Most people seem to be dissatisfied with their body profile. There are fat ones who obviously need to shave off the pounds, but find it impossible because of comfort eating, and there are those of average proportions who seem to see themselves differently to how the mirror reflects. Some - women usually - think of themselves as gross when they are pleasantly formed (maybe a bit overweight, maybe almost perfect) and start on a course of dieting. Their weight goes down a bit, and they think, 'Oh, I've earned a small reward!'
The dieting is the source or cause of dissatisfaction, and they might never get back to where they started off, so a bit of comfort eating is in order and they give up, or go overboard and start bringing up their food so as not to put on weight. Illness can follow, because one thing or another is upset in their metabolism due to a lack of this or that... And so the cycle goes on. Some succeed in their diets, but most don't really know how, or can't follow instruction and take 'shortcuts', hoping to achieve their aims quicker and succeeding in putting on excess weight..
With added weight comes the lack of confidence, then they give up and the state health system 'picks up the tab',