As far as personal responsibility goes, here is my take. I am extremely overweight but have lost 60 pounds over the past few months. I have a long journey of years ahead of me to get to the goal weight I arrived at in conversation with my personal physician. I both accept responsibility for the actions which led me to my current health crisis and recognize aspects of my upbringing over which I had no control. I was taught by a parent to adopt binge eating as a coping mechanism for emotional pain. That coping mechanism became a vicious cycle when my growing weight caused more and more emotional pain which caused me to eat more and more to "cope" with that pain.
Anyone who mocks my appearance in person or online is not contributing to me becoming healthier. I am already eating zero sugar and counting my calories, using a treadmill, and in a weekly support group of other people working on our weight. I already have to conquer a great deal of shame to simply go out in public. These people ganging up to gawk and cackle at my kind have nothing to do with helping anyone get healthy or fit. These men and women are sadists who get off on the pleasure of kicking other people when they are down.
I understand the interest in having difficult public conversations about health issues, but sometimes a public discussion can't help. A public conversation about the negative effects of alcoholism isn't likely going to make an alcoholic stop drinking. Talking about the negative effects of unhealthy eating are not likely to make a person who was taught to use food as an emotional outlet in that person's formative years stop eating unhealthily. If people are shamed for or confronted over what they eat, they will simply hide their behavior as much as they can and sneak food when no one is looking, as I have.
It's in many ways a very personal issue. As Dan Ariely observed in his book "The Honest Truth About Dishonesty," the human mind is very good at helping us rationalize negative behavior. The only thing that got me to stop my inexorable path of declining health was the imminent fear of becoming so heavy I would lose the ability to walk. And yet, I continue to have some very difficult moments keeping focused on the need to change. There is no such thing as a lasting epiphany when a self-destructive behavior has been lodged in one's personality since childhood.