[HN Gopher] Being overweight overtakes tobacco smoking as the le...
___________________________________________________________________
Being overweight overtakes tobacco smoking as the leading disease
risk factor
Author : giuliomagnifico
Score : 190 points
Date : 2024-12-11 14:51 UTC (8 hours ago)
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| malfist wrote:
| I saw a news article the other day that the obesity rate
| decreased instead of increased last year for the first time in
| well over a decade.
|
| I wonder how much GLP-1s have to do with all of that, and how
| much more they'll do.
| quaffapint wrote:
| I do wonder how much affect it has. At least in the US most
| insurance companies won't cover them (unless you already have
| diabetes, for example) and at over $1,000 a month I can't see
| how the people who could really benefit from this to lower the
| numbers can possibly afford it.
| malfist wrote:
| From personal experience, it's ridiculously easy to get a
| compounded formulation from one of the telehealth suppliers,
| and it's cheap even though you can't submit it to insurance.
| I think I pay $200 and get two one month vials for it.
|
| It's been marvelous for me, I was just over the edge into
| overweight, so no one would prescribe it for me, even though
| I had a borderline pre-diabetes A1C, and reactive
| hypoglycemia runs in my family.
|
| My choices were gain another 10 pounds, or find a telehealth
| that wasn't bothered by not following the FDA rules so
| strictly. So that's what I did, I got a script from
| telahealth and now I'm smack dab in the middle of the healthy
| weight range (-24lb), haven't had a hypoglycemic incident
| since I started it, and as a bonus my IBS-D went away
| completely.
|
| I've reduced my dose to the point that I'm at the dose you
| start out on, and that has let me keep my weight constant
| without losing more or gaining more. Plan to stay this way
| for a year and then see about titrating it even more until
| I'm off of it. I also followed their instructions and only
| titrated up when I wasn't seeing weightloss, so I never hit
| the highest dose, and kept my weight loss to .75-1.5 lb/week.
| Perfectly sustainable.
|
| This has been miraculous, and something that multiple years
| of consistent dieting hasn't solved. And as a bonus, I can
| now do my strength training I love without feeling like I
| have to eat the house on the recovery day
| aoanevdus wrote:
| Random question about how those compounding pharmacies
| work. Can you order a higher dose and then just stretch it
| out by taking the minimum dose to save cost? Do they
| automatically bill you monthly or can you skip months?
| malfist wrote:
| That's kinda what I'm doing. They still send me enough
| for my max dose reached (1.5mg/wk), but I've titrated
| down (to 0.5mg/wk) since I'm at the weight I should be
| at, so I just use a vial for a month, and toss the
| remainder. They send me two vials at a time.
|
| The vials have a 6 month use by date, though evidence
| indicates semaglutide is stable for 1 year. I can log
| into the portal and tell it to skip a month, but since
| it's a push system, I don't get automatically billed. I
| actually have to do a checkin and the doc has to approve
| the refill. So if I have extra vials, I just skip that
| month's check in.
|
| There's some indication that you don't have to toss the
| vial after a month, the FDA set those limits assuming it
| was insulin that is used sometimes more than daily. 4
| penetrations of the vial's membrane probably isn't enough
| to contaminate it, but I'd rather be on the safe side so
| I don't use the vial for more than a month at a time. My
| partner is a pharmacist, so that part of the influence
| for the safer approach.
| daedrdev wrote:
| I think which is usually they start you at a small dose,
| ramp you up in dosage, then ramp you down when its time
| to come off, that way you dont suddenly feel much
| hungrier when it goes away because you've slowly adjusted
| it.
| sjsisjxjdjd wrote:
| > something that multiple years of consistent dieting
| hasn't solved
|
| Did you continue to track calories while using the drug?
|
| As somebody who has successfully increased and decreased
| their body weight over the years (after initially being
| obese), if you're able to diet consistently I don't see why
| a drug is needed. My guess is whatever diet you were on was
| consistent for the weight you were at.
| malfist wrote:
| I don't find calorie tracking to be very successful. In
| my mental ecosystem, it penalizes spending calories on
| healthy foods (why eat that banana if it's just
| calories), and I don't do so well with a budget, constant
| go over just slightly.
|
| I had better luck with Weight Watcher with "free" healthy
| foods and the segmentation between weekly and daily
| budgets. Then weight watchers tweaked their point values
| so much that I couldn't stick with it very well, and when
| I dual tracked points and calories the new WW plan had me
| at under 1400 cal/day, which isn't sustainable.
|
| > if you're able to diet consistently I don't see why a
| drug is needed
|
| It'd really really really really really really hard to
| stick to a diet, especially long term. GLP-1s puts eating
| healthy and good portion sizes all on autopilot. I don't
| have to plan out how I'm going to manage my hunger and my
| food noise, it's just auto pilot. I naturally gravitate
| to eating enough, but not too much, and mostly plants.
| whatshisface wrote:
| Bananas aren't really that healthy. Like you said their
| nutritional value is mainly just calories.
| nemomarx wrote:
| I don't think 1400 is unsustainable? it'll lead to losing
| weight continuously, maybe a half pound a week ish, but
| that's sustainable for as long as you have weight to
| lose, isn't it?
| sjsisjxjdjd wrote:
| Yes, very likely.
|
| https://en.m.wikipedia.org/wiki/Angus_Barbieri%27s_fast
| mmierz wrote:
| This depends on your size and activity level. The last
| time I dieted, I was losing a pound a week on 2700
| calories. 1400 would have been a severe crash diet.
| voisin wrote:
| > And as a bonus, I can now do my strength training I love
| without feeling like I have to eat the house on the
| recovery day
|
| I am interested in hearing more about your strength
| training on this. Do you find that eating less slows your
| gains and PRs?
| malfist wrote:
| I'm sure it does, but I'm not a good enough strength
| trainer to really notice. I'd say I'm closer to an
| intermediate lifter than a beginner, but I'm not advanced
| enough to really notice a difference.
|
| Time in the gym is my biggest blocker today, not what I
| ate.
| hirvi74 wrote:
| I am curious, if you don't mind. Have you noticed any other
| fringe benefits? By that, I mean a reduction in alcohol
| consumption or other non-food vices? Any cognitive benefits
| like an increase in focus or concentration?
| SystemOut wrote:
| I'm on Mounjaro for T2D, previously on Ozempic. Besides the
| weight loss and the blood sugar control it also eliminated
| my IBS as well. Before the drug certain foods, especially
| nuts would cause excruciating digestive issues. I can now
| eat them without worry. It's been amazing.
| caffeinated_me wrote:
| Any recommendations on telehealth suppliers to contact for
| that compounded formulation? They're easy to find, but I'm
| not sure who is trustworthy on this topic.
| 2snakes wrote:
| Mochi / Henry Meds. Mochi is the cheapest.
| criddell wrote:
| I just went through the quiz at Mochi and it said I was
| eligible for their nutrition program but not medication.
| The FAQ says your BMI has to be over 30 or 27 if you have
| some other health condition.
| jimbob45 wrote:
| Doesn't seem like it will matter. The core patent expires in
| 2026[0] and the rest expire in 2033. It seems like most will
| have access to at least some form of the drug affordably
| within the next five years.
|
| [0]https://www.reddie.co.uk/2024/08/30/the-year-of-ozempic-
| an-i...
| danans wrote:
| Ozempic is around $100/month in most western European
| countries, including the country of it's maker, Novo Nordisk.
|
| Sen. Bernie Sanders has been recently calling out this
| company for charging an order of magnitude more in the US,
| where it is priced like a cosmetic medical product.
| bwestergard wrote:
| This paper provides a helpful breakdown of types of mortalities
| and how they're associated with BMI. It's interesting to see that
| the lowest All-cause mortality is at a BMI of 25. A BMI of 30
| doesn't increase the hazard ratio that much, but a BMI of ~45
| doubles it. The minimum for cancer mortality is notably lower
| (21) but perhaps surprisingly the minimum communicable disease
| mortality is at a BMI of 26.
|
| https://www.thelancet.com/journals/landia/article/PIIS2213-8...
| hooverd wrote:
| My guess: less cells mean less cancer, but it's good to have
| reserves if you're fighting off a virus?
| ethagknight wrote:
| More likely relates to diet. There was a recent WashU study
| directly linking high fructose diets to increased cancer.
| Cancer cells are vigorously growing, needs lots of available
| fuel, a diet full of corn syrup fuels both fat and cancer.
| JumpCrisscross wrote:
| > _a diet full of corn syrup fuels both fat and cancer_
|
| Or sugar. Or modern fruits. The problem with HFCS isn't
| that it's got fructose (so does cane sugar) or is made from
| corn, it's that it's cheap sugar.
| enaaem wrote:
| How much fruit do you have to eat before it becomes
| harmful? I can imagine juice can easily be over consumed
| but solid fruit is very satiating.
| JumpCrisscross wrote:
| > _How much fruit do you have to eat before it becomes
| harmful?_
|
| Unclear. The aforementioned study fed mice sugar water
| [1], and cautions against extending its findings to fruit
| as "natural fructose obtained from plants typically
| confers metabolic benefits due to its slower absorption
| rate and the presence of beneficial plant fiber and
| antioxidants."
|
| It does mention, however, that "human
| physiology...confronts challenges when metabolizing
| fructose beyond 25g/day." That's like a cup of grapes, a
| medium pear or half a mango [2].
|
| [1] https://www.ijbs.com/v20p3480.pdf
|
| [2] https://www.webmd.com/diet/ss/slideshow-fruit-sugar
| BobaFloutist wrote:
| >solid fruit is very satiating.
|
| Very briefly.
| hollerith wrote:
| I've stopped eating fruit (and carrots, which have fruit-
| like levels of sugar) with the exception of tart (i.e.,
| less sugary) cherries out of a desire to limit my
| fructose intake. I was eating raspberries, too, which are
| much lower in sugar than most fruit, but stopped because
| of their high levels of oxalic acid, but I do expect to
| restart raspberries in a few years because I expect my
| ability to tolerate oxalic acid in my diet to improve
| slowly over the next few years. (In contrast, high-
| fructose foods including most fruit are probably gone for
| good.)
|
| Of course, I'm not asserting that everyone should do as I
| am doing. There is substantial variation between
| individuals here.
| homero wrote:
| It's funny all the modern fruit I see is bigger but dry
| and not sweet at all
| pengaru wrote:
| AIUI cancer cells are also metabolically inflexible; they
| like glucose, not ketones.
| voisin wrote:
| Good evidence for this found here: "Tripping over the
| Truth: The Metabolic Theory of Cancer"[0]
|
| [0] https://www.goodreads.com/book/show/23496164
| JumpCrisscross wrote:
| > _AIUI cancer cells are also metabolically inflexible;
| they like glucose, not ketones_
|
| Is there a selection effect at play? As in, a person with
| high serum glucose levels will tend to have cancer that
| likes glucose? That would imply the solution isn't
| ketones _per se_ , but changing the fuel from whatever
| the cancer grew up with.
