Took a little break from the internet and touched some grass and it was great. Wander back in here after my hiatus and what do I find? Just a thread with a bunch of fatphobia.
Cute.
For a community that is incredibly careful about protecting its users from the -phobias and the -isms, there sure is a hell of a lot of unchecked fatphobia here basically any time fatness gets brought up.
It’s something I’ve noticed on the left in general as well. The leftist org I’m in has almost no fat people in it and something tells me that’s not because there aren’t any fat leftists out there.
Fatphobia is rooted in anti-Blackness and ableism.
I’d highly recommend the “Maintenance Phase” podcast with Michael Hobbes and Aubrey Gordon, as well as Aubrey Gordon’s books “What We Don’t Talk About When We Talk About Fat” and “You Just Need To Lose Weight.”
TL;DR: There’s mounting evidence that anti-fat bias in medicine is more to blame for poor medical outcomes in fat people rather than just the fat itself.
Diet and exercise don’t result in long-term weight loss for something like 95% of people. As a leftist, are you really gonna sit here and blame this on individual choices rather than systemic issues? Are you really gonna try to convince us that 95% of people are just lacking willpower?
Please note that this thread is not an invitation to convince me I’m wrong or share your own personal anecdotal story of successful long-term weight loss with the implication that others can do it because you did it. This post is a request that any thin person (or thin-adjacent person) reading this who wants to argue about how being fat is bad for your health do some research and some self-crit. This post is a request that this community rethink the way it engages with discussions about fatness, diet, fatphobia, and anti-fat bias.
Anti-fat bias literally kills people.
What you said was not fine, for the record. Frankly, formerly fat people are some of the worst about this.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5764193/
Again, I highly recommend the resources listed above as a starting point. u/khizuo listed some great info as well.
That article doesn't claim any numbers and only discusses the physiological and psychological responses that cause people to stop maintaining their diets - the central concept is that diet and exercise will result in long term weight loss, but issues around perception (both of self and how much they're consuming), appetite, support, coping mechanisms and more make it difficult for many people to maintain the diet and exercise long term without additional intervention. Literally, they put the weight back on because they stopped the dieting and exercise.
Health is more complex than just your weight, and going on a diet isn't an easy or simple undertaking, but we're not doing fucking calorie-denialism here.
Ok it says 80% of the weight lost was gained back in 5 years and it’s a meta-analysis of 29 different studies so that’s a huge dataset. There’s also some anti-fat bias in the study, but regardless, the implication here is that all the people in all the studies fucked up because they couldn’t stick to a diet and exercise plan longterm. As a leftist, that explanation comes up short for me.
But frankly, this is what I didn’t want to do in this thread.
“We’re not doing calorie denialism here.”
This is the problem. You think my body burns calories at the same rate as your body? You think the human body is a simple machine where you input 500 calories into my body and your body and our bodies process, store and burn them the same way? It’s far more complex than “CICO” and I’m fucking sick to death of thin people preaching about the SiMpLe sCiEnCE. I’m not doing it. Don’t bother responding, I do not have it in me to do the back-and-forth.
The OP specifically asked thin people to STFU, listen, do some self-crit, and do some fucking reading. It’s not an invitation to debate weight loss shit with me. Read the responses from fat people in this thread and fucking do better. It’s exhausting.
What do you mean "as a leftist"? It's incredibly immaterial to just disbelieve that large lifestyle changes are extremely difficult to make and maintain. Ask anyone who's broken a simple habit like nail biting - it takes a lot of time and effort to make small changes to unnecessary habits, and reducing your food intake and doing more exercise are incredibly big changes with lots of material conditions to get in the way. How easy do you think it is to stick to your diet when you've had a really shitty day at work, or go out and exercise when it's cold and raining? That's exactly why the study recommends maintenance visits - people checking up, advising, and encouraging them so they can overcome the many obstacles in their way. Just because "diet and exercise" are 3 words doesn't mean they're easy to stick to.
Hey, I don't mean to make this thread more unpleasant for you, but as a thin person myself, and one who absolutely hates the CICO garbage bullshit argument, I would like to point out that this is less about thin vs fat and more along the lines of the trans debate, where one side, which knows absolutely fuck-all about biology, tries to insist that its oversimplified understanding of the biology at issue is the One True Answer (and in case I'm being unclear, in this analogy the CICO people are the transphobic "muh chromosomes" types).
As someone who has studied biology, I would like to point out to these people that the body reacts to its own energy state (rich, poor, somewhere in between) in a wide variety of ways. One of the most important cellular signaling molecules is cyclic AMP, which is the depleted version of ATP, the basic energy storage molecule of life. When there's a bunch of cyclic AMP around, the cell (and by extension the body, if this is the case in other regions as well) adjusts its energetic behavior accordingly.
