Articles like this piss me off. Not because it's a bad article, but because it's stuff we've known for ages. Especially the environment stuff. You can't say obesity costs the NHS and not fix the underlying problems. How can you justify processed food not being taxed to oblivion while allowing for price gauging of organic foods for example. The system is fucked!
this post was submitted on 09 Jul 2025
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“Eat less, move more” in my case looked like going to bed hungry from lack of money and doing hours of manual labor every day for about 18 months.
I got down to my ideal weight, but as soon as I wasn’t broke and didn’t have to do manual labor I went right back to being fat.
The conversation should not be about eat less move more, it should be about the [Paper] The Carbohydrate-Insulin Model of Obesity - Beyond “Calories In, Calories Out” - 2018
TLDR: Carbohydrates drive insulin, insulin drives obesity. This is far more clinically relevant to obese patients then the current form of CICO shaming (if the current advice doesn't work for you, its a moral failing on your part)
Carbohydrates/sugars are very addictive, breaking the habits does take a holistic approach, but education is a good first step.
We now understand that obesity is multifactorial. Genetics, childhood experiences, cultural norms, economic disadvantage, psychological health, mental illness and even the kind of job you have all play a role.
These are associations not causation, it's being kind of used as a excuse for why nobody has done anything yet.
This “obesogenic environment” refers to the world we live in. Its one where high-calorie, low-nutrient foods are cheap and everywhere, and where physical activity has been engineered out of everyday life, from car-centric cities to screen-dominated leisure time.
Not a mention of carbohydrates?
higher rates of obesity and deprivation
Overfed and undernourished - This is a problem with processed foods to be sure, but people are eating to satisfy their carbohydrate addictions and not whole food nutritional needs.
I'm disappointed Jet. I was eagerly awaiting your input on this and rather than address what's being said in the article, you're just pushing your preexisting agenda.
Did I miss something in the article? Some underlying unifying thesis? I'm looking at it again, and its not saying much specific.
Framing it as a personal failure not only ignores decades of evidence – it actively harms the very people who need support.
I thought I was agreeing with this.
pushing your preexisting agenda.
Yeah, when I know the solution to obesity and addiction, and I see people suffering from those exact things, I'm going to my best to ensure people are informed of their options and the underlying mechanisms. My life would have been very different if I had know this at a younger age.
"Eat less, move more" is the goal, but many obese people have massive hurdles to go and do that. Be it time, mental health, social circle, etc. It's insanely hard to be able to even take time to reassess your daily routine and even more so to actually try to get out of your patterns.
Did you read the article?
Stigmatisation of fat people in the medical industry is a real and extremely dangerous phenomenon that actively harms public health. The registration of obesity as a disease WILL increase the stigma even more and put everyone in even greater risks apart from being completely useless.
For the rest, this article is very true. The proper steps and objectives indicated help with the health of every human, regardless of body size. The same proper steps help everyone be more healthy regardless if they are maintaining, losing or gaining weight.
Being fat is a serious health issue. Sugar coating it doesn’t help anyone. It enables unhealthy behavior even more than it already is.
Just being considered fat is not an health risk to the amount you think it is. A very large amount of research attributing fat directly to certain issues is outdated.
https://www.jci.org/articles/view/31021
https://journals.plos.org/plosbiology/article?id=10.1371%2Fjournal.pbio.0060237
Obesity-associated improvements in metabolic profile through expansion of adipose tissue
Hypertrophic vs hyperplasic genetic phenotypes result results in better insulin sensitivity into obesity. This paper does not say obesity isn't harmful to health, just that in one dimension hyperplasic people have a better outcome and higher levels of obesity
It's Not How Fat You Are, It's What You Do with It That Counts
If someone was morbidly obese but was insulin sensitive, i.e. no visceral fat, yes they wouldn't be exposed to most of the co-morbidities - just the structural problems (joints, knees, arthritis), and hormonal dysregulation (via adipose aromatase interactions). This paper even speaks to this itself.
The Benefits of Physical Activity for People with Obesity, Independent of Weight Loss: A Systematic Review
This is a non-sequitur and while physical activity is beneficial for obesity people it doesn't remove the morbid dangers.
None of the papers speak to a safe way to be obese, just that it can be mitigated in some circumstances. If someone is obese and metabolically healthy, by virtue of their better hormonal situation their hunger regulation and satisfaction will work well and they will trend down to their homeostatic healthy weight (and no longer be obese).
I'm firmly in the camp of fat acceptance, we have to meet people where they are, but we should also educate and encourage our rotund friends to be the best version of themselves. Acceptance, Encouragement, Demonstration, Enablement, Success.
On a personal note - thank you for making your vote manipulation accounts the same name - the fact your double voting your own posts and downvoting others isn't a good look.
I absolutely am of fat acceptance too, very heavily in fact. And I wasn't saying the risks are still there, but at the same time I want people to understand that a fat person isn't stricticly unhealthy because of the many factors involved in one's health and it is very often ignored.
Yes, I admit I did. I get EXTREMELY sensitive to this topic, and end up sounding dumb or doing stupid shit despite wanting to make good for myself and others. I am genuinely sorry for doing that, and I want to reconcile and want to have a proper discussion without anyone being attacked. I am truly sorry for trying such a dumb move.
I want to reconcile and want to have a proper discussion without anyone being attacked.
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
- elevated insulin
- elevated industrial oil consumption
- adrenal tumors
- chronic stress
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.
want more widespread knowledge on what to do to have an healthy life
I tried to spread this knowledge, but I was met with some resistance :)
medical assistance due to the very heavy focus on weight as a metric for health
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.
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.
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.
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.
he latter still focusing on general healthly living without attempts to point it to size and proper active debunking and 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).
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:
- cut fructose
- cut sugar
- cut industrial oil
- cut processed food
Take your pick, all improve lives. Nobody is trying for perfection, just better
Your linked article directly says being fat makes you sick.
Fat acceptance kills people.
They don't unless they are referring to other studies. Also, they are extremely clear on the different situations and not just with "being fat" unlike how you are implying.
Medical malpractice and such dangerous generalisations from both medics and non-medics kills people.
Your links say nothing of the sort. They only say, if you‘re fat and diabetic your insulin levels are fucked and it’s difficult to treat.
Did you even read them, or are you purposefully being misleading? Because with such a comment I am very much inclined on the second
being completely useless
Can't it help with getting treatment for it? At least here in the US you have to justify everything as medically necessary or your insurance won't cover it.
Anecdotally my mom is obese and was getting glp 1 for a while but she doesn't any more because the insurance said it wasn't necessary to treat her borderline diabetes and they stopped covering it.
Hearing/reading how it is in the US, it won't change much of anything. They will still decline it