I think it's stated elsewhere that people are overweight yet malnourished due to calorie-dense but low-nutrition food. This leads to overweight health issues that can be attributed to malnutrition but don't fit the profile of "starving to death". The cause of death are other nutrition-related afflictions like diabetes, heart disease, stroke, and even some forms of cancer.

So yes, they're not bones-through-the-skin malnourished, it's more complicated than that.