It seems public healthcare is not feasible in the United States while the majority of Americans are overweight and a third are obese. It causes too many expensive health problems that are preventable by maintaining a healthy weight. Perhaps the government should simply pay people to keep their BMI under 25.
The current article suggests obesity is the top modifiable dementia risk, which suggests that there's other risk factors that are more important and not modifiable.
It might be tricky to actually reward healthy lifestyles via health plans, since people generally need more care as they get older.
OK, but they cause a lot of death and injury quite apart from their effect on weight. Societies that drive more miles have higher mortality rates. When you compare health care in the U.S. to other Western countries you have to consider how much we drive, how fat we are, and how many of us overdose.
This subthread was actually about the feasibility of public health programs in the U.S. And that's a topic that needs to account for those 3 areas in which we are outliers, especially if, as inevitably happens, people get around to drawing comparisons between the U.S. and Europe.
You don't eat only for energy, you also eat for nutrients - and they are a lot more varied and complex than the standard list of protein, carbs, fat, vitamins.
To use an extreme example so that it's easier to relate to: You can eat only sugar and nothing else and far exceed your energy requirements, but you will still have lots of appetite despite already having eaten too much in just energy.
Food composition matters - and optimizing for energy (counting calories) is a losing battle. Of course, this also requires that people have had experience with various foods. Kids grown on mostly just fast food, pizza and coke probably won't be able to develop healthy habits no matter what.
Yes it is technically possible to force a body to remain slim by counting calories. It also is either very cruel or, if you manage it on your own, requires an absurd amount of discipline to constantly battle your desires. Yes some people have a huge appetite for the obviously wrong kinds of foods, like more pizza and more ice cream and no water please because it "does not have taste" but coke or some other industry-made drink. When the body was "mis-trained" it can't magically desire the right stuff that it never learned about. The environment matters too, it's probably a lot easier to not eat terribly in Japan than in some US mid-west town.
I know eating healthy food for non-caloric nutrients is important. But don't most people already eat at least some healthy food? Couldn't most obese people get back to a healthy weight just by cutting out junk food, without adding any more healthy food to replace it?
They're usually poor and the junk food is subsidized. The us has underground cheese bunkers to keep the dairy industry running, you won't be seeing a nutritionally complete tempeh salad on the dollar menu.
I had some unfortunate experience with heavy metal poisoning (university clinic diagnosed - mercury, shown by lab tests). There was zero danger of dying and I doubt it took away any of my life expectancy. But it SUCKS and especially the brain works at a substantially lower level. I did not understand even simple sentences even after reading them several times at the height of the problem. I wrote Internet comments that made no sense when I read them again the next day, but at the time it felt perfectly alright and logical (sentence structure was weird too).
(Just an aside) And you know what? I had to end up with a senior researcher doctor at a university clinic before getting diagnosed. Because most doctors were a little like your question: They looked at the vitals and found no obvious disease and sent me home "it's all in your head". Which is funny because it's largely true - mercury being a neurotoxin, but for some reason the brain being the product of physics and bio-chemistry not registering with the oh so "science and evidence" based doctors, who seem to have a strangely meta-physical and esoteric view of it.
Anyway, back on topic:
I find this obsession with the binary outcome "death / no death" strange. Before death, your extremely parallel structure (not just your own trillions cells, each cell itself has lots of independently working parts, and then there are even more bacteria and other organisms occupying your insides and the outside who all contribute and are often affected too) does a poorer job of bringing the "you" into being. See your body like a computer running the software that is "you". The quality of the simulation drops if the hardware is impacted (you are the activity of your parts - a brain without activity is not "you", you are not there if the hardware does not run the "you" software). But the life expectancy may not be impacted at all.
Surely, if you provide far from optimal fuel you can expect the quality to suffer too, not just when you are poisoned or otherwise restricted.
So, it is a question of what version of "you" do you want to be? Is mere existence enough?
I'm not saying people should actually follow the Twinkie diet because they want to lose weight, just that a handful of people have done it as an example to prove it's only CICO that matters. Besides, anyone with the discipline to follow the Twinkie diet could easily follow a healthier diet too.
“Clinically speaking, metabolic health is defined by optimal levels of five markers: blood sugar, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference—without using medication.“
Things like a high sugar Twinkie diet will expose you to diabetes risk independent of calorie intake.
