Just cutoff all support for them. I recently heard Japan doesn't allow fatties to have government benefits. If you have enough money to overeat, then you clearly don't need assistance and/or don't deserve it until you are able to prioritize your needs. No Medicaid, ebt, disability, section 8, etc. for any obese person over 30 bmi. If necessary remove the kids from the home of the parents are unable to support them without gov't support. I'm all for social safety nets for people that fall on tough times, but lazy groups like fats freeroding on the system makes everyone less willing to have their hard earned tax dollars fund other people's poor decisions, work ethic or lifestyle. A few of my good friends are Dr's and they can't stress enough the strain these people put on the Healthcare system. Elimating free care for this group would be a significant step towards making Healthcare affordable again, regardless of how you feel about single payer.  There has to be at least some shred of personal responsibility in a functioning society and many groups today would rather milk the system, make and excuses and throw around blame than do anything to improve their situation.