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I recently (and by recently, I mean two weeks ago) started water fasting, and to displace the constant feelings of food cravings I started watching food-related videos, most notably: TLC's 600lb Life. It is extraordinarily trashy TV, but illuminating.
Before I describe the negative observations, here's the positive ones: A) All of the successful patients had a good attitude to begin with (they wanted to lose the weight, and were willing to commit) B) They followed the doctor's instructions (important.) C) They had friends and family who were supportive and were generally affable individuals to begin with (likeable!)
As a representative slice of the people who get really, really fat, they're about 5% of the population. The rest that follows is the generalizations of everyone else.
Now. For the hot takes:
THE OBESE ARE IGNORANT
Do you remember the much-maligned food pyramid from your health classes, the one that put way too many grain carbs at the bottom? At the very least, it puts vegetables on the second tier, and fast food at the very tippy top. And these people don't even know that. The very concept of CICO they stubbornly defy. They don't seem to know anything about basic nutrition that even a kid would know. And it's not like they're getting fat off good cuisine, either. (A fat gourmand with a diverse palette would be, at the very least, a good friend to have to ask for recommendations.) They're just eating fast-food slop paid by their welfare checks. And speaking of...
THE OBESE ARE ENTITLED
There is a certain childlike narcissism that accompanies each and every one of these patients, that demands the world bend around them: that they should be fed, bathed, and cared after without giving anything back in return. They frequently manipulate their family members and spouses to look after them, hand and foot, even their children. They're rude and throw tantrums, and their ignorance only strengthens their stubbornness. (They even disagree with their own doctor, a man they're self-selected to seek out!) They continue their bad eating habits - even in the hospital itself! - and have food snuck in for them to eat. This inevitably leads to...
THE OBESE ARE STUPID
In wrestling, where the tiers are segmented by weight class, in order to hit the weight limits, athletes often go to extraordinarily lengths to temporarily lose 5-10 pounds before weigh-in to get as much of an advantage as they can. In the show, in order to qualify for bariatric surgery, patients need to lose a certain amount of weight so that it is safe for them to go into surgery. Now, admittedly, going to 1200 calorie diet when you're used to 10k+ is pretty hard, but even going to 5,000 - twice the amount of a healthy adult - would guarantee weight loss without significant dietary changes, other than portions.
Do they do this? Of course not.
In fact, I'm pretty sure they don't even weigh themselves beforehand. It's always a surprise and a shock when - surprise of surprises - that eating the same amount as you did before would maintain it. (In fact, some of them even gained weight.) The tantrums, the lies, the threats - all are laid bare before the uncaring measure of the livestock scale.
Of course they don't get the surgery. And they're always left wondering why, the poor buggers.
So, in conclusion, I have come into belief that you should judge people for being obese. Not to say that all fat people are ignorant, entitled, and stupid. But they definitely have at least one of these traits, and should be avoided at all costs.
One of my guilty pleasures is trash TV, including My 600 Pound Life.
Your observations are generally true for the people on that show. But I think you're being rather uncharitable.
First of all, the patients on that show are extraordinarily obese and unhealthy. They are not your "usual" fat person, but people who've literally reached the point of "lose weight or die." They are also, of course, selected for dramatic and disagreeable personalities who will make for good TV. (You can even see viewers complaining when the season is "too boring" because the patients are cooperative and not dramatic enough.)
You also neglected to mention that most of them are suffering from severe mental illness. The food addiction that has rendered them nearly immobile is clearly a mental illness in itself, but most of them have all kinds of other problems. Most of them are impoverished and come from abusive backgrounds. Childhood sexual abuse is a very common theme. You say they are stupid, entitled, and ignorant; there's a reason you don't see many of them who come from stable and supportive middle class families. Most of the time, when we see family members, they are as fucked up as the patient, if not as fat.
And it's a reality TV show! You know that shit is heavily edited, right? My 600 Pound Life, like most such shows, has been accused of staging confrontations, feeding the "participants" their lines, crafting "storylines" to make them more dramatic, and so on. The patients may be real and their issues are too, but I would not trust the show to be giving you a really accurate picture.
Now, more generally I agree that fat people (even "normal" fat people) have a strong tendency to be in denial about how much they eat and how little exercise they do, or about the health effects of obesity. But it should be obvious that making broad generalizations based on the personalities who appear on a reality TV show is just taking cheap swings at easy targets.
I'm not in denial about anything; I'm just not willing to spend the rest of my life fighting against my set point by suffering from starvation neurosis and working a part-time job at the gym in order to maintain a healthy weight.
Set point theory is very popular among fat activists, yes.
People's metabolisms do vary (which is why "CICO" is both true and simplistic - the "burn rate" is not the same for every person). But nobody weighs 400 pounds because that's what their "set point" says they should weigh, and I have only ever met two kinds of severely obese people: those who admit they eat too much, and those who make up reasons why somehow normal rules of biology and physics are different for them.
For the most part, pro-CICO people seem to reject the idea of fast or slow metabolisms.
I don't know what pile of straw you've found your "pro-CICO people" from, but in my experience, they are happy to point you directly to places where you can see the variability for yourself. I'll even preempt any digging in the straw you might do to claim that "pro-CICO people" simply reject the concept of metabolic adaptation, because they actually write entire articles about it, what it is, what it isn't, and what it practically means for people.
At the end of the day, they say things like that the Cunningham equation (or a few others) actually do a pretty good job of getting you to the right ballpark, but then you probably need direct observation if you want to really nail down where you are with precision. My wife and I proceeded with direct observation, and sure enough, the population-based equation estimates got us pretty darn close, but what was really incredible was that even though the data was insanely noisy (which was expected, and I have enough background in numerical analysis to know how awful that noise would be for estimating derivatives), the trend line over a couple years of tracking (through periods of cutting, periods of maintaining, and periods of gaining) was bang on at exactly 500cal/day = 1lb/wk... for both of us. The "pro-CICO people" that you strawman are actually doing things like putting direct observation into an app rather than making ridiculous claims like there being no variability whatsoever.
The thesis of CICO is that it's not just a useful guide, but literally an iron law of the universe. Ever heard of something called thermodynamics? So it's not obvious to me how a "metabolism" (whatever that is) can conjure up, or delete, energy or mass.
Personally I found CICO useful for losing weight and not useful for gaining weight. But, based on my own direct observation, you'll probably just call me a liar or say that I was tracking wrong. That is of course, what every CICO advocate does immediately. After all, CICO is (apparently) totally perfect and based on thermodynamics.
Perhaps you should read the link, discussing variability in the calories out portion. Saying that CICO is thermodynamics and that there is variability at least in CO is perfectly consistent. I'm not sure what windmill you think you've slain.
I will not call you a liar, but this is indicative of the mindset with which you are entering this conversation. You have tarred the people you hate with a scarlet letter and then simply closed your mind to any meaningful discussion. Very bad epistemic hygiene.
I don't hate CICO advocates, I just don't know if there's a constructive conversation to be had with people who consistently respond to everything with "you're lying" or "you must have missed something". This is also epistemic closure - anyone who struggles with CICO is always accused of lying.
As I've already said I did get some benefit from calorie tracking. I think it's useful even just to learn how many calories are in your food. So of course, I don't hate CICO, but of course this kind of defensiveness is also very typical of CICO advocates.
If the defense of CICO epicycles is that "uh, actually sometimes people just burn extra calories for no reason", that's not that compelling. Isn't the point of CICO that it should always give you predictable results, and that if your results are wrong, it's because you made a mistake or are lying?
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