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[-] Griseowulfin@beehaw.org 3 points 1 year ago* (last edited 1 year ago)

The weasel word in all this is “overweight (but not obese)”. This is because obesity is definitely associated with diabetes, heart disease, stroke, sleep apnea and the sequelae of these diseases. Excess fat in our body, glucose in our blood, and weight on our skeleton taxes the body and that will have consequences.

I think we are in a new era for how we see and treat obesity, with better understanding of how it affects us individually and societally, with more tools to tackle it. As such, we should not downplay the importance of weight in a person’s health.

Articles like this really don’t give a full picture of clinical decision making and the job of a physician to make high level research accessible to the patient (which involves simplifying things lots of the time). This leaves us with a headline that makes the public think that doctors don’t know about obesity, which simply is not true. It’s just that the nuance isn’t as big of a deal as this author makes it seem.

[-] FZDC@beehaw.org 4 points 1 year ago

The weasel word in all this is “overweight (but not obese)”.

I think that's the whole point of the article. Lots of doctors seem to assume that all-cause mortality is correlated with BMI in a straight line, but this article argues that it's actually U-shaped with the minimum in the "overweight" range. It's arguing that these specific people in that overweight but not obese category are getting bad medical advice and treatment because of assumptions derived from observations of the group of people who are overweight or obese.

[-] insurgenRat@beehaw.org 2 points 1 year ago

So the research into this is hilariously terrible. The podcast maintenance phase has a pretty good couple of episodes on just how fucking garbage the data on what being fat actually does to your health is. e.g. this one https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5idXp6c3Byb3V0LmNvbS8xNDExMTI2LnJzcw/episode/QnV6enNwcm91dC05NTUxNTU1

Outside of extremes by far the overwhelming factor in health outcomes is exercise

Yet when you go to the doctor how much time do they spend talking about your cardio routine vs popping you on the scales or talking about weight? Doctors also generally provide much worse care to fat people, and frequently blame unrelated medical conditions on weight. Further we have very little idea how to help people moderate their rate. It's not like tendon damage or whatever where we can prescribe a specific activity with good patient compliance and outcomes, mostly people just vaguely gesture at calorie restriction which almost nobody can sustain indefinitely.

So we really need better research and education here, and if you're worries about your health I'd say stop pinching your tummy in the mirror and start something like the couch to 5k program.

[-] insurgenRat@beehaw.org 2 points 1 year ago

Also P.S. before you poke somebody over their weight or sneer or judge consider how you would feel if someone judged you as morally inferior because your resting heart rate is over 65 you sloven. What's that? you have reasons? whatever you say it's simple, just workout more.

Not a nice or useful interaction is it? we're all trying our best and generally don't appreciate unsolicited advice that comes with judgement.

[-] forestG@beehaw.org 0 points 1 year ago

Yet when you go to the doctor how much time do they spend talking about your cardio routine vs popping you on the scales or talking about weight?

Well, last doctors I 've seen actually got angry when I mentioned that I 'll get back on my bike. They said 2 weeks after the surgery to insert plate and screws after my crash were not enough. They didn't bother to ask my weight at any instance. Orthopedic surgeons.. XD

Seriously though, effects of exercise on human health are not exactly lacking in research. Its pretty old, but I found it really very interesting.

[-] insurgenRat@beehaw.org 2 points 1 year ago

surgeons just hate everyone less compliant than a corpse :p

[-] wesker@lemmy.sdf.org 1 points 1 year ago* (last edited 1 year ago)

It's wild how fat America has gotten. I don't even know what works and what doesn't from a health advice perspective, anymore.

[-] StringTheory@beehaw.org 1 points 1 year ago* (last edited 1 year ago)

Pictures and home movies from the 1970s are shocking. People were so much leaner then than now. And going further back, the silent movie actor “Fatty Arbuckle” was considered so fat it was his nickname, yet he wouldn’t look at all extraordinary today.

Seems like it’s the snacking culture, so much snacking “3 meals and 3 snacks” is normal. It didn’t used to be.

[-] Kingofthezyx@lemm.ee 1 points 1 year ago

There's also a big difference between "life expectancy" and "quality of life". Being overweight is uncomfortable, limiting, and can be a burden on people around you. I have no way of knowing if I'll live longer, but my life has become immeasurably better since I went from nearly obese to normal weight.

Additionally, I think the biggest factor to control for is socioeconomic status. A well-off fat person is probably going to have better life expectancy than a poor skinny person.

