Her boyfriend or husband is most likely a fetishist. Why? Because it looks like they are wealthy so they could afford WLS and professional help for her severe eating disorder if they wanted to.
I agree that her husband's a fetishist, but wealthy? Not by a long shot. She's put in a lot more effort at decorating their place than most, but it's all cheap stuff, and the place is a generic shoebox.
She could probably find a way to get WLS paid for, but, as
@Thomas Eugene Paris pointed out, the cost of quality treatment for eating disorders is very high, availability is limited, and not all insurance providers will cover inpatient care. Corissa Enneking, for example, already had over $100,000 in debt even before she got approved for a mortgage loan, and part of it, she claims, is old medical debt from eating disorder treatment (which obviously didn't work) that she had to pay for out-of-pocket, and is still paying for. And, IIRC, Jude Valentin also ended up going all the way to Tennessee for inpatient ED/psych care (which obviously didn't work) sometime during her last couple of years of college, when the real world failed to coddle her and she had a meltdown. Jude's on Medicaid, which I can't imagine paid for it, so I would not be surprised if she or her dad still have outstanding debt from that.
And this lady doesn't seem to want to change anything. Living in that body's got to be terrible, but if she's always been that fat, that's her normal, and she has no inkling how terrible it is. Plus, she has a willing enabler and caretaker, no kids, and no other obvious responsibilities that would provide external motivation to change. So unless she discovers an internal motivation to do it, this is just how she's going to live her life, even as it kills herāwhich, IMO, is sad, because unlike our regular cows, she seems genuine, and is kind of funny.