These subsidized 'unhealthy' foods are highly calorie dense. While in-theory, you can eat less, you will not feel full like you would with low calorie dense food.
For example, an Apple weights 200g and is 110 calories. Whereas a double cheeseburger at McDonald's is 173 grams but 450 calories.
Is there? Because the evidence for weight loss to improve health is consistent, abundant, and overwhelming. And the evidence for all the other stuff seems to reside mostly in the realm of unverified "common sense."
Frankly, you are trendsetters, not the odd exception. You are just ahead of the curve, but the rest of the world is following you.
I am 44 and I am aghast at how fat some of the youngsters here in Czechia are. Middle-aged people are, too, much fatter than when I was young. This isn't a common grumbling of an aging person, the trend can be measured fairly well.
I am not sure how our public healthcare systems will cope 20-30 years down the line. Aging (greying) of the population plus chronic metabolic diseases caused by obesity, treatable but not yet curable, will be a double whammy.
“For people aged between 65 and 69, around 2 in every 100 people have dementia. A person’s risk then increases as they age, roughly doubling every five years. This means that, of those aged over 90, around 33 in every 100 people have dementia.”
A cure would be great, but it's not something we can just buy by throwing enough money at it. This argument feels like saying to try to find a cure for lung cancer instead of getting rid of asbestos and getting people to stop smoking.
Clicking through the submission shows: "Approximately 1 in 3 of ADRD cases (36.9%) in the US were associated with 8 modifiable risk factors, the most prominent of which were midlife obesity (17.7%; 95% CI, 17.5-18.0), physical inactivity (11.8%; 95% CI, 11.7-11.9), and low educational attainment (11.7%; 95% CI, 11.5-12.0)." Interpreting those risk factors as saying x% higher risk than not, i.e. a relative risk of 1.177, it's a far cry from smoking relative risk findings > 20.
I agree that just solving the disease, or at least making its treatment options cheaper (so that it's not a big deal if some people cost a bit more to treat than others), is a lot better than trying to alter levels of service based on BMI. But throwing more money at ADRD directly is probably a mistake, especially given findings like https://www.science.org/content/blog-post/faked-beta-amyloid...
I'm much more in favor of solving aging. Maybe see what happens if you give SENS $1bn/yr. Don't even need to take more public money, I'm sure Alzheimer's researchers won't miss it. (Though even without SENS being better funded, things are looking up; there are more groups, and things have been able to be spun out into startups. It's especially relieving that the Theranos case hasn't completely destroyed the concept of VC-funded health-related startups as a class, since VC money is a lot better than government money dollar-for-dollar. Before his personal drama with SENS recently, Aubrey estimated 50-50 odds at solving aging by 2035. With more funding, that could probably be improved.)
Incentives are perverse. We reward seniority in office when we really need people to cycle in and out more often. Though perhaps a bit less frequently.
You know that whole trope of "the science/medicine just keeps getting better". For Dementia it is just getting worse. We have a better handle on cancer than pryon diseases. Please spend your money on fusion research instead, it has a better outlook and roi.
They used to cling to statistical fallacies about "keeping an active mind" but now we know no amount of crossword puzzles will keep proteins folding right. Cognitive health just masks symptoms longer.
Woah. My grandmas is 92 and has done the crossword everyday for years. I’m not going to tell her that science shows it isn’t helping her offset dementia.
Maybe instead the government should "simply" stop doing everything it can to increase the cost of healthcare. When something is cheap enough (as our tech industry has many times observed), it's not a big deal to leave big factors of inefficiencies on the table and get on with other stuff.
I’d be surprised if paying people to keep their BMI low had more of an impact than the doctors repeatedly and clearly telling everyone who listens that obesity increases the risk of dementia and premature death.
Agreed. I think one step would be to have public healthcare, but only for people who are at a healthy weight (as determined by body fat percentage).
For example, Type 2 diabetes is a big cost burden for any health system. 70% of people with Type 2 diabetes who are also overweight would be asymtomatic if they lost weight. Why spend money on these people if the best course of action is free? (I.e., eat less food)
Even better: Do what certain Latin Amercan countries did and take the fight against convenience food and the producing industry serious. Tax sugar, reduce max sizes of soft drinks,... You name it. Using public healthcare as a way to punish people seems to go counter the goal of oublic healthcare.
