there's a lot more excuses than there are medical issues. are there some people with issues? sure, but there are a ton more who do "muh thyroid, muh metabolism, muh galbladder, muh pcos" strawgrabbing. everyone wants something to be wrong with them so they have a ~reason, but the fact is, most people don't have that reason. it's just an unwillingness to wake the fuck up and make a change.