Everyone has allowed themselves to make an offhand comment about obesity, whether as a societal problem or on an individual level. It’s almost a reflex, and the idea that weight is entirely based on personal lifestyle choices (and maybe genetics) is deeply ingrained in our culture. But America, despite its growing problem with obesity and its related illnesses, is not simply a country of lazy people who only want to eat hamburgers. There are a huge amount of factors at play here, many of which seem to decide our fate before we even pick up the fork.

1. Obesity is deeply tied to class and race.

While obesity is a problem that can be found in every income bracket, it is far and away most likely to affect poor people living in wealthy countries. In America, poor women are the most likely gender group to be obese, and, with the exception of Asian-Americans, ethnic minorities are heavier across the board. In fact, if you are a low-income black woman in America, you are twice as likely as a wealthy white woman to be obese in your lifetime.

And while it could be argued that this is coincidental, it likely has something to do with the fact that:

2. Food deserts are an extreme problem in America.

Food deserts refer to the neighborhoods and communities — disproportionally represented in urban areas like New York City or Chicago — where access to fresh, healthy, affordable food is heavily restricted or non-existent, and where the only “grocery stores” are poorly-stocked convenience shops. The USDA has even developed an interactive map to find out exactly how accessible food is in any given area. While it’s easy to point the finger at parents in these communities who feed low-nutrient, high-calorie food to their children, it’s also important to understand how difficult in can be to find alternatives within reasonable distance to their homes.

3. Obesity makes it physically much harder to maintain weight loss than for a person with a normal BMI.

The actual number of fat cells in your body do not decrease as weight is lost, the cells only shrink in size and become “lean,” with obese individuals often having up to twice as many cells as a thinner person. This will make maintaining their weight more difficult for the rest of their lives.

4. Two people of the same size can burn calories differently.

There are many factors that contribute to someone’s overall metabolism, but the difference can mean that two people eating the same number of calories will store different amounts of weight as a result. And though you can work on changing your own metabolism, much of this is decided by genetics.

5. School lunches are less nutritious now than ever.

We all know that school lunches aren’t great, but we often underestimate how bad they actually are, and how damaging they can be to a child’s health and future relationship to food. One study showed that children who ate lunch at school vs. at home were significantly more likely to be obese, to have higher levels of “bad” cholesterol, and less likely to participate in moderate exercise.

These lunches set children up on an unfair path, particularly when combined with the fact that:

6. Most schools only require 30 minutes of health education per week.

We know that this isn’t even close to enough, and yet physical education programs are always amongst the first things to be cut when budgets are reduced.

7. Just this past week, Agricultural Secretary Tom Vilsack referred to ‘inner-city children’ who couldn’t recognize a tomato.

And while his comments may seem fairly extreme, when you combine food deserts, poor health education, abysmal school lunch programs, and financial limitations, it’s not an extreme scenario. In fact, several independent programs have been formed specifically to teach children about fruits and vegetables in the classroom. (The documentary on American hunger A Place At The Table even contains a scene in which a teacher explains to her class full of second-graders what a melon is and where to find one, most of whom had never seen one.)

8. We become literally addicted to the bad foods we eat.

A recent study has actually compared the addictive properties of food to that of heroin, caffeine, and nicotine. If we are going through cycles of cravings and fatigue and irritation when it comes to eating, that isn’t a coincidence. Our bodies are actually becoming dependent on the food, and this only increases as we consume more of it.

9. …And companies are doing this intentionally.

Junk and fast food companies are not stupid. They spend millions of dollars and millions of hours of research engineering the perfect food that’s going to keep you reaching back into the bag over and over again, nearly against your will.

10. Labels will openly trick us about health benefits.

In order to combat negative press, get on the increasingly lucrative “healthy food” train, and convince people that eating their products is good for them, many companies deceptively label their foods with supposed health benefits. Breakfast cereals are a great example of a staple food that promises vitamins and nutrients, but doesn’t mention the excessive amounts you would need to eat to achieve them, or the refined sugar, fat, and calories that cancel out the positives. It’s as close as you can get to lying to the consumer without actually doing it.

11. The problem is not going to improve unless we work together.

As long as we continue to point the finger at the individuals around us, and not at the greater underlying problems, this issue is only going to worsen. Obesity has increased steadily over the past forty years, along with its related illnesses, despite increasing spending on both personal diet programs and medical treatments. If the trajectory continues, 44 percent of Americans will be obese by 2030, and the related costs will only increase in tandem.

However, it has been demonstrated that many obesity-related illnesses, beyond just the weight itself, can be reversed through diet and lifestyle changes. But diet doesn’t mean “special diet products,” it means a change in the way we eat and the access we have to food and food education. So before we talk about a lazy person eating McDonald’s, maybe we should be talking about a lazy country who isn’t taking care of its people.