Yes, I think ultra-processed food is a good candidate for being the root of the problem, but it seems only recently that people have tried to do anything about it.
It is very dangerous to advocate government prohibiting access to care based on limits they choose. be very wary of unintended consequences, and potentials of abuse
It may sound find and good to impose limits in this way, but I can think of all kinds of ways that could be abused
Type 2 diabetics get fat because of the insulin injections they are using. Not because they are eating more or are more lazy than the average person. The real solution for Type 2 diabetics is a low-carb diet. Doctors in the US, UK, and Australia routinely reverse Type 2 diabetics for their patients using low-carb diets.
> Just allow insurance companies to charge more for “avoidable” things like motorcycle riding, inactivity, obesity, smoking.
Insurance companies already ask for a subset of this. My health and life insurance asked about smoking (multiple times), and life insurance specifically requires you to get a health exam done at a doctor if you are trying to opt into a high tier of coverage. My life insurance also asked me if I am doing any "extreme sports/activities", with their listed top examples of it being motorcycle riding and skydiving.
None ever asked about obesity or inactivity. I am all for obesity being treated like smoking, but inactivity is a bit of a tough one to filter or screen for.
Oh well thanks for solving the problem there chief. Who knew you only had to pay people to lose weight.
Edit: Downvote me all you want, these are just stupid internet points. But what the guy/gal said was offensive to anyone who’s struggled with weight loss.
Edit 2: Sounds like I should really lose some weight before I interview.
Why? I’ve been heavy. I’ve been light. Burn more calories than you consume and you lose weight. I don’t think it’s fair others should need to pay more for my healthcare if I choose to use my American freedom to be heavy?
That’s not what OP said, they said the government should pay people to lose weight. As if getting a $100 check in the mail each month would change people’s behavior. It just lacks any real understanding of why people are overweight to begin with.
A $100 check is not going to get someone to choose Broccoli over Ice Cream...
for example I have for force myself to eat vegetables, cant stand them, no matter how they are prepared, I have a heightened sensitivity to bitter things. It is not a cost issue that prevents me (and many others I know) from eating "healtly" things, it is fact that to us they taste like crap
and yes I know "how to prepare them", I am actually a pretty decent cook, and tried every preparation method known to man, just my taste buds reject veggies, especially cooked veggies, Salads greens, Spinach, Green Peppers, Tomato's, Cabbages, etc are tolerable and make up the bulk of my vegetable intake
I did what you are doing for years and finally switched to a low-carb diet instead. It works much better for me. I still eat 200g spinach and 150g broccoli a day to get the vitamins I need. It tastes excellent when fried in butter with lots of spices and eggs/meat. I instantly lost 7kg and 9cm around my waist eating the same amount of calories. And my blood results are “superb” according to my doctor. I recommend the “low carb down under” YouTube channel for the science talks.
You're projecting an implementation onto an idea. It seems bad faith. The ability, or physical and emotional investment to lose weight isn't exactly insignificant, so you're right to emphasize that - projecting ignorance and malice on the idea rather than criticizing it's merits isn't helping though? $100 check contingent on nothing does seem like it could go wrong as well as being subjectively offensive, but you are the one who suggested that right? What would work best I wonder. I was lucky in the sense that my life's circumstances forced me to lose all my spare weight.
I certainly wasn't trying to, just giving you my impression of your intentions. Are you trying to impune and argue, or is that just me? What ideas are you suggesting besides the $100?
It’s more complicated than that. If you don’t keep your insulin low then you literally can’t loose fat no matter how little calories you eat. The body will simply down regulate your energy expenditure to match your calorie intake if it can’t access your body fat. So you will be colder, have less energy, be more tired etc.
Is anyone seriously engaging with the question of what to do about obesity from a public health standpoint instead of riding their dietary/urban planning/economic hobby horse or coming up with yet another vacuous PR campaign to promote "healthy choices"? As far as I've been able to find, there are zero examples of countries with an obesity epidemic that have managed to even halt it, let alone reverse it. Every major explanation of the epidemic I've seen fails to actually fit the data, often blatantly so (e.g. blaming things that spiked well before the epidemic in a given population, or trends that flattened or reversed decades ago while obesity continues to rise).
