He is on a weight loss ward, I believe. There should be no food carts and no family visits either, so that they don't have people bringing them food. Then just lock them in around the clock, except for PT and carefully controlled meals.  They should also be informed that, should they choose to discontinue treatment, then they will not be able to receive treatment for any other conditions ever again (unless they lose the weight). The thing that gets me is they are sending the super obese guy who PROBABLY won't succeed in fixing his shit. They should be sending someone else who is only a little overweight and isn't so far gone. Once someone makes it past BMI 25, they go to the weight loss clinic until they are back down and in good shape or they lose all access to health care. Screen everyone at their yearly physical and checkup, and if they refuse to get the yearly checkup, then they are denied all medical treatment for the year.