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Culture War Roundup for the week of August 14, 2023

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Not a defense of 'fat acceptance', but by normalization I think you mean positive acceptance? Obesity is, in any objective sense, normal in many communities in the United States.

Arguably obesity needs ... not necessarily more shame, it was and still is incredibly shameful in the eyes of most. I think a combination of explicit coercion, both towards the obese and towards those who create the conditions that lead to it (i.e. those who sell the food), is justified.

I think there’s a bit of a difference between shaming and simply not going along with the problem. Watching your kids eat themselves into weighing well over 100 lbs before they hit double digits and not even saying anything is borderline abuse. Watching someone you care about eat themselves into morbid obesity and saying nothing isn’t being kind. And I think as far as the media goes, it shouldn’t promote unhealthy lifestyles. You could also consider taxing foods that cause obesity.

I'm not sure taxes are that effective here - it's analogous to the sin tax problem, addicts really want alcohol / cigarettes, and raising the price reduces their consumption, but doesn't stop them from eating them. And there's a lot of cheap awful food.

There aren't really any legal options here because any law that would 'work' would require a different legal system/culture that'd be willing to enforce it. Analogous to how even if all of the legislature and SCOTUS were possessed, they couldn't actually make infidelity illegal, nobody would follow or enforce that.

So imagining legal solutions is just larping, but anyway: Not allowing selling unhealthy food to fat people is an option, but they (probably?) care enough about eating massive amounts of food and you just get the war on drugs but worse because you can buy the drugs at walmart.

And that leaves banning unhealthy food - just not politically viable, nobody supports it. Most on the far-right who claim to support it on twitter would probably revolt when it banned the unhealthy stuff they liked.

You can't ban "unhealthy food" because in the case of obesity, the dose makes the poison.

This just seems flatly untrue. Surely any quantity of e.g. fizzy drinks is net-negative for nutritional content.

Certainly not. It's not clear what "net-negative for nutritional content" would mean.

I mean that a fizzy drink is like tobacco or cocaine, in that there is no amount of it which is actually net-beneficial for the human body. It's not "the dose makes the poison": no quantity of it is good for you.

Ah, in that case it is not true. Nutritionally, assuming you mean sodas rather than champagne or something, a fizzy drink is basically just simple carbohydrates. They also usually contain salt which is not strictly speaking a nutrient. There's nothing inherently wrong with these things.

I eat literal packets of gelatinized sugar while running long distances. I would be irritated if I wasn't allowed to do so because other people lack self-control.

Not that this solves the many problems of bans, but I (vague guess) don't think people would get fat off of sugar packets, for the same reason they don't just pour sugar into water and drink the sugar-water.

But they do do this in the form of soft drinks. Watch sweet tea being made some time and you will see the unlikely volume of sugar required. Then there's lemonade, whatever Kool Aid exists now, and of course most all fruit juices. There are other flavors besides sugar, of course, but basically yes you have sugar water being consumed with regularity by great numbers of people who then continue to be fat. Does no one else remember the con where people warned off of fat by the FDA would count the fat grams and ignore the massive sugar content (see SnackWells) and remain as unhealthy as ever?

While I don't think the FDA is as wild and woolly as some claim it is, it has enough problems that I would be very hesitant to blindly accept a sudden mandate with penalties if I didn't adhere to it. And if I would be hesitant, you can bet many of my friends actually living in the US would go berserk and have their guns out if someone threatened to take their fat kids to Child Protective Services because of too many breakfast burritos or whatever.

Politico article rather critical of the FDA

Not that this solves the many problems of bans, but I (vague guess) don't think people would get fat off of sugar packets, for the same reason they don't just pour sugar into water and drink the sugar-water.

They do, they just claim it's iced tea.

lol, thats's sort of what I meant - people seem to only like the sugar/fat/carbs in combination with other flavors. But maybe they'd just combine the raw materials and flavors themselves when they got hungry

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I don't think so? Certainly seltzers or non-nutritive sweetened sodas are basically neutral.