It feels like we're either not even trying, or are ruinously confused about what we're up against.
I remember reading a Twitter thread (i know) where someone who's done a book or something on this subject realized that all the studies bacically say the same thing.
Nobody knows the reason, but the data all shows when it started.
* I know too; but it's not like the actual replication-crisis-suffering capital S Science reviews are that much better than twitter randos on certain topics... It's useful to reserve judgement and be skeptical about a lot of things. And demand base rates in addition to risk factors.
There is only one reason possible: we eat more than we need. A lot more.
Why we do this is maybe up for debate (personally my guess is because we can and food is tasty), but the basics of thermodynamics is not up for debate.
The reason is obvious: carbohydrates are addictive. The more you eat them the more you want to eat them. Brain scans show that carbs gives you the same kind of pleasure that other addictions gives you. To maximise the addition even more, you mix carbs, fat, and salt. The food industry knows this and does everything it can to turn consumers into addicts of their products. They have succeeded spectacularly.
This is an annoying take that comes up every time. It’s like saying people die because a critical organ stops functioning. It adds nothing to the discourse and tends to imply that it’s lack of will power.
I think you're missing the point of the analogy; it's not about assigning culpability for health problems, it's about illustrating the kind of comment that centers proximate causes when the surrounding discussion is about root causes.
It seems we’ve moved into the “acceptance” phase and phrases like “healthy at any weight” and different “body types” have become the norm. We just have no idea what to do.
As a very open-minded, progressive, pro gender revolution, LGBTQ individual, I just can’t wrap my head around the fat pride movements. News like this reinforce my opinion that they are plainly dangerous to public health.
One thing is to be accepting of a non-standard body, even including some degrees of extra weight, but justifying obesity is very different.
Completely agree, even as someone who has struggled with obesity and continues to struggle with overweight.
But there is an important nuance. In many if not most cases, obesity is really a behavioral health issue, and feelings of shame make it so much harder to deal with that productively. If overeating is a maladaptive strategy to negative emotions, walking around feeling shame and embarrassment all the time makes that so much harder.
So fat pride isn’t great, but fat acceptance, to one degree or another, may be productive.
It really should be something more like how society is moving to treat depression - an unfortunate thing that happens and requires treatment, but not necessarily a flaw that makes someone a bad person.
The current stigmatization around obese people is that they are seen as stupid, lazy, gross, and generally bad, inferior people. Even as a recovering fat person, who knows it’s wrong, it is hard to overcome the implicit bias.
The "fat acceptance" definition you use, I can totally get behind that. No one should be shamed for being depressed or being fat, they deserve support and help, as well as being treated as a normal human being deserving the same respect as everyone else.
However, the issue is that a lot of times when someone says "fat acceptance", they mean it in a sense of accepting that being extremely overweight can be totally healthy and fine. With a giant dose of anti-doctor sentiment mixed in, because "i know more than doctors because I use google to find other opinions supporting my current opinion".
If we want "fat acceptance" to be taken seriously, there needs to be a clear line drawn between those two usages of the term. The one you propose (aka the one in my first paragraph) is extremely reasonable and humane, and should be taken seriously. While the one I mentioned in my second paragraph should be separated as far as possible from that term. It just taints the definition you propose and makes people take it less seriously, which slows down the needle of progress that your definition is supposed to accomplish.
This may be a very cynical take but I believe "society" has move to "embrace" depression as something to be accepted and treated because there are BILLIONS of dollars in treating depression with medication. Doctors are far far far far far to quick to peddle a pharmacological solution to anyone everyone, the number of people on some kind of "anti-depression" medication is unreal, and unhealthy IMO
If we get a "fat pill" one day like we have for depression I would expect a similar trend
Also, please recognize that “hard to overcome” implies an effort to overcome and recognize that that thinking is wrong.
If I had to justify it, I would say that I have been conditioned over the course of 20+ years and continue to be conditioned to see non-fat people as desirable and fatness as gross. And to some degree it is rational - fat people are more likely to die young, experience health issues, struggle with hygiene or everyday activities; all things you don’t want in yourself, your partner, or people you rely on. It’s also clearly a mental health issue, which comes with its own stigmas. It takes time to overcome and unlearn all of that.
