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I was wondering this as well! It's inappropriate any way you look at it, but most people don't say things just because. The offender being institutionalized doesn't necessarily play a part in it.
Lose weight.
Ah for the good old days, when you could take a nutbag in an asylum and douse them with a firehose, or poke them with a sharp stick through the bars in their cage. JK Folks, JK. I wouldn't get too torqued out about this, since said resident probably thinks they're Napoleon.
In what world is it a "popular" misconception?
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Hey, at least you're not the one in the mental institution.
He's the one in the mental institution. Just ignore his derogatory comment.