What message would it take to make obesity rates plummet dramatically?

On the one hand, fat-shaming can make obesity worsen even more.

On the other hand, body positivity causes obese people to believe that they are not obese - additional source here.

Obesity clearly continues to be prevalent. But even medical professionals are now being pressured into not telling patients to lose weight. And the Healthy at Every Size movement has been around for a while. Increasingly, it seems that the momentum in society is going further and further away from health - that now, instead of reducing fat, society has resorted to embracing it instead. (See these articles: “Why I Glorify Obesity” and “I want to be very clear here, I am glorifying obesity.”) Even Michelle Obama was accused of fat-shaming.

So if being pro-fat or anti-fat ***both ***have the effect of increasing obesity…then just what can or should be done?
(Speaking of the Healthy at Every Size movement - do they truly believe healthy at *every *size? If 200 pounds, that’s one thing, but how could anyone be healthy at 600?)

I’m not sure there is a message that would make obesity rates plummet. I think there’s an element of human nature at work wen there’s an abundance of cheap food, especially if people have other stresses in their lives.

But some messages that might help:
Gas is too expensive to use it for routine errands. You had better walk or bicycle.
Here is a cheap/free supply of fresh delicious vegetables that are easy to prepare.
You have plenty of time to sleep.

“Big Pharma announces working weight loss pill. Testing has shown it works rapidly allowing people to shed all excess body fat in just 1 week. The only side effect is that your IQ will drop by 10 points.”

Doctors and pharmacies won’t be able to keep up.

“That’ll be $14.99 for the Big Mac and medium fry.”

Nope. Wouldn’t work at all. Chains like Red Robin and whoever, I don’t know, stay in business selling the same shit at these prices. $15 Big Mac would just make McD’s more profitable.

I basically disagree with the premise of this thread completely and it shows to my mind an ignorance of how people get and stay obese. I’ve talked about it before on nutrition/weight loss threads here (many years ago now), about how I was in good shape for much of my adult life until I retired from a military career and became much more sedentary + increased my intake of various unhealthy foods. Before I realized what I had happened I was about 60-70lbs past the point at which I would be considered obese (meaning that if I lost 70 lbs I’d “only” be considered overweight.)

I was able to lose that weight and have kept it off ever since, and especially the keeping it off part stands as frankly one of the hardest things I’ve ever done in my life. The personal anecdote aside, to really understand obesity I think it helps to think of a different hypothetical.

Let’s assume that by some weird quirk of human biology, it was found that males having orgasms suffer long term deleterious effects. Let’s say it was found that the male orgasm caused the release or generation of some biochemicals that, over a long span of time, dramatically increases the chances of developing fatal ailments that affect longevity. Since the effects of this are cumulative and take decades past the age of sexual maturity to develop, it’s something natural selection has not selected against–because the negative impacts are past the point at which natural selection “works” since it doesn’t really affect ability to procreate.

Let’s say that the rough estimate is if you had total abstinence from orgasm, your expected life span as a male would be 15-20 years longer. This means no intercourse, no masturbation, nothing.

What percentage of the adult male population would you anticipate follows a regime in which they have no orgasms for the rest of their life? What do you think the societal reaction would be to the males who failed to abstain, and thus suffered the ill consequences?

My guess is that very, very few men would follow strict abstinence to extend their lifespan. And that society at large would discuss it as “basically impossible to obtain, because the male sex drive is something essentially hardcoded into our biology, and while a man might be able to suppress it at times, it’s virtually impossible to resist this essential biological imperative that our bodies have.”

Obesity works on exactly the same sort of thing. Our bodies get fat largely because this is the way our bodies work. Powerful emotional and behavior altering biochemical processes make us want to get food in our bodies and does not make us particularly care overly about the consequences. Because we have complex brains and intelligence, we unlike most animals realize that our biology governed behaviors can sometimes cause serious negative consequences, so we recognize that being too fat is bad medically. But recognizing it and doing anything about it are very different things.

If I overfed my dog every day he would get very fat. I would not have to force feed him. He would just eat more as I served him more. If I took him to the vet, who would be blamed for him being fat? Me or the dog? I would be blamed because it’ widely recognized that dogs have evolved to get their fill of food ASAP and as a species that spent a lot of its formative years scavenging carcasses and such, it evolved to expect periods of plenty and periods of hunger, so it has no real biological hardwiring that tells it to shut off the feedbag when it starts to get dangerously obese. This is literally very similar to how our bodies work, we just like to believe we are so much better than the other mammals that we can easily override biological instincts and behaviors with intellect.

