It seems like every episode starts off with their bathing routine. That may be apart of the contract. The viewers want to see how they struggle in bathing, complain about how much they hurt, and then gorge themselves like gluttonous animals. If she gets hosed off on her porch as apart of her morning ritual, then it would seem she's obligated to let them document it in exchange for what I'm guessing is free surgery.  So fuck her. Fats have no dignity anyway, otherwise they wouldn't eat themselves into constant pain, disease, and disability.