I disagree. I think most people realize they are fat. I think they understand, at least subliminally, that they are unhealthy. Very rarely have a met people who are actually so in denial that they don't think they are overweight.

I think they don't know how to change. There is so much misinformation. If you are desperate and mal-educated, what do you believe? What if you can't make the changes that they suggest? What if you don't know how to cook? What if you can't go to a grocery store? What if you watch the news and different news anchors tell you different things? What if you go to your doctor and he tells you to lose weight through pills or some extreme unsustainable diet -- because most doctors don't know bunk about nutrition? What if you go to an RD fresh out of school who just wants to push her insane vegan, whole-foods, organic, expensive free-range cauliflower on you, but you still can't get to a grocery store? Then you do it, you reach into a hat a take out someone's gibberish theory because in your mal-informed mind they all look equally scientific and plausible. You lose weight. But a year later it is all back and then some. Now the little bit of that gibberish mixes in with the next gibberish, until eventually you give up because none of it makes sense. You are still alive and it is hopeless -- so f**k it.

I have a nutrition scientific bullshit meter I use with people. I ask them about "bad cholesterol." If they understand that there is no such thing as good cholesterol and bad cholesterol because cholesterol is a molecule, then they have passed the entry level understanding of science. They may be able to understand and identify basic nutritional information. If they actually understand what "bad cholesterol" is supposed to be, and what is actually being discussed, then they are able to understand more advanced nutritional information. Failure to wonder or question and failure to research once questioned, tells me that the individual will never understand. They have given up thinking critically on the whole subject of health.