| pengaru wrote:
| iirc the talk I learned this from said there's simply not
| many cancer variants that don't need abundant glucose to
| grow tumors. That the whole defect stems from hijacking
| the energy side to fuel uncontrolled growth, and it needs
| glucose.
| circlefavshape wrote:
| I know someone who tried to use keto to manage her bowel
| cancer, and died. Used to know rather than know I guess
| ifwinterco wrote:
| Yeah I see this take all the time and it's dangerous, it
| might have an element of truth but it's definitely
| dangerously simplistic. You can find advocates of low fat
| high carb diets also claiming that very low fat intakes
| improve cancer survivability.
|
| I'm sorry for your loss
| moduspol wrote:
| Perhaps people getting cancer treatments tend to lose a lot
| of weight before dying?
| strict9 wrote:
| Another possibility is that unexplained and unintended
| weight loss is associated with increased risk for many
| types of cancers.
| Izkata wrote:
| Yet another showing "overweight but not obese" might not
| actually be bad, and this post's title is wrong?
|
| ("Overweight" is the BMI range 25 - 30, "obese" is 30+)
| gklitz wrote:
| Being overweight increases the risk of developing quality of
| life reducing conditions and that is bad (it's not being
| overweight itself that is bad). This is the case even if it
| doesn't lead directly to dying. I would be careful about
| pushing the narrative that being overweight but not obese is
| just fine just because it won't significantly increase your
| chance of straight up dying. Type 2 diabetes is a treatable
| condition so might not lead to a significant increase in
| deaths, but not exactly something you would want to develop
| if you can avoid it. And your chance of developing just that
| does increase if you are overweight even if you are not
| obese.
| Izkata wrote:
| I'd like to emphasize the "might not": The impression I get
| from all these studies (I've seen them pop up pretty
| regularly for as long as I've been paying attention, nearly
| two decades) is that the border is actually wrong, that
| going from "normal" to "overweight" should be increased
| slightly from 25 to 27 or so. We're probably getting mixed
| signals in the "overweight" classification because "okay"
| and "bad" levels are being combined.
| wjnc wrote:
| The focus on kg/m2 (BMI) I cannot understand. Surely the lowly
| "body fat percentage" should be a better variable than kg/m2?
| Bodies are three dimensional you know!
| coldpie wrote:
| It is much easier to measure, and is a good enough proxy for
| the vast majority of people.
| bumby wrote:
| To quantify, I've heard MDs say that the outliers
| (relatively high BMI but low body fat) constitute less than
| 1% of high BMI people. They also said that those outliers
| are still at risk of certain health troubles, like sleep
| apnea.
|
| The suggestion of using BMI + waist circumference is an
| easier to measure risk factor than bodyfat percentage and
| helps to better capture those outliers.
| mannykannot wrote:
| I imagine the missing spatial dimensions are correlated with
| weight, for any given height.
| swatcoder wrote:
| BMI is trivial to measure conclusively, using tools that are
| almost universally available and ready. And at population
| scale, it's proven to be a strong and pretty signal for
| analyzing in studies like these as the ways in which BMI can
| fail for individuals is too uncommon for it to matter to
| population studies.
|
| It's a perfect tool to use for studies like these, as it can
| contribute understanding society-level concerns about the
| obesity epidemic and what impact we can expect it to have if
| it continues not to be tackled.
|
| But like with almost all medical and nutritional research,
| drawing conclusions for yourself as an individual based on
| these population-scale studies is inevitably fraught. In the
| case of BMI studies, you can often get a fair sense of
| whether you should be concerned or not, but do need to take
| into account other things that you know about your lifestyle
| and health. Your doctor, presumably, does exactly that.
|
| Meanwhile, body fat percentage tends to be _very_ hard to
| measure accurately in the first place and has different
| techniques that tend to have different error characteristics,
| making it hard to correlate it between studies done through
| different clinics, let alone against someone 's personal
| assessment at home or with their personal
| doctor/trainer/whatever. It probably has high relevance to
| some medical and nutritional outcomes, but isn't a very
| useful input variable for research because its inescapably
| noisy.
| hirvi74 wrote:
| I apologize if this is tangential, but I have noticed BMI
| research is often heavily criticized, but the same issues
| that plague BMI can easily be applied to psychometric
| measurements of intelligence (IQ), but somehow IQ is spared
| the same beating for some reason I must not understand.
|
| Perhaps my low IQ is showing, but why is one metric heavily
| criticized while the other is not? (Rhetorical)
| TylerE wrote:
| Huh? I haven't seen "IQ" seriously used in decades. Its
| flaw are well known.
| hughesjj wrote:
| Even in popsci/social media I've seen more and more
| awareness that it's "bunk" science.
|
| It's in the same category as all that "alpha male"
| theory, Meyers Briggs, polygraphs, and "left vs right
| brained" people.
|
| I'm starting to see more awareness around the concerns of
| "ballistic forensics" too, which is heartening.
| hirvi74 wrote:
| > Even in popsci/social media I've seen more and more
| awareness that it's "bunk" science.
|
| Devil's Advocate: Then why is it so heavily used still?
| (Then again, I guess back to my initial point -- the same
| could be said for BMI.)
| TylerE wrote:
| Proof that's it's still heavily used in serious
| scientific literature?
| hirvi74 wrote:
| How do you define 'serious scientific literature?' In
| other words, what type of evidence would you like me to
| present? Does any peer reviewed research that uses IQ as
| a factor count as serious? (Obviously, I won't present
| research that is _about IQ measurement._ )
| mewpmewp2 wrote:
| I have never had IQ test taken, but countless of times
| BMI has been calculated. Mind you I have had other mental
| tests done due to ADHD and Autism concerns, and some of
| them were similar about abstract logic, but they were
| combined with other things like focus, memory,
| multitasking, literary understanding and other mental
| capabilities. The results of these tests were presented
| as percentiles in the population.
| hirvi74 wrote:
| Interesting. I was given an IQ test for ADHD diagnostic
| purposes. There were other test given, as well. And in my
| opinion, the other tests were more indicative than the IQ
| test was (which I think is falling out of favor with ADHD
| testing). Then again, there were some issues with my test
| and scoring, so it makes me even more dubious of the
| (psuedo)science.
|
| I went through the arduous process merely for the formal
| documentation, which in hindsight has served me well. Not
| a single doctor has ever questioned my diagnosis.
| However, as the psych told me, a 10 minute conversation
| with me should honestly have been evidence enough. ;)
| mewpmewp2 wrote:
| Interestingly, the actual ADHD tests didn't find any
| issues, my main issue was my mind wandering in social
| situations, listening, understanding, keeping track of
| conversations and my own input. But whatever the tests
| were they were stimulating enough that I had no problem
| focusing. It's also repetitive, routineus actions that I
| have trouble focusing on, so it's almost like untestable
| issues. I did get the diagnosis though, I don't remember
| with what justification since the tests didn't allow for
| that.
| hirvi74 wrote:
| I was administered the WAIS-IV for the purpose of a
| clinical diagnosis about 10 years ago. My state still
| considers it one of many factors in whether one is a
| candidate for the death penalty. Some gifted programs
| still accept the scores as necessary evidence for
| admission.
| swatcoder wrote:
| > somehow IQ is spared the same beating
|
| I think this is the part you're getting wrong, which is
| why you're confused.
|
| IQ was contentious from its introduction in the beginning
| of the 20th century, caught some traction in the mid-
| century, and has mostly been on a decline of esteem and
| respect again since. It's never been very broadly
| accepted, let alone spared from criticism, nor have most
| other psychometrics, although (as always) there are
| bubbles of academia, industry, and the general population
| that swear by them and work to legitimize them.
|
| Kurt Danziger has published really great histories of all
| this.
|
| I'll add that his books are especially interesting in the
| context of all the AI buzz as insight into the history of
| "intelligence" (the word, the socially constructed
| concept, etc) helps wrap one's head around what it means
| when people working in CS try to repurpose its
| terminology in their own field.
| tptacek wrote:
| IQ is as far as I can tell quite well accepted as a
| diagnostic tool. The pushback is in its application
| across whole populations.
| hirvi74 wrote:
| FWIW, anecdotal data is also considered a valid
| diagnostic tool too, and we know how unreliable such
| information can be.
|
| Also, by populations, do you mean groups of particular
| types of people or just groups of people in general? If
| anything, I thought IQ really only had anything close to
| merit at large population levels. Much of what I have
| read clearly fails at an individual level.
|
| However, if you are talking about IQ's application in
| regards to populations like one race vs. another, then
| yes, I think the pushback is well deserved.
| tptacek wrote:
| I agree with you about your last statement! I think it's
| actually a pretty interesting comparable to BMI. BMI:
| useful epidemiologically, across large populations, but
| much less useful individually. IQ: much less useful
| across large populations, but useful as a
| diagnostic/clinical tool in individual settings.
| swatcoder wrote:
| > IQ is as far as I can tell quite well accepted as a
| diagnostic tool
|
| Inside certain bubbles, sure, because there's pressing
| demand to have _something_ quantifiable and sufficient
| supporters willing to assert its legitimacy.
|
| But good luck taking your test results outside of those
| bubbles to earn you some opportunity or respect, even if
| you can say your test was administered to the highest
| standards by the most respected administrators.
|
| Nobody here will take your results to mean anything.
| Nobody at your work will take your results to mean
| anything. The recruiter at some new potential job won't
| either. The prestigious university you want to attend
| won't care. Most of your partners and friends probably
| won't.
|
| Many of them may already have a sense of whether you're
| "intelligent" or not, either from personal interactions
| or from other practical indications. But good luck
| finding somebody of material influence who would hear
| your IQ score results and change their mind. It just
| doesn't have that weight.
|
| That's what it means for it not to be treated seriously
| outside of bubbles. There are supporters that back it,
| and there are institutions that rely on it, but outside
| of those very specific places, there's very very little
| trust in it.
| hirvi74 wrote:
| In any bubble where IQ is considered legitimate, just
| mention that Richard Feynman apparently had a recorded IQ
| of 124 or so (or Lewis Terman's study of gifted
| children).
|
| You'd think someone tried to convince those in the bubble
| that the Earth is flat. In my experiences, I have been
| met with all kinds of rebuttals like, "The test he took
| was probably over-weighted in verbal vs. spatial
| reasoning" or "He probably just blew the whole test off."
|
| No one has a copy of the actual results to my knowledge,
| but he and his sister (who oddly enough scored higher)
| verified the story back in the day according to
| biographers. So, not telling what is the true story.
