Where did those questions lead you?
A BMI above 35 (severe obesity) is "associated with significantly higher all-cause mortality" [1]. Regular obesity (30 to 35) is associated with higher morbidity, e.g. CVD, GERD and asthma. (Being underweight is more dangerous than being overweight [2].)
How did you conclude this? The evidence we have says obesity causes mortality [1].
> while I sit at a dinner table with friends and family eating significantly less than everyone and still gaining weight
Yes, this is metabolic syndrome. There is increasing evidence that some peoples' bodies will reduce base metabolism to compensate for reduced calorie intake or exercise, sometimes to the point of permitting starvation despite food intake, in an effort to conserve body fat.
Modelling nutrition thermodynamically is like trying to model flight with Newtonian dynamics. You can do it. But not in a practical way, and certainly not when it comes to edge cases.
> people are so committed to the idea of weight gain being a moral failing
Sorry you've experienced this. I've seen it too, in peoples' zero-information dismissal of e.g. Ozempic as a moral failing. (For disclosure, I've only dealt with weight gain as a cosmetic issue.)
Sun exposure causes melanoma. That doesn't make the beach evil. It just means that causation is established. It's not perfect. But if you're at risk of melanoma, knowing that causation helps. In the same vein, obesity causes mortality. That doesn't make being obese (or overweight) evil. It just means the causation is established. It's not perfect. But if you're obese, you and your doctors knowing that causation helps.
I wouldn't focus on that, food intake relative to others will be misleading.
Have you tried a food journal? For a week, take a picture of __everything__ you eat or drink. Go back and review it at the end of the week, a month would be better.
If you review it and think "yes, this is a reasonable amount of food" you now have a months worth of data to shop around to a doctor who can help you. If you have the opposite reaction, now you have a baseline to work against.
As an aside, do you drink a lot of soda?
Good luck, your tone is defeatist and I don’t have the energy to engage any more.
I don't think this is sufficient. I started tracking calories a few years ago, and it turned out one of the meals I thought was high-calorie was actually low-calorie.
Also with calorie tracking, only need to do it for a week or so and see if what you're eating is what you think you're eating. Something might add up to much more than you think.
What I have learned time and time again is that people are at best inaccurate at counting their caloric intake or at worst just entirely dishonest about how much they at eating. You are most likely eating a lot more than you think you are and have normalized it after 40 years of doing so.
It is possible that you may metabolize food slightly different from other people. What is not possible is that your body is defying conservation of energy and mass.
I wont go into all the possible problems with using dinner comparison as a benchmark, because the charitable take is that you sharing a sentiment, not proof of anything.
Your body has a lot of latitude in modifying its base metabolism. Folks with metabolic syndrome can reduce food intake to virtually zero and their bodies will still try turning off vital mechanisms before burning fat stores.
Most people get into obesity through bad habits. But good habits aren't enough to get out. (The exception to my first statement are those with genetic or hormonal factors.)
The challenge is that the syndrome is resistant to incremental change require a lot more than simply adopting what would otherwise be healthy steady state behaviors.
That is to say, the syndrome goes away if you get back to a normal weight, it is just extremely hard to do it. Im hopeful GLP-1 drugs will help some people break through this wall.
"Possible explanations have included earlier presentation of heavier patients, greater likelihood of receiving optimal medical treatment, cardioprotective metabolic effects of increased body fat, and benefits of higher metabolic reserves" [1].
In summary, obesity (BMI > 30) is a health problem. 40% of Americans are obese [2]. I'd be curious to see what fraction of overweight Americans become obese versus normal weight become either obese or underweight--the presumption seems to have been that being overweight (particularly when young) is a risk factor for obesity.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC4855514/
[2] https://www.niddk.nih.gov/health-information/health-statisti...