There are several reasons, IMHO for the 'epidemic' of obesity around the world.
For the first time in human history, since the 1950s we in western Europe & north America have lived in an environment of cheap, abundant food. Food has directly swapped with rent/mortgage as a proportion of houshold expenditure in the UK - off the top of my head I believe it was 45% food : 15% rent/housing in the late 19thC-early 20thC.
Individuals who have a genetic advantage in aeons-old evolutionary terms (ie., the ability to eat more and gain weight in times of abundance and survive the next period of dearth of food) are now placed in a environment of permanent abundance. The advantage of the delayed hormonal 'off switch' (Grehlin - the 'hunger hormone') is now a huge disadvantage and results in growing numbers of people with obese bodies.
Disordered eating is now rife - EDs are not just anorexia and bulimia. Hyperphagy, ARFID (Avoidant/restrictive food intake disorder) and binge-eating disorder are common in people who are fat.
There are some genetic conditions that have hyperphagy/polyphagy (over-eating to the point of being ill) as a facet. In Prader-Willi syndrome (a genetic abnormality of chromosome 15, where there's a significant deletion) people with it are
literally hungry all the time. There's a long list of genetically unalterable conditions that cause hyperphagia (AKA polyphagia) and here is a wee screengrab of the current wikipedia page at
https://en.wikipedia.org/wiki/Polyphagia :
View attachment 69280
It's interesting to note that in cases of disordered eating and genetic conditions, 'willpower' alone is probably not enough to stem the behaviour that causes obesity. It can be managed to a greater or lesser extent, and therapy/treatment is valuable but it's simply NOT just a case of a) being a greedy beggar and b) eating less/doing more.
So.. now to the
very personal point of this post.
I am fat, I am obese. I am just on or just below the morbidly obese point in terms of BMI.
I have been chubby/fat since the age of 3/4. I was a large child, teenager and adult. At times I've managed to lose some of my bodyweight - around 25% - but events and choices have then influenced a partial or total regain, such as a spinal/nerve issue that has resulted in 4 x emergency surgeries over the past 18 years and rehabbing with permanent disability.
I have disordered eating. Being very fat affects my health but it is also very hard to put on the 'eating brakes' sometimes.
If the substance was alcohol, nicotine, opiates then abstinence is effective. I sometimes wish that I didn't have to eat at all - imagine if you were an alcoholic but you actually had to drink 3 cans of beer a day to stay alive, or a junkie that had to shoot up a wee bit of heroin daily! I practice Intermittent Fasting to reduce that time window for eating to just a few hours daily but that in itself has a minimal effect of body size.
I would guess that most very fat people
know that they're obese. We
know that we overeat for various reasons. We
know our eating habits may be disordered. We
know our health is suffering. We need constructive interventions and intensive health management in this 'obesogenic environment' we live in, that our bodies are not designed for - not being condemned, labelled as being weak-willed, bullied or patronised. If one has an ED but is very fat, the UK health services has
very little, if not zero, interest in helping you. Morbid obesity might cause more deaths and health effects than anorexia but if you're skeletally thin and look frail and ill a heck of a lot more treatment comes your way, more quickly.
Basically, a bit more knowledge, love and understanding please. Most of us fatties aren't continually scoffing burgers and Mars bars. We're living with something like an addiction and failing every day.
(edited for typos)