Call for an urgent rethink of the ‘health at every size’ concept • Hacker News Board

Re: Call for an urgent rethink of the ‘health at every size’ concept

#31

Post by rtl49 » Tue, Nov 17, 2015, 8:20 PM UTC

DHJSH wrote: post #23

Frondo wrote: post #10

Earlier quoted context omitted.

I think you're touching on the heart of the tension behind the "health at every size" movement. I know a couple of people who are big advocates of it, and surprise surprise, they're all pretty fat. They're still wonderful people, and I of course don't respect them less because they're fat. You know, for me, it's like..who cares? It's not my body. I'm even pretty sympathetic to how much difficulty they have doing basi…

The HAES people don't seem to have a lot of respect for people at normal sizes. It's less "Healthy At Every Size" and more "Healthy at MY Size".

Perhaps so for some. The challenge for those of us who are not their size is to empathize despite the temptation to adopt a belligerent stance in response.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#32

Post by rtl49 » Tue, Nov 17, 2015, 8:31 PM UTC

mseebach wrote: post #21

atwebb wrote: post #8

Earlier quoted context omitted.

That goes for a lot of issues, it's hard to empathize. Addict? Just stop using Alcoholic? Just stop drinking Gambling issues? Just stop betting Depressed? Just cheer up Unmotivated? Just try harder There are underlying, complex factors to most of these and many other issues. It's easier to ignore them when you've never directly dealt with it.

Yes, absolutely -- but all of these ills, as with obesity, are possibly even more ill-served by an acceptance movement.

You seem to have confused promoting positive health decisions among obese individuals notwithstanding the amount of food they consume, and the acceptance of obesity as a healthy condition in itself. However much some have misinterpreted "Healthy at Every Size," the former is its organizing principle.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#33

Post by thatswrong0 » Tue, Nov 17, 2015, 8:32 PM UTC

DHJSH wrote: post #27

300,000 people die every year from Obesity. It's our #1 killer. And it can be solved by eating less. See this study in the NEJM: http://www.nejm.org/doi/full/10.1056/NEJM199212313272701 Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects Of all the "diet resistant" subjects studied, ALL of them (100%) were grossly underreporting actual calories consumed and overexerting physical…

Except _what_ you eat has a big factor in how much you eat. Some foods are more satiating than others. Some are more addicting than others.

So eating less may also require eating different.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#34

Post by vox_mollis » Tue, Nov 17, 2015, 8:32 PM UTC

gmarx wrote: post #30

vox_mollis wrote: post #3

In modernity, hurt feelings are the ultimate sin, public health be damned.

Hurting peoples feelings does not improve their health. My guess is (I don't know you) looking down on fat people is one of the mechanisms by which you make yourself feel worthy. You are not doing it from their benefit. Believe me, it is a vanishingly rare person who is fat and doesn't mind it. The fat acceptance movement is about feeling helpless and just wishing people would stop giving you a hard time on top of it

My guess is (I don't know you) looking down on fat people is one of the mechanisms by which you make yourself feel worthy

I can correct your guess, here. Looking down on my fat former self is one of the mechanisms by which I keep myself healthy.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#35

Post by rtl49 » Tue, Nov 17, 2015, 8:39 PM UTC

DHJSH wrote: post #27

300,000 people die every year from Obesity. It's our #1 killer. And it can be solved by eating less. See this study in the NEJM: http://www.nejm.org/doi/full/10.1056/NEJM199212313272701 Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects Of all the "diet resistant" subjects studied, ALL of them (100%) were grossly underreporting actual calories consumed and overexerting physical…

You haven't written anything I can show to be factually inaccurate. But the trouble is with one word: "simply."

Unless you subscribe to a metaphysical interpretation of human behavior, the fact that obesity is such a widespread health problem is ipso facto strong evidence that some set of environmental factors is at play.

The insistence that this large population of people bear some kind of personal responsibility for their condition completely misses the point and is, in my opinion, an obviously useless suggestion to make. I'm not aware of any evidence that instilling a sense of shame in people who are obese is likely to ameliorate their condition, and the experience of many would seem to suggest it is likely to have the opposite effect.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#36

Post by atwebb » Tue, Nov 17, 2015, 8:42 PM UTC

sharpray wrote: post #11

atwebb wrote: post #8

Earlier quoted context omitted.

That goes for a lot of issues, it's hard to empathize. Addict? Just stop using Alcoholic? Just stop drinking Gambling issues? Just stop betting Depressed? Just cheer up Unmotivated? Just try harder There are underlying, complex factors to most of these and many other issues. It's easier to ignore them when you've never directly dealt with it.

There's an obvious difference here. If the addict can't find drugs anymore, he can't use them. If the alcoholic can't find alcohol anymore, he can't drink it. If the gambler can't find slot machines, he can't gamble. If the overeater can't find food, he can't eat. The same can't be said for depressed and unmotivated people - there's nothing you can take away from them in order to keep them from suffering depression o…

>lack of self-control

I don't know where you come from, I don't know what life you've led and things you've seen.

