Yeah, I've got tons (pun intended) of relatives (cousins, aunts and uncles) in exactly the same boat as your friend! They're grossly overweight, diabetic, and unhealthy.

They've all seen my success with losing weight and my husband's success with both losing weight and getting his T2 under perfect control. But even tho, for the most part, my relatives pay their own health insurance premiums, they always want to get their doctors' approvals first.

Being diabetic costs them directly bu they're still afraid of changing their diets without their doctors' approval. They've all been deeply conditioned to believe that "doctor knows best."

Their doctors (mostly aging, small-town docs who care about their patients but haven't the time or energy to keep up with the latest research0 instantly phoo-phoo LC as a "dangerous fad diet," give them the standard "go/stay low-fat, cut salt intake, eat-less and exercise more" advice and send them out the door with another Rx for their latest ailment.

Makes me sad and ANGRY... but at least THEIR health problems don't affect the quality of MY life on a daily basis.

You are a kind and amazingly generous person to put your life on hold to take care of your friend's family every time he goes into hospital. Kudos to you. BUT, have you considered what is going to happen to his family when his diabetes and health complications kill him? At 400 lbs it is very unlikely that he will live out a normal life span!

Unless you want to spend the remainder of your life taking care of his family, you may need to INSIST that he make some sort of change and very soon. At least insist that someone else in his family learn to drive AND that he purchase a significant amount of life insurance to take care of his family after he dies. And believe me, as a 400 lb diabetic, he's going to find life insurance premiums are extremely expensive!

I'm hoping that having the UK National Health Service give the green light on low-carb will eventually have a domino effect that will get the small-town doctors that my aunts/uncles/cousins go to finally see the light. Until my family members' own doctors say "low-carb is okay," my aunts/uncles/cousins are going to keep on suffering with diabetes and dying younger than they should.

Suspect the same is true for you friend.