from now, and probably even sooner, we will look back at the "treatments" for severe obesity and view them the way we now view medical interventions such as bloodletting. For people to get to these super-high weights, there is way more going on than just traumatic events and bad choices.  The field of research on genetics in obesity is really interesting.

 

Here is a little snippet about one study

 

"Dr Rachel Batterham from UCL and University College London Hospitals, who led the study, said: "We've known for a while that variations in the FTO gene are strongly linked with obesity, but until now we didn’t know why. What this study shows us is that individuals with two copies of the obesity-risk FTO variant are biologically programmed to eat more. Not only do these people have higher ghrelin levels and therefore feel hungrier, their brains respond differently to ghrelin and to pictures of food – it’s a double hit."

 

See more at: https://www.ucl.ac.uk/news/news-articles/0713/15072013-How-obesity-gene-triggers-weight-gain-Batterham#sthash.YUJ8hUYW.dpuf

Edited March 18, 2016 by ChristmasJones

[Granny58]

When your kid is 26 and completely dependent on you for everything you eat, you can control that. Refuse to feed him whatever he demands. If he whines and cries, leave the house. It's not as if Sean could run after his mother and continue his tantrum.

exactly.  that is what I have never been able to understand.   

Can't somebody make some underwear for these people? I have noticed that most of them don't wear underwear and then when they are moved their shirt/dress lifts up and they are exposed. When the church people moved Sean out of the wheelchair he totally mooned them. eeeewww

my friend was a nursing assistant and she said that the penises of very obese men sinks into the fat, you can't really see it.  I think we've all seen that here....the fat hanging down covering the genitals.  Unless one is being washed, or whips her leg up like one of them did (can't remember name), those areas probably are usually covered....by their own hanging bodies.  

[firecrackerz26]

I think everything I think has pretty well been said, but I'd still like to throw my two cents in. Starting with the food mom was feeding him, what was he going to do besides throw a verbal tantrum, get up and chase her? The whining about needing to eat ran pretty thin, I can't for the life of me understand why mom was going out to get him a "snack" of McDonalda burgers, fries, and sundaes, then two pizzas at a time, donuts, etc. did mom REALLY not SEE how large he was? 919 lbs? Then instead of going home and lose weight you get to 1003? Then going home from the hospital, after pulling a stunt of a fake heart attack because you're throwing a tantrum because you can't manipulate things to get more food? Counseling should have been there sooner, for both Sean and mom. Sean is just like a child, he whined, manipulated, and knew mommy would get him anything. And his attitude was very childish, playing his game boy and all when he didn't want to hear something, like the nutritionist.

And yes, the scene where he told mommy in the dr office he had pooped himself! Yuck!

[Armchair Critic]

Granny58 I noticed we both have the taste for fine entertainment, Sister Wives and My 600 Pound Life. ;) LOL

 

Sean's voice sounded a bit like Chay who was on last season.

Edited March 18, 2016 by Armchair Critic

[auntjess]

Didn't Sean say he had behavioral problems as a child?  I wasn't sure whether this was the cause or result of his father's treatment of him.

I see some of you figuring out the calories in some of those pizzas and fast foods, but me---I'm more stunned by the expense.  They may spend $40-$50 a day on fast food for 2.
And maybe because I watch Engineering Disasters and Mike Holmes, but when he went out on the balcony, and leaned over, I thought it might collapse.

[aliya]

As a mom of 1, I'll admit that I seldom came home from shopping or a day out without a treat for my son. Yes, sometimes it was food, but it might also be a toy car, a book, a cute t-shirt, etc. The idea that the only thing she could bring him was food is ridiculous. 

 

Just catching the rerun on YT and finally paid attention to his foot. I cannot imagine that my kid hurts himself like that and I don't take him to every specialist in the country to find treatment. Sean and his mother seemed a bit higher on the economic scale than many of Dr Now's patients. I get the feeling there was insurance - shoot, a lot of places will work on difficult patients for free or almost free. In addition to doing more to fix his foot, I would have had him out of bed just to avoid blood clots, etc. I'm not seeing the mother love here. 

 

Re the 800 calories. Yes it's low, but you can eat a lot of veg and low glycemic fruit for 800 calories. He could have stuffed himself with salad and some legumes. That burger, etc. had to be 1000 calories on its own.

Edited March 19, 2016 by aliya

[Cherrio]

Didn't Sean say he had behavioral problems as a child?  I wasn't sure whether this was the cause or result of his father's treatment of him.