Culturally, the 'pro gender revolution, LGBTQ' movements and the fat pride movement (amongst other movements) are part of the same underlying thrust of our society. The basis is the idea that the individual should be free to be/do whatever they want (especially wrt themselves/bodies), and it's oppressive to have social norms/laws which restrict or even make the individual feel bad for being as they 'truly' are.
To suggest a way of living is not ideal (even with solid utilitarian arguments) for a set of individuals can be considered oppressive, as you are saying who they are is somehow not good enough. The individuals sense of themself and their feelings are tantamount in a culture so centered on the individual.
On a slightly related note, it does seem like our culture is also moving away from believing humans have free will. A lot of maladaptive states (from a utilitarian perspective) that humans can be in are increasingly described as 'unfortunate'/'unlucky' things that 'happen' to them. This relates to the sense of oppression for social norms that would suggest one way of being/living is not good - "How dare you say my current state is bad, I can't control that!"
Indeed, the National Association to Aid Fat Americans (NAAFA), now the National Association to Advance Fat Acceptance, was founded in 1969. In 1973, an activist group "Fat Underground" had a manifesto that included "We see our struggle as allied with the struggles of other oppressed groups against classism, racism, sexism, ageism, capitalism, imperialism, and the like." Since at least the 80s, fat people have used the phrasings of "coming out as fat" / "come out of the closet" to mean their acceptance of their bodies/not finding fatness offensive/no longer stressing about dieting.
What's interesting is the question of agency getting tied up with fatness in the first place. There have been times even not that long ago that being fat was considered a sign of success. There were even these "Fat Men's Clubs" (https://en.wikipedia.org/wiki/Fat_men%27s_club) of rich and fat businessmen celebrating their weight and eating a lot. But then fatness became bad, marking a lack of agency, and acquired other negative aspects like being greedy (contra magnanimous) and stupid and having 0 sex appeal (contra, say, the Venus of Willendorf, though you don't really need to go back that far), and being unhealthy, and being an overall burden to society whether it comes to airplane seats or healthcare costs.
Since dieting/keeping slim in the face of our modern abundance is now considered a mark of successful exercise of agency, fat acceptance types have to somehow decouple their eating behavior from their weight, if they want to maintain some semblance of agency here. (Despite the way our culture seems to be moving I still think most people want to maintain an idea of agency, even if that's in going against what it means to be agent-y.) So sure the 'fatness' is something that just happens to them, like being tall or short, it's not even unlucky really, and it's pretty much impossible to change in the long term anyway (with even some science backing up the failures of long-term weight loss after dieting). However they can twist it, the goal is to be free from the moral failing/agency failing concern that they're not acting in responsible/good ways. They can still be considered good in other ways.
And now that they're no longer preoccupied with their "exercising agency" failings from fruitless dieting and what have you, they begin to exercise more agency! Check out this cover letter from 1981 by Wilma Kuns on how she was able to start living her life once she accepted her fat: https://naafa.org/s/Nov-Dec_1981.pdf I think it's pretty typical, even today, and sure is reminiscent of other groups' "coming out" expressions of exuberance. Instances of exercising agency can be as simple as throwing out a scale, or a sense of a new-found ability to actually make choices and decisions (the foundation of agency) for things like clothing, sex (either feeling able to pursue it at all without feeling disgusted in themselves/partner, or being able to say 'no' and not just take what they can get), or doing activities or working jobs they wanted to do but were previously afraid of suffering social ridicule for. Having a bit of self-confidence feels like an agency booster, so of course removing this constant "you're fat and unworthy of life/fair treatment/love/health/..." mentality helps, regardless of whether it's rationally backed or not.
But it also gives a sense of agency in another way: exercising resistance, namely to society's (or some segment of society's) ideas of what it means to be healthy and beautiful. There's a lot of this form of agency these days. It's rather amusing that such acts of agency still reinforce the overall societal demand for agency, for distinguishing yourself as an individual making choices and pursuing what you think of as your idea of success.
I've never heard of things like alcoholism pride, for instance (maybe I'm wrong). What makes obesity so different that it gets these defenders, despite the indisputable link with a wide array of health issues?
> I've never heard of things like alcoholism pride
Alcohol is substantially engrained in culture, country music or top 40 playlists. Today listening to a country playlist, about 70% of songs mention beer, whisky, or tequila.
