This squib from the Physician's Briefing website reflects some broad truths, considering it results from a survey of peoiple at risk for diabetes in Finland: Excerpts:
"Only 36 percent of at-risk men and 52 percent of at-risk women perceived the need for lifestyle counseling. ... Of those individuals who perceived the need for counseling, 35 percent refused to participate." About a third of the people who agreed to participate never showed up even once.
As you know, diabetes is a dead-serious condition. Those who contract it can lose limbs, and/or their eyesight. When I was in rehab just over 20 years ago, a fellow with whom I overlapped briefly was diagnosed as suicidal because he had diabetes and was still eating sugar.
And yet: Substantial numbers of people who are at risk appear to think they can handle the threat on their own, or just with food, or by ignoring it. Such behavior sure seems to imply a lack of appreciation for the gravity of their situations.
What I find striking about the pre-diabetics' behavior is that its just like what I observe in my area of interest: people suffering with obesity — which is a class of people different from those with obesity — and people who are affected by the obesity epidemic. (This, of course, is just about everyone, like it or not.)
My successful escape from extreme obesity (so far) had far more to do with lifestyle change than with food choices. But getting people to see that is tough going. Ask almost anyone about how to lose weight and they're going to cite a diet.
Meanwhile, I think you'd agree that most people would consider the complications of diabetes to be more severe than complications from living with "just" obesity. If the more serious subset is often unwilling to consider the consequences of their choices, the disregard is only greater in the larger group. Even though it is also life-degradlingly serious.
The biggest value of wider recognition of obesity's severity is that many who have it will be willing to consider more robust solutions. Although, based on the Finnish study, maybe not.