I see some of you figuring out the calories in some of those pizzas and fast foods, but me---I'm more stunned by the expense.  They may spend $40-$50 a day on fast food for 2.

And maybe because I watch Engineering Disasters and Mike Holmes, but when he went out on the balcony, and leaned over, I thought it might collapse.

I thought the same thing about that balcony.   Also, riding in the elevator. I thought if that had been me, I would of refused to ride with him.  It reminded me of that Disney ride.

[firecrackerz26]

Yes, about the injury. He said he tore ligaments in his ankle, so he was bedridden after that. 10 years ago I I tore ligaments in my ankle, I got them repaired, went through PT, all with state insurance, so I don't want to hear that he couldn't have done the same.

I also agree with what everyone is saying about the food and just how much he must have been eating, I'd truly throw up eating that much! My meal for him, which I think I mentioned earlier, would be grilled chicken salad, lots of green, tomato, cucumber, carrot, lo cal dressing, watermelon with cantaloupe, cup of yogurt, and large glass of ice water with lemon wedge. That meal sounds better to me than pizza anyway. If he had started eating like that, taking responsibility for himself maybe he wouldn't have gotten to 900 lbs. but then when Dr Now sent them home to lose weight and he gained, I do think it was the maddest I've ever seen Dr Now. I also believe he may have some kind of developmental issue too, it would explain a lot of things.

Edited March 18, 2016 by firecrackerz26

[CarolMK]

I only made it about halfway through this episode and had to turn it off, it was so depressing. I'm thinking that Sean may be mentally ill, or something else is going on with him, that allowed him to get up to that size and become bedridden at such a young age. Was the father actually abusive? Did he have any siblings? It didn't seem to make sense to me as to why he gained so much weight as a child.

[CousinOliver]

I'm sort of questioning Dr. Now's speculation that it would take 30K calories per day to gain weight (or did he say 20K? I can't remember). The calculator I linked above said just over 6K calories per day are needed to maintain 550lbs, completely sedentary. I'm thinking its more in the 12-16K range to gain weight at 800 lbs.

One formula is weight x 15 = amount of calories for maintenance. (Well, weight x 15 + exercise, but exercise isn't an issue here).

So 900 x 15 = 13,500 cals for maintenance.

He gained 100 lbs in a month (I think.) If we assume an excess of 3,500 cals per lb gained, that would be 11,655 calories per day beyond what is needed to maintain a 900 lb body.

13,500 + 11,655 = 25,155 cals/day consumed, averaged.

Now, I don't actually believe this is the case. I think the super morbidly obese have slower metabolism and other issues that mean a smaller number of calories are needed than this formula would suggest, but it's still a high number (Dr Now's own employee, Angie Flores, has made a similar point in an earlier special). Maybe he gained on 15,000 cals or 10,000 cals, still a lot of food.

But, if Dr N is old school, he's probably using a formula like this to ballpark 20,000-30,000 cal/day.

Link to formula: http://yorkcatholic.org/wp-content/uploads/sites/3/2013/10/Calorie-Calc.pdf

[Rancide]

If he is on SSI, plus the oxygen tank, that must mean he is  under a doctor's care. In order to claim SSI, the claim has to be substantiated with regular doctor's reports. I know lots of docs don't want to take on weight related stuff, other than to say you need to lose a few pounds, but in this case I have a hard time believing any doctor wouldn't be pitching a fit over Sean and his weight and just continue to sign off on reports. 

 

I'm a lawyer, and when I was in law school I did SSI appeals (administrative hearings for people who had been denied SSI benefits based on their paper applications) as part of my law school clinic.  Basically, there are a couple of ways you can get SSI.  Either you can have an outright disability that would prevent anyone from working (e.g. stage V cancer and bed-bound), or you can have a combination of factors, none of which taken alone would render someone disabled but when put together, combined with the personal characteristics of the individual make someone incapable of "substantial gainful activity."  

 

MOST people who get disability are getting it because of the combination of factors and not just outright medical condition.  For example, a paraplegic with a college education would probably not qualify for SSI because there are a lot of jobs for the highly educated that can be done virtually entirely from a seated position.   If someone is a paraplegic and a high school dropout, it's going to be much harder to find a job because of a lack of abundant sedentary jobs for people with no education and no particular skills.  Or maybe someone has schizophrenia that can be controlled with medication, but the medication makes the person extremely lethargic, makes it really hard for them to concentrate, and causes them to need frequent naps.  

