Weight problems, when it considerably limits a person’s skill to carry out fundamental work actions, might qualify as a disabling situation underneath sure applications. Eligibility and cost quantities for incapacity advantages associated to such a situation are complicated and depend upon numerous elements. These elements can embrace the particular program (Social Safety Incapacity Insurance coverage or Supplemental Safety Earnings, as an example), the severity of the situation’s affect on day by day life and work capabilities, documented medical proof, and the person’s work historical past and earnings.
Securing monetary help via incapacity applications may be essential for people whose well being circumstances forestall them from incomes a residing. These applications function a security internet, enabling people to satisfy fundamental wants whereas addressing their well being challenges. Traditionally, the understanding and recognition of weight problems as a probably disabling situation have advanced, resulting in higher consideration of its affect on a person’s skill to work. This evolution underscores the significance of searching for skilled medical and authorized steerage to navigate the complexities of the appliance course of.
The next sections will delve deeper into the particular necessities and processes concerned in making use of for incapacity advantages associated to limitations attributable to extreme weight problems. This can embrace a dialogue of the medical analysis course of, the required documentation, and the potential appeals course of. Data relating to out there sources and help companies may also be supplied.
1. Severity of Practical Limitations
The severity of purposeful limitations attributable to weight problems performs a essential position in figuring out eligibility for incapacity advantages and the potential cost quantity. Profit applications deal with a person’s capability to carry out work-related actions, and the extent to which weight problems impairs this capability is a central consideration. A transparent understanding of those limitations and their affect is essential for navigating the appliance course of.
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Bodily Limitations:
Bodily limitations ensuing from weight problems can embrace restricted mobility, issue with extended standing or sitting, decreased stamina, and challenges with lifting, carrying, or manipulating objects. For instance, a person might battle to carry out duties requiring bending, stooping, or reaching. These limitations can considerably affect a person’s skill to interact in substantial gainful exercise.
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Respiratory and Cardiovascular Impairment:
Weight problems can contribute to respiratory and cardiovascular circumstances, equivalent to sleep apnea, shortness of breath, and hypertension. These impairments can additional restrict a person’s skill to carry out bodily duties and should necessitate frequent breaks or restrict the forms of work environments they’ll tolerate. As an example, a person with sleep apnea might expertise extreme daytime sleepiness, impacting their skill to pay attention and carry out duties safely.
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Psychological Well being Impacts:
Weight problems may be related to psychological well being circumstances like despair and nervousness, which may additional compound purposeful limitations. These circumstances can have an effect on focus, motivation, and social interplay, additional impacting a person’s skill to take care of employment. For instance, a person battling despair might expertise issue with attendance, punctuality, and finishing work duties.
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Impression on Each day Residing:
The severity of purposeful limitations can also be assessed based mostly on how weight problems impacts a person’s skill to carry out actions of day by day residing. Difficulties with private care, meal preparation, family chores, and unbiased mobility can additional display the extent to which weight problems impairs a person’s general functioning. As an example, a person who struggles to decorate or bathe independently might require help, additional highlighting the affect of their situation.
The cumulative affect of those purposeful limitations straight influences the willpower of incapacity. A complete evaluation considers the mixed results of bodily, respiratory, cardiovascular, and psychological well being impairments on a person’s capability to carry out work-related actions. The extra extreme and pervasive the restrictions, the higher the probability of qualifying for incapacity advantages and probably receiving the next cost quantity. Documenting these limitations clearly and totally is important for a profitable software.
2. Medical Documentation
Medical documentation serves as a cornerstone of incapacity claims associated to weight problems. The power and comprehensiveness of this documentation straight affect the result of the appliance course of. It supplies goal proof of the severity of the situation and its affect on a person’s skill to perform, forming the idea for figuring out eligibility and potential profit quantities.
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Diagnostic Information:
Diagnostic information play a significant position in establishing the presence and severity of weight problems. These information might embrace physique mass index (BMI) calculations, waist circumference measurements, and outcomes from imaging research or different related exams. A constant historical past of excessive BMI and related well being circumstances strengthens the declare. For instance, documentation of a BMI persistently above 40, coupled with information of makes an attempt at weight reduction interventions, supplies substantial proof of the situation’s chronicity and affect.
