After having watched some bits of "My 600-Pound Life", it's been made abundantly clear to me that behind most (if not all) death fats is at least one enabler. So many of the subjects of that show are barely mobile or bedbound, and they have partners, friends, or family members waiting on them hand and foot, bringing them whatever food they want and trying to hide the fact from Dr. Now. I don't see how anyone could get to this level of terrifyingly obese without 'help'. The reasons said enablers have for their behavior ranges from what definitely looks like fat fetishism to simple inability to say no to the death fat's demands and weather their tantrums.
It's sad, because these enablers are effectively assisting someone's slow, painful suicide. It's baffling to me how you could do that to someone you claim to care about. Even worse when they truly drink the Fat Acceptance Kool-Aid and vehemently defend the death fat's behavior as well as their own.