Well, the glasses are indeed fixed by possibilities of treating practically everything, and I guess the lack of guts are explained by the training that cadets undergo before and after joining up - as well as the fact that I doubt that food from the replicator is food exactly as we know it, so that should take care of spare calories which are synthesised away.

But yes, on the whole, today's undesirable features are clearly not a part of the Star Trek universe.