|
| For the sake of argument, let's assume Feynman's score
| was indeed accurate. I think it makes people extremely
| uncomfortable for two reasons:
|
| 1. Some individuals with high IQs (IQ >= 130) feel
| threatened or ashamed by the fact that someone with an
| high but unremarkable score was capable of truly
| remarkable contributions to their field.
|
| 2. The scores are truly not always accurate or might
| potentially measure something that isn't intelligence.
|
| If Feynman's score was indeed an inaccurate measurement
| of his intelligence, then that says more than I need to
| know about IQ testing.
|
| I mention Feynman because I am in agreement with you:
|
| > _Many of them may already have a sense of whether you
| 're "intelligent" or not, either from personal
| interactions or from other practical indications._
|
| No one would consider Feynman to be unintelligent by any
| stretch of the imagination. However, at the end of the
| day, his score truly _doesn 't matter._ Feynman nor
| anyone else is not remembered because of their
| intelligence, but rather, his contributions. Besides,
| exceptional people tend to be, well, _exceptional._
| hirvi74 wrote:
| > there are bubbles of academia, industry, and the
| general population that swear by them and work to
| legitimize them.
|
| Perhaps you a right, because this is my main exposure to
| psychometric. From much of what I have read from various
| journals, there are clearly those that are contrarians,
| but mainstream academic psychology presents IQ as if IQ
| is some infallible measurement of human intelligence.
|
| Despite IQ's merits being contentious (like BMI), it is
| still widely used regardless. IQ testing is still used
| for clinical diagnostic purposes (why I had to take one),
| entrance in to some gifted academic programs, in judicial
| contexts, etc..
|
| Based on my personal research and experiences, I align
| with the contrarian views vs. the mainstream, academic
| views.
| hluska wrote:
| IQ routinely gets destroyed. As an example, I was an
| undergraduate in the 1990s. My statistics class skewered
| the use of IQ back then. According to some friends with
| undergraduates, they still use that as an example of
| statistics being used badly.
| hirvi74 wrote:
| People say that, but then people like me are administered
| the tests for clinical diagnostic purposes (right or
| wrong), and even my state still considers the scores to
| be a valid measurement of intelligence, and thus a factor
| in whether someone convicted of murder is eligible for
| the death penalty.
|
| I think the concept is bullshit myself, but regardless
| the damage is done, and still being done for what it is
| worth.
| Natsu wrote:
| IQ is an interesting one. There are indeed plenty of
| issues in actually measuring it and deciding what we're
| even measuring to begin with, but at the same time, I've
| heard some people try to say it doesn't even exist at
| all.
|
| Which seems odd, because I've yet to see anyone who
| doesn't believe that stupidity exists and it's the other
| side of the same coin.
| hirvi74 wrote:
| > I've yet to see anyone who doesn't believe that
| stupidity exists and it's the other side of the same
| coin.
|
| I do not think that is the argument though. Clearly,
| there is some sort of distribution of all human
| attributes. I think the argument is in how (in)accurately
| something as qualitative and arbitrary as intelligence
| can be measured.
|
| I like the analogy of athleticism. Some people are more
| athletic than others, but again, such differences are
| generally highly contextual. I am sure some sort of test
| composed of factors like the number of push-ups, sit-ups,
| and time trial of a 100m dash could be used to generate
| some sort of AQ (athletic quotient).
|
| However, scoring high on the 100m dash might positively
| correlate with performance in sports, but I would not
| wager that a high AQ is truly indicative of athletic
| performance as a whole. At least not in any transitive
| sense when mapped to many sports. For example, Usain Bolt
| might have a very high AQ because of his running ability,
| but his AQ might not serve him well in a game of ice
| hockey or swimming.
| worik wrote:
| > BMI is trivial to measure conclusively
|
| That does not make BMI a good measure.
| tptacek wrote:
| It does for some applications, and not for others. In
| epidemiology you're looking at the number across broad
| populations, where a lot of the "three dimensions"
| idiosyncrasies cancel out. You're likely to run into
| trouble taking literal BMI constants and turning them
| into individualized patient care instructions, though.
| maxglute wrote:
| It's an easier diagnostic metric. Being jacked shit house
| with high BMI will still suffer from health issues of merely
| being overweight relative to frame.
| voisin wrote:
| > Being jacked shit house with high BMI will still suffer
| from health issues of merely being overweight relative to
| frame.
|
| Do you have evidence for this? (Assuming getting jacked
| without the use of steroids)
| fluoridation wrote:
| Well, for one, it places the same strain on the skeleton,
| with all the consequences that entails. Mass is mass, no
| matter if it's muscle or fat.
| nradov wrote:
| Well yes and no. Strain on the skeleton from excess
| muscle isn't particularly a problem unless someone is
| really huge or does a lot of running. The skeleton adapts
| to handle the load. Having more strength in the muscles
| that stabilize joints actually reduces the risk of joint
| injuries -- up to a point.
|
| https://peterattiamd.com/belindabeck/
|
| The medical problems with excess muscle mass tend to be
| more on the cardiovascular system than the skeleton. And
| the process of gaining a lot of muscle mass can increase
| the risk of musculoskeletal injuries (especially if using
| PEDS), which is a key confounding factor when looking at
| population health statistics.
| byproxy wrote:
| Wouldn't some (if not all) of that be mitigated by the
| increase in bone density that comes with resistance
| training?
| fluoridation wrote:
| The problem is not bone density. Your bones are never
| going to break under your own weight unless there's
| something _seriously_ wrong with you. The problem is
| joint health.
| byproxy wrote:
| Sure, guess I read your comment as bone-focused. That
| said, joints also do get more resilient when resistance
| training. Although, I'm aware not necessarily at the same
| rate as the muscles themselves, leading to issues where
| the muscles are capable of handling more weight than the
| joints can happily handle (if we are to personify
| joints). But, I think that issue is mostly obviated with
| good programming and load management.
| maxglute wrote:
| Your heart is still moving the same weight, fat or
| muscle. It's the same from system stress. Experiencing
| more health issues from bulking even at >20 bodyfat is
| pretty common... blood pressure etc. At some point just
| being a bigger person who has to eat more takes a toll.
| nradov wrote:
| BMI is more of a _screening_ metric than a diagnostic
| metric. It 's not really diagnostic of any medical
| condition beyond obesity itself, but if a patient is
| outside the normal BMI range then that can be a reason to
| justify additional diagnostic tests for certain conditions.
| DiskoHexyl wrote:
| Let's put it like this: the probability of an individual to
| be at a BMI of 30+ AND being very lean, while not using PEDs,
| is extremely low. So low, in fact, that it doesn't make sense
| to even look into these outliers from the societal health
| point of view.
|
| Imagine a 180cm 98kg male. That would be a BMI of 30. How
| often do you see people of that size with visible abs? And of
| those, how many are the ones who've never touched steroids,
| sarms, peptides and hgh?
|
| If a person's BMI is less than 30, they are going to be okay
| no matter what their body composition, and with a BMI of 30+
| they aren't going to be okay, whether they are fat or jacked.
| Both obese and insanely built people put massive strain on
| their knees and back, both typically have high blood
| pressure.
|
| Then the adipose tissue itself has various negative
| inflammatory effects on health, which sceletal muscle
| doesn't, and fat people encounter psychological side-effects
| of being unattractive, which jacked people don't, but PED use
| has its own list of well-known issues, and being THAT MUCH
| into bodybuilding is highly correlated with body dysmorphia
| alongside other physch issues.
|
| So both are bad, and when speaking about general population
| health, we shouldn't really focus on body composition- BMI is
| good enough marker on its own
| heraldgeezer wrote:
| If you are not an ELITE athlete or bodybuilder... then BMI is
| accurate. You are coping.
| hluska wrote:
| Outside of elite athletes, BMI is good at what it's for. It's
| just an easy way to express the relationship between your
| weight and height. Everything else requires specialized tools
| and contains a large margin of error.
| thr3000 wrote:
| This particular statistic has a ton of problems. It's
| impossible to disassociate the various causative pathways that
| land you at a BMI below 25. A ton of them involve diseases and
| chronic conditions.
|
| Unfortunately, it's very hard to impossible to RCT this. And if
| a study has no RCT, take it with as much salt as your diet
| allows.
|
| You definitely don't want to intentionally _gain weight_ on the
| basis of this. If weight control is easy for you, I would
| personally strive for a lower BMI.
|
| If losing weight below 25 is hard for you and your body just
| seems to refuse to do it, then you _might_ be OK at 25.
| 0xffff2 wrote:
| What's RCT?
| tptacek wrote:
| Randomized controlled trial.
| pessimizer wrote:
| > This particular statistic has a ton of problems. It's
| impossible to disassociate the various causative pathways
| that land you at a BMI below 25. A ton of them involve
| diseases and chronic conditions.
|
| I'd beware of using this sort of hand-waving to ignore the
| studies, there are also effects pushing the relationship
| between average health outcomes and BMI in the other
| direction. Your ethnic origin seems to be very important, and
| for ethnicities who already have a high propensity for Type 2
| diabetes, higher BMI is a factor, but not a huge one.
|
| > _Strikingly, in those with a normal weight, the prevalence
| of diabetes was 5.0% in whites, 10.1% in Asians and American
| Indians /Alaskan Natives, 13.0% in Hispanics, 13.5% in
| Blacks, and 18.0% in Hawaiians/Pacific Islanders._
|
| > Furthermore, when they examined the relative risks for
| diabetes for each BMI category by race/ethnicity, Zhu et al.
| reported that across all racial/ethnic groups whites had the
| steepest BMI gradient, followed by Asians, American
| Indians/Alaskan Natives, Hispanics, Hawaiians/Pacific
| Islanders, and blacks.
|
| https://diabetesjournals.org/care/article/42/12/2164/36251/D.
| ..
|
| Another potential distortion comes out of this when you
| consider that black and Hispanic people are the fattest in
| the US. Blacks and Hispanics can have lower lifespans for
| reasons other than BMI, such as access to health care, high-
| quality food, exposure to violence, physical jobs, etc...
|
| So just these two factors complicate the picture in general
| (your fattest have the least access to health care and most
| exposure to danger and neglect), and and in the other
| direction specifically for white people (an increase of BMI
| in white people makes a huge difference in their incidence of
| diabetes.)
|
| Anecdotally, I'm black, and there's a lot of thin diabetes in
| my family. My dad usually runs about 20-21 BMI, and is pre-
| diabetic. His mother, who is also small, though not quite as
| small, is also diabetic. As far as I can tell, the fatter
| people in both sides of my family are no more likely to be
| diabetic than the thinner ones.
| patorjk wrote:
| This kind of stat is misleading and is seen in many health
| metrics - blood pressure, cholesterol, etc. In fact, it's
| sometimes known as the "cholesterol paradox" because people
| with higher cholesterol have a lower risk of dying. However,
| it's misleading because blood pressure, weight, and cholesterol
| often come down as people suffer from chronic disease or
| malnutrition. The chronic diseases people get are often from
| their weight, blood pressure and cholesterol, and when this is
| corrected for, the all-cause mortality curves better reflect
| what a healthy person's numbers should be. So in reality the
| lowest point of the all-cause mortality curve for BMI is below
| 25. 25 is not optimal.
