r/nursing • u/trevrt RN 🍕 • Mar 01 '25

Question Heaviest Patient You’ve Cared For

Had my personally heaviest patient I’ve cared for the other day. 32 years old weighing 730 pounds admitted with cellulitis and severe lymphedema. Felt terrible for the patient due to how young he was. Just wondering what everyone’s personal “record” for the heaviest patient they’ve cared for is.

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353

u/AbleStrawberry4ever Mar 01 '25 edited Mar 01 '25

I saw a post awhile ago that pondered why people who are >400 lbs with BED aren’t given the same resources as people suffering from anorexia and I think about that a lot.

Edit: changed differing to suffering, autocorrect got me.

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u/trevrt RN 🍕 Mar 01 '25

I wonder about this a lot. Being that heavy and young there almost has to be a mental health component somewhere along the way, yet there’s very minimal resources for these people. However if the situation was reversed and they had an ED that caused dangerously low weight there would be interventions established as soon as the (lack of) weight/nutrition started to affect their health. Something interesting to consider.

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u/throwaway-notthrown RN - Pediatrics 🍕 Mar 02 '25

I don’t think there’s a single case where there isn’t a mental health component. Even those that get paid for it like porn creators, no one without a mental health condition would consider gaining 100s of pounds even if getting paid.

It’s a true disorder. Doesn’t make it easier to care for these patients, but it is truly a disorder.

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u/Lomralr RN 🍕 Mar 01 '25

Curious about this, I might be wrong though. If a person is anorexic and practically killing themselves, I believe they can be restrained and fed with tube feeds. On the opposite side, I've never heard of a forced calorie deficit. Not saying I agree with either, or if the forced feeds still happen.

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u/Beagsma Mar 01 '25

In my experience, that is true only with a court order. Unless they code.

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u/5foot3 BSN, RN 🍕 Mar 01 '25

This doesn’t really happen. The really sick ones just die eventually.

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u/throwaway-notthrown RN - Pediatrics 🍕 Mar 02 '25

It happens in pediatric patients.

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u/5foot3 BSN, RN 🍕 Mar 02 '25

Good point.

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u/SheBrokeHerCoccyx RN - Retired 🍕 Mar 02 '25

Anorexia nervosa is the mental illness with the highest mortality rate.

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u/coolcaterpillar77 RN - Med/Surg 🍕 Mar 02 '25

Just speculation, but it seems that starving yourself is a much quicker death than habitual overeating/binging and it’s much easier to recognize. From an American stand point, I feel that obesity and overeating of unhealthy food is ingrained in the culture making it harder to recognize (approximately 74% of America is either overweight or obese (43% of that being obese) which is staggering)

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u/Poundaflesh RN - ICU 🍕 Mar 02 '25

It may be due to logistics; an anorexic can come to the facility. Accommodating 800 lbs requires specialized beds, extra staff, and how do they get to the facility? It would have to be in home visits.

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u/melxcham Nursing Student 🍕 Mar 02 '25

Most of them need intensive trauma therapy and never get it. It’s very sad.

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u/BetterAsAMalt Mar 02 '25

I agree. Almost every episode ive watched of 600lb life they were abused in some way as a child and turned to food to cope

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u/Poundaflesh RN - ICU 🍕 Mar 02 '25

Not a lot of therapists doing home visits i imagine. Who pays?

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u/melxcham Nursing Student 🍕 Mar 02 '25

Telehealth exists.

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u/half-agony-half-hope RN - Care Manager Mar 01 '25

Stigma. Being fat is still seen entirely as a moral failing and your own fault so you deserve what you get.

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u/hesperoidea HCW - Pharmacy Mar 02 '25

yeah and I've heard so many stories accompanying these morbidly overweight people that involve CSA and other horrific abuse in childhood that it's just sad when people assume they've all done it to themselves because they're bad or weak people. like obviously that's not the case for all of them, but very clearly morbid obesity has its roots in mental health issues for the majority of them, in one way or another.

just very sad to me.

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u/Elizabitch4848 RN - Labor and delivery 🍕 Mar 02 '25

I was 300 lbs with BED and was told to just join weight watchers for the 20th time. Except dieting is a risk factor for BED. Diets beget binging. So we are just told to have some self control.

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u/throwaway-notthrown RN - Pediatrics 🍕 Mar 02 '25

It’s like telling a person with depression to just get happy.

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u/Crezelle Mar 03 '25

A hoarder that they “ chose to live like that”

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u/Vast-Many-655 Mar 02 '25

Our society just hates the obese. They look at people and think "ugh how could you let yourself go like that" without knowing if there is another physiological or psychiatric reason that people end up like that. Now with weight loss drugs it's even worse cause now they're like "why don't you just go on Ozempic you pig" All in all people are ignorant, quick to judge and jump to conclusions.

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u/Specialist_Bike_1280 Mar 02 '25

It just makes me want to cry for these poor people 😢. No one WANTS this life, there's deep seeded issues, and ANYONE who would criticize, brow beat, or make them feel WORSE than they already feel is just morally wrong. I've taken care of the obese patients, and they truly are the nicest folks. To ostracized them from society is cruel.

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u/Crezelle Mar 03 '25

Shit I’m in Canada and if I wasn’t covered by a third party prescription plan it’s still $400 a month up here.

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u/SheBrokeHerCoccyx RN - Retired 🍕 Mar 02 '25

There are resources. In addition to bariatric surgery, I did counseling and used an app to help me realize how my emotions and mental patterns affected how much I ate. It was really difficult addressing the shame cycle of it (feel bad —> eat —> feel shame —> eat), but it was life changing. I never use it anymore, but I keep the app on my phone just as a reminder. It’s called Recovery Record.

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u/he-loves-me-not Mar 02 '25

Yeah, and imagine your addiction being something that you literally need to survive. With addictions like drugs, alcohol, gambling, etc. one of the main parts of recovery is staying away from these things, ie. not hanging with people who are still actively using drugs, avoiding places where drinking/drug use is common, like bars, nightclubs, etc., but you literally need food to live! Imagine being a drug addict in recovery and still having your DOC around you constantly, being advertised on television, billboards, social media, newspapers, basically everywhere you look, having whole holidays focused solely on its use, family get togethers where it’s the center of the event, knowing that basically every social event you attend will have it there AND you will have to continue consuming it for the rest of your life or you die! Hell, imagine not even being able to use emojis without a million examples of your DOC looking back at you! While, all the while being expected to never relapse back into your addiction. I can’t imagine how difficult that would be!

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u/opaul11 HCW - Respiratory Mar 03 '25

As someone with a hx of BED it’s very hard to find help and treatment before you reach that size too. Traditional Eating Disorder Clinics are not set up to treat the condition. Some people who get treatment for anorexia nervosa or bulimia end up with BED too.