When you're that obese you're well beyond personal responsibility. Personal responsibility is enjoying a big thanksgiving dinner and then eating light for the next week or so, or eating some salads for a bit to have a hot girl summer. Obesity is increasingly looking more like a hormone disorder (the latest "miracle" weight loss drugs are all hormone-regulating) or an eating disorder of some sort and should be addressed as such.

Personal responsibility is great, but we're all paying for patients with type-2 diabetes (and other lifestyle related chronic conditions). We pay in terms of higher taxes for Medicare/Medicaid, higher premiums for private commercial insurance, and higher charges from providers trying to cover losses from indigent patients who default on medical debt. People are unlikely to suddenly become more responsible so what is your solution?

The optimal amount of helping hands and second chances are greater than zero.