|
| Dr. Carvalho recently made a video on this topic (he even
| mentions the BMI curve). You can watch it here:
| https://www.youtube.com/watch?v=n4h135SBebc
| hooverd wrote:
| I wonder if we'll see an increase in other nicotine related
| issues. It's hearsay from my gen-Z colleagues but apparently
| there's a bit of a ZYN/snus epidemic.
| xnx wrote:
| Nicotine might be one of the least harmful things in cigarettes
| compared to tar, carbon monoxide, benzene, formaldehyde,
| cadmium, arsenic, etc. Nicotine by itself isn't too different
| from caffeine.
| llamaimperative wrote:
| > Nicotine by itself isn't too different from caffeine
|
| Yes it is
|
| You should actually look up the literature. Chronic use is
| actually harmful in a lot of the same ways that tobacco
| smoking is. Obviously it's a huge improvement over tobacco
| use, but it's also a huge downgrade from abstinence as a
| whole.
| snovymgodym wrote:
| Nicotine on its own frankly isn't that harmful outside of
| addiction. Not great for you, but it's orders of magnitude more
| healthy than being obese.
| k4rli wrote:
| Zyn barely has any nicotine. In Europe most are 5x stronger but
| even 10x stronger pads at 50mg/g exist. This is nothing new.
| E-cig liquids have been as strong for a long time as well.
| flippyhead wrote:
| Well, this is excellent news. I can start smoking again!
| INTPenis wrote:
| ...in Australia might be worth adding.
| deadbabe wrote:
| People are trying to make being overweight as something
| acceptable instead of a condition to be treated.
| formerly_proven wrote:
| majority and all
| BadHumans wrote:
| "People" is doing some heavy lifting here. There are some
| fringe people on trying to push that but most people I see are
| trying to explain that the main problem with obesity is that it
| is a food supply and class problem.
| dsign wrote:
| There are also tons and tons of people trying to lose weight,
| and having an awful time at it :-) . Just three minutes ago I
| was summarizing 2024 for myself. I did an awful lot of SUP,
| and tried to lose weight. Results: weight decreased, then
| increased back when I got into a relationship that included
| unhealthy habits. I got rid of the factors that worked
| against my weight control effort and now things are looking
| up again. But most people in my age are married and with
| kids, and they are not going to leave or even fight their
| significant other and the kids over the family's eating
| habits....
| teaearlgraycold wrote:
| Gotta set the family eating habits right from the start.
| zer8k wrote:
| I would not call billboards for clothing featuring morbidly
| obese people "fringe".
|
| "Fat acceptance" is actually quite popular. It's not fringe.
| Fringe is being a furry. The entire medical field walks on
| egg shells because of so called "fatphobia".
| BadHumans wrote:
| You are going to show me an example because people don't
| really know what morbidly obese means I've learned.
|
| You also say fringe is being a furry as if there are 10 or
| 20 furries and not millions of them.
| IncreasePosts wrote:
| I'm not so sure about that, especially with all the
| commentary coming out of the Brian Thompson murder.
|
| A lot of people are angry about the fact that the US spends
| the most on healthcare, but we don't actually live that long
| - with the implication that healthcare here in the US is a
| racket just stealing our money and not helping us.
|
| But, why don't we live very long, compared to other people? A
| big reason is probably how fat we are, and how little we take
| care of our bodies. The best health care system in the world
| won't be able to fix you if you've ignored doctors orders to
| lose weight for 30 years and then have some health issues
| associated with that.
|
| So, while people aren't explicitly saying "being fat is
| great", they are implicitly saying it, by pointing to
| something other than our own lifestyle choices as to the
| reason why we have bad health outcomes relative to the amount
| we spend on healthcare.
| teaearlgraycold wrote:
| People are trying to remove middle-school grade social behavior
| against people that are overweight. When I see someone that's
| overweight I should simply see a person. Their doctor and loved
| ones should highlight the issue because they want them to live
| better. But if they're a stranger, coworker, or anything but a
| close friend it's not appropriate for someone to step in and
| start commenting. They shouldn't even think about that.
|
| Not to mention that people confuse health standards and beauty
| standards. Being a little rounded is of no health risk. And you
| can be very overweight (like a sumo wrestler) and very fit at
| the same time if you are both exercising and eating in excess.
| psunavy03 wrote:
| Pretty sure the long-term effects of sumo wrestling are not
| great for the wrestlers any more than they are for offensive
| linemen in American football.
| teaearlgraycold wrote:
| Sure. But the point is there are some fat people that can
| do things your average skinny office worker never has. I've
| seen chubby guys cycling up mountains in the Bay Area like
| they do it every week.
|
| There's an interesting article I read a while back where a
| woman (who was heavy in part due to muscle mass but also
| body fat) went to a personal trainer to improve her cycling
| performance. She had just cycled from SF to LA. Even though
| the trainer was a professional, certified and likely had a
| degree, he could not mentally shift from the idea that she
| was there just to lose weight.
|
| To be fair, carrying less weight will make your cycling
| performance improve. But from what I recall he was running
| it like a weight loss program and assumed she'd never been
| in a gym before. She had filled out a form with all of her
| exercise history and goals. I would have expected him to
| work up her back squat, weighted lunges, etc. At least as
| part of the program.
| deadbabe wrote:
| It doesn't matter if some fat people are active, the fat
| is still hurting their bodies. How are their knees doing?
| How is the stress on their heart? Their arteries? When
| was the last time they could even stand with their arms
| hanging down straight at their sides instead of pushed
| out perpetually at an angle?
|
| When you're fat for a long time, you forget what it's
| like to be light weight, you forget how easy everything
| feels. Being fat is like walking around with a two 25
| pound dumbbells strapped to your body everywhere you go.
| My fatter friends complain when we go to a dense concert
| or festival and I can just turn sideways to slip easily
| through crowds, leaving them behind. Trivial things like
| this is what you forget when your body has become too
| large.
| Uvix wrote:
| Not to mention that said middle-school grade social behavior,
| if anything, will only make the problem worse.
| teaearlgraycold wrote:
| Depends on the culture. I'm told that in Japan the shaming
| works. There you will get scolded by your boss for being
| overweight. There's a law that explicitly brings weight-
| shaming into the workplace.
|
| Not that I think it's the ideal. But it supposedly did
| cause a reduction in BMI. And many of those called out said
| they appreciated the pressure.
| karaterobot wrote:
| The problem is that there is no behavioral solution that ever
| has been empirically proven to work across a broad population,
| over a long term.
|
| And while "just eat less" has an intuitive appeal as a
| treatment strategy, alas, it's been shown again and again to be
| a dead end in practice, much as "just don't spend money" or
| "just do less heroin" don't seem be effective treatments for
| poverty or addiction. It is sometimes difficult to get over the
| bias that what seems intuitively effective in theory is not
| actually so in practice. But, as we're evidence-driven people,
| we need to look elsewhere.
|
| Surgical interventions, and GLP-1 receptor antagonists work,
| but they are expensive and there is limited access to them at
| present.
|
| So, as of today while I agree that it is a condition to be
| treated, there are no effective treatment options _for a
| population_ , which is the scope of what this article is
| talking about. Thus the situation we're in.
| UweSchmidt wrote:
| It appears that sentiments that downplay or dispute the health
| risks are growing in large social media bubbles, with strong
| effects on the real world. Efforts to push back on serving
| unhealthy food are undermined, doctors discouraged from
| discussing weight with their patients as a personal and sensitive
| issue; overweight models validate unhealthy body compositions.
| This surely has to please the food industry, which is as culpable
| as the tobacco industry in harming peoples health.
|
| I would propose a concerted effort through mandatory levels of
| food quality that is served to the public (e.g. schools,
| hospitals), funded by a higher tax on sugary atrocities, limits
| on sale of sugary food and drinks to children, and an outright
| ban on any substance designed to create cravings.
| voisin wrote:
| Rather than a tax on sugary food how about we cut subsidies
| that make simple carbs artificially cheap?
| bumby wrote:
| I believe the "artificially cheap simple carbs" is a
| secondary effect, with the primary effect of making corn
| cheap due to national security reasons. So before removing
| the subsidies, you'd want to have a plan for managing that
| risk.
| slothtrop wrote:
| The subsidies predate the "great grain robbery" where
| farmers sold large stockpiles to the Russians, which helped
| Nixon secure election victory. Before that, as part of the
| New Deal, was the Agricultural Adjustment Act which
| literally paid farmers to destroy livestock and not use
| land in order to boost prices for farmers. Strictly
| speaking, I don't think this was a case of national
| security.
|
| Today it's just a case of entrenched interests: large key
| midwestern farmers would stand to lose money, whether you
| have a tax or reduce subsidies. They stand to gain more by
| not mitigating obesity rates.
|
| Mind you they could diversify away from corn. If consumers
| eat whole grains or meat instead of sugar, that's still
| money for farmers. But it would entail growing pains.
| bumby wrote:
| I think tradition is certainly part of it, but I think
| that take misses some important nuances. A few:
|
| - agriculture isn't necessarily fungible. Land that is
| used for one product isn't immediately capable of being
| used for another, or at the same value (monetarily or
| calorically)
|
| - A large part of corn production is used for feedstock.
| That means there would be systemic issues in the
| production of meat if it had major disruptions. That's
| another reason why you can't just swap corn for meat
| production.
|
| - subsidies sometimes trade efficiency for stability.
| This isn't always a bad thing. A volatile market can make
| farmers lose their hat. A significant amount of farmers
| are generational, meaning there aren't a lot of people
| starting out unless they grew up farming.
|
| - corn isn't just about food. Part of the national
| security element is fuel (ethanol). Again, recognizing
| the inefficiencies, this is more about stability. Other
| agricultural products can be used for fuel (e.g.,
| soybeans for diesel) but the distribution of fuel needs
| and agricultural capacity is not in their favor.
|
| - I'd put this in the "tradition" bucket but there are
| political concerns. Politicians have to place nice with
| places like Iowa because of how political primaries are
| structured.
| slothtrop wrote:
| > agriculture isn't necessarily fungible. Land that is
| used for one product isn't immediately capable of being
| used for another
|
| Key word being "immediately". That's right, but
| substitutions do exist. Hence, growing pains.
|
| > A large part of corn production is used for feedstock.
| That means there would be systemic issues in the
| production of meat if it had major disruptions. That's
| another reason why you can't just swap corn for meat
| production.
|
| Globally, soybeans are more often used, and these can
| (and do) grow in the US. Notwithstanding, you can just
| keep growing corn without subsidy - meat prices would go
| up. That could be politically contentious, but less total
| meat consumption could lead to better health outcomes.