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Doctor’s Statements:
Detailed statements from treating physicians are essential for outlining the purposeful limitations imposed by weight problems. These statements ought to describe the particular methods through which the situation restricts a person’s bodily skills, respiratory perform, cardiovascular well being, and psychological well-being. Particular examples of limitations in day by day actions and work-related duties needs to be included. A doctor’s assertion detailing a person’s incapacity to face for greater than quarter-hour as a result of ache and shortness of breath, for instance, affords concrete proof of purposeful limitations.
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Therapy Historical past:
A complete file of therapy historical past demonstrates a person’s ongoing efforts to handle their weight problems and its related well being issues. This file ought to embrace particulars of dietary modifications, train applications, drugs, weight reduction surgical procedures, and some other interventions undertaken. Proof of constant engagement in therapy, even when unsuccessful in attaining important weight reduction, demonstrates a dedication to addressing the situation and its affect. As an example, documented participation in medically supervised weight reduction applications, coupled with information of prescribed drugs and remedy classes for associated psychological well being circumstances, strengthens the declare by demonstrating proactive engagement in managing the situation.
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Information of Different Impairments:
Documentation of coexisting medical circumstances, equivalent to diabetes, hypertension, sleep apnea, or joint ache, is essential for demonstrating the cumulative affect of weight problems on general well being and purposeful capability. These information assist set up the interconnectedness of those circumstances and their mixed impact on a person’s skill to work. For instance, medical information documenting diabetic neuropathy within the toes, exacerbated by weight problems, additional illustrate the severity of purposeful limitations and their affect on day by day life and work actions.
The cumulative weight of this medical documentation types a complete image of the person’s situation. It supplies the adjudicator with the required data to evaluate the severity of purposeful limitations and decide the person’s eligibility for incapacity advantages associated to weight problems. A well-documented declare, supported by sturdy medical proof, considerably will increase the probability of a good end result. This underscores the essential significance of meticulous record-keeping and collaboration with healthcare suppliers to make sure a whole and correct illustration of the person’s well being standing and its affect on their skill to work.
3. Work Historical past
Work historical past performs a major position in figuring out eligibility and profit quantities for incapacity applications, notably Social Safety Incapacity Insurance coverage (SSDI). SSDI is an insurance coverage program funded via payroll taxes, and advantages are calculated based mostly on a person’s earnings file. Understanding the connection between work historical past and incapacity advantages associated to weight problems is important for people searching for monetary help as a result of extreme obesity-related limitations.
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Current Work Historical past:
Current work historical past is an important think about SSDI eligibility. The Social Safety Administration (SSA) makes use of a system of labor credit to find out eligibility. People typically want a sure variety of work credit inside a current timeframe to qualify for SSDI. The required variety of credit relies on the person’s age on the time of incapacity onset. For instance, somebody who turns into disabled at age 31 might have 20 work credit earned inside the previous 10 years, with no less than six of these credit earned within the final three years. A constant and substantial current work historical past strengthens an SSDI declare.
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Whole Earnings:
Whole profession earnings affect the quantity of SSDI advantages a person might obtain. The SSA calculates advantages based mostly on common listed month-to-month earnings (AIME). Increased earnings over an extended interval typically lead to greater AIME and consequently greater SSDI funds. Whereas weight problems itself doesn’t straight have an effect on earnings calculations, the size and consistency of employment, influenced by a person’s skill to work, straight affect potential profit quantities.
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Impression of Weight problems on Work Historical past:
Extreme weight problems can considerably affect a person’s skill to take care of constant employment. Practical limitations attributable to weight problems can result in job loss, decreased work hours, or an incapacity to safe employment within the first place. This disruption in work historical past can have an effect on eligibility for SSDI, notably if the person has not amassed ample work credit as a result of obesity-related limitations. For instance, a person who experiences frequent job losses as a result of obesity-related mobility points or different limitations might have gaps of their work historical past, probably affecting their skill to satisfy the work credit score necessities for SSDI.
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Supplemental Safety Earnings (SSI) Concerns:
For people with restricted or no work historical past, Supplemental Safety Earnings (SSI) could also be an alternate. SSI is a needs-based program for people with restricted revenue and sources. Work historical past is much less essential for SSI eligibility than for SSDI. Nonetheless, the severity of purposeful limitations attributable to weight problems stays a central think about figuring out eligibility for SSI. For instance, a person with minimal work historical past however extreme obesity-related limitations stopping them from performing even fundamental work actions may qualify for SSI based mostly on their medical situation and monetary want.
