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Which is it, an important role in certain overweight people, or just an excuse for being out of shape?
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Both. Genetics certainly does have an influence on one's weight. But so do eating habits and exercise. While some people are bound to be a bit round around the edges, they should at least do their best to keep their weight under control.
I should add that one's size and physique does have an influence on how an umpire is treated and percieved. Someone who comes out to the ballpark in this kind of shape is going to find it hard to earn much respect:
http://www.youtube.com/watch?v=CKqbONBsUJs
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The fight is easier these days since a "come to Jesus" meeting over my heart with a cardiologist. Nothing motivates like the ultimate consequence.
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I'm sorry to hear this, and I hope you stay healthy. When did this happen, what happened, etc.?