Q: My wife and I have been married for 15 years. We have two daughters, 13 and 11. When we married, my wife worked as a nurse and weighed 110 pounds; she now weighs 500 pounds, stays at home and refuses to leave the house except to get food from the drive-through and go to the doctor. She refuses to cook or shop for the family.

Our older daughter tips the scales at better than 300 pounds, has been diagnosed with diabetes, has been hospitalized several times and misses a lot of school. The younger daughter weighs nearly 200 pounds and is following in the same footsteps.

For years, I have been working two jobs and taking care of the house, since my wife refuses to cook or do much cleaning. The girls are getting more like their mother every day, and I feel helpless. I love my family, but it’s depressing to see more than 1,000 pounds of humanity doing nothing but getting bigger. My boss has started to complain about the size and frequency of my family’s insurance claims. I hate to say it, but I am embarrassed to be around any of them. I want a divorce, but I’m afraid my wife will take me to the cleaners.

A: With more obese Americans today than ever before, the cost to our society is fast approaching $100 billion per year. Whether or not obesity is classified as an illness in the future, the meteoric rise in the number of obese adults and children is a significant factor in the increasing number of Americans who are disabled because of high blood pressure and high cholesterol levels, diabetes, heart and kidney disease, strokes, sleep disorders, respiratory problems, some types of cancer and psychological problems that include depression and low self-esteem. These problems, in turn, result in higher — and more — medical bills.

Not surprisingly, family courts are seeing increased litigation dealing with this disturbing issue when custodial parents take noncustodial parents back to court to try to collect for “extraordinary medical expenses” incurred when obese children are medically treated for obesity at private clinics. While some courts have recognized the problem and, in some instances, have required payment, other courts have not required payment if the standards established in the treatment program are not followed at home, because this renders the treatment relatively useless. Since a child can’t be “locked up” in a medical facility for the rest of his or her life, the custodial parent and the child must take responsibility for following the course of treatment at home.

In some situations when the parent does not provide necessary dietary care and treatment for an obese child, the child has been removed from the parent’s care. This is especially true when, as in your situation, the parent is also obese and fails to exert the proper parental control necessary for the child’s physical, mental or emotional health. Courts have no problem removing children from the parent’s care if the youngsters are malnourished; judges shouldn’t have a problem doing so when children are morbidly obese.

While your situation may be difficult, it will only get worse. The best thing you may be able to do for your children is to place them in a situation where they will get help, since it appears that your wife won’t do so voluntarily.