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From the sidebar: > good health is the best prescription for preventing chronic diseases That's bad enough to approach self-parody, but in a way it's very ill

From the sidebar: > good health is the best prescription for preventing chronic diseases That's bad enough to approach self-parody, but in a way it's very illustrative of the fact that apart from smoking cessation and arguably some other forms of drug addiction treatment, we have very little in the way of demonstrably effective lifestyle interventions to prevent chronic illness. There are mountains of epidemiological associations and sometimes even plausible physiological mechanisms for many of these things, but it often turns out that the obvious intervention just defies the correlation instead of changing the outcome (cf. Goodhart's law), or changes things in a statistically significant but practically underwhelming way. As far as I know, obesity is mostly significant as a public health issue because it makes many conditions modestly worse, not because it's the primary cause of any given problem. Losing weight might mitigate an illness such that you cross some diagnostic threshold and are thus "cured", but you're still in a much different state than someone who wasn't at risk of that illness at any weight. That doesn't mean you shouldn't try to maintain a healthy weight, just that it's wishful thinking to expect that doing so is going to solve all or even most of your problems. In general, it's important to recognize that health is a complex topic and not fool ourselves into thinking we've found the key to good health.

chiefalchemist 9y ago
Put another way...if you have a serious medial issue being overweight can be the difference between life and death. Instead, we have Oprah selling "love your body" as if that love will save you went a health crisis comes knocking.
- erikpukinskis 9y ago
  Loving your body while you're overweight and getting to a healthier weight are not at cross purposes. Shame causes people to dissociate with their bodies which makes exercise and healthy eating harder. The fact that we are encouraged to think of being overweight as a personality flaw makes it much harder for people to lose weight. They take their weight as evidence of their weakness which causes a detrimental cycle. It's also true that popular notions of "healthy weight" are medically inaccurate. Many people who are a normal healthy weight and have no medical reason to lose weight still think they are overweight. There are lots of good reasons to encourage people to think of themselves as healthy at non-skinny sizes.
  - 0xcde4c3db 9y ago
    There's also a huge amount of distorted thinking about the relationship between body shape and weight or body fatness. For example, it's extremely common for people to believe (and dishonest elements of the "fitness industry" to promote) that there's some diet or exercise to change a feature that's primarily determined by skeletal structure or muscle insertions (peaked biceps, thigh gap, etc.).
  - chiefalchemist 9y ago
    Sure. Agreed. People can believe whatever they want about their bodies. The issue is the disconnect between healthy body image and actual health. My issue with Oprah (for example) is she sells the love but never the facts. Concequently people believe they're going to be fine with diabetes, as long as they love their bodies. Sorry, but that's a lie. As for shame. Yeah, abuse is wrong. I'm not in favor of abuse. But lies aren't helping either. Normalizing the unhealth is bringing the (healthcare) system to its fat little knees.
    - oddlyaromatic 9y ago
      >Concequently people believe they're going to be fine with diabetes, as long as they love their bodies. You make a giant leap here from 'I have value as a person regardless of my physical shape' to 'medical science matters not to me because my self-love gives me magical powers' ... Just wondering what that is about. It seems uncalled for. > its fat little knees. Oh. I'd like to gently suggest you may have a chip on your shoulder about this topic and maybe it's interfering with your analysis.
      - qume 9y ago
        Your paraphrasing of the parent post is incorrect and misleading.
        oddlyaromatic 9y ago
