When most people talk about obesity, the blame often falls on donuts, McDonald’s, fast food, lack of exercise, or lack of willpower.

But as a primary care physician, I see a different reality. Obesity is not always born from a donut, and it is not always caused by time poverty. Yet in many cases, it grows out of time poverty, a system that robs people of the space to think, to plan, to rest, and to live with intention. Yes, food choices matter. Yes, exercise matters. Yes, willpower matters. But none of these can thrive when time itself has been stolen.

The four components I see every day

Family struggles can lead to financial stress. Many single parents raise strong, resilient children. But for some, when one adult is left to carry all the responsibilities of work, childcare, and survival, the pressures can be heavier. In certain families, that stress contributes to health challenges, including obesity.

Financial stress can lead to low socioeconomic status. Poverty often pushes people into survival mode. Bills stack up: medical, car, housing, insurance, loans. For many, every choice is constrained by cost.

Low socioeconomic status can result in endless work and little time to think. Plenty of people work two, three, even four jobs. They wake at 7 a.m. and collapse at 11 p.m. With that kind of life, it becomes very difficult to plan meals, organize priorities, exercise, or process emotions. Without time to think, life becomes reactive instead of intentional.

Lack of time to think can lead to searching for relief. Human beings need pleasure, joy, and release. When exhausted, the brain often looks for the quickest boost of dopamine. For some, that comes from food; for others, from sex. Neither is wrong. But when they become the only available pleasures, they can become traps. For some, food contributes to obesity. For others, sex may bring new responsibilities and more financial stress. Both can deepen the cycle.

The vicious cycle

• Family struggles may contribute to financial stress.
• Financial stress may increase the risk of poverty.
• Poverty often forces people into endless work that robs them of time to think.
• Without time to think, many turn to quick dopamine from food or sex.
• This can lead to obesity, new responsibilities, or both.
• Those outcomes can fuel depression.
• Depression often worsens obesity, sometimes directly and sometimes through medications like SSRIs that can cause weight gain.

And the cycle continues.

What this system really steals

Overwork does not just harm health. It can erode relationships. Couples may drift apart. Parents, exhausted, may have little left to give their children. This system does not just take health. It steals time. And instead of addressing root causes, society offers expensive so-called solutions: antidepressants, weight-loss pills, and injections. Workers become patients. Patients become customers.

No excuses. No victims. Just clarity.

I am not excusing harmful choices or denying that food, exercise, and willpower matter. They do. But the core of the obesity crisis is not laziness. In many cases, obesity reflects the impact of a system that deprives people of time, the space they need to plan, reflect, move their bodies, and live.

A global reflection

This is not just about capitalism. Similar patterns exist in non-capitalist systems as well, where corruption and instability create their own cycles of hopelessness and suffering.

• Capitalism creates cycles of bills, overwork, and dependency.
• Non-capitalism creates cycles of hopelessness and blocked opportunity.

Both systems leave people paying the price. Every system has shadows. Humanity has not yet discovered a way to truly balance survival with health, family, and time.

The hope ahead

If time scarcity is one of the root causes, then the solution is to give people back time.

• Time to plan meals.
• Time to process emotions.
• Time to exercise.
• Time to care for family.
• Time to think.

When people have that, health often improves. Families can stabilize. Communities can strengthen.

Obesity is not simply a personal weakness. In many cases, it is a symptom of a system. The answer is not blame. The answer is giving people back time to live and be human.

Avan Jaff is an internal medicine physician.