Paul Mason, Addict 1

Formerly Fat, Latterly Lapsed 1” and the three subsequent posts trace the journey of the (previously) world’s fattest man from England to the USA and back to his homeland. In the Diagnostic and Statistical Manual of Mental Disorders, addiction criteria are grouped into four major areas: physical dependence, risky use, social problems, and impaired control. We will be checking in with them along the way.

In the early 1980s, Paul Mason had been romantically disappointed. He later told reporter Justin Heckert that his love affair with food started then:

It hit the back of your throat, and you’ve got that endorphin that’s released in your brain and that makes you feel good. I began to be just like a drunk.

In the late 1980s, before becoming housebound and famous for being fat, Mason worked for the British postal service, fed his gargantuan appetite by stealing cash from customers’ envelopes, and went to prison for a year. This is known as “Not managing to do what you should at work, home, or school because of substance use” and also, “Using substances again and again, even when it puts you in danger.” Locked up, he conducted himself with an addict’s ingenuity, trading bribes and favors for extra food.

His father died; he moved back in with his mother, and his dedication to eating began in earnest. He lived in bed, alternately eating and napping. Assistants were required to help with his elimination needs, and an expensive machine was needed to raise his body from the bed for cleaning and sheet changing. This would come under the diagnostic heading of “Giving up important social, occupational, or recreational activities because of substance use,” “Spending a lot of time getting, using, or recovering from use of the substance,” and several other criteria.

Writer Sarah Lyall later quoted him:

Food was an escape for me. It was like going to a different world, where you felt comfort.

Mason told the reporter that during that time he thought about literally nothing else except his next meal. He remortgaged his mother’s house to pay for his ever-increasing consumption of food, and lost the respect of his sisters. From the list, “Continuing to use, even when it causes problems in relationships.”

Eventually, a tabloid publication titled a piece about him, “The Man Who Ate His House.” Except, it wasn’t even his. Playing fast and loose with the money and property of others — even the closest loved ones — is a classic hallmark of addiction.

In 2017, Mason described to Heckert the condition he had been in almost 15 years earlier, when he had only weighed 800 pounds:

“I had a waistline of eight feet,” he said. “I was permanently lying down. I was six foot four, so my stomach was wider than I was high. I was in a bubble. I let all my dignity go; I just didn’t care. I was focused on food. That one thing.”

That lack of caring for anything but the substance of choice; that willingness to sacrifice not only dignity but every other factor that accounts for the quality of life, is characteristic of addiction. With both parents gone, Mason turned the corner and decided seriously to pursue weight loss surgery. He later told Lyall,

You dig yourself out of that escapism that surrounds you — I don’t know what word I would use, but it was like crack, really — and then you grasp at life.

The surgeon who did the 2010 operation, Dr. Shaw Somers, later reminisced about those times with Heckert. Speaking of Mason’s mental condition prior to his bypass surgery, Dr. Somers said,

His despair and psychological trauma — he didn’t see any way out. The only thing that gave him comfort in life was food. It was a drug of abuse, freely available, heavily marketed. I think that’s almost universal to people who get to that size.

Your responses and feedback are welcome!

Source: “DSM 5 Criteria for Substance Use Disorders,”, undated
Source: “How the World’s Heaviest Man Lost It All,”, 03/07/17
Source: “Losing 650 Pounds, and Preparing to Shed a Reminder of That Weight,”, 04/22/15
Image by Christian Flores/CC BY-SA 2.0

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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