Hi Seth, Yes you're exactly right. There is a lot more to it, especially around pyschological conditions, medications, and pulmonary issues. The message to diet and exercise is far too simplistic and implies far too much control. It's good you mentioned health care costs as well. A true understanding of what people are up against would go far in policy decisions. The current understanding is simply not working or even making it worse.

FYI, I'm in a high tax bracket in New Zealand but still only pay 26% in taxes. That pays for our universal health care system, and I don't pay for insurance. In New York I paid up to 35% tax (plus state and local), plus $1,800/month for health care. Don't let anyone tell you universal health care is more expensive than the US system.