4 ms·

Maybe because "medical breakthroughs" are not needed. Moderation and self-discipline in diet and exercise are needed. Psychological issues (or parenting failu

Maybe because "medical breakthroughs" are not needed. Moderation and self-discipline in diet and exercise are needed. Psychological issues (or parenting failures for the young) may undermine those - as indicated in the article - but its difficult to see where "medical breakthroughs" add value to more common-sense solutions.

PhasmaFelis 4y ago
This is the same vibe as people telling me I don't need ADD/anxiety meds, I just need to toughen up and try harder. If moderation and self-discipline work for you, that's great. They demonstrably aren't working for millions of people. If medicine can help fix this, there's no reason it shouldn't.
- mellosouls 4y ago
  Psychological issues [...] may undermine those I explicitly mentioned that and am very aware of it as an issue; I am criticising the idea of surgical approaches being "medical breakthroughs", not psychiatric/psychological treatments, including medicine. I should have distinguished that in my comment for clarity.
  - rsr 4y ago
    If a surgery were developed that reversed the effects of alcoholism and dramatically reduced a person's desire to consume alcohol, wouldn't we still consider that a medical breakthrough?
    - mellosouls 4y ago
      I think so, but I suspect it would be neuro or related surgery and, regardless, we need to distinguish between severe "last resort" cases in extreme contexts (which obviously exist in alcohol, eating and other disorders), and more generally aimed surgical "quick fixes" as in the article that are a) not needed and b) detrimental to the individual and society as they undermine those long term solutions, disciple and moderation as discussed.
andrewla 4y ago
Okay -- what is your idea for how to get people to practice moderation and self-discipline? I don't think anyone would disagree that these would be effective if they were accessible, but practically speaking, telling people that they need to do this doesn't work as a medical intervention. And I would be surprised if there were obese people that were not aware of this already. The solution is "simple but not easy" and so is ineffective for the vast majority of obese individuals. In the meantime, the article talks about concrete progress being made to reduce obesity along with it's associated health problems. It's all well and good to say that "it's your fault for being weak and undisciplined" but saying "and therefore you deserve to die" seems a bit extreme.
- mellosouls 4y ago
  saying "and therefore you deserve to die" seems a bit extreme I'm pretty sure you are misquoting me in the last sentence. :) Yes, psychological help including medication should be available and may well be necessary in many cases, but surgical procedures cannot be considered breakthroughs, as it implies positive progress on defeating an issue caused by mental/character/beahavioural weaknesses in the individual or their parents. what is your idea for how to get people to practice moderation and self-discipline For a start, making it clear to them that it is down to moderation and self-discipline in the matter of diet and exercise, and not mollycoddling, "fat-positivity" and made-up physiological excuses. Basically, tell the truth and don't lie. And I would be surprised if there were obese people that were not aware of this already. I don't share your surprise, but might agree awareness and self-reflection are only the first steps to individual progress.
  - andrewla 4y ago
    I acknowledge my hyperbole. My point is just that while you try to convince a patient that they need to improve their willpower, they are suffering from the effects of obesity, which has innumerable other comorbidities. Every day that they spend obese is courting health problems related to obesity. > I don't share your surprise, but might agree awareness is only the first step to individual progress. I think I can say with near certainty that awareness is in fact only the first step. The question is what the next steps are. Saying "psychological help" is a dodge -- what specific psychological methodologies have been proven to work in this regard (I'll give a hint here, none of them). So what comes next? If you lecture them about willpower and stop the mollycoddling (which I assure you, no mainstream medical professional has anything but the harshest things to say about diet or fat positivity), and you give them an exam that proves that they understand what it comes down to, but they keep the weight or gain more weight, then what? Lock 'em up? Put them in a more advanced class to teach them? > surgical procedures cannot be considered breakthroughs Sure they can be. We have to be very very very cautious about surgical approaches, because our understanding of human physiology is far from perfect, and there might be long-term problems, etc. But if we make a better, less impactful procedure with fewer side effects, then surely that can count as a breakthrough. The transformation from open surgery for gastric bypass to laproscopic procedures (lap bands and later sleeve gastroplasties) was huge because it greatly reduced complications, and the move to endoscopic procedures (which are non-surgical) has dropped the risk of surgical complications to close to zero. Similarly the progress on GLP-1 agonists have shown some impressive improvements over previous generations of drugs (like fen-phen) that were actively dangerous. Pursuing healthy weight change or trying to address the food chain issues or other problems may present better long-term alternatives to having healthier weight, but in the meantime, these procedures/drugs can significantly reduce the health risks that come organically from excess weight.
deleted 4y ago
[deleted]

