Do overweight people with diabetes have themselves to blame? Yes! Just like almost every other disease, obesity and type 2 diabetes are at least in part caused by what we do. As examples, behaviors like smoking, exposure to stress and what we eat contribute to whether we suffer heart disease, infections and many forms of cancer. In fact, even not getting eight hours of sleep each night affects health. So yes, overweight people with diabetes have themselves to blame, in part. But, is there any point to assigning that blame? Is anyone helped by that blame? Do we typically blame the smoker dying of lung cancer, or do we as neighbors and friends try to help the patient and his or her family? Do we usually blame the rock-climber who was injured—after all, she chose that dangerous activity—or do we as neighbors and friends help her take care of her young children until she is better? In most situations, we have sympathy and empathy in regard to those suffering from illnesses and injuries. We can see ourselves in that person's shoes. We can see that blame is pointless. It helps no one. And so it should be with obesity and type 2 diabetes. But it often is not the case. In fact, overweight people are often blamed and ostracized and shunned. It happens on playgrounds, in schools and in hiring for jobs. Enough. In more than 20 years, I have treated people with diabetes. I have seen thousands of overweight patients, and none of them could keep weight off with ease. Why is that? Why can't people just eat less and exercise more? Because overweight and diabetes are not just caused by what we choose, but also by our genes, the behaviors of our mothers before we were born, our jobs and the society that we live in. This may be hard to understand. After all, nobody makes me eat a second helping at dinner. Or do they? While there is a lot more to it, whether I have that second helping is in part a function of how hungry I feel and how much willpower I have. And guess what—both are affected by my genes and my upbringing. We each understand this much better with smoking. Both how addicting cigarettes are and how strong willpower is to quit vary from person to person, based on genes and upbringing. Society can also have an influence, whether it's the allure of advertising making smoking seem desirable or an individual's surrounding environment, which if it includes smokers might induce some individuals to smoke themselves. Considering all these factors, some people can just quit, while others cannot quit even after they have had a heart attack. So again, do overweight people with diabetes have themselves to blame? Yes! So let's all try as hard as we can to live healthier. We do have the personal responsibility to exercise our willpower as best as we can. But, also, let's stop blaming those among us who have health problems related to obesity. Instead, let's support each other in trying to make healthier choices in all that we do. And let's work together with our politicians on making our towns, schools and work places healthier in many ways. Jan Ulbrecht, MD, is one of the diabetes physicians at Centre Medical and Surgical Associates and is credentialed at Mount Nittany Medical Center. He is also one of the four co-directors of the Penn State Diabetes Center.