[-] davehtaylor@beehaw.org 3 points 1 year ago

Being overweight is uncomfortable, limiting, and can be a burden on people around you.

The amount of times I've heard this used as fat-shaming rhetoric is shocking.

"You're immoral, you're selfish, why can't you think about everyone around you who has to put up with, and is affected by, your obesity."

It's inexcusably vile. It's hateful rhetoric. I'm sure you don't mean it that way, but that's what it is. And the problem is that such hateful language toward fat people is so, so pervasive, accepted, and woven throughout our society, that people say things without even realizing how harmful they are.

Also, socioeconomic status is probably the most important factor. As you said, a fat person with access to affordable health care with competent doctors that don't blame everything on weight, is going to be much healthier than a poor skinny or poor fat person. Further, if you're in a marginalized community, it makes it even more challenging. Then you have food deserts, long working hours, poor wages, lack of affordable child care. Lack of affordable education to help get out of your situation. Lack of social mobility depending on who you are.

It's almost like the person's body weight is barely even a factor in deciding their health.

[-] agressivelyPassive@feddit.de 1 points 1 year ago

It's not fat shaming, it's stating the truth. And I say that as a former fat person.

Being fat is not just fate or lottery, it's a challenge one can and should overcome. All that sugarcoating of language does nothing for fat people and rather works against them, since it normalizes a willfully unhealthy state.

Let me be very clear here: being fat is nothing to be positive about. There's zero, literally zero benefits, but tons of disadvantages and problems.

[-] storksforlegs@beehaw.org 3 points 1 year ago* (last edited 1 year ago)

People aren't "wilfully" fat. People struggle to prevent weight gain/lose weight to the point of self harm and eating disorders. It's not sugarcoating to say you should treat people with respect if you really want to help them.

The main message of being "fat positive" is mostly just "don't be a dick to fat people". Because a) don't be a dick anyway, and b) being a dick doesn't do anything except make people feel like bad. If your intent is to be harsh in order to help, the data proves that when people are fat shamed, it usually causes them to gain even more weight.

So if you really want to help people be healthier or have better quality of life, be encouraging and positive.

[-] agressivelyPassive@feddit.de 2 points 1 year ago

There's a difference between shaming and telling the truth.

Fat positivity may have been intended to mean "no hate" at some point, but today it is used as "no criticism". It's the same principle as free speech ultras claiming that someone else infringes their free speech by criticizing what they're saying.

Again, being fat is not positive.

[-] Gaywallet@beehaw.org 4 points 1 year ago

And you're making a value judgement on these people that they haven't put in enough effort to make themselves not fat, ignoring the differences in our bodies and experiences. It's simply not nice to keep pushing the same rhetoric all over this post. We get it, you managed to get healthier and you wish to extol the virtues of how you managed to do it. For many people, they already tried all the things it took you so long to adopt and telling them that they need to try harder or have no excuses is not helpful to them.

You need to be nicer on our instance.

[-] agressivelyPassive@feddit.de 1 points 1 year ago

You need to understand that sugarcoating everything is not helpful.

Seriously, what is so hard to get about that? You jumped directly from "not lying" to "hateful insult" and that's just not a valid point. If a doctor tells you, that you will die sooner because you smoke, drink, or eat too much that's not hateful, but simply a factual statement.

Just tell me: how will any obese person benefit from simply ignoring their actual problems? You want to be super cushy positive, I get it. But in reality, you're just advocating for deadly silence.

Accusing anyone who disagrees with you of being hateful is either lazy, evil, or stupid.

[-] Gaywallet@beehaw.org 5 points 1 year ago

I'm not saying you're being hateful, I'm asking you to be nicer. You don't seem very receptive to being told by an admin or a mod to follow our only rule, so you're getting a 7 day ban to think things over. If you show up again and keep violating our only rule, you'll get a permanent ban.

[-] storksforlegs@beehaw.org 4 points 1 year ago* (last edited 1 year ago)

Well, regardless what you think of fat positivity and how others interpret it, you should still treat people with understanding and respect.

And again, if you're trying to convince someone to lead a healthier lifestyle, (even though you are making assumptions about that) a negative approach is only going to be counter-productive.

[-] davehtaylor@beehaw.org 2 points 1 year ago* (last edited 1 year ago)

Ah, I see. So you read my comment and was like "hm, the person they replied to probably wasn't being hateful. Let me swoop in there and make sure I make my bigotry clear."

