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.
Itās something Iāve noticed on the left in general as well. The leftist org Iām in has almost no fat people in it and something tells me thatās not because there arenāt any fat leftists out there.
Fatphobia is rooted in anti-Blackness and ableism.
Iād highly recommend the āMaintenance Phaseā podcast with Michael Hobbes and Aubrey Gordon, as well as Aubrey Gordonās books āWhat We Donāt Talk About When We Talk About Fatā and āYou Just Need To Lose Weight.ā
TL;DR: Thereās 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 donāt 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 Iām 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.
That article doesnāt 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 theyāre 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 isnāt an easy or simple undertaking, but weāre not doing fucking calorie-denialism here.
Ok it says 80% of the weight lost was gained back in 5 years and itās a meta-analysis of 29 different studies so thatās a huge dataset. Thereās 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 couldnāt stick to a diet and exercise plan longterm. As a leftist, that explanation comes up short for me.
But frankly, this is what I didnāt want to do in this thread.
āWeāre not doing calorie denialism here.ā
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? Itās far more complex than āCICOā and Iām fucking sick to death of thin people preaching about the SiMpLe sCiEnCE. Iām not doing it. Donāt 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. Itās not an invitation to debate weight loss shit with me. Read the responses from fat people in this thread and fucking do better. Itās exhausting.
What do you mean āas a leftistā? Itās incredibly immaterial to just disbelieve that large lifestyle changes are extremely difficult to make and maintain. Ask anyone whoās 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 youāve had a really shitty day at work, or go out and exercise when itās cold and raining? Thatās 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 ādiet and exerciseā are 3 words doesnāt mean theyāre easy to stick to.
Hey, I donāt 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 Iām being unclear, in this analogy the CICO people are the transphobic āmuh chromosomesā 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 thereās 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 doesnāt work in reverse is, frankly, very silly.
Also, to all you nonbiologists arguing here: if itās entirely diet and exercise, why is Ozempic so effective in comparison to such a regimen, hmmm? Maybe itās 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?
CICO is true. But, itās not useful; we canāt measure the actual calories your body absorbs, the actual calories your body burns, nor can we control them. Yes, some actions influence it, but thereās many, many reason why āeating 200 fewer calories and exercising 200 calories worth of work a dayā may not lead to 400 calories worth of āfat lossā.
Ozempicās 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.
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 aboveāI daresay those are playing a role here). Those molecules are critically important to the way the body processes energy, and we still donāt understand that system very well (if we did, weād 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. Itās like telling someone they need to pee less, as if thatās an easy thing to just do.
Itās useful because for most of us itās 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 itās completely useless and somewhat insulting medical advice. But thereās no need to throw the baby out with the bathwater.
Iām glad you recognize that, but nonetheless, āthe babyā in this case is a falsehood. See here for a real-world example: https://hexbear.net/comment/5779945
Edit: better link
Itās not a falsehood. First of, one example wouldnāt disprove literal decades of research proving the contrary, but also this example isnāt 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, thatās 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, itās simply not an absolute rule in any useful sense.
And, its also pretty insulting to say for āmost of usā CICO is the only way to regulate body weight, when thatās 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 canāt accurately track that?
How does one explain body-builders, who calculate very closely their intake and burning of calories (as well as nutrients)? Thatās not just āclose enough to be useful,ā is it?
I understand that CICO isnāt 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 āof course water is just protons, neutrons, and electrons pushed together with forces in a shapeā to explain waterās purpose in cellular reproduction. Itās technically correct (itās 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 itās 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 thatās not a useful solution applied to healthcare on any sociological scale. And itās not useful when thereās no āsolutionā 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
I donāt understand how the first part disagrees with what I said? Many body builders do estimate it close enough to be useful, yes. But, itās still estimates. We have no way of tracking things like ābasal metabolic rateā, and how that might change over time and under different conditions (which, isnāt to say it canāt be estimated). If you are working out or doing physical labor to a large degree, like body builders and professional athletes do, you can make those basal calories and their fluctuations basically negligible, able to be left as just a line item. When professional bodybuilders are eating 5000 calories a day, yeah, deviations in ābackground caloriesā donāt really matter.
I donāt want to discount the math pros do as unimpressive, or not useful. But thereās a lot of it that is ānapkin mathā, figured out second or third hand, from the data that is able to be tracked accurately.
but I donāt think the āaverage personā is expected to work out for 6 hours a day, nor would they likely be capable.
When I say CICO is the only way to regulate body weight I donāt 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 donāt nothing changes.
Thatās so vague to be useless though. Many people that struggle to lose weight, the āproblemā isnāt the physics of it. Itās the mental aspects, of appetite and craving, and the socioeconomic aspects, of time, money, attention, what food is available at what distance, price, and effort.
And, when eating fewer calories can make their bodies go into āstarvation modeā, burning fewer baseline calories and making any physical exertion exhausting if not impossible, it is insulting to say āCICO!ā
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