The idea that this doesn't work in reverse is, frankly, very silly.
Also, to all you nonbiologists arguing here: if it's entirely diet and exercise, why is Ozempic so effective in comparison to such a regimen, hmmm? Maybe it's because CICO is and has always been bullshit, eh?
The reason Ozempic is used for weight loss is because it slows down your digestion and reduces appetite and cravings. It literally just makes you eat less. How is that an argument against CICO?
Ozempic slows digestion and increases satiety in the brain, yes, but it also stimulates secretion of insulin and suppresses glucagon release (you know, the energy signaling molecules, of the sort I mentioned above--I daresay those are playing a role here). Those molecules are critically important to the way the body processes energy, and we still don't understand that system very well (if we did, we'd be able to cure diabetes).
And even if your oversimplification here was accurate, how would that be an argument that CICO is useful? That argument amounts to telling people to ignore their biological drives, all the time, and basically forever. It's like telling someone they need to pee less, as if that's an easy thing to just do.
It's useful because for most of us it's the only way we can realistically regulate our own body weight, which a lot of people want to do. For people who struggle to do that, as well as obviously for people who chose not to, I agree that it's completely useless and somewhat insulting medical advice. But there's no need to throw the baby out with the bathwater.
I'm glad you recognize that, but nonetheless, "the baby" in this case is a falsehood. See here for a real-world example: https://hexbear.net/comment/5779945
Edit: better link
It's not a falsehood. First of, one example wouldn't disprove literal decades of research proving the contrary, but also this example isn't incongruent with CICO at all. You can increase caloric consumption and lose weight if other factors causes your body to burn more calories.
Calorie tracking can be useful for some people, yes.
but, that's not the same as CICO. We cannot know nor control actual calories in and actual calories out. Anything we do to estimate them is just that, an estimate. Sure, for some people, those estimates are close enough to be useful. But to bandy CICO around as an absolute is insulting. Unless CICO can be actually measured, it's simply not an absolute rule in any useful sense.
And, its also pretty insulting to say for 'most of us' CICO is the only way to regulate body weight, when that's not really true. There are many many other ways of losing weight outside of tracking or caring about CICO. Yes, technically, at the end of the day, it must be because of CICO, but like, why should we care enough to track that, when we can't accurately track that?
How does one explain body-builders, who calculate very closely their intake and burning of calories (as well as nutrients)? That's not just "close enough to be useful," is it?
I understand that CICO isn't useful when applied to a social, biological, or psychological situation in which CICO isnt practical or desired or such. It seems to me this discussion is very clearly a case like "of course water is just protons, neutrons, and electrons pushed together with forces in a shape" to explain water's purpose in cellular reproduction. It's technically correct (it's absolutely true that these basic components are what makes it up), but their interactions and forces between them cause emergent properties which need to be dealt with in chemical and biological terms.
This same thing feels like why this discussion always goes badly: of course CICO is real, because 2nd law of thermodynamics is a law for humans too. But of course it's not useful to discuss lifestyles, desires, appetites, and complex activities. If you can spend lots of time tracking it all really well, and not allowing any externalalities to grow, it is useful. But that's not a useful solution applied to healthcare on any sociological scale. And it's not useful when there's no "solution" wanted or needed.
I am not sure honestly how to have any sort of proof about the affect of fatness on other health aspects, or whether there is. Scientifically, it seems almost impossible to me. What does that proof even look like? Major comparisons of health outcomes taking only BMI into account? Finding the bias against fatness separately and taking it into account? But then it will be discovered that health indicators are based on studies of skinny people, so the indicators need re-evaluing, and further down this chain. This cycle is where we are lost and people are talking past one another. Solution to this? More focus on health study funding and diversity in it/remove capitalist incentive structures which always want to change everyone. Then see how the health indicators are looking.
Anyways, this ended up not just being a reply to you, but my take on the whole situation. Sorry for that. The first paragraph (and partially the 2nd) were to you though
When I say CICO is the only way to regulate body weight I don't mean calorie tracking. Calorie tracking is absolutely not required, or arguably even helpful, for most people. But you have to do SOMETHING that either changes the amount of calories you consume or how much your body burns. If you don't nothing changes.
CICO is true. But, it's not useful; we can't measure the actual calories your body absorbs, the actual calories your body burns, nor can we control them. Yes, some actions influence it, but there's many, many reason why 'eating 200 fewer calories and exercising 200 calories worth of work a day' may not lead to 400 calories worth of 'fat loss'.
Ozempic's most important aspects seems to be its effect on the brain (not to say its effect on digestion are unimportant). See the research showing Ozempic helping people with the gambling addictions.
Removed by mod
Removed by mod
Thank you. I’ll give this a look over on the other side of my shift.
I honestly didn’t see it as being potentially harmful. Just…giving my experience. :\ Sorry.