And you could say, they're talking about a cool beverage every few days; and then you'll see the Social posts normalizing that a bottle or 2 of wine a night is normal, or that "it's 5 o'clock somewhere" as if alcohol every day at 5 is healthy. But then you'll meet a reformed alcoholic who started from these references. And then you'll hang out with "normals" with a person who is sober or even a moderate drinker and realize that the majority of American adults do have a problem with alcohol (they even feel uncomfortable if someone is asks for a water), it's just normalized
People with alcohol problems will often say "yeah, but I'm not an alcoholic", as if there's some magic line that you can cross that suddenly means it's bad for you, and if you have one drink less you're fine, when really that line starts at the first drink.
This is one of the reasons, people are moving away from the term, and using "unhealthy alcohol use" as a term for the condition, and also “a person with an alcohol use disorder” or “a person with a drug use disorder" rather than alcoholic or addict.
fyi, there is a difference between 'problematic consumption' and 'addiction', and there are separate tests for each. of course they're correlated and there is a path that leads from one to the other, but there are important differences - especially since addiction is pretty much considered to be sticky.
so once you are addicted, you'll stay that way, even if your consumption ceases completely (at which point you're an addict who doesn't exhibit problematic consumption). that's why clean alcoholics (or any clean drug addicts) are usually advised to stay teetotal indefinitely: they'll usually bounce back to their old patterns very quickly if they have a fallback.
Its a gender thing. When men have problems we tell them to fix it, when women have problems we are told to sympathize with them. Alcoholism is mostly a male issue while obesity is gender neutral and hence includes a lot of women.
If you think obesity and alcoholism have remotely the same level of risk, you are woefully misinformed. The people you call “defenders” are simply asking to be treated like humans. The biggest health issue for obese individuals isn’t their obesity, but the fact that most doctors refuse to treat their health issues directly, and instead blame every problem on the patient’s weight, without providing any solution.
If the stats show that being overweight increases your risk "X-fold", I promise the doctor is suggesting weight loss, which is at least a partial solution.
Correct, there's that line where the body shaming and bullying are more likely to make the fatties go back inside, not get in the pool, and skip participation.
That was me in school. I would not have had such issues with weight had it not been repeatedly and antagonistically drawn to attention, and used as an excuse to exclude or diminish my personhood.
Fair point, but I’m in no way suggesting that it’s ok to bully fat people or not help them overcome their self-acceptance issues. But it self-acceptance is prioritized over fixing an objective health issue (obesity, not being a bit overweight), then it becomes a problem.
It’s complicated! Ha. Yeah I mean there’s no value in harassing an individual at all about their fat pride, when they are not responsible for but most likely victims of society… a society that positions cheap and unhealthy food options at every corner.
Be mad at McDonald’s. Be mad at Family Dollar. Be mad at bullies. And be made about fat pride too, that we as people have created the conditions that have been so toxic to some people that almost by necessity they inoculate themselves from horrible attitudes that have never helped them in the slightest.
Very good points. But frankly, this is Capitalism self-preservation in action. Convincing people of being proud of whoever they are is easier than fixing a systemic issue created by greedy corporations. It’s like prioritizing personal responsibility as a sustainability policy. It’s easier to buy into an ecological lifestyle (put down that plastic straw!) than fixing the systemic underlying issues through which big corporations generate profits.
It helps to think of it as one of many movements resistant to health and longevity becoming entrenched as a universal moral standard.
Some people think that there are more important values in life than those things, and don’t want to have to fight for their right to live by those other values.
Here, it’s a right to eat and be active in the way they want, for whatever reasons they want, without having to answer to someone else’s concern over their health or longevity.
I feel the point is more nuanced than you suggest. Clearly, nobody should be made to feel shit because they are overweight, but that's quite different from being actively proud of being overweight. It feels like a fine line to walk - making sure people feel happy and confident in who they are, but at the same time empowered and supported to make life improving decisions without feeling they're "letting the side down".
Public health is just an aggregation of facts about individual health right? Leaving aside the enormously important exception of epidemiology.
Obese people have poor health outcomes, which harms them. Insofar as it's meaningful to even say "harming public health", this harms public health. But since a collection of data is hard to harm, I think this framing is unhelpful.
Do that many people just not know better? I know some people really have no idea how calories work but I see obese smart people who should know better.
