genetics - yeah, some people are also predisposed to being alcoholics. but that doens't mean those people should just give in to their genetics and accept that's their place in life. having a slower metabolism means you need to be more mindful of what you eat and you'll have a harder time staying trim than other folks. that sucks and im sorry you got dealt a bad hand. but being fat is unhealthy and you should make an effort to keep the weight down just like alcoholics should make an effort to not drink. how would you feel if an alcoholic told you "its not my fault i'm this way, it's my genetics" to absolve responsibility?
medications + disease - i already addressed those
psychological factos - emotions make us do all sorts of things, its our job to keep them in check and to make responsible decisions. emotions can lead us to abuse various substances (including food) but that doesn't mean its not still a choice
social issues - i do understand the idea of a "food desert", so that's fair.
edit: i did not mark your post fwiw
that's why i said "vast majority" and not "100%"
I agree that lifestyle changes, when possible, can/should improve outcomes. We should make societal changes to create a situation where changing lifestyles to healthier ones is easier to do (e.g., access to food, exercise equipment, etc.)
All I'm advocating for is a balanced perspective on these issues. Many people don't understand/acknowledge that. I appreciate your willingness to do so.