 

The doctor's report is part of the SSI package, but it's not all there is.  And honestly, unless someone's condition is extreme (brain damaged and non-verbal), it's very hard to get a full picture in the medical report.  So lots of people who should qualify get denied and end up having administrative hearings to determine their eligibility.  These administrative hearings are great because they're in-person and gives the officer a chance to evaluate in person.  The first client I represented was someone who had been turned down because her diagnoses were almost all mental health related (depression, anxiety, dissociative tendencies, paranoid thinking), and she really didn't look THAT disabled on paper, but no one who talked to this woman for even 30 seconds could ever imagine she was employable by anyone doing anything.   

 

At these administrative hearings, there is a representative for the government, and that person looks through a jobs book and has to come up with examples of jobs the person could reasonably hold.  If they can't do it, the person wins.

 

There is no job that Sean can hold.  The fact that it's "his fault" that he can't stand or sit up or move around at all is not relevant for SSI consideration.  Unless someone from the government can find some job he is qualified for and can physically do that exists in substantial numbers in the US economy, he's disabled for SSI purposes.

 

And add me to the list that thinks Sean was mentally challenged.  I wanted APS (or whatever the acronym for CPS for adults is) to come do an intervention.  It wasn't clear to me he was bright enough to be making decisions for himself, and mom seemed like she was possibly guilty of adult abuse.  Given his seeming low IQ and self-reported insatiable appetite, I was wondering if he had Prader Willi Syndrome or something.

[Noirprncess]

Oh, yes Sean was not only gross but definitely that man-child. He's needed a mental eval since he was a little kid. His mother allowed his acting out to go unchecked into his adulthood. Ain't no way, no how, a child can admittedly in their own words be a demon-seed, biting and terrorizing others unchecked, turn into a functioning adult. So, Sean was the whiny, bratty end result.

I also would have GLADLY fed him 800 calories if only force him to lose weight and not be cleaning his nasty hands and gigantic behind.

I am watching Fat Chance now and yelling, "he ain't that into you chick.". If you fly that many miles and think you have plans, but dude bails, he ain't into you.

[ChristmasJones]

Now, I don't actually believe this is the case. I think the super morbidly obese have slower metabolism and other issues that mean a smaller number of calories are needed than this formula would suggest, but it's still a high number

 

This calculator  that I linked above uses the Schofield reference formulas. On their site it says:

 

"At the other end of the scale, obese people tend to have their activity dependent energy expenditure overestimated. Accordingly, a correction factor for body mass indexes over 30 is applied."

 

- but their scale only goes up to 550 lbs. -  http://www.health-calc.com/diet/energy-expenditure-advanced

[Mrs. P.]

I couldn't stop looking at his teeth (or lack of them) wheh he was packing food into his mouth. It made me wonder what the super obese do when they have tooth problems. No way could Sean have gone to a dentist to have decayed teeth restored. I guess he'd have to go in an ambulance to a hopital where a dentist could be brought in to extract them. That really disturbed me, but I guess losing his teeth was the least of his problems.

[LilyoftheValley]

He was SO nasty.  At least some of the people on this show eat with utensils.  I gasped when he said that putting him in the hospital seemed "excessive".  Dude, you're literally on your death bed all day.  How is hospitalizing a person in that condition excessive? 

 

It sounds to me that Sean has some mental/learning disability that caused him to be overly emotional.  Overly emotional kids are "spazzes" to other kids and so other kids reject them.  Thus mom made up for it ten fold by spoiling him.   He hurts his foot and then the spoiling finally reaches peak levels of bliss.  Sean gets to stay home with his mom and get everything he wants, he does not have to deal with his peers, and mom gets a perpetually dependent child.  I mean there was no one else around in Sean's life.  I think that is the first time we have seen that on this show.  Most people at least have two people or more in their lives.  Some are enablers but some are also truthful and honest.  All Sean had was an enabler.  He only had one person in his life.  Sadly I do not see long term success for him.  Even when they were planning things he would do when he lost weight it was all stuff the two of them were going to do together. A man is his mid 20's should not have a social life that revolves entirely around doing things with his mommy.   Jeff on Intervention once called the relationship of a junkie mother and son "unconsummated incest" and that is sort of what Sean and Mom's relationship is like.  Not quite a gross, but they are living like a "couple".  They're going to go to the movies together, go to Disneyland together, go on a cruise together.  He's the man in her life and she is the woman in his life.  So messed up.

