Another cause of change one less noticeable but fundamental is the modern growth of population closely connected with scientific and medical discoveries. It is interesting that the United Nations has set up a special Commission to study this question.
Mind you I've always been a very off-message type of fat broad one who gladly admits she reached the size she is now solely through lack of discipline and love of pleasure and who rather despises people (except those with proven medical conditions) who pretend that it is generally otherwise.
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I am sure that I have been much more useful to society as a medical physicist.