Well you said it yourself. Even his doctor didn't tell him to lose weight. The guy was surrounded by a society that encourages and promotes accepting obesity. He only realized there was a problem when he tore a ligament while cleaning his home (lol). His doctor should have informed him a long time ago. Through putting forward the effort and seeing that it was, in fact, possible to lose enough weight to enter a normal BMI, he learned the truth.  Very often, fat people see progress pics of former fats who got in shape and they immediately dismiss them. "Steroids", "she starved herself", "photoshopped", etc. They literally think it's impossible and they'll never know the truth until they actually attempt it themselves.  Morbidly fat people are abhorrent to be around and societies that promote that state of being as acceptable are the real problem. As an example, many European countries are now hitting US levels of obesity. Their cultures are tolerant and accepting, and so fat people never have a reason to (a) prevent becoming obese and (b) lose weight once they are obese.  A good example of the contrary is Japan. They are a wealthy developed nation with a surplus of food, just like Europe. Except they don't have an obesity epidemic. Their culture shames fat people, men, women and children alike, and so people thrive to live a healthy lifestyle.  So while the morbidly obese ultimately don't deserve sympathy, imo it's important to recognize that western societies are actively encouraging obesity and censoring information relating to the negative health implications, ways to lose weight, etc. That is why we have a problem and countries like Japan don't. In fact, our culture shames people who do become fit. A fat girl got in shape? She starved herself and is now a slut. A fat guy got in shape? He took steroids and lives at the gym. An obese boy lost weight? His parents committed child abuse by restricting his diet. Tell someone you're losing weight through dieting and they'll instantly tell you that you're starving yourself and will fail. Some cite the statistic that most people rebound to their original weight after dieting, not realizing that a diet change is for life and not just something you do for a few months. They are woefully uninformed and desperate to promote feel-good misinformation because the harsh reality that everyone is responsible for their own state of being is too much to bear. So my personal view is that while the guy is an idiot for not looking into the facts himself, everyone around him enabled his obesity. There is a huge cultural element at the root of the obesity epidemic.