The interaction between work historical past and incapacity advantages for obesity-related limitations is complicated. A powerful work historical past typically strengthens an SSDI declare, whereas SSI supplies an alternate for these with restricted work historical past. Nonetheless, the severity of purposeful limitations stays the first figuring out think about each applications. Understanding these nuances is essential for people searching for incapacity advantages associated to weight problems, and searching for steerage from authorized and medical professionals will help navigate the appliance course of successfully.
4. Particular Program (SSDI/SSI)
The precise incapacity programSocial Safety Incapacity Insurance coverage (SSDI) or Supplemental Safety Earnings (SSI)performs a essential position in figuring out eligibility and profit quantities associated to weight problems. Each applications administer incapacity advantages, however they differ considerably of their eligibility necessities and funding mechanisms. Understanding these variations is important for people searching for monetary help as a result of obesity-related limitations.
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Social Safety Incapacity Insurance coverage (SSDI):
SSDI is an insurance coverage program funded via payroll taxes. Eligibility for SSDI is based on a person’s work historical past and the severity of their incapacity. Candidates should have earned ample work credit to qualify. Profit quantities are calculated based mostly on common listed month-to-month earnings (AIME), reflecting the person’s prior earnings. Within the context of weight problems, candidates should display that their situation considerably limits their skill to interact in substantial gainful exercise. The quantity of the profit is not straight decided by weight problems, however reasonably by the applicant’s work historical past and earnings.
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Supplemental Safety Earnings (SSI):
SSI is a needs-based program funded via normal tax revenues. Eligibility for SSI relies on monetary want and the severity of the incapacity. Work historical past is much less essential for SSI eligibility, though it could be thought of. Profit quantities are decided by federal and state pointers, with a most federal profit quantity. For people with weight problems, SSI eligibility hinges on demonstrating that the situation considerably limits their skill to carry out fundamental work actions, even sedentary ones. The profit quantity will not be straight tied to the weight problems itself however is topic to revenue and useful resource limitations.
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Assembly the Incapacity Definition:
No matter whether or not a person applies for SSDI or SSI, they need to meet the Social Safety Administration’s definition of incapacity. This requires demonstrating a medically determinable bodily or psychological impairment that’s anticipated to final no less than 12 months or lead to loss of life, and which prevents the person from participating in substantial gainful exercise (SGA). For weight problems, this implies offering complete medical proof demonstrating the severity of purposeful limitations ensuing from the situation and the way these limitations forestall substantial work. The definition does not particularly point out weight problems as a standalone qualifying situation, however reasonably focuses on the purposeful limitations it imposes.
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Mixed SSDI/SSI:
In some instances, people might qualify for each SSDI and SSI. This will happen when a person meets the medical standards for incapacity and has a restricted work historical past leading to low SSDI advantages that fall under the federal SSI profit charge. In such instances, SSI can complement the SSDI funds to make sure a minimal degree of revenue. For people with obesity-related disabilities, this mixed method might present extra complete monetary help, particularly if their work historical past has been affected by the situation.
The selection between SSDI and SSI relies on a person’s work historical past, monetary sources, and the severity of their obesity-related limitations. Understanding the nuances of every program is essential for navigating the appliance course of successfully. The quantity of incapacity advantages acquired is not straight decided by the prognosis of weight problems itself, however reasonably by the affect of the situation on the person’s skill to work, coupled with their work historical past (for SSDI) or monetary want (for SSI).
5. State Laws
State rules can affect the incapacity panorama, notably regarding Supplemental Safety Earnings (SSI). Whereas the Social Safety Administration (SSA) oversees the federal SSI program, states have the choice to complement these federal funds. This creates variability throughout the nation relating to whole SSI profit quantities and may affect how obesity-related disabilities are assessed inside particular state contexts.
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SSI Dietary supplements:
States can select to complement federal SSI funds, resulting in variations in whole profit quantities. These dietary supplements are decided by particular person state legislatures and may differ considerably. A person receiving SSI in a state with a beneficiant complement might obtain the next whole profit than somebody with the identical degree of incapacity residing in a state with out a complement or with a smaller one. This variability is unbiased of the weight problems itself however can considerably affect the general monetary help out there to people with obesity-related limitations.
