But I think it's very far oversold. People are happy to find something to cling to which absolves them of responsibility, so many people jump at the thyroid condition... whether it's valid for their case or not.

But some few people do certainly suffer from thyroid conditions which makes weight loss and weigh maintanence more difficult.

Here's the question: if we know that being fat does absolutely lead to much higher medical costs - meaning that it's more expensive to insure fat people - then does it matter WHY a person is fat when considering the cost to insure someone?

:)

But it seems that some kind of subsidy could be provided for the very few legitimate cases where a hormonal condition over-rules a person's individual responsibility.

As for the Pacific Islander, or quite a few other ethnic or genetic groups (including any and all athletes, tall people, short people, and many others), the objection should be against using the completely useless BMI to evaluate a person's health. If waist-to-hips ratios or accurate body fat percentages were used, then no-one who was actually healthy would be mis-catagorized as "overweight"... Fat people could be legitimately be given higher premiums to pay for their higher health care costs... and the world would make sense.