So imagining legal solutions is just larping

One solution can be going through children:

  • food ed classes about maintaining a proper diet (we had a topic covering this in our biology class, but that was like two lessons at most, I am thinking of a repeating module like sex ed)
  • do schools perform medical check-ups on their students every year? That would be an appropriate moment to screen them for extra weight or obesity
  • anyone who's technically overweight gets a second check-up to see if they really are. If they are, their parents get a brochure about feeding their children right
  • if anyone's obese, then the CPS is involved. The parents are given half a year to show progress, if they can't, the kid is placed in a foster family that has proven to be able to cook healthy and delicious meals.

Based on the quality of foster care and CPS... this seems like a major disaster for child welfare.

We've had government guidance about eating for decades. The problem is that while the public have followed this guidance diligently (eat more carbs, replace animal fats with seed oils, eat less red meat) obesity trends ever upwards. People have obediently replaced butter with margarine and lard with canola oil based on the spurious idea that this would protect them from heart disease, and yet people have never been fatter.

The current childhood obesity rate in the US is at about 20%. Do you want to rip 20% of children from their parents because they happen to be victims of a global epidemic?

The current childhood obesity rate in the US is at about 20%. Do you want to rip 20% of children from their parents because they happen to be victims of a global epidemic?

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The problem is that while the public have followed this guidance diligently

Citation needed. I doubt most people are diligently following FDA guidelines. How many of them really do stick to the diet of 50 grams of protein, 78 grams of fat, 275 grams of carbs, top up with 180 more calories of your choosing (please choose protein)?

Yes. Shame should not be the only tool to assisting in reducing fatness.

We have a myriad of options other than shaming, let's use them all.

One of the arguments of the fat acceptance people is that shame doesn't work. Being fat isn't exactly desirable in our society, and they regularly get badgered to lose weight by doctors and skinny relatives. The whole point of the fat acceptance movement is to remove what they see as an unfair stigma.

I would say shame does work, but it needs to be more constant and even. You should feel shame evenly and not at distributed points.

they regularly get badgered to lose weight by doctors and skinny relatives

In the Year of Our Lord 2023, is that really the case? My sense from the doctors I know as friends is that they are absolutely loath to suggest, "Ya know, diet and exercise could help with..." because they know 1) Patients don't want to hear it, and 2) They aren't going to do it anyway.

I have other close friends who are obese and have proactively asked their doctor for help. Like pleading to have some direction, a support structure, a pathway to success. You know what the most phenomenal response I heard was? "Well, you're getting older... [next topic]."

In forums like this one, people constantly constantly lie about how weight loss/gain works. One bucket is CICO disbelievers generally (the true cranks). Others retreat to some form of, "Well, CICO may be true, but it's not helpful, so we really just need to point out that most people have absolutely no control over their weight." This is a complete lie that is far less helpful than explaining how things actually work and making suggestions for how to properly plan, build a support system, etc. It is not the people who are saying, "This is the way, walk you in it," who are doing the thing that doesn't work. It is the people who are perpetuating this lie, saying that the only choices are shame or doing nothing (or, I guess, like, chemicals or something that magically change CICO), who are doing the thing that doesn't work.

In the Year of Our Lord 2023, is that really the case? My sense from the doctors I know as friends is that they are absolutely loath to suggest, "Ya know, diet and exercise could help with..." because they know 1) Patients don't want to hear it, and 2) They aren't going to do it anyway.

From my experience, that's completely not true. Every doctor suggests it as if it's a novel idea you've just never thought of. They don't have many suggestions beyond that, other than to tell you to go see a specialist, who also doesn't have any ideas to help.

The most frustrating thing I find is that doctors also don't want to tell you to just eat less, which is in my experience the only thing that'll cause you to lose weight. If you adopt a strategy of severely limiting calories or working with some strategy that works for you but is not officially approved (like being really strict but having cheat days), then they think you have an eating disorder, and they warn you about that. They tell you to just lose weight, but don't approve of options that actually work for you.