Do people just not care? I understand some people not caring, like computer scientists or “manly” men. But even they should understand that obesity is really bad for health and QOL. They don’t have to become normal weight either: being overweight doesn’t have the negative physical and mental health effects, but they are obese to the point where it does affect those things.
Are they hungry? I get this part. I’ve experienced real hunger and it’s not the “just wait until dinner” kind. I could never maintain a normal weight if I had to endure constant hunger and the effects associated with it (low energy, brain fog, mood dysregulation - these are very real things people experience when not eating enough, and which fat people experience even when eating enough when they have hormonal issues).
Except, obese people also eat junk food which makes you more hungry. If it was hunger I would expect to see more people eating large plates of protein and vegetables, but it seems like even with CICO most people just don’t get fat on protein and vegetables. Do whole foods just not satiate? Or do people not understand which foods make you feel full, which make you satisfied, and which make you satisfied while tasting good (skinless chicken breast and raw salads with no dressing are not good meals).
I don’t have anything against obese people. But supposedly over 40% of Americans are obese, and many are obese in other countries. This is very strange and honestly depressing. Maybe it’s because I live in communities where less people are obese (college towns and a suburban community in a very blue state), because indeed while I see obese people it seems like way less than 40%. Particularly depressing is child obesity, which is really strange because kids tend to have higher metabolisms and even skinny kids’ diets are really junky.
I think most people would really like to be not obese, and if those people could lose weight with low effort it would be a huge benefit to them and society. So it’s important to understand why so many people are obese. Because like I said, 40% are obese despite most knowing better, and a lot of people seem to be like “yeah”.
A full answer to your first why is a mystery. But a related question is a lot more tractable because you can ask fat individuals: how can you stand being fat? For a lot of fat people (and I invite you to look at a BMI height/weight chart to see what counts in analysis as fat/obese), they're like "yeah" about it because that's the extent it seems to affect their daily life. That is, in the experience of a typical fat person, getting their BMI under 30 (if obese) or under 25 (if merely "overweight") would not actually be a "huge" benefit to them. Being fat and even obese doesn't actually preclude a lot of fat people from doing the things they want to do.
Even from a pure health perspective, the relative risks of being fat often top out at like 2x for the most fat and specific health issues. The relative risk for dementia from this submission's study is only 1.177x. (Smoking, in contrast, finds relative risks for lung cancers > 20x.) But if the base rate is low, even 2x of that rate is still fairly low, and not necessarily enough to care about making a potentially difficult life change over.
Getting into the "severely obese" category (BMI > 40) I think is where day-to-day issues become more common, though that's "only" about 9% of the US adult population.
We actually know what is going on. It’s called carb addiction. The more carbs you eat, the more carbs you want to eat. In modern societies we have easy access to as many carbs as we want. That is a new phenomenon. Sugar used to be so expensive that only the rich could afford it. And back then only the rich had the kind of health problems that we now see everywhere in our societies (Metabolic syndrome).
I hear the “self-control” argument a lot, but that is definitely not all
Obesity hasn’t been an issue since somewhere in the 1970s. And not everyone was constantly starving before then. Yeah we are predisposed to eat more than we need but we have satiety signals, unlike some animals which will literally eat until they explode.
More importantly people display self-control in other regards. Lots of obese people have become really successful, lots are genuinely tough people. People have the self-control to finish school, work, and otherwise take care of themselves (e.g. keep the house clean). Why don’t they have the self-control to choose a steak and salad instead of pizza and fries?
I guess I was drawing a false distinction between things modifiable via medical intervention and things modifiable via lifestyle modification. The relevant thing must be that you have a condition, not what could be done about it, and there's clearly some overlap between the two categories (e.g., obesity).
Japan has one of the highest rates of soy consumption in the world and they also have some of the least obesity and the longest lifespans so I fail to see how soy is problematic in increasing obesity.
Next time you get virtually any salad dressing or even a non-sriracha hot sauce such as that served in little packets from e.g. Wendy's or McDonald's, you will find soybean oil as one of the ingredients.
Soybean oil is nearly impossible to avoid if you are eating out; and it is found in a lot of other foods such as salad dressing, etc. I would encourage you on your next trip to supermarket to make note of how many processed foods contain soybean oil. Only good quality olive oil is free from PUFAs among the various vegetable oils.
