I think the worst part is that it's just a different subculture. I could easily be wrong. But I think that if you took most fairly well off people and put them into the same financial state and location as the average fat person than their weight would quickly balloon up. Someone whose muscles depend on individual attention from someone else, whose food is all prepared and managed by someone else, and who doesn't really grasp why any of that works is little different from a fat person who gets a gastric bypass.