The Economist article waves vaguely at some unspecified correlations observed by neuroscience and implies a causative relationship. They say the brains of the obese react differently to food, ergo their obesity is an involuntary physiological response. It is equally, if not more, likely that the deleterious food related behaviors of the obese have rewired their neurological response to food. Their brains react differently because they’ve been trained to, much like a substance abuser or gambler’s brain develops a different response to those substances and behaviors.

There’s not any scientific support for the conclusion presented in the article that obesity is most frequently an involuntarily acquired physical condition, and population statistics would militate against it. The increase in obesity in the past twenty years cannot reasonably be ascribed to any genetic differences because population genetics cannot change that quickly. So the change HAS to be cultural/behavioral or environmental. Saying obesity rates increase because of an acquired medical condition is essentially the same as saying poor populations have more drunks because of some unknown medical malady, and not because they’re poor and desperate and have little else to do but drink until they’re insensible to how desperate their condition really is.

One of the prime difficulties with formulating an appropriate reaction to this problem is this absurd focus on whether or not obesity is involuntary or evidence of a character flaw, as if fixing that question one way or the other will solve the problem. 1) Of course it is not an involuntary physiological condition. There is no good population level science leading to any other conclusion than Americans eat too fucking much and sit on their asses all the time. You can only come to a physiological conclusion by focusing on small, carefully selected populations. 2) Moral harangues leveled at individuals are not a good solution to public health problems. Yes, that fat-ass eats too damn much and that’s why his corpulence overflows the borders of his seat, but if you want to fix a population level problem you need population level solutions. You need better food regulations e.g. rearranging food subsidies to lower the cost of quality food and increase the cost of processed junk, legally mandating portion control on the  food service industry, providing better public education on nutrition, decreasing the work week to afford more leisure time for physical activity, providing more public space to engage in that activity.

Of course, all of those solutions would negatively affect corporate profits, whereas a medical response, like you support is an awfully sexy option for the medical-industrial complex. If obesity is considered to always be a condition to be medically treated across the whole population, then that is a truly massive (pun intended) new profit center for them. But this is not a problem with medical origins, they’re purely social and economic. Food is cheap in the U.S., selling twice as much of it for maybe a 20% increase in revenue is a huge boon to big agribusiness, and is in fact the only real path to the kind of growth required of a publicly traded, for-profit company. So the food industry does whatever it can to get Americans to buy more food. Restaurants market larger portions as a selling point and processed food companies spike their product with as much sugar and salt as they can. At most low to mid priced food service businesses it’s no longer even possible to order a reasonable portion size at a reasonable price. As has been noted recently in NYC, a small soda has somehow become a pint with the large sizes hovering around a full quart of sugar-water.

The thing is, and why I cannot stand these arguments that obesity is an involuntary medical condition: when you focus on medically treating obesity, you’re really just aiding the wonderful capitalist practice of selling people both the problem and the solution. It is not a problem with a medical origin. It’s like saying cholera is a medical problem with a medical solution. It’s not, it’s a water supply and sewage treatment problem with a water supply and water treatment solution. Obesity is a food-supply problem and needs a food-supply solution.

Agreed on the rest, though.

For clarity, I don’t believe in “bad” obese people. Everyone where you can’t point to the reason why their body is fucked up is just someone where you can’t point to the reason why their body is fucked up yet. My point was that I’m evidence that fatness isn’t linked to the sins of gluttony and sloth, nor is thinness linked to the virtues of industry and restraint. Other folks who don’t have evidential links as to cause are just medical mysteries right now.

We used to think that bad things happening to you was a sign that you were being punished by God for some secret sin or moral failing. Now… well, we believe that bad things happening to you is probably a sign that you’re being punished by an abstract moral force (or God) for some secret sin or moral failing.

Cancer patients are mostly exempted from the “bad shit is happening to you for a reason” clause, along with some victims of crime, some accident victims, and some people who get sick (sometimes – sometimes you got sick “because you don’t take good care of yourself”). Some parts of society are willing to accept that some people in poor economic situations didn’t do it to themselves, so that’s another advancement. I can’t think of many other cases yet.

