Progress

In FatLand, anyone desiring the equivalent of Hospice Care receives it. But so much progress has been made in improving outcomes of diseases and illnesses that formerly led to this state that very few people now need such care. People who would formerly have been confined to their beds receive therapies targeted to their conditions, especially but not only the Mondo Sized on whom OtherSide/USA doctors often gave up.

Of course there are way fewer Mondo Sized people than there were a generation ago in FatLand. Why? Well, people are not put on diets, which turned out to be one of the quickest ways to gain weight. People are not harassed when they move or participate in athletic activities or simply take a walk. People eat Kwhat they like, so they don't develop eating disorders which cause their weight to yo yo or spiral up. And no one is told that they cannot have x food or that s/he must eat y food, or must eat 12 servings a day of z food.

Kind of like the best kind of urban planning:  Let people do as they wish and build as they wish, but be prepared to help them along, and make sure that no one tendency or fashion or building group accumulates too much power.