|
| > subsidies sometimes trade efficiency for stability
|
| Leaving aside the question of balance, pros and cons:
|
| Farmer stability is not inherently contingent on corn
| subsidy. Even if we wanted to keep subsidies as a
| constant, you can subsidize something else.
|
| > part of the national security element is fuel (ethanol)
|
| This doesn't require subsidy. The US produces more than
| half of the world's ethanol fuel. Notwithstanding that,
| fossil fuel extraction has also grown through fracking. I
| don't see the security angle at all.
| bumby wrote:
| I think we disagree that soil is fungible for growing
| crops. Even if I were to steelman your stance, it still
| requires considerable inputs to do so. All of this ends
| up making food cost more.
|
| Similarly, I think making HFCS more expensive isn't
| likely to make foods less calorically dense. What it will
| do is make them more expensive as manufacturers put use
| more expensive alternatives.
|
| I do think your ethanol stance is a circular argument.
| The US produces a lot of ethanol because of the
| subsidies, so it doesn't make sense to point to that
| production level as a reason to get rid of subsidies.
| Fracking is a good counterpoint, but also a politically
| contentious one if your stance is that the US should ramp
| up fracking to offset agricultural subsidies.
|
| I certainly agree that subsidies have inertia that's hard
| to overcome. (My favorite example is the alpaca subsidy
| that was implemented for warm-weather clothing for the
| Korean War that stayed on the books until the 1990s). I
| also agree they need to be tailored to the current
| environment.
|
| The bulk of your point seems to be we can get rid of
| subsidies in exchange for higher and less stable food
| prices. Historically, our food is quite cheap today but I
| find the idea that the proposed solution to obesity is to
| make food more expensive not very palatable (ha). I
| personally don't think that is a good tradeoff because my
| position is it's calories and not HFCS that is the
| largest contributor to the obesity problem. My OP was not
| saying "keep subsidies" but rather "be aware of the
| systemic effects of getting rid of subsidies". I think
| there are lots of arguments to get rid of corn subsidies,
| but I find the obesity one pretty weak. So the simple
| solution of "just get rid of subsidies" will create all
| these negative consequences that need to be managed for
| something that isn't likely to move the needle much on
| obesity. That doesn't seem like a great tradeoff and I'd
| label it as one of those simple solutions that sounds
| great as a sound byte but isn't particularly pragmatic.
| Going back to the original point, if your goal is to make
| food more expensive to curb obesity, there are probably
| more straightforward and effective ways of doing so that
| don't have all those additional factors.
|
| The only way that take makes sense to me is if you think
| there is something unique about HFCS that leads to
| obesity compared to other sweeteners when controlled for
| calories. I don't think the science supports this.
| slothtrop wrote:
| > I think we disagree that soil is fungible for growing
| crops. Even if I were to steelman your stance, it still
| requires considerable inputs to do so. All of this ends
| up making food cost more.
|
| To transition, yes. This is an upfront cost that can be
| alleviated, food does not need to cost more after-the-
| fact. Trump haphazardly paid off farmers in his previous
| tenure, it happens.
|
| > Similarly, I think making HFCS more expensive isn't
| likely to make foods less calorically dense. What it will
| do is make them more expensive as manufacturers put use
| more expensive alternatives.
|
| That is the point, I think. Those particular foods are
| calorie-dense.
|
| > so it doesn't make sense to point to that production
| level as a reason to get rid of subsidies.
|
| Unless you think production levels would fall to pathetic
| levels on the global stage, and that this production-
| level is essential, I don't see why not.
|
| > I find the idea that the proposed solution to obesity
| is to make food more expensive not very palatable (ha).
|
| Specific foods, to be clear. Packaged products with added
| sugar would be affected. Meat does not have to be if the
| new policies account for it.
|
| > it's calories and not HFCS that is the largest
| contributor to the obesity problem
|
| non-satiating (nil fiber + protein) caloric-dense foods
| facilitate higher calorie consumption. Sugar is not the
| only vehicle for this, but it's part of the equation.
| Sugary drinks deliver lots of calories for very little
| satiety, for example. Other vectors are flour + fat +
| salt, fried foods.
|
| I agree that "just get rid of subsidies" can be overly
| simplistic, but it belongs in the conversation. The point
| is that cheap and highly-available highly-promoted junk
| food creates a perverse incentive for consumers to eat
| more of it at the expense of their health. It's
| everywhere, including school cafeterias.
|
| Any large-scale national solution invariably entails some
| kind of deterrence. Either junk food costs more, or is
| less available, or healthier alternatives are actively
| promoted and cheaper ($$$, I would throw education in
| this category too). Pick your poison.
|
| Ostensibly, cutting spending would be more popular with
| voters in general than increasing taxes and spending.
| Also, falling tobacco smoking rates are a major success
| story which can be attributed primarily to sin tax (high
| prices), eliminating advertisement, and educating the
| masses.
| bumby wrote:
| > _Unless you think production levels would fall to
| pathetic levels on the global stage, and that this
| production-level is essential, I don 't see why not._
|
| A few reasons: 1) again, it's partly a national security
| issue. Under crisis, "global supply" is a concern; just
| ask Germany after trying to turn away from Russian fuel
| supply 2) Infrastructure has a relatively large lead
| time; we can't just ramp up production on a whim. 3) It's
| odd that you point to global supply as the rationale
| while simultaneously advocating the largest global
| supplier severely reduce production. Again, that feels
| like circular logic. Ie "The US doesn't need to produce
| ethanol because the world has so much ethanol
| production." No, the world has so much ethanol production
| because the US produces a disproportionate amount. Remove
| the latter and the argument doesn't hold.
|
| I don't think we disagree that making food more expensive
| can change eating habits. I think we disagree on the most
| effective vehicle for that.
|
| Look at it this way: we both seem to agree that calories
| are the problem. Your argument hinges on sweeteners being
| a proxy for calories, and HFCS being a proxy for
| sweeteners, and agricultural corn being a proxy for HFCS.
| You're targeting something that is three levels of
| abstraction away from what you actually care about. My
| position is that it makes more sense to target what
| you're actually after: calories.
|
| If your stance is getting rid of corn subsidies is
| administratively simple compared to targeting calories, I
| think I disagree mainly because of the administrative
| burden of all the other effects we've discussed.
|
| I don't disagree that deterrence is part of an overall
| strategy. I'm simply pointing out that one should be wary
| of the tradeoffs. Policy is about prioritizing, and IMO
| there are likely more pragmatic approaches with less
| tradeoffs that need to be managed.
| jermaustin1 wrote:
| Most corn is actually farmed for meat production (beef,
| pork, and poultry) not human consumption. I doubt the
| farmer cares if their corn goes to a human or a cow, so
| long as they get the best price, and uncle sam fills in
| the rest.
| edflsafoiewq wrote:
| The causality seems more likely to go the other way to me.
| llamaimperative wrote:
| For almost any problem people care about enough to discuss on
| a forum like this, it's a fools errand to try to determine
| "which" way causality goes. It goes both ways. You can't
| isolate the cause. It's a feedback loop which is what makes
| it persistent and hard to solve and ergo worth discussing on
| a forum.
| nerdjon wrote:
| There is a middle ground, and I agree that there are some
| people that have gone too far.
|
| I think body positivity, validating those choices with models
| that represent more people is a good thing. As a society we
| should not be judging someone for their choices or making
| medical claims about their bodies when we don't know their
| story.
|
| But I also see the extremes of just ignoring it, not even
| wanting your doctor to talk about it. (I do realize that there
| are some exceptions to this like when it comes to eating
| disorders) I don't understand this. I want my doctor to tell me
| everything, hell I will overshare in the hopes that something
| is a thing that needs to be addressed.
|
| I have also personally seen a subset of people that push back
| on anyone wanting to loose weight. I have lost about 45 lbs
| over the last year (still not at my target weight but I am very
| close, about 5-10 lbs off so really not stressing and for
| context I am 6'5). A friend I have not seen in a while recently
| gave me a hug, commented that I was loosing weight and asked me
| "Why". I was put off by it, because why is that even a
| question? You would get mad if I asked why you were gaining
| weight.
|
| My point here, there is a middle ground and there is a right
| and wrong place to address this. Society shaming someone isn't
| the right choice and ignores that we don't know what is really
| going on with someone.
| throwaway756544 wrote:
| > I think body positivity, validating those choices with
| models that represent more people is a good thing. As a
| society we should not be judging someone for their choices or
| making medical claims about their bodies when we don't know
| their story.
|
| I'm slightly overweight and an ex-smoker. For years, nothing
| seemed to help me quit--high taxes, indoor smoking bans,
| health risks, and so on didn't diminish my desire to smoke. I
| tried quitting a few times for financial and health reasons,
| but it never stuck.
|
| What ultimately got me to quit was social stigma, especially
| after having kids. The stigma around smoking has grown over
| the years, but it reaches another level when you become a
| parent. Other parents didn't hesitate to judge me for
| smoking, and I realized there was no way my kids wouldn't
| face social consequences because of my habit. That was the
| push I needed to quit.
|
| I do believe it's wrong to judge people for their choices,
| but at the same time, I sometimes wonder if we're going too
| far with body positivity. I don't have all the answers, but
| I'm grateful for the stigma surrounding smoking--it helped me
| make a positive change.
| didibus wrote:
| I know a few people who lost weight and got super fit out
| of body positivity movements.
|
| In general, the body positivity movement I've seen is about
| respect, encouragement, and support. It's not about
| encouraging bad habits, but being inviting to those who
| feel ashamed and would normally avoid going to the gym, a
| dance class, or to ask advice about healthy eating, etc.
| UweSchmidt wrote:
| As usual it comes down to the increasing individualism, that
| rejects any overarching societal guidance in favour of
| judgement-free self-expression ("body positivity"). This
| removes any collective bargaining or collective action (some
| of which I proposed in my parent comment) and exposes the
| individual to systemic risks (food industry making people
| fat, medical industry giving them a pill to feel better),
| unless the individual is equipped with enough of Bourdieu's
| social capital to navigate the pervasive health risks of the
| modern food supply. Allowing this minefield in place is also
| a convenient way to maintain class, leaving the unwashed
| masses hampered by health issues (like diabetes), reduced
| cognitive function and less attractiveness.
| didibus wrote:
| > not even wanting your doctor to talk about it
|
| There's been a lot of misdiagnosis due to doctors just
| thinking it's a weight issue. I think that's one of the
| reason people have an issue with doctor's handling of weight.
|
| The other area is that it often ignores that the patient is
| already actively aware, and trying to combat their weight
| gain. The doctors are not being helpful by just stating the
| obvious.
|
| Lastly, many doctors are kind of outdated in their knowledge,
| they'll recommend old diets that are not as effective
| anymore, or they won't encourage exercise, just diet, or they
| won't consider family history, and so on.