In my experiences, self-control is hardly the actual problem. The addictions/compulsions are manifestations of the depression or the lack of self-worth or mental imbalances or personal issue X.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#37

Post by rtl49 » Tue, Nov 17, 2015, 8:48 PM UTC

vox_mollis wrote: post #34

gmarx wrote: post #30

Earlier quoted context omitted.

Hurting peoples feelings does not improve their health. My guess is (I don't know you) looking down on fat people is one of the mechanisms by which you make yourself feel worthy. You are not doing it from their benefit. Believe me, it is a vanishingly rare person who is fat and doesn't mind it. The fat acceptance movement is about feeling helpless and just wishing people would stop giving you a hard time on top of it

My guess is (I don't know you) looking down on fat people is one of the mechanisms by which you make yourself feel worthy I can correct your guess, here. Looking down on my fat former self is one of the mechanisms by which I keep myself healthy.

We quickly lose sight of what it was like to have been a certain way. Whatever the origin of your unhealthy weight, and whatever purpose a negative evaluation of your past self serves, I think most would agree that derision is unhelpful as a tool for reducing obesity. On the other hand, its prevalence and the language many use while doing it seem to suggest that they find it gratifying. Some consider this a problem in itself.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#38

Post by DHJSH » Tue, Nov 17, 2015, 8:49 PM UTC

rtl49 wrote: post #35

DHJSH wrote: post #27

300,000 people die every year from Obesity. It's our #1 killer. And it can be solved by eating less. See this study in the NEJM: http://www.nejm.org/doi/full/10.1056/NEJM199212313272701 Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects Of all the "diet resistant" subjects studied, ALL of them (100%) were grossly underreporting actual calories consumed and overexerting physical…

You haven't written anything I can show to be factually inaccurate. But the trouble is with one word: "simply." Unless you subscribe to a metaphysical interpretation of human behavior, the fact that obesity is such a widespread health problem is ipso facto strong evidence that some set of environmental factors is at play. The insistence that this large population of people bear some kind of personal responsibility fo…

Eating fewer calories than your body needs every day will always lead to weight loss. Certainly it's easier if you rearrange your diet, but that's a secondary point.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#39

Post by rtl49 » Tue, Nov 17, 2015, 8:54 PM UTC

DHJSH wrote: post #38

rtl49 wrote: post #35

Earlier quoted context omitted.

You haven't written anything I can show to be factually inaccurate. But the trouble is with one word: "simply." Unless you subscribe to a metaphysical interpretation of human behavior, the fact that obesity is such a widespread health problem is ipso facto strong evidence that some set of environmental factors is at play. The insistence that this large population of people bear some kind of personal responsibility fo…

Eating fewer calories than your body needs every day will always lead to weight loss. Certainly it's easier if you rearrange your diet, but that's a secondary point.

You're not engaging with what I wrote. The trouble is with refraining from consuming so many calories. The fact that so many people find this so difficult is proof enough that it is not "simple" in the sense of being easily accomplished, and that environmental factors likely contribute to its difficulty. Thus attention should be focused on discovering and addressing these factors, instead of applying social pressure to the obese to eat less.

Re: Call for an urgent rethink of the ‘health at every size’ concept

#40

Post by cookiecaper » Tue, Nov 17, 2015, 9:10 PM UTC

thatswrong0 wrote: post #33

DHJSH wrote: post #27

300,000 people die every year from Obesity. It's our #1 killer. And it can be solved by eating less. See this study in the NEJM: http://www.nejm.org/doi/full/10.1056/NEJM199212313272701 Discrepancy between Self-Reported and Actual Caloric Intake and Exercise in Obese Subjects Of all the "diet resistant" subjects studied, ALL of them (100%) were grossly underreporting actual calories consumed and overexerting physical…

Except _what_ you eat has a big factor in how much you eat. Some foods are more satiating than others. Some are more addicting than others. So eating less may also require eating different.

Yes, and the problem is that our food supply is optimized to be more addictive, because it allows everyone in the supply chain to make more money. Quite literally every commercial entity is against an individual eating filling, low-calorie foods, because it means they're spending less money on food in general. This is on top of the evolutionary forces that already make our bodies crave super-high-calorie food. It's a lot for someone to fight.

Experiment: go to Wal-Mart and try to buy maple syrup (actual maple syrup; mostly what they call syrup at Wal-Mart is literally just water, corn syrup, and dye). Now try to buy canned pears without any added sweeteners (if you find one without sugar, it has Splenda). Now try to buy a loaf of bread without any added sugar (most loaves contain brown sugar). Almost everything in almost every conventional grocery chain in the U.S. is loaded with sugars, sweeteners, and other addictive substances. Even if you try really hard to buy healthy foods at a normal grocer, you are going to have a hard time.

Not everyone with a weight problem is shoving 50 Snickers down their gullet every day, and that characterization has to stop if we're going to realistically address the issue.