Well, I sure hope this guy doesn't smoke. He will certainly get double whammed!
Where on earth did you get that picture? I always feel sad in a way when I see people like that - I think a lot of it is their own doing (some are set up for it by childhood obesity) but I have compassion for them. I have a friend (non-smoker) who was enormous - couldn't even walk - she did gastric bypass. She's had some complications from the bypass but I suppose death would've been an even greater complication and she was on that road had she not had bypass.