I've been poor. I've been in situations where the only lunch option was McDonalds. Didn't get fat. Didn't get diabetes. How come? Ordered a cheeseburger, small fries, water, while all of my co-workers "super-sized" their orders. My bill and my BMI were always far lower than theirs. People here can blame corporations, "red staters", "food deserts", and whatever other divisive new york times nonsense they want. Ultimately, you've only got one pancreas, and instead of pointing fingers, you should take care of it.

I didn't get pre-diabetic until I was wealthy--eating out, non-stop sushi and Thai. Unfortunately for me, rice has a very high glycemic index. It is not suited to the genetics of my people.