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It really does depend on the setting. In a pre-industrial society, obesity would be rare. Maybe it might exist among the upper classes, in which case it would be a sign of status, possibly even seen as a Good Thing.
It would have to be rarer than it is now, but obesity has been well documented for thousands of years, and it wasn't generally well thought of or enviable, even if it was more common in the upper classes. Food wasn't scarce at all times and places in history. People tended to be more physically active (unless they were so rich they got carried everywhere in litters), but this evidently didn't protect everyone. Of course, for farmers, the level of activity varied with season. Many tasks required a person to sit for long periods too, and peasant diets were pretty grain based. The health risks associated with obesity were known in Classical times, which suggests it was common enough to be of concern.
https://books.google.com/books?hl=e...9PhVn8#v=onepage&q=history of obesity&f=false
I'm guessing that near-complete absence of sympathetic characters who are very heavy from fantasy and historical fiction (as well as from stories set in more modern times that aren't specifically issue focused) might reflect modern cultural biases more than an attempt to portray things realistically. Though a character living in a historical time or place would likely have biases against very heavy people too. With speculative fiction, one can portray things differently, of course.