Perhaps we need some way of gathering data by sending a bunch of obese testers to doctors. Sort of in any event, either response is equally useless, though I can understand why doctors would opt for either path, given their experiences/incentives. What I think we can both probably agree on is that they are not likely to give real, actionable advice that can be directly pursued to success, and that is the real shame.

This really strikes me as wishful thinking. Richard Hanania made the comparison with smoking. In the West, the rate of smoking has plummeted since the 1960s. I'm sure raising awareness of the dangers associated with the smoking played a significant part of that, but I don't think anyone can really deny that a major cause of this shift was simply social: smoking has more widely come to be seen as a filthy habit, which imposes a social cost on those who choose to do it. In much of the world it's illegal to advertise tobacco products, and legislation or local rules make it less convenient to do so.

If obesity was a truly immutable trait, criticising a fat person for being fat would be like criticising an amputee for having one leg. Fat acceptance activists are incentivised to downplay the mutability of their condition, in order to present it as something that they are powerless to prevent.

One of the arguments of the fat acceptance people is that shame doesn't work

This argument is simply untrue. I would eat far more and be fat if I would not be ashamed of being (potentially) fat. Another big factor is health impact, and more extreme fat deniers deny also health dangers ("healthy at any size" insanity)

It does work for some people, you can definitely find cases of people losing the weight, and they often frame their motivation in terms of self-image and shame.

It works for a tiny minority of people. For almost everyone else, long term fat loss through diet is impossible.

Which really shouldn't surprise us. The global obesity epidemic didn't start due to a global reduction in shame or increase in laziness. It affected every country and population on the planet that started consuming the modern industrialised country diet. There is clearly something in this diet (or some other environmental stressor) that is causing obesity. Personally, I think it's the vegetable oils, but whatever is causing it, approaching the subject moralistically is a pointless distraction.

I know multiple people personally who have lost weight in the long term, and I myself am sitting quite stably at about 15kg below my peak weight (though I will probably try to gain weight again soon). The notion that it's impossible is just ludicrous.

I will say that I think some very morbidly obese individuals have permanently wrecked their body's ability to regulate hunger and weight. I give credit to their tales of constant, unbearable hunger and strict dieting for slow results. But such people are still the minority, and their situation is still ultimately the result of their decisions.

I agree that the obesity crisis is not a result of a sudden decline in morals, and I've said the same thing myself. And yet, it is a moral crisis. Changes in technology cannot be blamed here. Just as the opportunity to steal separates thieves from honest men, the opportunity to overeat reveals the gluttons among us. The refusal to engage morally with this issue is tying people into knots, forcing them to insist that weight loss is impossible or to search for villains in the hecking sneed oil, because otherwise people would be responsible for themselves. And you know what, if Linda wants to eat ice cream and Harry wants to drink beer, go ahead. It's not important to me that everyone looks like a model. But it's sad, frankly, when people tell themselves that they can never lose weight. Because some of them will believe it.

And yet, it is a moral crisis. Changes in technology cannot be blamed here. Just as the opportunity to steal separates thieves from honest men, the opportunity to overeat reveals the gluttons among us

Yet curiously, their gluttony disappears when sth like Tirzepatide is introduced into their bodies.

But it's sad, frankly, when people tell themselves that they can never lose weight. Because some of them will believe it.

I could lose lots of weight - even without modern drugs. The thing is, it's like holding your breath. With additional effects like your thought process being regularly hijacked to think not just about eating, but even stuff related to eating (it's pretty bizarre). Eventually you will be compelled to stop. And then overeat until you reach your initial weight. And then maintain it. Almost as if it's not about random whims made at the time ("I want this ice cream now"), but organism attempting to maintain homeostasis (and not caring that its idea of homeostatic amount of fat is unhealthy).

With Tirzepatide, I went down from about 103kg IIRC, to 84-ish (and I still continue to lose weight). Without any suffering. It's laughable that some non-fat people think they're virtuously eating less than they actually want to eat.

