Health issues are between a patient and their doctor. "F**k fatties!" is bad, and I don't understand how anyone can disagree with this.
Treatment and management of obesity-related medical conditions is a private matter between patient and doctor. Obesity itself is a
public health crisis, so while attacking individual overweight/obese people for their physical state is generally inappropriate, narrowing the aperture on what is considered "acceptable" body shape and lifestyle is absolutely necessary. And when it comes to loved ones, sometimes a reality check is needed to encourage them on a better path.