        I'm open to learning why you think this. I was trying to accurately reflect the message I believe underlies the sentence that I quoted. If you think the statement "people believe they're going to be fine with diabetes, as long as they love their bodies" implies something different, please be specific. It still appears to me that the message is "people who watch Oprah or otherwise develop a positive body image, even if they are overweight, believe this positivity protects them from harmful medical conditions like diabetes that might be related to their body's general condition."
- UnoriginalGuy 9y ago
  > Instead, we have Oprah selling "love your body" as if that love will save you went a health crisis comes knocking. Pretty sure you only brought that up because you perceive Oprah as being overweight. "Love your body" is one of NOW Foundation's programs. The program description is: > Every day, in so many ways, the beauty industry (and the media in general) tell women and girls that being admired, envied and desired based on their looks is a primary function of true womanhood. The beauty template women are expected to follow is extremely narrow, unrealistic and frequently hazardous to their health. The Love Your Body campaign challenges the message that a woman’s value is best measured through her willingness and ability to embody current beauty standards. Oprah helped advertise and promote that program.
- 0xcde4c3db 9y ago
  I'd be more worried about Oprah being an eager springboard for the next Dr. Oz or Rhonda Byrne, who encourage people to embrace utter nonsense and snake oil. At least "love your body" in a broad sense is compatible with the concept of optimizing it.
darawk 9y ago
Being obese makes diabetes pretty substantially more likely.
- UnoriginalGuy 9y ago
  Being overweight or the diet associated with being overweight? Particularly with recent research showing that the gap between periods of consumption can help the pancreas regenerate[0]. [0] https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-02-24-fasting-diet-may-help-regenerate-a-diabetic-pancreas/ https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines...
  - darawk 9y ago
    That's an interesting question, but I guess I don't understand the point of the distinction? If you're just pointing it out, ya, I think that's an interesting question to consider. But for practical purposes i'm not sure there's a difference.
    - QAPereo 9y ago
      A diet full of starches and sugar, a diet of almost only fat and meat, and a diet of mostly the two combined could all lead to obesity. Are they equally likely to lead to diabetes? Is it obesity, or a correlation between obesity and drinking your own weight in Coke every week that is the highest risk factor?
      - deleted 9y ago
        [deleted]
      - maccard 9y ago
        With a sample of n=1 I have close family member who developed diabetes with a perfectly “healthy” diet, just out of control portion sizes. Since losing weight, they’re “cured”.
  - cloverich 9y ago
Gatsky 9y ago
There is some good quality evidence for dietary interventions snd cardio/cerebrovascular disease/cancer, although it is difficult to interpret and nutritional science in general is a disaster. Without too much exaggeration, exercise also improves every surrogate and hard end point ever tested. Eg http://www.nejm.org/doi/full/10.1056/NEJMoa1200303 http://www.nejm.org/doi/full/10.1056/NEJMoa1200303 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415727/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415727/
hammock 9y ago
It's not "bad," it's the paradoxical truth. Sort of how people say, limit sodium intake to prevent high blood pressure. When all the studies say it's ok to eat as much sodium as you want, as long as you're healthy. But if you have high blood pressure or compromised kidneys, you should limit it.
rando444 9y ago
I'm in the opposite group. I really think it is that obvious that good health and exercise is the key to a long life. I think all you really have to do is take a look at nearly anyone over 80+ .. the vast majority of the people who make it to these ages or older have a few things in common, and we can call it coincidence, but it's probably not.
mesozoic 9y ago
If you don't want to be sick then don't be!

