In his specific case, I do think that there are some mental health challenges. Every time he is forced to eat healthy for any extended period of time, he gets into a bad mental funk even as he is losing weight and seeming more healthy. Of course the same worldview that sees eating healthy as abandoning his roots/traditions also sees talking to a psychologist as blasphemous.
I do think that we need to have a national conversation about what a healthy weight and typical portion size looks like. We have gotten so far removed from normal world standards that 20 pounds overweight now seems normal to us.
One last observation. I used to work in poor schools and 80% of the kids were fat by 4th grade. I would say it’s 15-20% at the upperclass school I work at now. The difference isn’t money or time. It’s simply how they view food and nutrition. We would talk about cheap, healthy, and easy meals with the moms and the response was almost always “my kid doesn’t want to eat that”. They would roll in with a 2,200 calorie lunch the next day. But, all the kids were fat so there was no societal pressure to change.