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Their health suffers so much that we should just feel sorry for them.
Lots of people suffer for reasons beyond their control, whether that's hormone issues, disability, no access to healthy food or dietary advice or the fact it's often cheaper to eat crap than healthy stuff or no education around the issues. You've then got how it's related to unobtainable beauty standards (probably not so much in this case), Jameela Jamil posts a lot about this kind of related issues where she suffered with anorexia in the past and photos of her at her healthiest are the ones people have called her obese.
snottyotter-
Also you've got societies where huge women are preferred by most men, e.g. Nigeria. More and more white British men are expressing the same preference. No doubt there are psychosexual explanations. My sister IMHO has a disastrous figure, but some men are like a dog with two dicks when they see her from afar.
nick_h.
Their health suffers so much that we should just feel sorry for them. They're shortening their lives, and deep down they know it. Scorn is superfluous. You can feel scorn, but it's a bit cruel to give voice to it.