People on this board are generally pretty supportive of weight loss.
The simplicity of weight loss is undeniable; eat less, exercise more. That does not make it easy, however. Simple things can in fact be quite difficult. It is simple to run the 100-meter dash in ten seconds flat - you just need to take long steps really fast. That doesn’t make it easy.
Have you ever noticed that if you look at pictures from two generations ago, there are hardly any fat people in them? We need to stop convincing ourselves that it is normal, acceptable and inevitable. It is none of those. Instead of worrying about fat-shaming we should admit that it’s an epidemic disease and we need to fight it as such.
That doesn’t even make sense. How in the hell is a doctor or other health professional supposed to tell their patients that they’re overweight, obese or just could stand to lose a few pounds, if they have to tiptoe around ninny-baby fat people for fear of fat shaming them via shit that’s all in the patient’s head and the doctor never said or even necessarily intended to imply? And some people need to be told- a “healthy” weight according to the charts is what most people would consider “thin”. As in a 6’1" man with a 34" waist kind of thin.
They’re only in control of what they actually say. If some fat person is too much of an oversensitive whiny baby for a doctor to tell them what they already know, then maybe they should be seeing a therapist or psychologist as well.
I mean, my doctor tells me that I should lose weight every physical. And I know it’s in the context of his duty of care as a physician. I AM fat- obese even, although barely in that category. And I’m not butthurt or anything about it when he tells me- I’d be a lot more disturbed if he didn’t- that’s by far my biggest risk factor in terms of health.
Also, the body-positivity movement may be causing obesity to become more prevalent:
I know that women face much more social pressure than men do to be thin. But speaking as a man who is significantly overweight, my perspective is that from a purely medical perspective, a lot of people seem to see nothing wrong with a woman being overweight.
My experience–and I fully realize that this may be partly due to “frequency illusion”–is that nearly every generic article that talks about obesity says (in effect) that it’s more or less ok for women to be obese because of how they carry the weight, but a man who is obese is just begging the gods to smite him down with a heart attack.
I’ve had a dentist tell me I should stop smoking, without first asking if I did. I said I didn’t smoke, I’ve never been a smoker. She snorted. I took a piece of paper, wrote down “TETRACYCLINES”, gave it to her, left the office and went to the front desk to ask for a new appointment “with a doctor whose IQ is above room temperature outdoors in the South Pole on July 24th, please”.
Re. Flyer’s point, there’s several issues there:
Its not normal. But we really don’t know what to do about it. Anti-obesity efforts are largely ineffective.
In ~50 years I doubt obesity is a problem, because medicine will understand how obesity works and how to treat it. But right now, advice about lifestyle is largely ineffective at treating obesity over the long term on a society wide level.
In the last few years, I think the obesity rate for women has increased from 36% up to 40%. Women are judged harshly for being obese, and people know obesity is bad for them. And people have heard ‘diet and exercise’ millions of times. None of that stopped the obesity rate from climbing. Doing the same thing isn’t going to change the issue.
Absolutely correct.
And how do we fight epidemic diseases?
If there was an epidemic of malaria say, how would we fight it?
Would we go out and tell people they have malaria and tell them to get healthy? Would put out posters educating people that malaria is bad for you?
Or would we analyze what has changed in the environment, deal with it as the public health issue it would be, notice that we now have lots of standing water breeding mosquitos for some reason, that has caused so many more to get malaria, address those causes, and both do what we could to drain those cesspools and to work on improving preventative measures like better netting? We would not rail upon those with the disease for having it and tell them that the issue is their lack of discipline or character.
There is a worldwide epidemic of obesity. The cause is a significantly more obesigenic environment. But while there would be little public resistance to draining cesspools and to figuring out how to implement better netting there is much objection to to the parallel in society to address the problem of obesity.
Because the one table to rule them all is simple and fast to some degree. The table is a mere crude screening tool far from perfect in any population. But BMI of 32 is overfat with probable health implications whatever your ancestry.
And even more so because the research on understanding the impact of ancestry on the significance of BMI and other measures of obesity is still in progress. There actually IS an Asian BMI calculator that is set with the recognition that Asians and Asian Americans may have increased health risks at a lower BMI, likely mostly secondary to a getter tendency to store visceral/central fat. And different countries are setting standards of their ownbased on this data.
Yes it is true, at for diabetes rates, for other non-white populations as well, to varying degrees:
The last bit is slightly odd as Blacks as a population have lower percent body fat for the same BMI than do whites. So as monstro notes, BMI of Blacks may overestimate obesity as defined by percent body fat, but underestimate the health impacts of the level of BMI anyway.