[Guest]

Jeff on Intervention once called the relationship of a junkie mother and son "unconsummated incest" and that is sort of what Sean and Mom's relationship is like. Not quite a gross, but they are living like a "couple". They're going to go to the movies together, go to Disneyland together, go on a cruise together. He's the man in her life and she is the woman in his life.

I was struck by the early photos of both Sean and his mother. Both of them were of normal weight before the dad left the picture. After he was gone, both Sean and the mother had gained a significant amount of weight. My theory is that she started binge eating to soothe her own pain and either Sean emulated that or she started encouraging him to do the same. Now she finally has the one man who will never leave her.

When the pizza guy dropped off the delivery, the mother took in THREE pizzas. I wonder if Sean ate the third too or she put it away for a "snack" for later.

His left foot reminded me of a manatee's.

And I'm afraid that surgery will do him no good. I don't understand why they don't have long-term inpatient weight loss for these folks at a specialty hospital. (And not Brookhaven for those who remember that show!)

[operalover]

Someone above mentioned they thought Sean and his mom were better off financially that some that we see. But the opening of the show shows their apt complex and it is a real shithole. The one in Houston they moved to is much nicer- a big upgrade, thanks TLC!

However, he has something attached to the cieling to help him hoist himself back up into the bed after he pees in the bucket in the morning, and the oxygen, so there must be some health care workers involved. Why they did not get him help for his foot is beyond me. He said he tore ankle ligaments, but why is his foot like that? Is it related? The mom did not want that foot fixed!

 

And "maybe a medium fries" cutting back?

Edited March 18, 2016 by operalover

[gunderda]

I'm currently semi-counting calories (I mainly only do it during the week) and my goal is about 1500/day. I'm overweight but not super obese. But if someone told me I had to restrict myself to 800/cals a day I would likely cry.   So to me that seems a little excessive.  Especially when someone is that large and they should be able to lose weight easily by just cutting out sodas.  

I think if they would have given him a more manageable limit they wouldn't have rebelled against it so much. 

[goodbyeglittergirl]

This was the first episode of this show that I nearly just turned off rather than watching all the way. The relationship between mom and son was just so codependent and Sean just was so whiny and unwilling to change. I hope for his sake everything works out but I can't imagine how it will.

[Noirprncess]

I've said this before, but, I do think one of the main reasons Dr Now seems "slow" to send patients to other specialties like psychiatry immediately is because so many are on some form of state medical health plan. From what I've seen, a number of states still operate like old school HMOs in that they require referrals and approvals FIRST before a patient can see a specialist.

Instead of the show explaining that, they just present it as a "last option" kind of thing for Dr Now.

I bet Sean's foot didn't fixed because he had a temper tantrum about having to go to the hospital or being examined. His mommy probably didn't force him to either. How many times did he say he didn't like hospitals during this episode?

[Granny58]

I'm a lawyer, and when I was in law school I did SSI appeals (administrative hearings for people who had been denied SSI benefits based on their paper applications) as part of my law school clinic.  Basically, there are a couple of ways you can get SSI.  Either you can have an outright disability that would prevent anyone from working (e.g. stage V cancer and bed-bound), or you can have a combination of factors, none of which taken alone would render someone disabled but when put together, combined with the personal characteristics of the individual make someone incapable of "substantial gainful activity."  

 

MOST people who get disability are getting it because of the combination of factors and not just outright medical condition.  For example, a paraplegic with a college education would probably not qualify for SSI because there are a lot of jobs for the highly educated that can be done virtually entirely from a seated position.   If someone is a paraplegic and a high school dropout, it's going to be much harder to find a job because of a lack of abundant sedentary jobs for people with no education and no particular skills.  Or maybe someone has schizophrenia that can be controlled with medication, but the medication makes the person extremely lethargic, makes it really hard for them to concentrate, and causes them to need frequent naps.  

 

The doctor's report is part of the SSI package, but it's not all there is.  And honestly, unless someone's condition is extreme (brain damaged and non-verbal), it's very hard to get a full picture in the medical report.  So lots of people who should qualify get denied and end up having administrative hearings to determine their eligibility.  These administrative hearings are great because they're in-person and gives the officer a chance to evaluate in person.  The first client I represented was someone who had been turned down because her diagnoses were almost all mental health related (depression, anxiety, dissociative tendencies, paranoid thinking), and she really didn't look THAT disabled on paper, but no one who talked to this woman for even 30 seconds could ever imagine she was employable by anyone doing anything.   