|
| In those cases, your "doctor bringing it up" can actually
| just lead to more weight gain, because it can create
| increased cortisol level from stress and worries, make you
| more depressed, and so on, which won't help you lose weight.
| monero-xmr wrote:
| I have told plenty of friends and family that they are fat
| gross slobs and need to lose weight, and that is the cause of
| many of their non-specific maladies that doctors can't seem to
| pinpoint. Sometimes you need to sit someone down and level with
| them, I'm not going to pretend.
| llamaimperative wrote:
| > I have told plenty of friends and family that they are fat
| gross slobs and need to lose weight, and that is the cause of
| many of their non-specific maladies that doctors can't seem
| to pinpoint. Sometimes you need to sit someone down and level
| with them, I'm not going to pretend.
|
| Key question: are they cured now after you were a jerk? What
| was the ROI on relationship damage per pound lost?
| monero-xmr wrote:
| It's fine because when I say this it's because the context
| of the conversation has been set that I'm going to tell
| them hard truths
| llamaimperative wrote:
| You avoided the actual question: did it work?
| bigstrat2003 wrote:
| Some people may need to be told that, much like some
| alcoholics are in denial about their condition. But many
| other fat people _know_ they have a problem, are trying to
| solve it, and are struggling because it 's incredibly
| difficult to overhaul your lifestyle (even with help and
| resources). While telling the first group of fat people "hard
| truths" might be what they need, it will simply demoralize
| the second group and might get them to stop trying. It's not
| as simple as you're painting it.
| shin_lao wrote:
| Tax won't solve anything - just make it socially unacceptable
| to be obese.
| llamaimperative wrote:
| Interesting because Pigouvian taxes have a long and storied
| history of being extremely effective while your proposed
| solution has... zero evidence of effectiveness?
|
| Feel free to provide it though.
| bigstrat2003 wrote:
| It already is. If you are obese, you:
|
| * Can't get clothes that fit you
|
| * Are uncomfortable on public transit, in public places like
| theaters, etc as the seats are designed for someone much
| smaller than you
|
| * Can't get into relationships
|
| * Get social feedback ranging from well meaning (but still
| embarrassing) to downright cruel on a regular basis
|
| In discussions like this, someone _always_ says "the
| solution is to shame people" as if it's some kind of picnic
| to be fat. It's not - it's _fucking miserable_. And even with
| all that people are still having a hard time taking control
| of their lifestyle. Shaming people even harder isn 't going
| to accomplish a thing.
| yamazakiwi wrote:
| I don't know about you but I'm paid to sit in a chair for 12
| hours a day.
| didibus wrote:
| America got fat from a culture of fat shaming. So like, we
| know that doesn't work. Or at least this is not how I see the
| cause/effect.
|
| To me, it appears that being fat was unacceptable and
| shameful culturally, but everyone still got fat, and insanely
| fat even. And once so many people were fat, they started to
| campaign against the fat shaming.
|
| So fat shaming could actually be seen as having caused the
| issue.
|
| I think being able to openly talk about the difficulty,
| challenges, and struggles of weight gain/loss, recognizes the
| people's struggle, encouraging weight loss, promoting methods
| and mechanisms, etc. might be more effective.
|
| From the research I've seen, this is also supported by it.
| Fat shaming can cause increased stress and cortisol levels,
| emotional eating, avoidance of exercise (especially in
| public), depression and anxiety, and avoiding medical care
| due to fear of judgment. Which all in-turn contributes to
| weight gain.
| didibus wrote:
| I still feel like the root causes are not well known. Blaming
| sugar is the current trend, but this article talks about
| weight, American have a fat heavy diet as well, which is very
| high in calories. Sure, cutting our sugar helps you lose
| weight, but did sugar cause you to eat all those calories or
| was it fried food? Who knows?
|
| Then there are processed foods, is that actually the culprit?
| Or is it really sugar?
|
| Then some things are confusing, someone else linked to a study
| that showed that "lowest All-cause mortality is at a BMI of
| 25". Well that's verging on overweight, so people with
| "healthier" BMI have higher rates of death, weird.
|
| A few days ago a study showed that sugar intake from pastries,
| ice creams, chocolate and candy reduced your risks of 7
| cardiovascular diseases. What's going on?
|
| I say that as someone that's normal weight. I can understand
| some counter-reaction being wishful thinking, or part of body
| positivity movements, but objectively when I look at what we
| know, it's still quite fuzzy.
|
| Having said that, I would not mind over-enforcing in this case.
| I'd love it for portion sizes to be smaller, for processed
| foods to be phased out, for sugar content to be lowered in
| packaged and restaurant products, for deep fried foods to be
| less common, etc. And ideally, for what we do know is healthy,
| vegetables, fruits, lean meats, fish, poultry, often the least
| refined as possible, to be both accessible, convenient and
| cheap.
| siliconc0w wrote:
| Nicotine helps control weight so it also makes sense that as we
| smoke less we'll gain (even) more weight.
| hoppyhoppy2 wrote:
| The headline refers only to tobacco smoking, not vaping,
| patches, etc. I wonder how overall nicotine use (from all
| sources) looks
| Liquix wrote:
| it may also help that tobacco-free nicotine products (vaping,
| pouches) are gaining popularity vs. more traditional and deadly
| administration routes (cigarettes). of course there are myriad
| cons and unknowns resulting from any nicotine habit, but cancer
| trending down is always good to see.
| grantseltzer wrote:
| Excellent analysis and deduction!
| naming_the_user wrote:
| Sometimes I read this stuff and think I live in the most
| ridiculous bubble.
|
| It's bizarre to me that people don't look after their health.
|
| I wake up and I'm like, right, there are three tracks - financial
| (go to work, develop career, run business, do admin, whatever),
| physical (exercise, keep relatively fit, don't eat 4000 cal a day
| unless bulking), social (don't just sit at home all day and
| become a gremlin). There are others but that's the main.
|
| I don't spend equal amounts of time on them but they're all
| there.
|
| It seems to me that apparently other people don't think of it
| this way. They just sort of wake up and do whatever on autopilot
| and go to sleep and whatever happens to them happens. What's that
| all about?
| asdasdsddd wrote:
| We live in a bubble, the average american spends 2hrs a week
| with friends
| moduspol wrote:
| I agree. I think you do live in the most ridiculous bubble.
| vile_wretch wrote:
| You definitely live in a bubble but it isn't the kind you think
| it is
| whtsthmttrmn wrote:
| Addiction, depression, it's a cycle. Something happens that
| causes depression, eating gives some feel good chemicals and
| being a sloth is to avoid potential disappointment.
| criddell wrote:
| I don't think it's that complicated. When one side of that
| triangle ends up consuming too much of your time and attention,
| the other two suffer.
| amonon wrote:
| Many people are on autopilot. They have not been taught to be
| intentional about the day to day fundamentals of their lives.
| For the most part, I think that used to be achieved through
| social contact which has substantially diminished in the past
| few decades.
| swatcoder wrote:
| > What's that all about?
|
| People learn _what_ to care about and _how_ to care about those
| things from others, with the most impact coming when they 're
| young.
|
| Many of today's parents already missed the boat on learning
| self-care, and don't even have the insights to share with their
| own children, who become even more detached from it.
|
| They don't know how to cook food that isn't either prepackaged
| or some ornate gourmet meal that takes lots of work, they don't
| know how to eat for their health in a way that's satisfying,
| they don't know how much to eat, they don't know what it means
| to be active throughout the day, they don't know how to rest
| without constant stimulation so that they're emotionally and
| physically refreshed, etc etc
|
| We can point them towards some study or a bit of blogspam that
| asserts some narrow claim about what's optimal, but that's not
| the way that most people learn self-care and never has been. So
| they mostly keep doing what was _actually_ taught to them,
| which tends to bias strongly towards sedentariness,
| overstimulation, and indulgence these days.
| ruined wrote:
| and of course, school plays a large part. most of the school
| experience involves sitting very still, and the cafeteria
| menu is selected more for cost than anything.
| bluefirebrand wrote:
| A large part of workplace experiences also involves sitting
| still and being sedentary these days too
| whtsthmttrmn wrote:
| Combined with frequent treats brought in by coworkers (a
| colleague of mine likes to bring in breakfast bagels from
| McD for my small team...hard to resist lmao)
| paul7986 wrote:
| I do wonder how much influence your parents have on you
| living a more sedintary lifestyle in life. My father was
| sedintary his whole life (later in life he broke his hips
| numerous times) while my mom was a Jane Fonda zealot and much
| older now is still active. Both my sister and I have followed
| in my mom's footsteps tho myself much more due to my
| lifestyle and who/type I want to attract for partners. I use
| chatGPT to count my daily calories, exercise daily and gym
| visits two or three times a week.
| ThrowawayTestr wrote:
| Bro, have you tasted food before?
| hnpolicestate wrote:
| I've developed a drug habit over the past year. I'm not
| overweight at all but, I assume people's mental health leads
| them to neglect and abuse the body for quick dopamine hits.
| Baconator with a large coke would immediately improve my mood
| but then make me feel miserable after.
| grnoeianoreae wrote:
| >It's bizarre to me that people don't look after their health.
|
| I'm 39 years old. Once my obligations in life are done, I'm
| putting a bullet through my brain. Probably just another 10
| years or so this point.
|
| It's of benefit to look after my own health but at the same
| time, why? By the time my poor life choices start catching up
| to me, it will be time to go anyways. If my health deteriorates
| before then, then I'll just shoot myself in the head sooner
| rather then later.
|
| To me I'd rather enjoy what little time I have left indulging
| into a little hedonism then trying to plan for a future that
| doesn't exist.
| psunavy03 wrote:
| You need to see a professional, frankly. That is not a
| healthy outlook.
| stnmtn wrote:
| Have considered the possibility that you might enjoy the
| moment right now more if you take care of your body by
| exercising and eating well?
| bbor wrote:
| The future holds an unknowable amount of discovery and joy,
| for both you and your children to find together; however
| bleak it may seem, I hope it's not out of line to say that
| there's one internet stranger rooting for you to see the
| light behind the trees. Personally, my life goal is to visit
| the moon. Why? Because fuck it, that's why. A slightly-more-
| sustainable, useful, and poetic goal than Everest, I suppose.
|
| If you're gonna die anyway, why not make a mark on the world,
| do your weird personal thing that only you could do? You
| might not have a statue like Ozymandias, but in my humble,
| naive, and young (27) opinion, chances are likely that you'll
| be glad you did.
|
| https://www.poetryfoundation.org/poems/46565/ozymandias
| karaterobot wrote:
| You don't say so, but I'm guessing you're on the younger side.
| Mere speculation on my part, for the sake of argument. Most
| people who die of weight-related issues are quite a bit older,
| so put that in your mental model, along with this: Many things
| which seem simple and obvious at one point in life become hard
| and frustrating later on--and vice versa.
