Lisa Markwell: Don't judge addicts. Treat them

The idea of a chair collapsing under one, or thighs spilling over on to the neighbouring economy seat on a plane, is enough to terrify most of us. Ditto that mortifying moment in a changing room when the zip won't close on a size-medium dress. Nothing says "time to cut back on the cakes" like a bit of public humiliation.

So what are we to make of Paul Mason? This week we learned that Mason, who weighs 70 stone, requires a life-saving operation and the options for taking him to hospital include a Chinook helicopter and a specially adapted five-ton ambulance.

It makes for uneasy reading – a bed-ridden 48-year-old who requires full-time helpers, with the undesirable title of the Heaviest Man in Britain, eating three family-sized takeaway meals a day and slowly, surely, heading for an early grave.

He must know humiliation well: in 2002, the last time he required medical treatment, massed firemen and a forklift truck got him out of bed and into hospital. The curtains around Ipswich must have been twitching overtime.

Mason lost weight after that, but, according to new reports, he didn't want to be slimmer (less fat?) so he continued to eat his unhealthy, calorie-laden meals and became super-morbidly obese – enough so to miss his mother's funeral six weeks ago. So perhaps he doesn't care that his condition is being scrutinised, his entitlement to surgery and benefits debated. Perhaps he is beyond humiliation. He must have given permission for photographs of himself in his adapted bed to be published this week.

If he wishes to become the World's Fattest Man, as reported in sections of the press, he will continue to eat as much after his gastric band surgery as before, and the intervention won't have been either helpful to him, or a good use of NHS funds.

I don't begrudge him getting medical and psychological help – he is costing us far less than a long-term in-patient would and no one would complain about a chronic anorexic receiving healthcare. But it would be instructive both for him and us to try to understand this strand of obesity – not medically predetermined, or the result of hormonal imbalance, just eating far too much, for far too long.

What he doesn't need is the kind of pat advice the latest celebrity guru Mel B told a family last night as part of the Seven Days on the Breadline documentary. She promised the unhealthy, overweight parents that she would pay for their gym membership, as if that would solve everything.

It says something about us that we feel comfortable in – at the least – passing judgement on the obese, and – at the worst – pointing and laughing (or even assaulting, as in the case of overweight London woman Marsha Coupe, attacked on a train. Ms Coupe is now campaigning to have discrimination against individuals based on their size made illegal).

As we know all too well, legislation doesn't prevent cruelty or bigotry. But anything that helps us to look beyond Paul Mason's pies and concentrate instead on his psychological state is a good thing. Addiction is a disease and he, it seems, has got it.

l.markwell@independent.co.uk