Barring a SERIOUS medical problem (and there are some), it REALLY is sloth and gluttony -- years and years of it.
One CHOOSES to eat more or less throughout one's life.
One CHOOSES to get off one's butt (whatever size) and move or one CHOOSES not to.
I'm in the fitness business and have friends and family who are obese.
There are natural endomorphs, large boned folks who will weigh more. There are ectomorphs, those with the bird-size bones. The mesomorphs are the medium builds, which make up most of the population.
Obesity doesn't have to do with sensitivity to carbohydrates, slower metabolisms or cooking from scratch. Obsesity has to do with FOOD and EXERCISE. We aren't that complicated a species.
Most obese or even overweight people think it's ONLY about food. That is ONLY half the equation. Exercise is an essential as food. Most fatsos and overweight people see ONLY the food. So, they focus ONLY on the food and try very hard to ignore the entire other half -- EXERCISE.
I have TWO friends and TWO acquaintances who are honest about their problem with food and exercise. The rest always making excuses.
1. Fatsos are usually SNEAK eaters. They eat amazingly little in public. They are outstanding performers when it comes to food.
2. They may DO lots of stuff, have lots of energy and be very "busy"....but that stuff involves as little real movement as possible.
They walk when they could run; they stand when they could walk; they sit when they could stand; they rest when they could move; they take elevators/escalators when they could take stairs; they wait for ANY ride; spend a tank of gas to park closer...the list goes on.
After the decades of sloth and gluttony the medical problems set in. That usually (but not always) gives them the excuse to not exercise. They have a rock solid (as in lard solid) excuse for doing every kind of exercise.
It is amazing. But, the result is the same. They spiral downwards in movtivation, self-esteem, whatever the original lacuna existed to make them overeat.
It's so simple.
Usual pattern: weight goes off for a while.
Then because they don't really understand or believe the effects of NOT exercising while dieting, they gain more when they go off the diet and put back on their original weight PLUS. That is, that without exercise, about HALF the weight lost is muscle. That is the worst-case scenario. They end up needing fewer calories to live because they have less muscle mass because they didn't exercise.
Aging people naturally lose muscle mass....so THEY may eat the same amount of food they always did but will gain weight because they don't understand that they've lost muscle mass.....and they don't replace it or keep it up.
It is so simple but fat people simply CANNOT eat less or exercise more for an extended period of time. The backbone that is required there just doesn't exist.
It's my belief that everyone can change, whether they are 14, 34, 54 or 84. But the change HAS to come from within. It won't happen any other way.
As John Hagee once said: If you want what you've never had, you have to do what you've never done.
Imagine ME, quoting John Hagee. :o)
"EAT LESS for the rest of one's life.
EXERCISE MORE for the rest of one's life."
I will say AMEN to the second statement, but the first statement is part of the problem. My obese friends got fat by eating less...and less...and less over a lifetime.
Also, everyone shouldn't eat the same diet. Some people are more sensitive to carbohydrates and should eat mostly protein and veggies; whereas some people are less sensitive to carbs and should eat less protein and fat, but more carbs. That's why there are success stories for all the diets: hi-protein Atkins; hi-carb Pritikin; and mid-range Zone. But the food pyramid and American medical dogma is a hodgepodge of all of them, and leaves us w/ 60% of adults overweight.
Some of the fitness rags now say that for people who are already reasonably fit, 15-20 minutes of interval training burns fat very well. Of course you have to burn off CHO to burn fat, but the CHO depletion and fat loss happens for several hours after exercise, not just during. Also, I have read that intervals preserve muscle mass better than long moderate aerobic exercise.
Of course, intense interval training for the morbidly obese is likely to result in serious health consequences.