I think that's my biggest problem with people "achieving" (and I use the term loosely) this kind of weight. AT some point, someone has enabled them to do so. When it gets to the point that the person is so overweight that he or she cannot leave the house - cannot stand up - cannot care for him/herself, someone is taking over those responsibilities and continuing to provide food in unhealthy quantities.
While I think anyone who gets to the point that they can't move bears some responsibility for saying "hey, I have a problem here", the people who continue to enable them past that point are being criminally negligent. I do think that criminal charges should be pressed against people who contribute to someone who is in this kind of situation.