Meat is expensive and fresh and frozen vegetables aren't particularly cheap, leading some households, particularly families and lower income, to pick items like rice, potatoes, noodles etc which are cheap and can go farther. They're calorically dense but not filling so it's easy to consume a ton of calories to feel full from eating rice and butter or butter noodles.
There's also the education aspect as one might not know or be able to eyeball what 250g of cooked rice looks like and serving sizes (at least in the US) can be deceptive. Until recently, there wasn't a sticker on 20oz soft drinks that contained the nutrition facts of the whole bottle.
Also, while push ups might be free, walking and running isn't. There's a ton of places in the US with sidewalks in poor condition if there's any sidewalk at all. Pedestrian deaths are way up recently as well so walking/running on the road isn't completely safe
Sure there will be some that have problems "self inflicted from their own gluttony", but you're making this out like it's the case for everyone using Ozempic while also attributing obesity 1-to-1 with choosing to be overindulgent. You could do with a little more compassion as it's not as simple as you're trying to make it.