I don't use a weight to classify someone as morbidly obese, and you're right that there's a gray area. I've known several people who get winded and raspy from standing up, because of their weight -- that's unhealthy, regardless of the number on the scale. I can get around the day without generally feeling tired, although I think I'd feel better at 220#. My doctor wants me at 210#, and he can go blow himself. :D
As with most chicken-and-egg scenarios, I think the answer is, in many cases, both. Some people start out perhaps a little overweight, and learn to tie that weight with other things wrong with their life, especially when other kids tease them. The depression and the overeating become joined, and evolve together. Then it becomes a cat-rat farm: If they lost weight, they'd feel better about themselves, which means it's their fault their sad because they haven't lost the weight, and so they eat to make themselves feel better. As someone who has battled depression himself, I know that, in those case, just identifying the cause doesn't go a long way towards fixing it -- I have, and still sometimes do, identify as "a depressed person," and one anxiety I have is what will happen if I stop being depressed? I don't have labels for myself (although I'm developing them) that translate to "a content person." Having the realization, "I'm 450# because..." isn't useful in my opinion unless there's another thought, "I've become 280# because..." ready to take its place.
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As with most chicken-and-egg scenarios, I think the answer is, in many cases, both. Some people start out perhaps a little overweight, and learn to tie that weight with other things wrong with their life, especially when other kids tease them. The depression and the overeating become joined, and evolve together. Then it becomes a cat-rat farm: If they lost weight, they'd feel better about themselves, which means it's their fault their sad because they haven't lost the weight, and so they eat to make themselves feel better. As someone who has battled depression himself, I know that, in those case, just identifying the cause doesn't go a long way towards fixing it -- I have, and still sometimes do, identify as "a depressed person," and one anxiety I have is what will happen if I stop being depressed? I don't have labels for myself (although I'm developing them) that translate to "a content person." Having the realization, "I'm 450# because..." isn't useful in my opinion unless there's another thought, "I've become 280# because..." ready to take its place.