chiefalchemist 9y ago

Put another way...if you have a serious medial issue being overweight can be the difference between life and death. Instead, we have Oprah selling "love your body" as if that love will save you went a health crisis comes knocking.

erikpukinskis 9y ago
Loving your body while you're overweight and getting to a healthier weight are not at cross purposes. Shame causes people to dissociate with their bodies which makes exercise and healthy eating harder. The fact that we are encouraged to think of being overweight as a personality flaw makes it much harder for people to lose weight. They take their weight as evidence of their weakness which causes a detrimental cycle. It's also true that popular notions of "healthy weight" are medically inaccurate. Many people who are a normal healthy weight and have no medical reason to lose weight still think they are overweight. There are lots of good reasons to encourage people to think of themselves as healthy at non-skinny sizes.
- 0xcde4c3db 9y ago
  There's also a huge amount of distorted thinking about the relationship between body shape and weight or body fatness. For example, it's extremely common for people to believe (and dishonest elements of the "fitness industry" to promote) that there's some diet or exercise to change a feature that's primarily determined by skeletal structure or muscle insertions (peaked biceps, thigh gap, etc.).
- chiefalchemist 9y ago
  Sure. Agreed. People can believe whatever they want about their bodies. The issue is the disconnect between healthy body image and actual health. My issue with Oprah (for example) is she sells the love but never the facts. Concequently people believe they're going to be fine with diabetes, as long as they love their bodies. Sorry, but that's a lie. As for shame. Yeah, abuse is wrong. I'm not in favor of abuse. But lies aren't helping either. Normalizing the unhealth is bringing the (healthcare) system to its fat little knees.
  - oddlyaromatic 9y ago
    >Concequently people believe they're going to be fine with diabetes, as long as they love their bodies. You make a giant leap here from 'I have value as a person regardless of my physical shape' to 'medical science matters not to me because my self-love gives me magical powers' ... Just wondering what that is about. It seems uncalled for. > its fat little knees. Oh. I'd like to gently suggest you may have a chip on your shoulder about this topic and maybe it's interfering with your analysis.
    - qume 9y ago
      Your paraphrasing of the parent post is incorrect and misleading.
      - oddlyaromatic 9y ago
        I'm open to learning why you think this. I was trying to accurately reflect the message I believe underlies the sentence that I quoted. If you think the statement "people believe they're going to be fine with diabetes, as long as they love their bodies" implies something different, please be specific. It still appears to me that the message is "people who watch Oprah or otherwise develop a positive body image, even if they are overweight, believe this positivity protects them from harmful medical conditions like diabetes that might be related to their body's general condition."
UnoriginalGuy 9y ago
> Instead, we have Oprah selling "love your body" as if that love will save you went a health crisis comes knocking. Pretty sure you only brought that up because you perceive Oprah as being overweight. "Love your body" is one of NOW Foundation's programs. The program description is: > Every day, in so many ways, the beauty industry (and the media in general) tell women and girls that being admired, envied and desired based on their looks is a primary function of true womanhood. The beauty template women are expected to follow is extremely narrow, unrealistic and frequently hazardous to their health. The Love Your Body campaign challenges the message that a woman’s value is best measured through her willingness and ability to embody current beauty standards. Oprah helped advertise and promote that program.
0xcde4c3db 9y ago
I'd be more worried about Oprah being an eager springboard for the next Dr. Oz or Rhonda Byrne, who encourage people to embrace utter nonsense and snake oil. At least "love your body" in a broad sense is compatible with the concept of optimizing it.

darawk 9y ago

Being obese makes diabetes pretty substantially more likely.

UnoriginalGuy 9y ago
Being overweight or the diet associated with being overweight? Particularly with recent research showing that the gap between periods of consumption can help the pancreas regenerate[0]. [0] https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-02-24-fasting-diet-may-help-regenerate-a-diabetic-pancreas/ https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines...
- darawk 9y ago
  That's an interesting question, but I guess I don't understand the point of the distinction? If you're just pointing it out, ya, I think that's an interesting question to consider. But for practical purposes i'm not sure there's a difference.
  - QAPereo 9y ago
    A diet full of starches and sugar, a diet of almost only fat and meat, and a diet of mostly the two combined could all lead to obesity. Are they equally likely to lead to diabetes? Is it obesity, or a correlation between obesity and drinking your own weight in Coke every week that is the highest risk factor?
    - deleted 9y ago
      [deleted]
    - maccard 9y ago
      With a sample of n=1 I have close family member who developed diabetes with a perfectly “healthy” diet, just out of control portion sizes. Since losing weight, they’re “cured”.
- cloverich 9y ago

Gatsky 9y ago

There is some good quality evidence for dietary interventions snd cardio/cerebrovascular disease/cancer, although it is difficult to interpret and nutritional science in general is a disaster. Without too much exaggeration, exercise also improves every surrogate and hard end point ever tested. Eg http://www.nejm.org/doi/full/10.1056/NEJMoa1200303 http://www.nejm.org/doi/full/10.1056/NEJMoa1200303 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415727/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415727/

hammock 9y ago

It's not "bad," it's the paradoxical truth. Sort of how people say, limit sodium intake to prevent high blood pressure. When all the studies say it's ok to eat as much sodium as you want, as long as you're healthy. But if you have high blood pressure or compromised kidneys, you should limit it.

rando444 9y ago

I'm in the opposite group. I really think it is that obvious that good health and exercise is the key to a long life. I think all you really have to do is take a look at nearly anyone over 80+ .. the vast majority of the people who make it to these ages or older have a few things in common, and we can call it coincidence, but it's probably not.

mesozoic 9y ago

If you don't want to be sick then don't be!