[yc-kraln]

> But short of that, are there not only two root causes left?

No.

Let me paraphrase the conversation I had with the head of obestity at one of Europe's leading research hospitals (top 5 in EU):

Once you get a certain amount of overweight, regardless of the cause, there are so many regulation systems in your body (at least 20 that we know of) which kick in to keep you overweight that it is not possible to diet and exercise your way back to a healthy weight without picking up a new disease (eating disorder, exercise additiction, etc.). The people who manage it spend the rest of their lives obsessively weighing everything they eat, exercizing every day, and even then if they slip up or lose mobility or something, inevitably they will become overweight again.

The only known medical treatment is operating on the stomach. This changes enough of the regulation systems (including the hormonal ones) that it has a reasonable chance of sticking. GLP-1 seems to offer a second option.

It continues to astonish me that eating disorders which result in weight loss are (correctly) accepted by society as diseases with complex causes which can include lifestyle and self-control but also mental health and innumerable other things, but if you're overweight clearly you are a sad sack of shit that just can't open their mouth without shoving food in it.