| kccqzy wrote:
| Schools don't teach this stuff and many people just don't know.
| In a school you automatically get the physical and social
| aspects (PE classes and forced collaborative projects, with a
| timetable you had no say in) but after graduation a lot of
| people didn't know they needed to expend effort to keep doing
| it. The first year I was working I didn't know I needed to
| actively exercise, or actively seek out social activities
| beyond just immediate colleagues.
|
| Fortunately I fixed that early in my career. I'm sure plenty of
| others still haven't.
| whatshisface wrote:
| I don't think you're really acting intentionally: it's more
| likely that you agree with your autopilot. My reason for saying
| that is that there are a lot of medications with behavorial
| side effects (weight gain, increased risk taking) that would
| change those parameters for just about anyone. If you were
| constantly hungry, you would eat, it's as simple as that.
| naming_the_user wrote:
| I have what feels like a continuously self correcting
| mechanism running in my brain. Like yeah, I might have a week
| or two or something of lounging, just punching the clock, but
| then every now and then I'll assess my goals and how they are
| going.
|
| The question I suppose is whether having a goal driven
| mindset is down to free will or not. If a large number of
| people are doomed to not have that I think that's really sad.
| elric wrote:
| My initial reaction is that yes, you do seem to be living in a
| very strange bubble. And, I say this out of curiousity rather
| than malice, I wonder whether you struggle with empathy?
|
| There are any number of reasons why people can't consciously
| prioritise those things. Maslow's Hierarchy Of Needs comes to
| mind.
| naming_the_user wrote:
| No malice taken, I do struggle with empathy, yes. To me a lot
| of people seem to just make unforced errors.
|
| There's like, someone who stands on a landmine and can't go
| to work, or someone who has a chronic condition that makes
| them feel nauseous all the time, etc.
|
| That doesn't explain 40% of a country being obese whilst the
| other 60% isn't, though.
| llamaimperative wrote:
| What was your upbringing like? What part of the world,
| what'd your parents do for work?
| naming_the_user wrote:
| I grew up in the UK. We have approx 30% obesity rates so
| less than the US but still pretty crazy.
|
| Single parent who worked (and still does work) low paid
| manual labour style jobs. Same with the estranged parent
| who was around for a while.
|
| I dunno. People talk about being a surroundings thing.
| But then the way it has worked for me and my siblings is
| that for the most part we've looked at the ways in which
| our own parents failed and tried to improve on that.
|
| For what it's worth we ate a lot of "crap" food growing
| up but just portion controlled it reasonably I guess?
| bbor wrote:
| > They just sort of wake up and do whatever on autopilot and go
| to sleep and whatever happens to them happens. What's that all
| about?
|
| I absolutely agree, and commend your focus on understanding
| over condemnation. Despite all the justifiably condescending
| responses to your post, you have the right attitude towards
| truth.
|
| My simple answer is that humans do not possess truly persistent
| (much less consistent!) consciousness, and that the concepts of
| "vice" and "virtue" are nothing more than imperfect social
| tools. Of course we can't abandon them altogether, but the
| questions _" Where does gluttony end and eating disorders
| begin?"_ and _" Where does laziness end and ADHD begin?"_ are
| in the midst of reshaping some very fundamental assumptions in
| our society, IMHO. The related question _" Where does self-
| pity/envy end and Major Depressive Disorder begin?"_ has seen
| huge changes over the past 1-2 decades (in some nations), and I
| believe the former two will follow a similar trajectory.
|
| In other words/TLDR: it's objectively challenging to balance
| competing priorities, where I mean "objectively" in an
| empirical, population-observation, sociological sense. Very few
| people have, like, an intellectual argument for not working
| out/eating right.
|
| As a somewhat tangential point, I'd say your three tracks
| aren't the only reasonable way one could organize their life
| (again, assuming you have the capability to even get to _that_
| point). For example, I spend a _lot_ of time worrying about
| politics, society, and my impact therein; otherwise, many
| people spend most of their time worrying about providing for
| /guiding/safeguarding their family, and a lot of young people
| (my past self included!) spend most of their day thinking about
| the social track in a much more anxious, peer-esteem-related
| way than you seem to.
|
| None of these are necessarily better or worse than others, but
| I think it reminds of an important truth: philosophy is not
| solved. If you feel confident that it has, I encourage you to
| think back on previous times in your life where you felt the
| same, only for your whole outlook to change in the intervening
| years ;)
| TuringNYC wrote:
| >> It's bizarre to me that people don't look after their
| health.
|
| The obesity crisis obviously has multiple causative factors.
| There are plenty of natural experiments suggesting that _some_
| of these factors are beyond human behavior and more systematic
| or environmental (e.g., hormones in food, etc) There are
| probably also societal drivers like overpopulation which leads
| to sprawl, longer commutes, more sedentary time, greater
| reliance on cars.
|
| I am not saying people should not hold themselves responsible,
| but we should not be quick to pin it all on individuals and
| should look at outsider factors also.
| cm2012 wrote:
| It's an emotional issue, not intellectual.
| BrandonM wrote:
| In addition to what others have said, daily demands on time and
| headspace can be overwhelming. My wife spends over an hour
| every day managing a chronic health condition. Raising kids
| well takes a lot of time every day. Some have loved ones with
| high needs that require care. Many spend 2+ hours commuting
| daily. Many work multiple jobs. Some spend a lot of time
| traveling away from home. Serious injuries can disrupt exercise
| routines and cause vicious cycles. Poor finances makes
| everything harder. Stress and depression can result from and
| exacerbate all of this.
|
| Appreciate your health and time and focus and good habits while
| you can, and may you keep them as long as possible.
| avalys wrote:
| I don't get why people get addicted to drugs. I just decide not
| to take drugs, and I have no problems! What's so hard about
| that?
| bwb wrote:
| Trauma / anxiety is a possible ingredient; people eat to fill a
| void. Same as anything that is self-destructive. People try to
| make themselves feel better and eating does that.
| Yeul wrote:
| Word. My mother had a pretty bad childhood. Had to take of
| herself since she was 16. Poverty, kids and a husband with
| mental issues led her to smoking. When her life was finally
| completely on the rails she could start to work on her
| addiction.
|
| I'm convinced that every person with an addiction has a sob
| story. There are no happy people sleeping under the bridge.
| Clubber wrote:
| I would say the problem is people are stuck spending most of
| their time and especially energy on #1 just to make ends meet.
| Obesity, like drug addiction is a disease of despair, and we
| have a lot of that in our country. Also, the longer you live,
| the more beat up you get. Taking care of elderly parents,
| dealing with shitty bosses, shitty partners, etc. It definitely
| takes a toll over long periods of time.
|
| I've recently made #2 my top priority due to an eye-opening,
| but fortunately reversible doctor's visit recently. When the
| priorities are lopsided as mine were, it takes twice the
| attention for #2 to get balanced than to maintain the balance.
| I'm making decent progress though. It will take at least a year
| to remedy.
| xkbarkar wrote:
| Heh. This comment sparked some angry commenters but in fact I
| agree.
|
| Was a single parent with full time job and took evening college
| classes.
|
| I watched what I ate and went out for a 30 min run whever I
| could. I also bicycled and did bodyweight excercises in front
| of the tv in what was my livingroom/bedroom when the kids were
| put to bed.
|
| This is 30 years ago and I am middle aged now and my stupid
| menopausal hormones make me gain weight if I so much as look at
| a croissant. I frequent the gym several times a week anyway.
| That menobelly covers my once flat stomach but I am still as
| strong as I was 30 years ago. Even stronger in fact. I rarely
| see people my age, especially women, at the gym. Thats a shame.
| You should join. Resistance training is crucial for women my
| age.
|
| Be angry or offended all you want people. Not taking care of
| yourself will be yours and yours only to pay.
|
| It starts with the kitchen, we need to watch what we eat. Eat
| nutritious foods. And we need to move those muscles and get the
| heartrate up a few times a week.
|
| And this is health we are talking about. Thin and fat free !=
| healthy
|
| Your body could not care less about political correctness, if
| you ignore it, it will lead to devastating lifestyle disease
| and untimely death.
|
| I am shamelessly going to plug Caroline Girvans videos on
| youtube or her app.
| standardUser wrote:
| > Be angry or offended all you want people. Not taking care
| of yourself will be yours and yours only to pay.
|
| That's not what people are reacting to. People are reacting
| to OP's staggering inability to comprehend the vast range of
| human experiences.
| SirMaster wrote:
| It must be a bubble, but it doesn't seem like it to me.
|
| What you write basically describes my outlook on my life as
| well. I view and act on things very similarly to how you
| described it. It seems to work very well for me.
| xenospn wrote:
| I think you're probably mildly autistic since most people think
| very, very differently than what you're describing.
| declan_roberts wrote:
| We're probably less than 3 years away from health insurers making
| GLP-1s free as a cost-saving measure.
| kylehotchkiss wrote:
| All funds currently diverted towards executive security
| details. Sorry, GLP-1 denied.
| OptionOfT wrote:
| I'm just thinking for myself, how much money I save, even
| though I'm paying out of pocket for ZepBound.
|
| I sleep better, so I gain an hour per day. At that rate my out
| of pocket per month is still less than my hourly wage.
|
| Not to mention food and shoes (yes, I'm someone who was
| overweight and hiked 5 miles a day...).
| jaco6 wrote:
| We need to wake up to the reality that solving the obesity crisis
| (if it is actually something we want to solve--enough healthy
| people may be happy with paying double for healthcare) may
| require measures perceived by modern liberals as authoritarian or
| cruel.
|
| I think this because measures like what we did with tobacco---
| public health demonization of junk foods and junk food
| consumption, banning advertisement of junk food, warning labels
| on junk food, and high excise taxes on junk food--are unlikely to
| ever be accepted by the healthy population that has no problem
| restricting its junk food intake to stay below BMI 30 (60+% of
| the population). They won't want to pay double for chips just
| because obese people can't stop themselves from eating two bags
| instead of one.
|
| The only alternative is to charge the obese population on the
| back end--when they pay for healthcare. Obese people would be
| made to pay a health insurance surcharge to compensate for the
| additional healthcare resources they consume. This measure will
| be decried as "insensitive" and "cruel."
|
| Alternatively we could do both.
|
| By the way--ozempic et al are unlikely to solve the crisis as
| some hope. Studies show average long term, sustained weight loss
| of 10-20 pounds. Good, but not enough to help people who are
| hundreds of pounds overweight--a sizable portion of the obese
| population that costs the healthcare system so much.
| honkycat wrote:
| Doing anything about the obesity epidemic has the same issue as
| 99% of our problems: People are getting rich off of selling
| cheap nasty food.
|
| You think a politician is going to go after billion dollar
| industries? Get real.
