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I just heard a bariatric surgery commercial on the radio and they referred to obesity as a disease.
It is a disease of the adipose tissue. Except for the rare individual who purposefully seeks to become obese, I do not think anyone chooses to become obese. The same dysfunction that can make a guy like you or me fat, or "overweight," in another person gets so far from normal function that weight just piles on, while all the while the person's muscles and organs are starved for energy because the body makes fat storage a one way street rather than a two way street.
The root cause is insulin resistance. This is what dumb doesn't get: These people don't get fat because they overeat. They over eat because they are fat and their fat cells refuse to let energy out. Why do they still get hungry? Because their own body is literally starving itself to death from the inside out.
Anyone who has gone keto will tell you that once your body has quit sugar burning and gone into fat burning mode, hunger becomes quite mild and controlled. But star eating the carbs and gain just four or five pounds and the binge eating follows soon after.