Cause of death: obesity

...but did emotional factors outweigh his physical problems? A 750 pound man dies:

John Keitz, 39, the vastly overweight Dundalk, Md., man who last spring began a physical therapy program, vowing to walk again after his extreme bulk had made him a prisoner of his bed for seven years, died yesterday of complications from an infection in a hospital in Youngstown, Ohio, his wife said.

Charismatic, funny, pugnacious, at times irascible, Keitz used his outsize personality to make friends and partially compensate for his otherwise restricted existence. He cooked and served chicken meals from his bed, played chess with neighborhood kids, 'danced' to rock music by heaving from side to side and used the telephone to stay connected with the outside world.

Life got away from John and Gina Keitz, one day at a time, one calorie at a time.

His wife, Gina, was at his bedside, as she had been steadfastly since he first 'went down' while making the couple a dinner of macaroni and cheese in the summer of 1998, when he weighed about 500 pounds.

Keitz's struggle, profiled in The Washington Post on June 26, provided a glimpse into the brutal and baffling physical and psychological hurdles involved in losing weight. He could not lie on his back because his chest bulk would suffocate him. He long refused to seek help, until, he feared, it might have been too late.

How does a bedbound man cheat on his diet? He was unable to walk for the last seven years of his life, but he cooked chicken dinners from his bed. How was this possible? Someone was enabling him. WAPO is sympathetic, and does not speculate. But clearly, we don't have the full story. Here's more:

Suddenly last week, his health declined dramatically. He was admitted Saturday to St. Elizabeth Health Center with a bacterial infection of undetermined origins that was attacking his organs, said Gina Keitz, 38. He was put on a respirator and a dialysis machine, and his heart would not pump without assistance, she said. It gave out yesterday morning.

A hospital spokeswoman declined to release details. But it is well known that extremely obese people live in a perpetual state of precarious health. The old term for those in Keitz's weight category is no longer politically correct but it may be accurate: "morbidly obese."

"The bodily functions and internal organs are not designed to carry the weight of what John was carrying," French said.

John Keitz grew up in Dundalk, the son of a steelworker at Baltimore's Sparrows Point. He was overweight as a child and became a fighter in response to playground taunting. He developed a lifelong love of cooking and worked in fast-food restaurants. He also briefly taught martial arts and sometimes settled disputes physically, claiming with some pride to have punched out a McDonald's manager who insulted him.

He said he tried any number of diets but came to the fatalistic belief that his body was incapable of losing weight. Some of his friends, however, said he did not heed warning signs and ate often, if not in great quantity at any one time.

"It was horrifying," Keitz said, looking back. "You just give up. You go, 'That's what I'm dealt with.' . . . You can only do what your body wants you to do."

After he became bedridden, one year melted into seven, as Gina sometimes worked more than one job at a time and the couple dealt with life on the edge of poverty and homelessness. Keitz made intermittent attempts to get therapy, but the sessions did not last. The abnormal became routine.

There's a chilling sentence: "The abnormal became routine." When his legs were unable to support his weight, he retreated to bed, and one year became seven. Was it a relief, to be bedridden? No more exhausting efforts to walk. No more staring strangers. And of course, someone was caring for him, feeding him...

This story makes me wonder about my own life. Take a long, hard look, Shrinkette. Where has the abnormal become routine?