what gets me is how people live like that. how can you get up each morning and then not be able to fit through a doorway and still think that your life is ok? I've seen people that are like that and see nothing wrong with their lives. there was one guy in Mexico that I remember reading about almost a year ago that had to be taken to the funeral home on a flat-bed tow truck.
Its a self control issue. In the interests of full disclose I was never unable to fit thru a doorway big, but I was around 360 big. It was my experience that unless something majorly jolts you into changing your lifestyle, you will continue to keep going as you were going and "start eating healthy and exercising tomorrow" In my case that was the onset of horrific acid reflux that had me laying awake at night thinking I was dying of a heart attack that got me to change my lifestyle then and there. I remember laying in bed saying "Ok God. You let me live thru this and I will turn this around. Ill start eating right, excersinging regularly, whatever it takes" 2 years later and im down 100 pounds and still going, so yeah.
People get stuck in their ways. When eating 20k calories is the norm, your going to keep doing it, and trying to stop is horrifically difficult and quite honestly painful. Food becomes an addiction at that point. That said do I think EMTs should have to bring extra equipment and the souped ambulances for people? God no. If we choose to get that large we do it knowingly (for the most part. There are obvious medical exceptions as has been posted in this thread already), and doing something knowingly and expecting others to take care of it is NOT what this country should be about. So by all means eat that extra cheeseburger, its your right. But don't expect the paramedics to bring a forklift with them on a call out. That said I expect to get vegan blood should I ever require a transfusion!