This show is about morbidly obese people who are trying to lose weight enough so that they can qualify for weight loss surgery, so they can lose more weight.
In every case, you are dealing with mentally retarded or mentally ill people. Not just them, but all their family too. These people are still using the 8086 chip in their CPU. In every case, they are totally dependent on county and public services to clean and care for them. They stopped being productive citizens years and decades before.
From a purely economic proposition, why should society bear any cost at all to support these people, let alone the enormous cost of rehabilitating them? They are never going to become productive, no matter how much weight they lose.
Losing weight is EASY. Stop eating so damned much. In the cases on this show, the people cannot even move around on their own. They are totally immobilized. If other people stop feeding them, they will get thinner.
In every case, their doctor put them on a strict diet. In every case, they ignored the diet, or simply added it to their normal diet. In every case, they lied to the doctor and acted mystified that they gained weight. In every case, the doctor (the same one for every person on this show) doesn’t call them out for being a liar.
I have to admit, when I watch this show and see the outcomes at the end, when I see a patient has died due to complications, I cheer a little inside. I have lots of human compassion. What I don’t have is the ability to see these things as human. They simply don’t have enough in common with me, mentally, behaviorally, or physically to claim them in my own species.