 

At these administrative hearings, there is a representative for the government, and that person looks through a jobs book and has to come up with examples of jobs the person could reasonably hold.  If they can't do it, the person wins.

 

There is no job that Sean can hold.  The fact that it's "his fault" that he can't stand or sit up or move around at all is not relevant for SSI consideration.  Unless someone from the government can find some job he is qualified for and can physically do that exists in substantial numbers in the US economy, he's disabled for SSI purposes.

 

And add me to the list that thinks Sean was mentally challenged.  I wanted APS (or whatever the acronym for CPS for adults is) to come do an intervention.  It wasn't clear to me he was bright enough to be making decisions for himself, and mom seemed like she was possibly guilty of adult abuse.  Given his seeming low IQ and self-reported insatiable appetite, I was wondering if he had Prader Willi Syndrome or something.

Thank you...this is an interesting post, all of it.  As to the mom, I could see how it falls under abuse, but I don't think she intentionally was being abusive.  I think she has her own issues and wanted to keep him to herself.  I think she seems intelligent enough, but this would be an emotional issue.  And I didn't think of it myself, but so many others posted that he should have been removed from the house makes perfect sense. 

[Barb23]

When I watched the episode a second time, I did notice Mom used "we" almost constantly including the reward chart, which is definitely creepy for a 26 yr old. I found it odd, too, that he didn't seem to have any friends. Besides the church friends (more like acquaintances) that they left behind, there was no one. It was nice they had the lady come in to help bathe him & she seemed happy to help. I think she said she also helped with meals, so maybe they did have an occasional not fast food meal. But after watching these two, I'm thinking she was more of a maid doing household chores while Mom was on the computer.

It was weird Mom talking about Sean getting treats like he was still 6. Even after his bathroom break when they were on the road, which seemed to upset him, she hands him one of those huge turkey legs to munch on & calm down. My God, I could have made a meal for 4 with that thing.

[notyrmomma]

I wonder how many of these people have problems that are more directly related to lipidema and lymphedema than to primary obesity? Sean's flesh was tearing because of the lymphedema. Some other folks have lipidema that never goes away. 

This was exactly the case with the "half ton killer" Mayra Rosales.  Yes, she had an overeating problem, but it was her lymphodema that was pushing her upwards of the 600 lb mark.  If you watch the show about her losing the weight (the murder charges were dropped) you see her actually leaking/oozing lymph fluids, like dripping under her bed, to get her weight down so Dr. Now could do her surgery.  It was the grossest thing I have ever seen on TV.

 

By the way, just try asking a regular family/general practitioner about lipidema....sad, but many people have this disorder, but doctors would rather just blame it on overeating.

 

I couldn't stop looking at his teeth (or lack of them) wheh he was packing food into his mouth. It made me wonder what the super obese do when they have tooth problems. No way could Sean have gone to a dentist to have decayed teeth restored. I guess he'd have to go in an ambulance to a hopital where a dentist could be brought in to extract them. That really disturbed me, but I guess losing his teeth was the least of his problems.

 

I also noticed many of these folks wear glasses (and they don't appear to just be reading glasses you buy at Walgreens because they are always wearing them).  How did they get them?  How did they sit in the optometrist's chair to get that prescription?

[operalover]

"I'm kinda getting fed up with all the restrictions" OMG yes I am rewatching, not sure why! Human behavior is fascinating. I'm at the part where the mom says they are  "truthfully" on a 1400 calorie diet and one piece of pizza this month and one donut. Then he rolls his eyes. He gets sliced apples with his lunch. There are chips in the pantry. He whines "I don't like this, I'm not in the mood for the physical therapist, I am doing fine on my own" 

 

And he had No underwear on in that wheelchair in the doctors office. Just a short top, no pants, and he got on the 800 pound scale and mooned the whole place. 

 

Why am I doing this to myself? 

[CousinOliver]

I wonder if Dr Now gives such a restricted diet because he knows they'll overestimate calories?

I'm almost certain he has said the inpatient diet is 1,200 cal/day, which seems to be the long-established standard for low end calories. It doesn't make sense that the controlled diet patients get 1/3 more calories.

I also tend to think that the initial psych eval are done before filming begins, so anyone not qualifying can just be turned down for show participation.

