I watch the show too, it's unbelievable! I think the show last week with the people living in a mountain of roaches and discarded depends (or "integrities" for PTM ;-) was the worst thing I've ever seen.
Not all of these folks have mental issues, IMO; extreme hoarding *is* a compulsive/obsessive behavior but some of those people are content to live like pigs.
There are those on the other spectrum who are obsessively cleaning their homes and themselves. That would make a kind of boring show, though.
I think it's a sin to put belongings ahead of family in one's priorities; this is the modus operandi with a great majority of these hoarders. Seeing what their compulsion is doing to their kids and spouses is heartbreaking. They also endanger their pet's health.
And there is that saying, after all..."Cleanliness is next to Godliness".