I don't find anything specifically virtuous about my own losing weight. In fact I sometimes worry that it's wrong for me to do so because I find it quite easy.

Yes, if you are given a moral choice and choose wrong, it is your responsibility, not the fault of society for giving you the wrong meds, or for making ice cream that tastes too good. Weight gain is not some biological inevitability. People a hundred years ago did not find their homeostasis point at gaining 2lbs every year. Not because of morality, but because of lifestyle and diet habits that are quite in reach for the average person today.

It works for a tiny minority of people. For almost everyone else, long term fat loss through diet is impossible.

What? Human bodies are not excempt from the laws of thermodynamics. If you burn more calories than you take in, you will lose weight. Period. And you won't gain weight if you don't put more calories in than you burn. You have to actively do something in order to stay or become obese.

Now, is weight-loss extremely hard psychologically? Oh, absolutely. My own weight struggles can attest to that and I'm not even obese.

But it isn't weight-loss that's impossible. It's getting people to not overeat that's impossible. Two very different things. To pretend they're identical is irresponsible.

If getting people to stop overeating is impossible, and the only way to lose weight is to stop overeating, then yes, losing weight is impossible. I don't see why making that distinction helps apart from allowing us to cast moral aspersions on fat people.

Like sure, it's technically possible to lock someone in a cage and feed them the exact number of calories they need to lose weight. But then their bodies will fight back by reducing their metabolism, increasing their food cravings and generally making them miserable. Not only that, their reduced metabolisms won't even recover after the (inevitably) regain the weight back.

So I stand by my original point, weight loss through diet is impossible. Once weight is gained, it's essentially permanent. A more interesting question is why obesity came out of nowhere in the mid-20th century and exploded from the 1970s onwards. There's really only one likely culprit in my mind.

A more interesting question is why obesity came out of nowhere in the mid-20th century and exploded from the 1970s onwards.

Obesity is defined as being above the threshold of a BMI of 30. Imagine a population where currently everyone has a BMI of 25, but it starts to increase by 1 every year from now. What would the corresponding graph like the one you linked look like? It would be 5 years of no change, until in year x+5 obesity "explodes" to 100%, despite the fact that the actual causal trend has been going on linearly for 5 years!

If we look at actual weight itself to avoid thresholding effects like I described above, there doesn't seem to be anything special about the 70s at all, they're right on trend. There's other data like discussed in this that indicate that the surge in weight had already begun around WWI, subsided a bit around the Great Depression and accelerated again in the immediate aftermath of WWII.

If getting people to stop overeating is impossible, and the only way to lose weight is to stop overeating, then yes, losing weight is impossible. I don't see why making that distinction helps apart from allowing us to cast moral aspersions on fat people.

It's important because the message is wrong-headed. Telling people that there is nothing they can do when there definitely are very simple things they can do (move more, eat less) is cruel because it leaves people to their misery.

Also, I don't see how it's necessarily wrong to cast some moral judgement on fat people. It doesn't mean I suddenly cast them out of the circle of persons who should be afforded curtesy, respect or dignity. It means I disapprove of behaviour that is harmful to themselves and others. I also disapprove when someone smokes indoors or farts in an elevator. And that disapproval might actually motivate them to break the cycle.

I know that our culture has elevated enabling people with all sorts of miscalibrated habits to a twisted virtue, but being nice and doing the right thing aren't always identical.

Not only that, their reduced metabolisms won't even recover after the (inevitably) regain the weight back.

Very interesting. Are there any studies with a larger cohort?

So I stand by my original point, weight loss through diet is impossible.

It is eminently possible. Eat fewer calories than you consume. If your point is that it's impossible to maintain unhealthy eating and exercise regimens without becoming fat, then you're right. But there is no law of nature that says you have to stuff your face. Your argument about drastically reduced metabolism after increased physical activity is interesting, but I'll have to see more evidence.