You know why I’m fat? Because I had to start progesterone at the age of 12 due to crippling dysmenhorreah, which gave me an artificial hormone imbalance (weight gain) and stimulated the broadening of my hips early and dramatically (big booty even without weight gain). There’s a LOT of other people who got that one naturally – not everyone is a slim hipped nordic supermodel.
And because I am at least the third generation in my family with severe chemical depression – which causes weight gain and tends to destroy attempts to get your shit together and lose weight, which is a cruel combination. This causes a vicious cycle of feeling shit about your body, which makes you more miserable, which leads to a slower metabolism, which leads to feeling more shit about your body, etc.
And most of the medication for depression causes… weight gain.

Obese people have actual measurable hormonal problems other than sex hormones – all kinds of crap messes up your metabolic rate, and all kinds of crap seems to mess up the hormones your body uses to regulate your desire for food (which are a pretty fancy-pants system that operates at a level far more basal than “willpower” or “rational thought”).

Fat people aren’t fat because we’re stupid fat slobs who deserve to be fat because we’re weak and disgusting. The attitude that we’re like this because we can’t be arsed to change, or don’t deserve to change because of moral failings? Bullcrap.

I like how there’s the “good” obese people and the “bad” obese people.

Yeah, it sounds like a c. 1993 description of AIDS.

Then there are the BAD obese people, who drink soda and don’t exercise and eat bad food!!(!!) Never mind that there are plenty of thin people who do this, who can be just as unhealthy. Those obese people are bad, bad, bad. They take up more space! They are unhealthy! We hate that they’re unhealthy because unhealthiness is bad (pause for drag on cigarette) and ohmygod really we’re just so WORRIED about them, we want them to lose weight FOR THEIR OWN GOOD.

Guess what- until you stop generalizing, until you stop assuming that the only reason people don’t eat well or exercise is they’re just so LAZY, until you can stop snap-judging obese people whenever you look at them, you’re not going to change anything, be it the person’s health behaviors or your airline experience. And yes, I’m sick of sitting next to people on a plane who I have to involuntarily cuddle for a cross-country flight because there’s no way for them not to be in my seat. But I don’t blame them, I blame the airline. When I was a child plenty of obese people were on the plane and for the most part, the seats were big enough for them. If seats keep shrinking then soon only very short supermodels will be only vaguely comfortable. 

That said, obese people obviously need more space.  I see hardly a reason to not accommodate them. 
Because I’m tall I have often gotten the seats by the doors, without asking.  Airplane and public transportation seating is made for small to average sized people.  If airplanes had a percentage of oversize seating it would not go unused.  If they ever had a shortage of oversized people, they could even stick a short skinny person there. 
One would really think our subsidies buy us seating approaching our respective sizes. 

I only mean its fair in the context of charging for weight, which is what airlines regularly do any way. But for some reason the weight of my luggage is of great interest to the airline, and carries with it a per Kg charge, and yet my weight is irrelevant. That’s not fair.

It’s not objectively fair because a 4’4″ person with a tiny bone structure gets permanent discount on flying while a 6’6 person with wide shoulders and big limb bones will never be able to fly cheaply regardless of their body fat or their respective needs (maybe the 6’6 person needs to fly a lot for business and the 4’4 person does not).  One need not agree with me that this is unfair but the fact that I don’t think it’s fair demonstrates that it isn’t “objective” at any rate.

You make a good argument, but I’m afraid that to me it’s still apples and pears.

I would put forth that a tiny percentage of Obese people are in such a condition due to genuine medical circumstance, especially as there are very limited conditions that could actually be responsible for obesity – as apart from hormone/metabolism related conditions (and mental health of course) it’s still just down to controlling your own diet.

Equally the number of wheelchair users who are in that position through prolonged abuse of their own body are probably in the single digits.  Simply being alive puts you at risk of losing your legs, so to achieve the same level of intent I’d expect to see you carelessly hurling your body from 2 story buildings.

If you put yourself in a position whereby participating in an activity becomes an inconvenience I don’t think that it’s fair to expect others to go out of their way to accommodate you.  Of course it’s nice if they do… but I don’t think it should have to be a legal requirement.