this post was submitted on 09 Jul 2025
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Great, let's start there.
Going to the topic of this post - I do agree Eat Less - Move More - isn't helpful. Though my rational (as I outlined in another comment here) isn't the same as the articles.
I fear the article is getting stuck in overwhelming "associations" with obesity, and "associations" with weight-loss. Part of the problem with the existing messaging, advice, and obesity programs is this type of "associative" advice can bit a bit confusing because associations don't speak the mechanistic cause.
Things I have seen documented as being directly causal to obesity in the literature
The last two are interesting in that they basically are a sneaky way to have persistently elevated insulin.
What would you like to see as a better form of obesity care?
I'm a fan of the multi-touch telehealth models as demonstrated by virta health and others. Consultation with doctor for medicine, nutritional plan, daily bio-feedback, coaching sessions, social community for peer pressure and approval. Perhaps one person can just read a book and fix their problem, or another person just needs to see bio-feedback data, having the holistic approach can meet people at many levels encouraging success, and forgiving mistakes.
That is all very good, but I also want a much lesser focus on the obesity itsself. I want a focus on not making people feel they are to be fixed based only of their size and instead looking for what exactly can be improved by promoting the general health of everyone. I want more widespread knowledge on what to do to have an healthy life, and not just aiming it for who has a larger body.
At the current time it is not uncommon for plus-sized individuals to actively avoid medical assistance due to the very heavy focus on weight as a metric for health, or for medical professionals to refuse care to plus-sized individuals unless it is a weight loss program. It is also not uncommon for "normal-sized" individuals to feel threatened by plus-sized individuals in case "they end up like them".
Proper knowledge and respect will go a long way, making both plus-sized and "normal-sized" individuals have less stress on their size and improving the quality of life of everyone.
I come from a position where I am obese myself and actively want to be so. I feel comfortable in my own skin, and I want to live my life in the body I like while doing what I can to mitigate the known risks. I want me, the objectively not many who feel like me, and who instead wants to be slimmer to have much less sources of stress. It would be much better for the quality of life of everyone.
I tried to spread this knowledge, but I was met with some resistance :)
The core problem is that most doctors do not get nutritional training, so they are stuck in the CICO / Eat Less - Move More world, because thats all they have heard.
Great, I'm glad you found happiness!
I was feeling a rush. I reading again it is true you were trying to do that. I apologize sincerily.
I would go the step further and including not only proper training of medics but also proper teaching in schools. The latter still focusing on general healthly living without attempts to point it to size and proper active corrections since without doing so it would increase stigma even more (where in schools can very easily lead to bullying, and it already happens for the same reason).
Bullying is also one reason why I believe in normalizing being larger, as I don't believe it is mutually exclusive to trying to achieve better health for everyone.
Thanks! But it can be truly stressful when discussing this from my position both online and in real life. Hearing that I am "killing myself" or that I am "killing people" is really hurtful.
Yeah, people are typically not open to having real discussions, especially online. Hyperbole and attacks are common. It's just the nature of human discourse, anything different is met with much contempt.
96% of westerners do not have optimal metabolic health. That includes all the Thin on the Outside Fat on the Inside (TOFI) people. It's a massive problem, obese people are just the easy ones to see. Thin people get heart attacks too! Metabolic health is at a all time low! This is a problem for everyone not just the obese.
Guilty of that errors myself.
That is very much why I want aiming for general health, because this is a global issues not specific to who looks larger. And let's not forget that people with an amount of fat considered healthy can still be unhealthy. But there is also the large possibility that perfect health just cannot exist in nature in a widespread way. We should always strive for improvements and continue promoting health, but trying to reach perfection to the widespread population will not be possible without extreme dehumanizing measures. I don't think we as humans have ever been good with that percentage.
What is the minimum intervention required to give people a healthier life:
Take your pick, all improve lives. Nobody is trying for perfection, just better