Obesity is a multi systemic, complex pathological process.  There is no one size fits all approach.  Some of us with 'normal weights' carry significant abdominal adiposity,which greatly increases our chances for inflammatory, metabolic and vascular diseases. Some of us will struggle to reach those parameters in our lifetime and still have 'normal' metabolic markers. The truth is, the scientific community is JUST beginning to understand why some are more afflicted than others.  Like everything, it's multifactorial.  Our environment, genetics, and unfortunately, where we live/socio economic status are huge factors.  Did you know that POMC neurons in our brain are  turned 'on' for certain (thinner) folks, and at 'thinner' times in our lives , and less so for others/and as we age? We're not even beginning to talk about the complex workings of our inner adipocytes, our hormones ghrelin, leptin, and the roles that increasing insulin resistance play.  Or that certain genetic mutations (the MC4R pathway, for example) predisposes certain folks to being heavier set.  We've also learned that those with a higher ratio of firmacutes/bacteroidetes (aka, specific bacteria in our gut) are more likely to struggle with their weight than those with lower ratios.  Meaning, the contents of your gut flora are often responsible for  increasing your inflammatory markers, not only increasing risks of obesity, but of Type 2 DM, Non Alcoholic Fatty Liver Disease, and inflammatory bowel disease.  

What you need from us is not more 'tough love', it's just love, support, and ACTUAL solutions-period.  MANY of these things can be improved with diet and exercise.  However, if that was all it took, we wouldn't have this epidemic today.  While antidotes are the not the plural of data, I want to assure my patients and medical colleagues alike that I, a board certified obesity doctor, a naturally thin person with abdominal adiposity so commonly found, who only gained some weight after having children/being peri-menopausal ,and someone who tries to walk 5000-10000 steps daily -that frankly, MANY of my patients put me to shame.  That's a fact, folks.  My passion in life is to educate the population and to help my patients keep the weight off-for good this time.  Wherever you are in this journey-we will be with you every step of the way

This may be the journey of a lifetime.  Whether it is or not-we're in it together.   Your success is OUR success.