Perfect echo of "I'm not racist. It's just science..."

I'm not going to validate your bigotry with a discussion. Enjoy being blocked.

[-] agressivelyPassive@feddit.de 1 points 1 year ago

Sure, because telling you from my own experiences is bigotry.

This behavior, ignoring the problem, is BTW exactly how people get fat. No, it's just a few kilos too much, that's fine. No, that tub of ice cream is perfectly fine, I walked to the store.

[-] LallyLuckFarm@beehaw.org 3 points 1 year ago

Sometimes I come down with 'i did it why can't they' but my circumstances and options were and are different from theirs. There are times when I have to actively remind myself that the things I do to manage my weight don't always align well with being a good friend; I have to meet people where they are, eat what works for me, and offer to share some guilt free. It's about providing pathways for someone to adopt healthier habits and encouraging successes.

@storksforlegs has some great advice regarding adjusting your language to help make your message of healthier lifestyles more accessible, so others can have the kind of success you've had (congrats, btw; great job!) but, you know... in their style of body positivity for them.

[-] agressivelyPassive@feddit.de 1 points 1 year ago

Sorry, but that's apologetic crap. Eating less is not that hard, you won't become a social outcast and it's not like you can never ever eat anything with your friends.

There are always hundreds of excuses, but hardly any of them are reasonable.

I'll absolutely concede that our western environment isn't exactly healthy and a lot of people are interested in us overeating, but blaming everything on external factors is addict behavior. And we shouldn't fuel that behavior.

[-] LallyLuckFarm@beehaw.org 4 points 1 year ago

I'm glad it was easier for you than for me but this feels diamissive. Other people don't have your life, they have theirs: social pressures, economic pressures, food access pressures, schedule pressures and a host of other things impact how well a person is able to change their habits. Advocacy that doesn't take these factors into account is less effective, because it won't address drivers of habit.

Actively losing one third of the weight I was carrying involved arguments with family and uncomfortable meals. It involved having to skip out on going to places with friends who just wanted dive bar grease food and drinks, and then explaining that we were still friends and why it was worth changing up the group's routine. It involved huge amounts of drama with my partner at the time, who felt that my weight loss was a judgement of them. Friends were dismissive when I voiced how I struggled with these challenges, saying I was making excuses and that it wasn't that hard if I was trying, which was incredibly demotivating.

There were just two people who acknowledged my feelings and experience, who understood that if I perceived something as a challenge for myself then it was. They would encourage me to continue overcoming it and offer suggestions and support. I encourage you to do what they did, because I think it will make you a more effective advocate. If we want people to achieve the kinds of successes we have, it has to be about them and not about us.

[-] forestG@beehaw.org 4 points 1 year ago* (last edited 1 year ago)

Eating less is not that hard

There are always hundreds of excuses, but hardly any of them are reasonable.

but blaming everything on external factors is addict behavior.

Okay, I 'll give it a go too. Even though @storksforlegs@beehaw.org already mentioned what I am about to say, obviously to no effect.

You say you are speaking from experience. That you 've lost some weight. And then you make claims that go way beyond your experience, that are far tοo general. I won't go so far as to say that the position you support is ignorant. This won't be nice. I will assume you are more educated than I am. But I will point out, that your experience alone hardly constitutes solid ground to speak for everyone. There is room there for you to be mistaken.

Addictive behavior is not rational. People get addicted to stuff, whether there are inherent addictive qualities to whatever they get addicted to or not, not because they choose so, but because they are vulnerable to addictive behavior. This, more often than not, is something indicating other psychological issues that need to be addressed. It can be insane amounts of stress, it can be depression, it can be many other issues that need to be addressed in order for someone with addictive behavior to get to a place where that person no longer needs crutches to function. Attacking how an addict rationalizes the addiction, not only doesn't address the issues that lead to this behavior but it probably adds to to them.

So, since you can't know why someone is displaying addictive behavior, implying, for example, that a person with severe anxiety that turns to food for comfort is lazy, is actually neither nice nor helpful. It's not even speaking the truth as you said. It's just negative, probably adding to the problem causing the unhealthy relationship with food.

I won't bother with the rest of the generalizations you 've already made, but I will suggest this. If you want others to respect your experience when you speak about it, try to consider its limitations before you draw assumptions that include other people's lives.

[-] Gaywallet@beehaw.org 0 points 1 year ago* (last edited 1 year ago)

This is about the overweight BMI category, not obese categories. It's also talking about how it's actually not associated with an increase in overall mortality, but rather the opposite. This observation has been around in literature for quite some time, predating the obesity crisis.

