Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention (“CDC”), American Heart Association (“AHA”), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of “extreme morbid obesity” (“EMO”)—situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success. Bariatric surgeries themselves are very high risk for EMO patients. Individuals in this state have impeded mobility and are partially, if not entirely, bedridden, highly vulnerable, and dependent upon caregivers who often are enablers feeding their food addictions. The article draws from existing Centers for Medicare and Medicaid Services (“CMS”) and Social Security Administration (“SSA”) policies and procedures for severe obesity treatment and disability benefits. The discussion also encompasses myriad areas in which the law imposes a duty to report on professionals to protect vulnerable individuals from harm from others, and constraints and prohibitions on accelerating the end of life. The article proposes, among other law and policy measures, to introduce an obligation on medical professionals to investigate and report instances of enablement when food addiction has put the lives of individuals at risk of imminent death. The objectives of the proposals are to give providers more leverage to prevent food addiction enablers from impeding treatment and to enable EMO patients to comply with treatment protocols, to save lives and, ironically, to empower enablers to stand firm against the demands of individuals whose lives have been consumed by their food addictions.

中文翻译：

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咬喂“鳄鱼”的手：极端病态肥胖症、临终关怀以及禁止伤害和加速生命终结的案例研究

根据美国疾病控制与预防中心 (“CDC”)、美国心脏协会 (“AHA”)、和其他当局。超过三分之一的美国人（39.8% 的成年人和 18.5% 的儿童）在医学上肥胖。本文重点关注“极端病态肥胖症”（“EMO”）病例——在没有积极的医疗干预的情况下死亡迫在眉睫的情况，减肥手术是唯一有可能成功的治疗选择。减肥手术本身对 EMO 患者来说风险很高。这种状态下的个人行动不便，部分（如果不是全部）卧床不起，非常脆弱，并依赖照顾者，他们通常是他们食物成瘾的促成者。本文借鉴了现有的医疗保险和医疗补助服务中心 (“CMS”) 和社会保障管理局 (“SSA”) 针对严重肥胖症治疗和残疾福利的政策和程序。讨论还包括法律规定有义务向专业人员报告以保护易受伤害的个人免受他人伤害的义务，以及对加速生命终结的限制和禁止的无数领域。除其他法律和政策措施外，该文章还建议医疗专业人员有义务调查和报告当食物成瘾使个人的生命处于即将死亡的风险中时启用的情况。