|
| It is a class issue, and an issue with the type of food that is
| "easy" to access for exhausted people with kids, long hours,
| etc...
| asciimov wrote:
| A good place to start would be addressing overeating as a
| symptom not the cause.
| bluSCALE4 wrote:
| We should be looking at eating poorly as well.
| dbg31415 wrote:
| Most insurance plans in the US don't cover treatments, drugs, or
| surgeries that work for weight loss...
|
| Seems like they ought to.
| hnburnsy wrote:
| Can we expect those Truth commercials to start fat shamming folks
| since tobacco and e-cigs are no longer a problem?
| andersa wrote:
| It is _much_ harder to treat a food addiction than a smoking one.
|
| The usual way to do that is to stop smoking entirely and
| eventually forget about it. You cannot stop eating. Food tastes
| good. We have infinite food available. The hell are we supposed
| to do about it?
| unclad5968 wrote:
| That's just because you consider all food equally. Nobody is
| out here dying from a vegetable or fruit addiction.
| davzie wrote:
| Tell that to Steve Jobs!
| qwerty456127 wrote:
| The same - just stop eating (for some time between a day and a
| week). I tried (for a week) successfully and that was fun. This
| way you discover you have power to choose to eat or not to eat,
| also learn to distract yourself from hunger and forget about it
| for whatever time you choose to. Switching to keto first,
| supplementing minerals - helps a lot.
| benatkin wrote:
| I don't think that's true at all. The reason people are having
| so much success in not smoking is that a lot of people never
| started smoking.
|
| Plenty of people have managed their food addictions and still
| are overweight. That's just the nature of it. If you think
| everyone who is overweight has an active food addiction, you
| should probably look into whether that's really true.
| jrochkind1 wrote:
| So, since smoking can help you lose weight...
| heraldgeezer wrote:
| Being slim and vaping or snusing might be better than just
| being fat honestly
| yen223 wrote:
| > Overweight, including obesity, overtook tobacco use as the
| leading risk factor in 2024, driven by a substantial fall (41%)
| in the burden attributable to tobacco use since 2003.
|
| According to the study, it's not so much that more people got
| fat, it's that fewer people are smoking. A lot of comments here
| missed this I think.
| sneak wrote:
| It's rarely news when life gets safer and longer and the median
| person's risk of death falls. :/
|
| Most people mistakenly think that the world is getting worse.
| slothtrop wrote:
| Mostly yes, though people did get fatter.
| swatcoder wrote:
| Imagine a chart with two lines spanning the last 50 years. One
| of those lines was very high at the beginning, and has
| generally been trending downwards. One of those lines was quite
| low at the beginning and has rapidly been trending upwards.
|
| The study is suggesting that we've reached a point where these
| two lines have finally crossed, which we probably could have
| anticipated coming sooner or later.
|
| That the most salient _recent_ observation is a change to the
| prevalence of tobacco-attributed disease doesn 't really change
| what it means for obesity-attributed risk to finally overtake
| it. That wouldn't have even been fathomable 50 years ago and
| the trendlines confirm exactly what needs urgent attention now.
| asciimov wrote:
| And they excluded vaping.
| gorjusborg wrote:
| I wonder if we'll ever get to a place where we hold food
| companies accountable for addictive, unheathy food being
| advertised and sold the way we hold tobacco companies
| accountable?
|
| I know there is a personal responsibility involved in both, but
| the situation seems similar.
| LPisGood wrote:
| Things like soft drink taxes already begin to do that.
| CodeWriter23 wrote:
| USDA shares the blame for placing Carbohydrates as the primary
| food source on the food pyramid.
| worik wrote:
| > USDA shares the blame for placing Carbohydrates as the
| primary food source on the food pyramid.
|
| I agree, but I have no real evidence, just a feeling.
|
| Is there any evidence?
| CodeWriter23 wrote:
| None of this is intended to be medical advice. Consult your
| own practitioner.
|
| This is publicly available, but to understand Dr. Fung's
| entire thesis on obesity and Type 2 Diabetes (along with
| his entire destruction of the prevailing mainstream
| treatment protocols for T2D) in particular, it is necessary
| to read his book, "The Diabetes Code".
|
| https://casereports.bmj.com/content/2018/bcr-2017-221854
|
| I've been following the protocol from The Diabetes Code for
| about 2 months. Objectively: 10lbs lost, key metrics are
| improved, medications deleted and a Type 2/inflammation
| related vision ailment objectively healing. I guess I need
| to say, I have no association with this doctor, receive no
| monetary benefits. Prior to that, working with an
| endocrinologist, my stats were deteriorating and my
| symptoms worsening.
| meiraleal wrote:
| Carbs craving is an evidence, I feel them myself and have
| much more difficult controlling the amounts of calories I
| eat when I'm eating more carbs and sugar. One person
| experience, especially if oneself, is a hard evidence.
| timmg wrote:
| It seems like, as a society, we're moving more toward "personal
| freedom" -- which includes "personal responsibility".
|
| Like: we used to ban alcohol, betting and drugs. But we
| unbanned alcohol and betting and are moving towards
| decriminalization of drugs.
|
| Not saying one way is right or wrong (I can see arguments on
| both sides, and I _personally_ prefer having freedom). But it
| does seem the general trend in (US) society these days.
| ausbah wrote:
| i think society should allow someone to partake in those
| activities because like you said personal freedom. but many
| if not all of those activities can develop into addiction
| which is a form of disease - so society should also heavily
| disentivize their usage. taxes, prohibited advertisement, can
| only get from certain places, etc
| jermaustin1 wrote:
| I can't wait for the unlicensed Twinkie dispensaries to
| start sprouting up.
| unclad5968 wrote:
| Wouldnt that just hurt the people prone to addiction? If I'm
| not addicted to alcohol and a huge tax is implemented then
| I'll just stop drinking. If I am addicted my problem has just
| been exacerbated because my addiction is now more expensive.
| I guess it might stop people from experimenting to begin
| with.
| giraffe_lady wrote:
| It's not a binary thing, addiction is very dynamic,
| especially alcohol because of its ubiquity in the west.
| Nearly all alcoholics no matter how bad once had a fairly
| typical usage pattern, often for many years or decades
| before something changed and they lost control of it.
|
| Changes to lifestyle, stress, recreation patterns, and
| access can all be factors in it spiraling out, and once
| you're there it's hard to gently wind it back. It's
| difficult to compare directly because a lot of the places
| with intentionally high taxes on alcohol also have strong
| public healthcare systems.
|
| But even simple measures like municipal ordinances against
| selling sub-500ml containers of hard liquor show small but
| clear results in reducing addiction rates. In any case the
| consensus among addiction medicine professionals right now
| seems to be in favor of this sort of "soft restriction"
| public health policy.
| standardUser wrote:
| We can have both. We can have broad access to all manor of
| food and drugs AND we can have strict labelling and
| advertising standards. We all know the entire concept of
| market capitalism is based on accurate and available
| information for marketplace participants, yet we keep letting
| the dominant participants manipulate the dissemination of
| information for their own benefit and to the detriment of
| consumers.
| base698 wrote:
| Big Tobacco became big food: https://www.pbs.org/wgbh/pages/fro
| ntline/shows/settlement/bi....
|
| When tobacco became problematic they bought all the food
| companies.
| standardUser wrote:
| In Mexico (and many other places) they put big labels on
| packaged foods that have high sugar content. I spent a month
| there and I found it really helpful. Of course in the US, any
| attempts at labelling for the benefit of consumers is fought
| tooth and nail by the food industry.
| benatkin wrote:
| I don't think those make a big difference. I've seen them in
| a lot of memes. They're easy to tune out, and are on a lot of
| healthy food.
|
| Here's some more info on it
| https://en.wikipedia.org/wiki/Food_labeling_in_Mexico#Labels
| standardUser wrote:
| US nutritional info panels are far easier to tune out, but
| many people still find them useful. Better to give people
| information should they want to put extra thought into
| their diet as opposed to keeping things obscured and making
| the task that much more difficult. The Wiki article says
| 10% of people take the labels into consideration. If 5-10
| million Mexican families eat healthier diets at the cost of
| simple labels covering some marketing materials, that seems
| like a fantastic deal for consumers.
| benatkin wrote:
| It's good to be able to easily access facts about food,
| yes. It's the warnings that I think are simply OK, they
| don't help much nor hurt much.
|
| For instance, most people don't need to worry about their
| dietary sodium, and I think in the US a lot of people
| could discover tasty food like soups and stir fries and
| curries that are high in salt and moderate their animal
| product consumption.
| https://www.health.harvard.edu/heart-health/dietary-salt-
| and...
|
| Edit: looking in that article it's good to avoid too much
| sodium, but a lot of people don't notice that how salty
| food tastes isn't always directly related to how much
| sodium is being consumed. Sodium deep inside of food
| isn't going to be as easy to taste as salt on the
| surface.
| skirge wrote:
| Never ending war with happy people.
| kevwill wrote:
| There is no doubt in my mind that the alcohol consumption is much
| more of a contributing factor to not only the obesity but also
| the overall decline in health wellbeing and raise in
| suicide/depression. Alcohol is socially accepted poison, and I
| feel its consumption in any amount is significantly worse for the
| individual than any poor diet/exercise regiment.
| nemomarx wrote:
| keep in mind alcohol is also poor diet - beer is especially
| heavy in carbs, very few alcoholic drinks are light really.
| alcohol is like having an extra side with a meal at least, but
| people would I think be more aware they were overeating if it
| was a plate of fries.
| kevwill wrote:
| Absolutely. There are a lot of people who get a whole extra
| day of kcal worth of beer in a week. Additionally people who
| drink a lot pretty much stop eating because they opt for the
| liquid lunch etc.
| heraldgeezer wrote:
| Honestly I have a BMI of 23 and feel like I have a "beer belly"
|
| If you are over 25 you just need to loose weight straight up
| nradov wrote:
| There are a lot of people who are "skinny fat": normal BMI but
| low skeletal muscle mass. This puts them at greater risk of
| sarcopenia and metabolic conditions as they age.
| criddell wrote:
| BMI is a great tool for a population. It's often not very
| useful for an individual.
|
| A BMI of 23 is a 5' 10" man who is 160 lbs. It doesn't say
| anything about body composition.
| heraldgeezer wrote:
| Honestly, fasting feels great and I just need that reminder that
| it does.
| ggm wrote:
| I found the ABC (oz) news reporting a bit deficient on this.
| Leading disease risk factor doesn't have to mean its rising, it
| can be that smoking has fallen and now, people who would have
| died of COPD and Cancer caused by smoking die of COPD and
| different cancers, caused by morbid obesity.
|
| Its probably just me but I found the language around absolutes
| and relatives a bit flakey. The overall population is rising so
| absolutes trend upward but leading goes to relatives, and so the
| rate of increase against population increase is material.
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