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State Incapacity Applications:
Along with federal applications, some states function their very own incapacity applications. These applications might have completely different eligibility standards and profit constructions than SSDI and SSI. Whereas these applications are separate from the federal system, they’ll present extra avenues of help for people whose obesity-related limitations forestall them from working. Understanding these state-specific applications is important for people searching for complete help.
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Medicaid Eligibility:
Medicaid, a joint federal and state program, supplies healthcare protection to low-income people and households. Incapacity standing, together with incapacity associated to weight problems, can affect Medicaid eligibility. States have flexibility in figuring out particular Medicaid eligibility standards inside federal pointers. This interaction between incapacity advantages and Medicaid eligibility can affect a person’s entry to healthcare companies wanted to handle weight problems and its associated well being issues.
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Value of Residing Changes:
State-level value of residing variations can not directly affect the effectiveness of incapacity advantages. Whereas federal SSI advantages are adjusted yearly for inflation, the precise buying energy of those advantages can differ considerably based mostly on the place a person lives. In states with greater residing prices, the mounted federal SSI profit, even with state dietary supplements, might not adequately cowl fundamental wants for people with obesity-related disabilities. This highlights the significance of contemplating regional financial elements when assessing the general affect of incapacity advantages.
Understanding the affect of state rules is essential for people searching for incapacity advantages associated to weight problems. State dietary supplements, state-specific applications, Medicaid eligibility guidelines, and regional value of residing variations all contribute to a fancy panorama. Navigating these complexities typically requires contemplating each federal and state-specific sources and rules, underscoring the necessity for knowledgeable decision-making and searching for steerage from certified professionals.
6. Particular person Circumstances
Particular person circumstances play a major position in figuring out eligibility for incapacity advantages associated to weight problems and the potential quantity of economic help acquired. Whereas normal pointers exist, the particular affect of weight problems on a person’s skill to work and their general purposeful capability varies enormously. Due to this fact, an intensive evaluation of particular person circumstances is essential for precisely evaluating incapacity claims.
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Age:
Age is a major think about incapacity determinations. Weight problems’s affect on bodily perform may be exacerbated by age-related decline. An older particular person with weight problems might expertise extra extreme limitations in mobility, stamina, and general bodily capability in comparison with a youthful particular person with the same BMI. This interaction between age and weight problems is taken into account when evaluating purposeful limitations and figuring out eligibility for advantages.
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Different Well being Circumstances:
Coexisting medical circumstances can compound the purposeful limitations imposed by weight problems. Circumstances equivalent to diabetes, hypertension, sleep apnea, and osteoarthritis can work together with weight problems, making a extra complicated and debilitating well being state of affairs. The presence of those comorbidities is taken into account when assessing the general affect on a person’s skill to work. For instance, a person with weight problems and extreme arthritis might expertise considerably higher limitations in mobility and day by day functioning in comparison with somebody with weight problems alone.
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Schooling and Ability Stage:
A person’s training and ability degree affect their vocational choices. Somebody with superior training or specialised expertise might have a wider vary of potential job alternatives, even with obesity-related limitations. Conversely, somebody with restricted training or expertise might face higher challenges find appropriate employment that accommodates their bodily limitations. This issue is taken into account when assessing a person’s residual purposeful capability (RFC) and figuring out their skill to interact in substantial gainful exercise (SGA).
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Residing State of affairs and Help System:
A person’s residing state of affairs and help system can considerably affect their skill to handle day by day actions and take part in work or work-related actions. Entry to transportation, help with family chores, and the provision of private care help can affect a person’s general purposeful capability. For instance, a person with weight problems residing in a supportive atmosphere with accessible transportation and help with day by day duties might expertise fewer limitations in comparison with somebody residing in isolation with out ample help.
These particular person circumstances, mixed with the particular purposeful limitations imposed by weight problems, contribute to a complete understanding of a person’s incapacity declare. The Social Safety Administration (SSA) considers these elements when evaluating eligibility for incapacity advantages and figuring out the suitable degree of economic help. Due to this fact, offering detailed and correct details about particular person circumstances is important for a profitable declare. The individualized nature of incapacity determinations underscores the significance of searching for skilled steerage to navigate the appliance course of successfully.
