There was a fringe that said being overweight was not unhealthy, but the more salient points were the following:

1. BMI was basically just pulled out of a hat, and it turns out that for many health concerns, the overweight class does better than the normal weight class, with the actual “clearly worse” outcomes really coming up as you trend into obesity.

2. Environmental and genetic factors are huge contributors to people being overweight. To some degree moralizing about weight loss is a bit like telling kids with asthma they should live in places with less pollution. Or telling someone with breast cancer to not have the BRCA gene.

3. Doctors would regularly miss health problems because they’d blame them on people being overweight / not exercising enough. Especially for difficult to diagnose issues, it’s easy to just point at the number you have that “looks bad”.

4. We still have no firm reason why people are gaining weight. The popular answer is sugar and processed foods but those very much already existed at scale in the 50s.

The tragedy is that it turned into a morality play where fat people were blamed for it, despite in many ways being as genetic as getting breast cancer.

The reality is people who actually study obesity know that basically GLP-1s are the only health intervention other than bariatric surgery that consistently works. At a population level no intervention has reversed fattening anywhere in the world.

To your point 4, we have lots of good reasons why people are gaining weight: they eat more. It's not exactly rocket science.

Obvious reasons include:

a) food is very cheap, especially processed food

b) portion sizes are comically large in the US

c) ubiquity of snacking and eating on the go, which is mostly high calorie

d) few people smoke now, and cigarettes are potent appetite suppressants

e) less social disapproval of being fat. To fair degree, being overweight is contagious

I agree completely with your last paragraph, at a society level. At an individual level, though, it's all on us to exercise self control for ourselves. Just most people don't want to.

> despite in many ways being as genetic as getting breast cancer.

This claim is utterly silly on its face. Look at pictures of folks in the US 60 years ago compared to today. The population did not randomly mutate a genetic condition towards the propensity of obesity. Folks who come from societies that are not all that overweight did not magically develop a genetic condition upon immigrating to the US. This claim is entirely non-credulous and most folks claiming such are doing so in bad faith.

Environmental is by far and away the largest factor. Meaning most everyone lives surrounded by highly palatable horrible-for-you food and lives extremely sedentary lifestyles entirely optimized for convenience.

It's really not something that needs ANY more examination than that. Fixing it is the hard bit. Everything else on top of this is a rounding error and not something that needs to even be discussed until the first order factor is fixed. Then we can start discussing nuance, outliers, and details. It's a waste of time otherwise.

GLP-1s are the only thing that has turned the tide even a little bit. Because people eat less. Any other benefit from that is again - secondary and perhaps interesting, but not the primary mode of action. GLP-1s proved it is the American diet that is the problem.