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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.
I think a lot of what you’re seeing— at least the parts that aren’t exaggerated for TV — are evidence of food addiction. Sugar, simple carbs, fat, and salt trigger the reward centers of your brain. And if you do so often enough, you’ll become at least mildly addicted. And the stuff they’re doing absolutely looks like any other addiction— lying, denial, manipulation. This can happen with things like screens, obviously drugs, alcohol. They don’t think they’re doing it too much, they’re in control, and they want other people to help them.
This is something I think needs to be addressed in general. I’m not convinced people are aware just how psychologically addicted you can get to food. And like any other addiction, if you’re not dealing both with the addiction and the psychological symptoms that got you addicted in the first place, it’s almost impossible to sustain the diet and lifestyle changes that you are making. You don’t get to 600 lbs and a cattle scale by having a normal relationship with food. I’d be surprised if there’s no underlying trauma that they’re treating with the dopamine rush that their food is providing.
Imagine instead of food someone is addicted to cigarettes. This is easy to imagine, many people are. Imagine still that its you who are addicted to smoking; who knows, maybe you actually are or have been.
So you decide that smoking is slowly killing you and you need to quit. You get together with a doctor that helps with this and your family is on board with helping etc. So far so good.
Now imagine that, while you have a great deal of motivation and support to quit smoking, it turns out that you actually need to smoke 2-3 cigarettes a day or your will die.
Food addiction is the only addiction that can never be totally abstained from. From your first days of life at your mothers breast, to the feeding tube in the hospice, man must eat or perish. Every other person is always also eating around you every day. There are massive advertising campaigns displaying savory foods to you everywhere you turn. People love talking about food. The government subsidizes it heavily.
Which feels more difficult? Asking a smoker or drug addict to never use their drug ever again? Or asking them to only get a little bit high a reasonable number of times?
I mean I totally agree with all of that, but I think there’s another huge problem in the sense that nobody, or very few people, seem willing to say that you can absolutely become addicted to food. The dominant idea is that it’s totally under rational control, under the premise that when you choose food you’re perfectly capable of choosing properly and that no other influences are at play. Or that the dominant reason people eat is because they are biologically hungry and therefore have no need to develop coping strategies or deal with underlying mental issues or traumatic experiences or bad coping mechanisms. In fact, quite often well meaning people tend to teach food as a cope. Giving a kid a lollipop after a painful injection is sort of teaching kids that the way to handle an unpleasant experience is to then treat yourself to sweets or food in general. And that’s just a one off. Sometimes you teach kids to do the same when it comes to any unpleasant experiences— eat something and feel better.
And as you mentioned, ads are everywhere. But even more, food itself (at least in the USA) is everywhere. Every public venue has food and drink available. Even public parks often have vending machines selling chips and cookies and sodas. Stores, even those where there’s no obvious connection to food, like hardware stores and craft stores always stock the chips, sodas, and cookies right next to the checkout. Imagine that for the smoker. Every place he goes, he sees cigarettes for sale, cheaply, and not even in a way that he has to ask for them or look for them. Just ready to be picked up and smoked.
I think until we really get the level of crisis and are willing to acknowledge just how addictive foods, especially those that are highly processed, can be, the public health crisis of obesity isn’t going to change. The psychological part has to be a part of this. If the women are using food to cope with something, that cannot change until you deal with that something which might be a really serious psychological issue like being an abuse or rape survivor.
That's how it used to be for smokers, until at least the 1990s.
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