What causes obesity to get worse?

Eat more, move less: Anything that causes an obese person to eat more calories or to exercise less will worsen his obesity. Examples: eating as a self-treatment for depression symptoms, eating due to hunger shortly after meals (from high Insulin levels combined with dropping blood sugar levels), not exercising due to being very out-of-shape, not exercising due to being embarrassed by one's public appearance, etc...

Too much food.: Eating too much and/or not moving enough are the main factors that lead to weight gain. Obesity worsens over time provided nothing changes as it's toll on the body continues. Focus on losing just 5% of your body weight to improve your health and then reevaluate your goals once you achieve that. Talk small walks to being increasing movement as well. Both help.