If you watch "My 600-lb Life" you probably have a lot of questions. You wonder how the heck people like 850-lb Steven Assanti and 900-lb Sean Milliken got so overweight. You can't fathom why caregivers would wipe butts and clean bedpans while overfeeding them. Are they just nice people or is there some sick pathology behind the caregiving? The reality TV show explores weight-loss fails and links obesity to enabling, codependency, and even, in some cases, Munchausen Syndrome by Proxy.

Obesity vs. Enabling

The morbidly obese may beat the battle of the bulge, but they'll never win the war on obesity so long as they have enabling caregivers.

To get a person to 800 pounds requires a plus-size support team and not the good kind. TLC's "My 600-lb Life" shows families taking care many steps too far. They encourage weight gain by buying, cooking and serving high-calorie junk food. They keep the person bedridden by doing everything for them and expecting nothing. Reality TV viewers shake their heads as enablers let them lay around, burn no calories and still get fed.

Food addiction and codependency

Enablers discourage weight-loss by making it so easy to live a sedentary life of overconsumption. That's the Herculean task Dr. Younan Nowzaradan faces -- to teach loved ones the dangers of caregiving and make the overweight person want to work for gastric bypass surgery.

Who wouldn't want to lose weight? A better question is who would want bariatric surgery when he or she has it so easy? How does caregiver stand waiting on someone? Goodness knows it's a thankless job: just ask James K's girlfriend and daughter, or Steven Assanti's dad, or Sean Milliken's mother. These people are codependent and not just to food addiction.

"My 600-lb Life" patients are mostly manipulative control freaks addicted to power. Assanti and others are prescription opioid junkies.

Munchausen Syndrome by Proxy

Whoa, you're thinking, enabling sure, codependent maybe, but Munchausen? Isn't that a bit extreme? Munchausen Syndrome and MBSP (Munchausen syndrome by proxy) conjure up creepy images of exhibitionists faking illness and saline-poisoning moms.

But it's not just the parent who feeds her kid Drain-O for attention. It's parents who overfeed their overweight kids until they become incapacitated adults like Sean and Steven. Instead of Pine-Sol in the soup, it's junk food. Case in point is morbidly obese Jennifer Lamb of "Mama June: From Not to Hot." She literally force-fed her overweight stepdaughter "Honey Boo Boo" sweets to sabotage the child's health. "My 600-lb Life" patients admit to using obesity to get drugs, sympathy and control. Are they addicted to attention and crave it as much as food? Do their caregivers enjoy the notoriety having a 900-lb relative brings?