The Ones We Sent Away

slime mold made most of his fat theory up and got shot down doing poor analysis. He’s a well meaning charlatan but a charlatan nonetheless.

skip his diet ideas. He’d tell you your baseball team lost because the humidity was too high when in actuality half the team is out sick with the flu. He ignores basic obvious reasons. Always a zebra when he thinks it’s never a horse…

I've seen the show. There's so much denial. Even here at Hacker News, suggesting that fat people eat too much food gets you downvoted and flagged.

Yes, something is sick with fat people that’s causing them to do that. Anorexic people exaggerate how fat they are and how much (how little) they eat, and that’s clearly some kind of illness that needs medical intervention and medication as needed to get them proper. Same for fat people, I think fat people have something wrong with them where the whole process of eat food -> feel sated is off. If everything I ate felt like half the portion is actually was I’d also be totally fucked up in how I understood my portion sizes too and would probably inadvertently lie on “objective” measures too!

Like I don’t know how much a portion of chicken is. But damn if I ate a chicken leg, and I feel like I ate nothing, I’d be sorely tempted to argue I didn’t have a full portion of protein… because it doesn’t feel like I did, in my body. I think that’s what’s happening to fat people. Otherwise drugs like ozempic wouldn’t be working like they do— the fat person doesn’t become suddenly honest on some dumb journal and suddenly the pounds come off! They just actually feel full when they should like normal people for once so their bodies are getting to normal people sizes.

While that is noble and appreciated unfortunately many facilities will turn you away because of the liability involved.

The unfortunate reality of working with populations that include severe developmental and intellectual disability, traumatic brain injury, dementia, mood disorder, etc is that impulse control can be severely impaired. This can lead to extreme and sudden violence that can catch you quite off guard if you are not prepared for it (and even if you are) and cause significant injury. The staff turnover rate and workers comp claims were crazy high as a result and part of the cause of the low pay (although there were many other major factors involved). It can be quite dangerous. Although to be clear this is absolutely not to suggest that someone who is mentally ill or disabled is inherently dangerous of course; this is a small subset of individuals whose functioning was impaired in such a way that made the likelihood of violent behavior significantly more likely. Often it was not intentional violence, more like a childish tantrum except with the body of an adolescent or young adult that could do serious damage. Although occasionally it was serious targeted violence too. I personally still have a permanent neck and spinal injury a decade later as well as a ton of scars from bite marks. I saw much worse. It’s not just some mild annoyance shit, it’s life changing ruin your body kind of injuries.

With that serious caveat the other issue is that there’s not really a “standard” name for these programs. They vary by level of care, by provider, by state, and sometimes even by county. But some examples from around me would be residential schools, residential treatment facilities, long term structured residences, etc. more generic terms are things like “group homes” and they’re all considered an extension of psychiatric inpatient treatment facilities.

Also fwiw depending on your state/locale there may be volunteer opportunities that offer training to help alleviate the above issues. At another program I consulted with later in my career they had volunteers who would socialize in this capacity. It was a really nice program; they would essentially go through a condensed version of the staff training. They wouldn’t do anything like restraints or things like that but they would teach them evasive maneuvers, de escalation techniques, and then train them on the clients a bit with staff before letting them do more independent socialization. Was really nice for the clients. The downside was the really difficult clients who had extreme behavioral issues tended to not get the service and they also tended to be the clients who got visited the least. But that’s the difficulty of the issue; when your behavior gets to that point you kind of need specially trained people around you at all times for safety.

And the thing is populations change the frequency of this a bit but not as much as you’d think. I’ve spent most of my career doing pediatric stuff, child and adolescent, with some stints doing adult work. All of those populations can have these issues obviously but it does tend to calm a bit with age in my experience. However, I have peers who focus in gerontology and dementia and have similar issues because of the impulse control issues that can come with that diagnosis.

I hope this doesn’t scare you off. I only hope to prepare you for the realities of the situation. I would hate to just post “oh yeah go volunteer” and have some kid bite you and have it get infected (human bites get infected super easily if they break skin, mouths are nasty!) or have your hair pulled and get your neck all messed up. You can do this and be safe if you are prepared and trained, you don’t need to be hypervigilant (that can actually make things worse), but you do need to be aware of your surroundings and know how to position yourself safely. That all said my suggestion would be to find a residential facility near you and contact them directly to see if they have any volunteer opportunities. If they just invite you they most likely have a population where none of this is a concern and you are good to go. If they offer training and you’re up to it go for it, you’ll learn a lot about safe positioning and de escalation techniques. If they ignore you I’m sorry, a lot of these places are overwhelmed and constantly short staffed unfortunately