7. Assembly Particular Standards
Eligibility for incapacity advantages associated to weight problems hinges on assembly particular standards established by the Social Safety Administration (SSA). These standards are designed to make sure that advantages are supplied to people whose circumstances genuinely forestall them from participating in substantial gainful exercise. Assembly these standards is important for a profitable declare, whatever the particular programSocial Safety Incapacity Insurance coverage (SSDI) or Supplemental Safety Earnings (SSI)underneath which a person applies. The quantity of advantages acquired is not decided by the weight problems prognosis itself, however reasonably by how the situation, at the side of different elements, impacts the flexibility to work.
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The SSA Definition of Incapacity:
The SSA defines incapacity as the shortcoming to interact in any substantial gainful exercise (SGA) by motive of any medically determinable bodily or psychological impairment which may be anticipated to lead to loss of life or which has lasted or may be anticipated to final for a steady interval of not lower than 12 months. Weight problems, whereas not a listed impairment in itself, can result in different impairments, equivalent to heart problems or musculoskeletal issues, that meet this definition. The bottom line is demonstrating how obesity-related impairments forestall substantial work.
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Medical Itemizing of Impairments:
The SSA maintains a “Itemizing of Impairments,” which describes particular medical circumstances and their severity ranges that mechanically qualify a person for incapacity advantages. Whereas weight problems itself will not be a listed impairment, associated circumstances like coronary heart illness, respiratory issues, or musculoskeletal issues could also be listed. If a person’s obesity-related impairments meet or equal the factors of a listed impairment, they could qualify for advantages extra shortly. Even when the itemizing is not met, purposeful limitations ensuing from weight problems can nonetheless qualify a person for advantages.
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Residual Practical Capability (RFC):
If a person’s impairments don’t meet or equal an inventory, the SSA assesses their residual purposeful capability (RFC). RFC is what a person can nonetheless do regardless of their limitations. This evaluation considers bodily, psychological, and sensory limitations. Within the context of weight problems, the RFC evaluation would take into account the person’s skill to elevate, carry, stand, stroll, sit, and carry out different work-related actions, taking into consideration the affect of weight problems and any associated impairments. The RFC willpower is essential for evaluating whether or not appropriate work exists that the person can carry out.
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Vocational Concerns:
After figuring out a person’s RFC, the SSA considers vocational elements, equivalent to age, training, and work expertise, to find out whether or not the person can regulate to different work. If the SSA finds that a person can’t carry out their previous related work or some other work present in important numbers within the nationwide financial system as a result of their obesity-related limitations, they’re thought of disabled and eligible for advantages.
Assembly these particular standards is paramount for acquiring incapacity advantages associated to weight problems. The SSA focuses on the purposeful limitations ensuing from the situation and the way these limitations forestall a person from working. The quantity of advantages will not be tied to the weight problems prognosis itself however is calculated based mostly on elements like work historical past (for SSDI) or monetary want (for SSI). Due to this fact, a complete analysis of the person’s medical situation, purposeful limitations, and vocational profile is essential for a profitable declare. The absence of a particular itemizing for weight problems underscores the significance of totally documenting the purposeful limitations stemming from the situation and its associated impairments.
Incessantly Requested Questions
This part addresses widespread inquiries relating to incapacity advantages and weight problems, offering concise and informative responses.
Query 1: Does a prognosis of weight problems mechanically qualify one for incapacity advantages?
No. Advantages are awarded based mostly on purposeful limitations, not diagnoses. The severity of limitations attributable to weight problems, and the way they affect the flexibility to work, is the figuring out issue.
Query 2: How is the severity of obesity-related limitations assessed?
The Social Safety Administration (SSA) assesses limitations via medical information, doctor statements, and generally consultative examinations. Proof ought to doc the affect of weight problems on day by day actions and work-related capabilities.
Query 3: What sort of medical documentation is required for a incapacity declare associated to weight problems?
Complete medical information are important. These ought to embrace diagnostic information confirming weight problems, doctor statements detailing purposeful limitations, therapy historical past demonstrating efforts to handle the situation, and information of any associated impairments.
Query 4: If one qualifies for incapacity as a result of obesity-related limitations, how are profit quantities decided?
For Social Safety Incapacity Insurance coverage (SSDI), advantages are calculated based mostly on common listed month-to-month earnings. For Supplemental Safety Earnings (SSI), profit quantities are decided by federal and state pointers, topic to revenue and useful resource limitations.