Yeah a bit of a box of worms to unpack.
Those are two links discussing the same article, an article that comes to one of the stupidest conclusions I’ve ever read. The observation that as there are more people fatter around us more of us underestimate our level of fatness is likely true. Concluding that is because of “body positivity” is without any support, at all.
OTOH there is much research that strongly suggests that fat stigmatization INCREASES the risk of further weight gain and of poorer health outcomes. A summary of the subject is available here.
Behaviors that are perceived as shaming or stigmatizing have more potential for harm than good.
We want to prevent obesity in the first place. We want everyone avoiding unhealthy nutritional patterns and exercising regularly, not just those who are overweight or obese. If you are not doing those things then, in our obesogenic world you are at high risk of becoming obese and minimally being unhealthy even at normal BMI, even if your BMI is currently “normal”. You are the target for intervention.
More so we need to modify how our environment has triggered this epidemic and figure out what is, analogously, the best netting.
Worms come in cans.
I really don’t need to know about what worms do when they watch porno man.
They also come in boxes.
And bait shops often pack them in Chinese food style boxes. (At least they did the last time i was in a bait shop)
A high percentage of the endometrial cancer cases I see involve patients who are drastically overweight. Apparently this is the type of cancer most strongly associated with obesity.
I recently signed out one hysterectomy case in which the patient was only in her early 30s, and described as morbidly obese.
I don’t think it would be “fat shaming” to tell someone who (for example) is 5 foot 5 and weighs 250 pounds that her risk of getting endometrial cancer is considerably higher than someone close to normal weight, or that she is also at increased risk of dying from diabetes and/or hypertension.
Sometimes warnings take time to sink in, and repetition can be valuable.
most likely it’s the result of eating a lot more carbs and processed foods rather than eating fresh foods. Also now with many more families with both parents working it’s a lot easier just to pick up fast food on the way home. Also if you go way back people had to work to get food by growing it, now they just buy it. When you grow food you get exercise by planting , harvesting, etc. Also you get exercise by having to care for hogs, cows, etc.
If one does actually read the real article btw the findings in fact strongly support that “body positivity” (which the authors’ introduction says is fashions aimed at “plus sized” and “vanity sizing”) is NOT a factor in the poor self-assessment of fatness.
For the hypothesis to be supported the target of plus sized marketing and vanity sizing would be more prone to BMI underestimation. Who is most targeted by plus sized fashions in the U.K.? Not men. Yet “men were more likely than women to underestimate their overweight or obesity status (38.8% vs. 16.8%)” And not the lower as opposed to the higher income groups, yet “bottom‐income quintile were 1.3 times (95% CI: 1.15‐1.49) more likely to misperceive their weight compared with those in the top‐income quintile.”
It is difficult for many to wrap their heads around the fact that interventions that result in the obese feeling shamed are counterproductive, but even if it seems paradoxical the data is consistent: greater body dissatisfaction makes behavior change to lose weight less likely. Being more satisfied with one’s body type relatively protects from greater weight gain.
Sure, I don’t have a problem with dispassionately framing it in terms of elevated associated risks; aside from the more extreme cases, the limitations of only noting an individual’s BMI should be taken into account as well.
It’s silly to me when some lurch to extremes on this topic. Dying tranquilly in their 80s or 90s is little more than a pipe dream for a lot of people with other stressors they deal with. I don’t like what seems to be the trend of laypeople acting like they can make assumptions about someone’s health by looking at them (and grandstanding like associated knowledge is becoming forbidden) or knowing their weight, and I would hope the doctors who would habitually posture like this are rare exceptions.
I have always instinctively perceived the movement for body positivity/acceptance to partially be in reaction to societal myths about body dimensions especially those transmitted by what is portrayed in tv, movies, and magazines. Some take it too far in reaction, as well as in the reaction to the reaction.
I am just on the verge of being obese and every time I go to the doctor he tells me I need to start exercising. I want to tell him that if I wanted to exercise I would have started years ago. As an expert on being bullied I don’t feel like I’m being “shamed.” Honestly it’s probably good advice that I wish I could take.
Well it’s also just flat out bad advice. You won’t lose weight via exercising, you lose weight by consuming less calories than your body uses. Exercising doesn’t really help, since while it burns calories it makes you feel hungrier and you end up eating more.
Also, for someone obese, the extra load of their fat mass makes exercising painful or even dangerous because their joints are well over their “rated” load limits.
Doesn’t mean you shouldn’t exercise - you should, for the clear health benefits - but only a relatively modest amount is needed. If you are trying to lose weight at a reasonably rapid pace, you accomplish this by eating a lot less, not by exercising a lot more.