PhasmaFelis 4y ago

This is the same vibe as people telling me I don't need ADD/anxiety meds, I just need to toughen up and try harder. If moderation and self-discipline work for you, that's great. They demonstrably aren't working for millions of people. If medicine can help fix this, there's no reason it shouldn't.

mellosouls 4y ago
Psychological issues [...] may undermine those I explicitly mentioned that and am very aware of it as an issue; I am criticising the idea of surgical approaches being "medical breakthroughs", not psychiatric/psychological treatments, including medicine. I should have distinguished that in my comment for clarity.
- rsr 4y ago
  If a surgery were developed that reversed the effects of alcoholism and dramatically reduced a person's desire to consume alcohol, wouldn't we still consider that a medical breakthrough?
  - mellosouls 4y ago
    I think so, but I suspect it would be neuro or related surgery and, regardless, we need to distinguish between severe "last resort" cases in extreme contexts (which obviously exist in alcohol, eating and other disorders), and more generally aimed surgical "quick fixes" as in the article that are a) not needed and b) detrimental to the individual and society as they undermine those long term solutions, disciple and moderation as discussed.

andrewla 4y ago

Okay -- what is your idea for how to get people to practice moderation and self-discipline? I don't think anyone would disagree that these would be effective if they were accessible, but practically speaking, telling people that they need to do this doesn't work as a medical intervention. And I would be surprised if there were obese people that were not aware of this already. The solution is "simple but not easy" and so is ineffective for the vast majority of obese individuals. In the meantime, the article talks about concrete progress being made to reduce obesity along with it's associated health problems. It's all well and good to say that "it's your fault for being weak and undisciplined" but saying "and therefore you deserve to die" seems a bit extreme.

mellosouls 4y ago
saying "and therefore you deserve to die" seems a bit extreme I'm pretty sure you are misquoting me in the last sentence. :) Yes, psychological help including medication should be available and may well be necessary in many cases, but surgical procedures cannot be considered breakthroughs, as it implies positive progress on defeating an issue caused by mental/character/beahavioural weaknesses in the individual or their parents. what is your idea for how to get people to practice moderation and self-discipline For a start, making it clear to them that it is down to moderation and self-discipline in the matter of diet and exercise, and not mollycoddling, "fat-positivity" and made-up physiological excuses. Basically, tell the truth and don't lie. And I would be surprised if there were obese people that were not aware of this already. I don't share your surprise, but might agree awareness and self-reflection are only the first steps to individual progress.
- andrewla 4y ago
  I acknowledge my hyperbole. My point is just that while you try to convince a patient that they need to improve their willpower, they are suffering from the effects of obesity, which has innumerable other comorbidities. Every day that they spend obese is courting health problems related to obesity. > I don't share your surprise, but might agree awareness is only the first step to individual progress. I think I can say with near certainty that awareness is in fact only the first step. The question is what the next steps are. Saying "psychological help" is a dodge -- what specific psychological methodologies have been proven to work in this regard (I'll give a hint here, none of them). So what comes next? If you lecture them about willpower and stop the mollycoddling (which I assure you, no mainstream medical professional has anything but the harshest things to say about diet or fat positivity), and you give them an exam that proves that they understand what it comes down to, but they keep the weight or gain more weight, then what? Lock 'em up? Put them in a more advanced class to teach them? > surgical procedures cannot be considered breakthroughs Sure they can be. We have to be very very very cautious about surgical approaches, because our understanding of human physiology is far from perfect, and there might be long-term problems, etc. But if we make a better, less impactful procedure with fewer side effects, then surely that can count as a breakthrough. The transformation from open surgery for gastric bypass to laproscopic procedures (lap bands and later sleeve gastroplasties) was huge because it greatly reduced complications, and the move to endoscopic procedures (which are non-surgical) has dropped the risk of surgical complications to close to zero. Similarly the progress on GLP-1 agonists have shown some impressive improvements over previous generations of drugs (like fen-phen) that were actively dangerous. Pursuing healthy weight change or trying to address the food chain issues or other problems may present better long-term alternatives to having healthier weight, but in the meantime, these procedures/drugs can significantly reduce the health risks that come organically from excess weight.

deleted 4y ago

[deleted]