Query 5: How does work historical past have an effect on eligibility for incapacity advantages associated to weight problems?
Work historical past is essential for SSDI eligibility. Candidates should have earned ample work credit. SSI is needs-based, so work historical past is much less essential, although nonetheless thought of. The severity of purposeful limitations stays a major think about each applications.
Query 6: The place can one discover extra data and help relating to incapacity claims associated to weight problems?
The Social Safety Administration (SSA) web site is a major useful resource. Consultations with incapacity legal professionals or advocates may present useful steerage particular to particular person circumstances.
Understanding these key features of incapacity advantages associated to weight problems can facilitate knowledgeable decision-making. Looking for skilled steerage is advisable for navigating the appliance course of successfully.
The following sections will element the appliance course of, the appeals course of if a declare is denied, and sources out there to these searching for help.
Ideas for Navigating Incapacity Claims Associated to Weight problems
Navigating the incapacity declare course of may be complicated. The following pointers supply steerage for people searching for advantages associated to obesity-induced limitations.
Tip 1: Seek the advice of with medical professionals:
Open communication with healthcare suppliers is essential. Guarantee thorough documentation of obesity-related well being circumstances, purposeful limitations, and therapy historical past. Detailed medical information are important for substantiating a declare.
Tip 2: Keep organized information:
Manage all medical information, doctor statements, therapy histories, and communications associated to the declare. A well-organized file system facilitates environment friendly processing and ensures all mandatory documentation is available.
Tip 3: Search authorized counsel:
Navigating the authorized complexities of incapacity claims may be difficult. Consulting with a incapacity lawyer or advocate can present useful steerage and guarantee correct illustration all through the method. Authorized professionals will help collect mandatory documentation, full software types, and symbolize claimants throughout appeals, if mandatory.
Tip 4: Perceive eligibility standards:
Totally analysis the particular eligibility standards for SSDI or SSI. Understanding the necessities, equivalent to work historical past for SSDI or revenue limitations for SSI, is important for a profitable declare. Being conscious of the factors helps candidates put together adequately and keep away from potential pitfalls.
Tip 5: Be ready for a prolonged course of:
Incapacity claims can take time. Gathering medical proof, finishing software types, and present process the overview course of may be prolonged. Candidates needs to be ready for potential delays and preserve constant communication with the SSA all through the method.
Tip 6: Take into account vocational rehabilitation companies:
Vocational rehabilitation companies can help people with discovering employment that accommodates their limitations. These companies may be useful, even when a incapacity declare is denied or whereas the declare is pending. Exploring vocational choices can enhance general well-being and probably scale back reliance on incapacity advantages.
Tip 7: Do not hesitate to enchantment a denial:
If a incapacity declare is denied, people have the fitting to enchantment. Many claims are initially denied, and interesting a denial may be profitable. Looking for authorized counsel throughout the appeals course of is very advisable.
Following the following pointers can considerably enhance the probability of a profitable incapacity declare associated to weight problems. Thorough preparation, skilled steerage, and a complete understanding of the method are essential for navigating this complicated panorama successfully.
The next part will conclude this exploration of incapacity advantages and weight problems, summarizing key takeaways and providing remaining suggestions.
Conclusion
The exploration of incapacity advantages associated to weight problems reveals a fancy panorama. Eligibility hinges not on the prognosis itself, however on the demonstrable and important purposeful limitations imposed by the situation. Navigating this course of requires an intensive understanding of each Social Safety Incapacity Insurance coverage (SSDI) and Supplemental Safety Earnings (SSI), their distinct eligibility standards, and the significance of strong medical documentation. Moreover, particular person circumstances, equivalent to age, different well being circumstances, and vocational background, contribute considerably to the evaluation course of. The quantity of incapacity advantages acquired will not be straight decided by an weight problems prognosis however is calculated based mostly on elements like work historical past (for SSDI) or monetary want (for SSI), reflecting the individualized nature of those applications.
Looking for skilled steerage from medical and authorized consultants is essential for successfully navigating the complexities inherent in incapacity claims associated to weight problems. This help can empower people to know their choices, compile mandatory documentation, and advocate successfully for his or her wants. In the end, securing incapacity advantages can present important monetary help, enabling people to deal with their well being challenges and preserve a fundamental lifestyle whereas navigating the restrictions imposed by extreme weight problems.