[AZChristian]

This was exactly the case with the "half ton killer" Mayra Rosales.  Yes, she had an overeating problem, but it was her lymphodema that was pushing her upwards of the 600 lb mark.  If you watch the show about her losing the weight (the murder charges were dropped) you see her actually leaking/oozing lymph fluids, like dripping under her bed, to get her weight down so Dr. Now could do her surgery.  It was the grossest thing I have ever seen on TV.

 

By the way, just try asking a regular family/general practitioner about lipidema....sad, but many people have this disorder, but doctors would rather just blame it on overeating.

 

 

I also noticed many of these folks wear glasses (and they don't appear to just be reading glasses you buy at Walgreens because they are always wearing them).  How did they get them?  How did they sit in the optometrist's chair to get that prescription?

 

I also wonder how many of the 600+ ladies (and men) get their nails professionally done and have lots of tattoos.  Home visits?

[Cherrio]

"I was wondering if he had Prader Willi Syndrome or something."

 

He does not have Prader Willi.    There are many physical characteristics that are easily identified at birth.

[ClareWalks]

Did Dr. Now even give them a specific meal plan for the 800-calorie diet? Because when they went back to the hospital and he'd gained a shitload of weight, the mom was like "what does he need to eat? More protein?" Dr. Now is dealing with THE most nutritionally-ignorant people in the country, so he needs to be extremely, ridiculously specific. And they should be told that the only salads they are allowed are vegetables only with plain vinegar. Balsamic, red wine, or apple cider vinegar, but no oil, no ranch, no nothing. Because we have seen sooooo many of these people think "I'm eating salad! It's healthy!" and pile on chicken, cheese, and ranch.

[gunderda]

I bet Sean's foot didn't fixed because he had a temper tantrum about having to go to the hospital or being examined. His mommy probably didn't force him to either. How many times did he say he didn't like hospitals during this episode?

 

He said it didn't heal properly so I imagine he probably threw tantrums about the physical therapy and just flat our refused to do it.  Just as he told his mom he didn't want to do any leg lifts.  HOW HARD IS THAT!?

Did Dr. Now even give them a specific meal plan for the 800-calorie diet? Because when they went back to the hospital and he'd gained a shitload of weight, the mom was like "what does he need to eat? More protein?" Dr. Now is dealing with THE most nutritionally-ignorant people in the country, so he needs to be extremely, ridiculously specific. And they should be told that the only salads they are allowed are vegetables only with plain vinegar. Balsamic, red wine, or apple cider vinegar, but no oil, no ranch, no nothing. Because we have seen sooooo many of these people think "I'm eating salad! It's healthy!" and pile on chicken, cheese, and ranch.

 

And after she said that Dr Now said "I gave you information on exactly what he should be eating" so we know they're given the information. 

 

I am honest and say that I eat very unhealthy salads lol  

[ClareWalks]

And after she said that Dr Now said "I gave you information on exactly what he should be eating" so we know they're given the information. 

 

I am honest and say that I eat very unhealthy salads lol  

 

Oh, I missed that part! Thanks! Then there is really no excuse. Anyone with functional literacy can read and follow directions.

[operalover]

Did Dr. Now even give them a specific meal plan for the 800-calorie diet? Because when they went back to the hospital and he'd gained a shitload of weight, the mom was like "what does he need to eat? More protein?" Dr. Now is dealing with THE most nutritionally-ignorant people in the country, so he needs to be extremely, ridiculously specific. And they should be told that the only salads they are allowed are vegetables only with plain vinegar. Balsamic, red wine, or apple cider vinegar, but no oil, no ranch, no nothing. Because we have seen sooooo many of these people think "I'm eating salad! It's healthy!" and pile on chicken, cheese, and ranch.

When she lied about the intake and then said "What should we be eating? Protein?" He said "I gave you the whole diet with all the explanations! You have it all outlined in the information!!!" They were given what they were supposed to do and played stupid. 

[poeticlicensed]

I don't understand why Dr Now doesn't have them use a medical diet delivery service. I get that he wants them to learn how to eat, but a medical diet delivery service would teach them because they will see the food being delivered every day. For someone 700 pounds, baby steps are in order. I realize that you have to be careful because there are many diet food companies that deliver highly processed foods, but there are some that deliver fresh. You can't unlearn bad habits  overnight, but if you have no food in the house and only eat what is delivered, its a beginning. 

Edited March 18, 2016 by poeticlicensed