'Eat more and move less' doesn't actually work. We have almost a century of evidence showing that this advice does not work. If it did, people would successfully be able to lose weight long term. Just Google 'long term weight loss study' and you'll find pages and pages of evidence showing that even among the small number of people who successfully lose weight, almost all of them gain it back. Dieting and/or exercising for weight loss does not work. Cruelty is pretending that fat people lack the moral fiber necessary to lose weight when actually, nobody can do it (barring a tiny number of outliers).

We do not control our appetites, we do not control our metabolisms, we do not control how our body partitions nutrients. We can temporarily override our appetite and consciously try to burn more calories through exercise, but ultimately the body's lipostat wins. Fat people have disregulated metabolisms, not a lack of self control. If self-control were really the issue, then we would have to come to the baffling conclusion that the entire industrialised world started to decline in self-control in the 1970s.

Or, it could be because we introduced massive amounts of an agricultural waste product into our diet in the mid-20th century that doesn't have the same nutrient profile as anything humans have eaten in our evolutionary history.

'Eat [less] and move [more]' doesn't actually work.

Of course it works. All the time. For countless people.

We have almost a century of evidence showing that this advice does not work.

We have tons of evidence of people not taking the advice, that's very different. We don't conclude from people driving drunk that "don't drink and drive" is bad advice or that drinking heavily doesn't impair your ability to pilot a car.

If it did, people would successfully be able to lose weight long term.

Tons (heh) of people successfully lose weight long term all the time.

Just Google 'long term weight loss study' and you'll find pages and pages of evidence showing that even among the small number of people who successfully lose weight, almost all of them gain it back.

The systematic review by Curioni and Lourenco (2005) found that weight regain in individuals included in both diet and exercise programs approached 50%. Not great, but far from "diet and exercise works for absolutely no one". And given that the review only included studies with obese and overweight people (who in all likelihood have a history of following unhealthy habit and likely exhibit low willpower), we can take that as the upper bound.

Cruelty is pretending that fat people lack the moral fiber necessary to lose weight when actually, nobody can do it (barring a tiny number of outliers).

The data does not seem to support this extreme conclusion.

We do not control our appetites

To some extent, we very much do, given that appetite does adjust to changed habits. We can also just ignore it, you know? We control our urges all the time.

Fat people have disregulated metabolisms, not a lack of self control.

Obesity certainly isn't monocausal, but I haven't seen sufficient evidence to exclude the latter explanation as a factor.

then we would have to come to the baffling conclusion that the entire industrialised world started to decline in self-control in the 1970s.

I don't find that baffling. Laissez-faire education styles, social mores that promote the externalisation of personal issues, and the abundance of superstimuli are all plausible factors for this.

Or, it could be because we introduced massive amounts of an agricultural waste product into our diet in the mid-20th century that doesn't have the same nutrient profile as anything humans have eaten in our evolutionary history.

Another very plausible factor.

Look man, if you want to conclude that telling people to exercise more and eat less isn't really that effective an intervention at the population level, that's fine. I think you have your work laid out for you. But to assert that therefore, it is literally impossible to lose weight and that CICO isn't a simple law of physics is throwing the babe out with the bathwater.

'Eat more and move less' doesn't actually work.

It makes you fat. And 'Eat less and move more' reduces your weight. And 'Eat less and move less' usually reduces your weight too.

Cruelty is pretending that fat people lack the moral fiber necessary to lose weight when actually, nobody can do it (barring a tiny number of outliers).

I assure you that if fat people stopped putting anywhere near as much food into their mouth, they would lose weight. This is a difficult thing to do, but it is quite simple. The issue is indeed self control, though also self-deception (pretending things that are high in calories are "healthy", pretending certain things "don't count", that sort of nonsense)

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There's really only one likely culprit in my mind.

Really?

It is not even per person. It is not compared with total callories change. Not compared with say sugar production.

If you look at the chart Trends in Daily Calories from Major Food Groups on this article, you'll see that vegetable oil consumption per capita has almost tripled since the 1960s. There are dozens of other sources online saying the same thing. Literally nobody is arguing that vegetable oil consumption has fallen. The only debate is whether the gigantic increase in vegetable oil consumption has anything to do with the gigantic increase in obesity that happened at the exact same time.