What are you trying to even say with this comment?

[-] wesker@lemmy.sdf.org 1 points 1 year ago

America is getting really fat. Reading the article reminded me of how fat this country is getting.

[-] Gaywallet@beehaw.org 0 points 1 year ago

While I appreciate your concern for how fat America is, I'm struggling to see how this comment is helpful or leads to a productive discussion in any way 🤷‍♀️

[-] wesker@lemmy.sdf.org 0 points 1 year ago

Lots of discussion going on around my comment right now.

[-] Gaywallet@beehaw.org 0 points 1 year ago* (last edited 1 year ago)

The discussion trying to process your extremely vague statement is not productive.

[-] wesker@lemmy.sdf.org 1 points 1 year ago

I think you're being a bit of a buzzkill.

[-] Gaywallet@beehaw.org 0 points 1 year ago

We're not a space for low effort reddit/twitter style gotchas. Be better.

[-] wesker@lemmy.sdf.org 1 points 1 year ago

Reducing my feelings to a "gotcha". Yeah, I don't want to browse a community with Reddit style moderation either, thanks.

[-] bermuda@beehaw.org 0 points 1 year ago

What are you trying to even say with this comment?

Haven't you heard? America bad.

[-] wesker@lemmy.sdf.org 0 points 1 year ago

You're suggesting that all fat people are bad?

[-] bermuda@beehaw.org 0 points 1 year ago
[-] wesker@lemmy.sdf.org 1 points 1 year ago* (last edited 1 year ago)

Were you being hyperbolic, as a mild defensive response to a perceived slight against your country and the people in it, when the real problems are public education failure, health system failure, political corruption, and a food industry that intentionally gets your youth hooked on things like HFCS at an early age?

[-] OofShoot@beehaw.org 1 points 1 year ago

When talking in a clinical sense, I think we need to standardize on a numerical standard, like body fat percentage or BMI. It's my understanding that people want to get away from BMI because it's crude, and I agree, but communicating in numbers will make things less confusing. Healthy body fat ranges depend on race, gender, and age, but it would still be better than using words the public has coopted to become unclear.

[-] Fal@yiffit.net 0 points 1 year ago

Healthy body fat ranges depend on race

This isn't really true. Unless what you're suggesting is that there's a biological component of race, which my understanding no scientist suggests. "Normal" ranges depend on race, but it's not like 1 race is healthier at a different weight than another

https://www.sapiens.org/biology/is-race-real/

[-] OofShoot@beehaw.org 1 points 1 year ago

While race is mostly a social construct, it's easier to use race as shorthand for "populations with long-term historical ancestry in a loosely defined geographical area, accepting that population mixing has been occurring since the dawn of time and will continue to do so into the future" than it is to say that whole thing every time

BUT, it's my understanding that, for example, Pacific Islanders are generally healthy at a higher body fat percentage than other groups of humans.

[-] ApathyTree@lemmy.dbzer0.com 0 points 1 year ago

BMI does use numbers, but is complete pseudoscience, and should absolutely be moved away from.

https://www.npr.org/templates/story/story.php?storyId=106268439

Kinda like the Myers’s Briggs is pseudoscience, and lie detectors, and a lot of other shit we use frequently in society.

I think what we need is just something scientifically based, like at all. Numbers or no numbers.

[-] OofShoot@beehaw.org 2 points 1 year ago

BMI is useful for historical population comparisons because you can calculate it using just height and weight and it's already been in use for a very long time. It's so crude as to be very misleading when applied to individuals, especially if you decide to turn your brain off when deciding how to evaluate the information.

The origins of the calculation are immaterial. It's value is in comparative studies, not direct judgement. The actual judgement of "good" vs "bad" BMI numbers is dumb(ish) but it is good for comparing populations across both time and space.

[-] NOSin@lemm.ee 0 points 1 year ago

Calling all of these "pseudo science", shows a gross misunderstanding of either the term, or the subjects mentioned.

[-] ApathyTree@lemmy.dbzer0.com 0 points 1 year ago

If you can show me that any of those things are actually supported by scientific study, I’m happy to learn, but yes, based on everything I’ve learned about them, they are pseudoscience. None of them are supported by any sort of research findings.