As someone who has actually done this I’m telling you it is among the hardest things I’ve ever done. Not to toot my own horn, but I’ve done hard stuff in my life. I had a long and fairly successful career as a military officer, achieving competitive promotions and had I had hard jobs. I did competitive powerlifting in my late 30s to late 40s, while never setting world records I regularly placed in meets with guys who could. I went into business for myself later in life and have built it into a profitable venture. I’m proud of the life I’ve lead and I’ve accomplished things that were not easy. But 100%, losing a significant amount of weight and keeping it off stands as one of, if not the most, difficult things I’ve ever done.

To be frank the abilities of an MD to affect this are all but non-existent, obesity is the result of very strong and extremely hard to alter biological imperatives that affect most humans (research I’ve read suggests a small subset of humans essentially don’t overeat when given highly palatable foods, which I believe is just a quirk in the human genes and unfortunately for most of us we don’t have those genes); simply telling someone facing a serious biological imperative “stop doing this” is basically nothing. Should MDs advise their patients on the dangers of being obese? Yes. Should they counsel them on things they could do to improve their health outcomes? Yes. But that advice alone should be expected to work about as well as advice to a 21 year old man to “abstain from all sex including masturbation” for health reasons.

While I have talked about it extensively before, all the research I’ve read suggests that when highly palatable (which is what heavily processed “Junk foods” are) foods are basically made freely available, the vast, vast majority of humans will eat to excess. And then to varying degrees some will get a little overweight and some will get morbidly obese. What we’ve also seen with global obesity rates is the more common highly palatable foods are in a society, the more widely they are made available, the higher the obesity rates rise. While the U.S. basically “lead the field” in this measure, we’ve seen time and time again obesity rates going up in countries that used to be significantly behind the United States in this measure. This process all but always follows the introduction of a more robust consumer market, highly engineered highly palatable foods becoming popular, and a cyclical effect where one generation after the other eats more and more of this stuff. We have seen obesity rates rising in countries we long believed had some magical immunity to it (for example in many burgeoning Asian countries.) China is a wonderful example of this by the way. In rural China and the poorest parts of China, obesity is around 6%. In some Chinese cities obesity has risen to over 20% and is considered a major challenge for Chinese society. The cities where we see these higher obesity rates there’s almost a perfect move towards more obesity that coincides with the greater availability of highly palatable foods in stores, the establishment of fast food restaurants and etc.

I don’t have a magic answer for this on a societal level but I can tell you for me personally the only way to break this cycle for a very long term period (what has been about 10 years now) has been draconian and dramatic changes to life style and frankly a level of “deliberate management” of what I do and don’t eat to a degree that I think most people would find very difficult. Especially because it only worked for me because this wasn’t a 12 or 24 week diet, this was something I had to and still have to stick with basically all the time. I’d say after 10 years of behaviorally restructuring my eating, I actually genuinely do not feel as many cravings for highly palatable junk foods, and I don’t find it as hard to live like this now as I did 7, 8 years ago. But to put things in perspective literally every day when I microwave my lunch, which is usually a simple meal that’s based around chicken and rice, there’s a moment where I’m like “it’d be nice to go get a burger today” or etc. I also can tell you from personal experience that if I follow that decision to “impulse eat” junk food, it’s going to beget another round of making that same impulse decision, which will beget another round to do the same, and very quickly I’ll be on the road back to obesity.

One of the only ways I’ve found I can let myself eat what I consider junk food is if it’s in a pre-planned situation where I’ve known about it before hand, and I deliberately know that I can’t chain it to a multiple day food binge. So I’m fine for things like Thanksgiving dinner, but I don’t keep any leftovers. It’s frankly a running joke with a lot of my friends how strict I am with what I eat, because it frankly makes me a bore in many aspects. But this is 100% what is required for me to break the cycle of overeating and obesity.

So frankly to answer OP, there is no “message” that fixes this. You either make highly palatable foods less available, a prospect which requires serious government interventions into society that many are uncomfortable with (including myself), or you find some way to lead people down the path I’ve taken, at scale.

I eat at McDonald’s-type restaurants virtually every day because the food is cheap. There’s no way I could keep doing that if it cost $15 for a Big Mac.

Martin Hyde, your post should be required reading in high school health classes and lots of other places. I hope you keep repeating your message, and I do admire you greatly for being able to keep your weight off (I know, the hard way, how difficult it is).

Everyone, please read Martin’s post thoroughly and repeatedly. I know it’s long but it’s packed with real, valid information, and good analogies to understand the factors involved in weight gain.

Well, t2 diabetes is gonna sicken and kill msny many people. That will become apparent soon.

You’re killing yourself for convenience. Grocery shopping and cooking food yourself is way cheaper (and I’m talking about real cooking, not heating something out of the freezer section) and way, way healthier.

