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> It’s a conscious decision making process that is self-inflicted.

I doubt very many people make a deliberate conscious decision to gain excessive amounts of weight, especially if they're dieting. You can argue that people should be making a conscious decision to navigate the labyrinth of data, misinformation, scammers, etc to try to learn what they actually need to do to lose weight successfully but I think most people just eat what they like best from what's available when they feel like eating and are more often than not surprised at the weight they gain. Even animals in research labs on strictly controlled diets who have had the same food intake and lifestyle for decades have been unexpectedly gaining weight.

I think it's safe to say that there's a lot more going on with weight gain than lazy people making a conscious decision to be fat and a lot more involved in losing that weight. Anyone can starve themselves, but loosing weight while staying healthy isn't always so simple. Changing a person's habits and lifestyles aren't always simple either. If medications can help, people should absolutely use them.