It's so easy to point out food that people should be eating and blame personal preferences for being overweight. And hey, a lot of times it is. But, you also have to look at it from multiple viewpionts. From a public health standpoint, you need to consider the availability of these foods. In the surrounding area of my college, there is an extremely high incidence of obesity. Why? Because of the food deserts-areas in which they only food available is packaged and there is a small amount of produce available. Many of these people work two or three jobs, are single parents, and don't have access to a car. On top of that, their nearby grocery stores only sell boxed and convenient foods. If stores have produce, its mostly rotten and in bad quality. What are people supposed to do? Either spend 10 dollars getting healthy food for a day or packaged food that could feed their family for a week? I don't think we can truly help patients if we don't understand these underlying factors and help improve them first.
This! There are so many underlying factors in the obesity epidemic and it isn't as simple as "they chose to become fat because they were too lazy to change their bad habits." Many of these people don't have the resources to eat healthily. If someone is a single parent working multiple minimum wage jobs, when they get home to feed their kid dinner and sleep and only have four hours before their next shift, is it easier to spend a few minutes heating up some frozen food or an entire hour making a meal? When will they have time to go to the grocery store and would it be even worth it if there's a corner store conveniently selling processed foods right down the street? And when that child grows up thinking that eating a hot pocket every night is completely normal, how do we change those eating habits? Even if we try to educate that child in school, how do we make sure he can actually make those correct choices, either monetarily or in his ability to get there?
Many of us are fortunate enough to have options available to us, but a staggering number of us don't. Obviously trying to improve access to fresh foods for impoverished people solves only a small part of the complex obesity problem but I think it's a part of the underlying issue. Unfortunately, I don't really think this is something that doctors can address outside the capacity of a concerned citizen--it's a problem for politicians and policy makers. :/