I agree with Martin. There is no message that will fix it. The consequences are vague and way too in the future. The human race has proven over and over again that we incapable of long term planning for long term benefits. We pretty much only respond to immediate consequences (i.e. take bite, get electrical shock).

The only things that will fix it are:

  1. Removal of cheap and easy food. This will probably take a near apocalypse type event or societal collapse (e.g. Venezuela).
  2. Medication or medical device that either reduces desire to eat or reduces calorie abortion.
  3. Medication or medical device that provides very immediate consequence to overeating (i.e. a fancy shock collar).

I would think #2 is the only item likely to be possible in the next several decades.

What was the reason you started on your weight loss journey? You could have kept enjoying eating all that rich, delicious food. What made you decide to endure all the hard work to lose the weight?

I think that for many people, food is more like a drug than a form of nutrition. Many people seek out sweet or rich tasting foods because it brings a lot of pleasure rather than they have a need for hydration or nutrition. For people to lose weight, often they need to address their compulsion around eating. It’s similar to how an alcoholic or addict needs to deal with their urges. But when someone is in the throws of an addiction, it’s hard to get them to give it up unless they are faced with some serious consequences. There needs to be a moment where they realize they cannot continue on their path and they need to do the hard work to turn things around.

The very fit instructor in one of my exercise classes said he used to be obese. What caused him to decide to lose the weight is when he couldn’t fit in an airline seat. He said that was his “ah ha” moment when he realized he needed to turn things around. So for him, it was probably a good thing that society wasn’t too accommodating to his size.

As someone who is both a recovering alcoholic and obese, I would agree with that. But, there’s one major difference, and it makes all the difference for me. Alcohol is not biologically necessary, it is possible to survive without it, but that’s not true of food. If overeating, or eating the wrong things, is in fact an addiction, it’s going to be harder to ddeal with than many other addictions because it’s impossible to stop entirely.

In general, we don’t expect addicts to moderate their use of what they’re addicted to, but to abstain from it, and that seems to be the best way to control it. The only way that could work with food would be to somehow forcibly ration the food supply of “problem eaters”, which seems unlikely to work.

Obviously some people have the willpower to change their eating behaviour, and others don’t need to. But for those that do, the addiction model shows how hard it is.

Personal anecdote here - social pressure/encouragement can do a lot. Over the last year, my local, extended family has lost about 20-25% each. Shifting us all into normal ranges rather than verging on obsese.

Two households of two retired couples and one adult son. We share about 3 meals a week and all have been watching portion sizes, snacks and calories. No extreme diets just adjusting our intake to suit metabolic changes.

Time is money.

During times when my spouse and I both worked, we gained weight. When one of us was able to not work for a bit, we cooked, exercised more, and were healthier. Direct correlation with the lifestyle of two wage-earners working long-hours (read: typical American sedentary) jobs.

Martin Hyde, thanks for your fantastic write-up.

It looks like perhaps the only thing that can be done is to simply spread and praise as many weight-loss success anecdotes as possible. Both fat-shaming and fat-glorifying sound counterproductive - and since, as you allude to, everyone knows that obesity does bad things to the body, it’s not an issue of education or the lack of it (millions of obese people can recite what obesity does to the heart, pancreas, etc.) - so the only thing that can be done to “lead people down the path you’ve taken, at scale,” as you say, might just be to heap more accolades on those who are trying to do it, and those who’ve done it?

What he said.

It’s not the message. It is the difference between the environment in which humans evolved, and the environment they live in today. Maybe they will come up with a pill that kills your appetite, and with manageable side-effects. Then maybe anorexia will be the problem from people who abuse it.

Regards,
Shodan

Absolutely, and it works in the opposite way also. Humans have always used food as a “social lubricant”. That’s tricky enough to deal with and then you get friends and family who pressure you into eating using gaslighting, guilt and just plain bullying. People who bring food into the office. Food constantly being shown in the media using the most tantalizing imagery possible. It’s a Gordian Knot to be sure.

There’s no message, at least no message for fat people (or potentially fat people) to make them stop being fat. Their own bodies and the entire structure of society and culture are involved in the process. This is not a messaging problem.

The other problem with obesity is that abstinence isn’t a good model; you can abstain, while you can’t not eat. That’s, I think the issue. Imagine alcoholics or smokers being told that they HAVE to smoke between 1 and 3 cigarettes/drink up to two drinks per day, but can’t have more than that. That would be spectacularly unsuccessful.

But that’s basically what’s being expected of obese people- every single thing you eat basically has to be less than what you burn off. Which considering how palatable and high calorie food is, and how ridiculously efficient our bodies are, makes that VERY tough.