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For the most part, you are right, but there are the occasional cases where the person really does have a medical condition that causes morbid obesity. Rare, but real.
I had a coworker a while back who weighed 500 lbs. I just assumed she had to have some kind of medical condition to weigh that much. I said as much to another coworker, who had known the woman in question longer and better than I had. She said "It's no mystery if you ever watched her eat lunch". I found out that she ate deep-fried food for every meal, she was in her 40s and still lived at her mother's house, as did her brother. She, her brother and her mother were all morbidly obese. She went home for lunch most days, to eat with her mother and brother.
There are some serious underlying psychological and family issues behind her weight, but no medical condition. She retired early with disability, but I'll bet by now she's got diabetes and heart disease.
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