[-] Gaywallet@beehaw.org 2 points 1 year ago* (last edited 1 year ago)

It's rather trivial to find a study talking about BMI, but talking about it in extremes like this does no one any good. I would highly suggest you go educate yourself on public health or at least read something in the literature before making such extreme claims. To help you get started, here's a fairly comprehensive review on BMI in the clinical context.

You do bring up a good point in that it's important how we use BMI and just what it represents. Major institutions such as the AMA have started to reassess exactly how BMI is interpreted (and providing guidelines) in the clinical sense, because there are problematic ways to use BMI. Of note, they do not advocate against using BMI, but rather it should be one of many indicators, as that's the basis of differential diagnosis in the first place.

[-] ApathyTree@lemmy.dbzer0.com 1 points 1 year ago

I’ve already educated myself on this stuff, and continue to do so as more information comes out, but thanks.

The condescending tone is classic considering the thing you linked has right in it:

“However, it is increasingly clear that BMI is a rather poor indicator of percent of body fat. Importantly, the BMI also does not capture information on the mass of fat in different body sites. The latter is related not only to untoward health issues but to social issues as well. Lastly, current evidence indicates there is a wide range of BMIs over which mortality risk is modest, and this is age related. All of these issues are discussed in this brief review.”

It’s a poor indicator because it lacks scientific rigor, aka pseudoscience.

[-] Gaywallet@beehaw.org 1 points 1 year ago* (last edited 1 year ago)

The question was whether it was a clinically relevant metric - it is absolutely a useful one. You are correct that it is not an indicator of percent of body fat, it was not designed to measure this and using it for this purpose is mislead. But there's a world of difference between "it's bad at measuring body fat" and "BMI is pseudoscience". It's unfair to characterize it as lacking scientific rigor because there are plenty of scientifically rigorous studies involving BMI. It is extremely useful as a clinical indicator of one's health, in the same way that body temperature can tell us things in the context of other metrics and can also tell us some high level information about a person's general health.

But perhaps most importantly, it's extremely useful when we come to population health where generalized indicators are often more useful than hyper-specific ones. Indicators which are easy to measure and gather from relevant data sources are also often more useful than ones which may be more accurate on a per-individual basis, but less important when measuring the health of entire populations. I apologize for any condescension in my comment, I was suggesting that you become more educated in matters of public health because indicators like BMI are invaluable in this space.

[-] Gaywallet@beehaw.org 0 points 1 year ago

It’s my understanding that people want to get away from BMI because it’s crude

Pretty much the only people advocating for this are people who get into weightlifting and I'd say the vast majority of them were already in the overweight category before putting on extra muscle. BMI is by no means perfect, but it's actually extremely good at doing what it was designed to do, which is give a quick and easy metric by which to judge someone's general health. It's meant to be a starting point for a discussion around exercise and other more important factors, when it's clinically relevant to do so.

[-] PaddleMaster@beehaw.org 1 points 1 year ago

I would disagree that it’s only weightlifters. I’ve competed at an international level in a completely different sport, and my teammates have the same concerns. And this goes for people who have been selected to represent the national team and those who have not.

I’m in a sport where it’s beneficial to weigh less, and many of us are considered overweight by BMI standards.

My sport is not represented in the Olympics, so we are talking (for the most part) about normal people who like to do sport. My teammates are all teachers, doctors, IT professionals. We aren’t people who are paid to workout all day everyday.

I’d argue that many gym-goers who are dedicated (like HIIT classes, cyclers,etc) would also agree that BMI isn’t great. I don’t have any studies on hand to support my experience/anecdotal evidence. But I’ve been in sport and various gyms for 10+ years and all the trainers, coaches and athletes say the same thing: don’t look at the scale unless you need to weigh in.

[-] lemillionsocks@beehaw.org 1 points 1 year ago

Nuance in applying the BMI is important. Like I'm a short guy(how short I'll leave it up to you) and according to the BMI I'd be a "healthy" weight at 120lbs. I can assure you if I ever drop down to 120 I would look like and feel like death(and honestly if I drop like that I might be!) .

The BMI can be a useful tool but what is and isnt a healthy weight can vary so much(and thats not even getting into lean athletes who are muscular obese and how silly that is). People have different body types and even then if you are visibly fat and not just broad shouldered or big breasted you can still be healthy. There's definitely a point where people hit where you get too big and the health problems and mobility problems start coming, but where that line is can vary and it would be nice to see the BMI usage change. So we wont get doctors ignoring patient symptoms and problems and suggesting you lose weight when something is wrong.

this post was submitted on 07 Sep 2023
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