Patty must be in so much physical pain. :( I know a woman who got to around that size (and I like and respect her very much - her background was more fucked up than you can begin to imagine and she did well to survive at all) and the things she told me - huge pain just on standing, needing help with washing and cleaning herself after using the loo, terrifying sleep apnea. Awful way to live.
I'm overweight, don't hate myself for it, and for mental health reasons am prioritising general health and fitness over weight loss. I know people smaller than me who get weight loss surgery and it really freaks me out - the idea of permanently fucking with my digestive tract is very scary to me. Much scarier than being a bit fat. But the day my poor daughter has to wipe my arse because I can't reach it myself is the day I ask for a gastric bypass. We all might end up in the role of carer to a parent, but I could never wilfully do that to her.