Meanwhile both sugar and grain consumption has actually been falling since the late 90s.

tl;dr: no indicator that calories from vegetable oils are special

Rates of chronic conditions like heart disease, asthma, cancer, and diabetes have grown 700% since 1935. Today, 6 in 10 Americans have a chronic disease.

Has Americans started to live longer by any chance since then? Or are better diagnosed?

With very quick look at https://www.macrotrends.net/countries/USA/united-states/life-expectancy - it seems that people now live longer and this person failed to even mention it!

In fact they start from "where our healthy life expectancy is actually decreasing year over year" - while from 1935 it massively increased!

Exercise graph is starting in 1998, how much change is from 1935?

Mixing stats starting in 1935, 1998 and just few years ago is a massive malpractice. You do not get to compare last 2 years of life expectancy and 97 of another. You need to take the same timeframe for both!

Also, curiously "total eaten calories" remains missing. From trend in plant vs animal foods: it is increasing. What may be enough to explain direct cause of people getting fatter, via simple CICO again.

(I have not even got to checking sources: I suspect that this exercise trend may entirely measure that people are more likely to lie about exercising and be unrelated to actual exercise being done)

A lot of relatively skinny people I know regularly shame themselves if they start to get a little fat. I’d almost say everyone does that whose skinny or fit.

I'm a (comparative) walrus, and let me tell you, I also shame myself. I avoid mirrors, going out, clothes shopping, and photographs, because just seeing my face makes my gorge rise.

The problem is that the shame turns into a ball of self-hatred and impotent rage in my gut and does not effectively spur me to take effective action; feeling bad about myself makes me more likely to turn to unhealthy foods for a hedonic bump-up, rather than hedonically-unsatisfying but long-term productive things like home cooking (yes I know home cooking can be delicious but I do not derive joy from the process and am currently marginally unskilled, so there's a learning curve that needs to be overcome) and exercise (which is painful, sweaty, and only reminds me how much less capable my body is now than it used to be).

Instead of shame, I need to find an emotional motivator which is a more effective spur to action rather than just recrimination.

I felt pretty gross at 90+ kg. Not that I don't have body issues at sub-80 too.

I can confirm that. As soon as you can look in the mirror and flex something you get this boost of motivation to improve your shape. I think it's much harder for obese people to get motivated, because going from 82 down to 72kg means your looks actually improve, but going from 160kg down to 140kg, that is, losing twice as much weight, might improve your quality of life (like, being able to wipe your own ass), but the person in the mirror is not that different: he's the same disgustingly fat person, just with some extra skin folds. Most people can't stay motivated simply by shame and the number going down for long enough.

Seconding this. I'm not particularly skinny but I'm not overweight either. However if my weight goes above my ideal target by more than 1kg I immediately tell my self "cut down on your eating" multiple times a day whenever I make food related choices.

I started feeling self conscious after hitting a BMI just a little under 24 (and immediately worked to drop it back down to the 22-23 range), it makes it difficult for me to even imagine how the morbidly obese can live with themselves.

It sucks. You know what makes suck-y feelings go away, at least for a little while? Delicious unhealthy foods. Not trying to justify it, just explaining the vicious cycle.

I think different, more potent and coercion-adjacent flavors of shaming (more common in the past?) would be more effective than shame is today, so I don't want to say 'shame doesn't work', but it's true that the very real shame a fat person would feel today or a few decades ago didn't work. But your local grocer or mcdonalds refusing to sell you triple-decker burgers because you're 350lbs (or just not stocking the product at all) might!

Also, whatever the mechanisms, many young and higher-class subcultures in americans have managed to mostly eliminate obesity among their ranks. I don't think this is mostly just by selection, and, while higher IQ and other values do contribute, I don't think you need to be 115+ iq to prevent yourself from being obese. Maybe those values will diffuse?