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Jesus christ, why is nature quoting a psychologist in an article about biology? > However, some researchers worry that these drugs play into some societies’ ob

• ethanbond 4y ago
  Because this isn't an article about biology, it's about health, and health isn't unidimensional
  • boxed 4y ago
    [flagged]
  • jobs_throwaway 4y ago
    Helping obese people lose weight is unidimensionally a good thing
    • ceejayoz 4y ago
      Very little in health is unidimensional. Suppose, for example, the presence of an effective weight loss treatment caused an increase in suicide rate in those who fail to benefit from the drug or can't access it for some reason?
      • starkd 4y ago
        That's an important consequence to consider. One that often gets omitted. Many drugs - like blood pressure drugs - often have depression as a side effect but it gets overlooked.
        • spoiler 4y ago
          My mother recently started taking these, and she doesn't have a very great mental health history to begin with. Do you have more information on this, and/or if this can somehow be mitigated?
          • ceejayoz 4y ago
            She really should discuss with her doctor, if possible. They can absolutely mess with mood, but in both directions. https://www.health.harvard.edu/mind-and-mood/blood-pressure-medications-may-affect-your-mood https://www.health.harvard.edu/mind-and-mood/blood-pressure-...
            • starkd 4y ago
              yes. discuss with doctor. But, surprisingly, many doctors don't even address the issue. They just dispense the pills. Patients need to press the issue.
              • spoiler 4y ago
                Ah yes, I wanted to arm her with some information (and I value a HN reference above a _more random_ internet source) about it so she can see with her doctor. Doctors in Croatia tend to be very flippant with medications. This goes as far as pharmacies having to sometime refuse giving medications due to known adverse interactions (sometimes dangerous even). Apparently their software should warn them of this the same way pharmacies get alerted of it, but I guess they dont care?
                • starkd 4y ago
                  I think they care. But moderate level depression is not even considered an interaction, so often it gets dismissed as an annoying side effect you just need to learn to live with. Often the patient themselves doesn't even recognize it as a consequence of the drug, it just becomes their reality.
          • 4y ago
    • ethanbond 4y ago
      That'd imply it's okay to put obese folks in cages without food until they've lost weight and I'd suggest that that's fucking insane. We've discovered another dimension!
      • vadansky 4y ago
        That'd imply it's okay to put smokers in cages without cigarettes until they've stopped smoking and I'd suggest that that's fucking insane. We've discovered another dimension!
        • jdminhbg 4y ago
          Are you saying that it wouldn't be insane to jail smokers to get them to quit?
      • bdavis__ 4y ago
        There are no fat POW's.
    • the_only_law 4y ago
      Let’s give them all meth. That should help with weight loss.
      • TylerE 4y ago
        [flagged]
        • the_only_law 4y ago
          Ok and what does that have to do with the topic at hand? Or do you just like adding non-sequiturs?
          • TylerE 4y ago
            We pretty much are giving pharmaceutical grade meth out
            • hirvi74 4y ago
              Dosage, not the substance, makes poison. Do you refuse any and all pharmaceuticals, or are such substances only okay when you take them?
            • _dain_ 4y ago
              Adderall is amphetamine, not methamphetamine. Methamphetamine is occasionally prescribed when front-line treatments fail. In any case, the dosage is far below what is used recreationally. ADHD patients rarely get addicted to medically-prescribed amphetamine, especially when it's the slow-release preparation.
        • lghh 4y ago
          Please stop stigmatizing adderall usage. Especially as a platitude. The stigma often prevents people who have ADHD from seeking things that alleviate it.
          • showdeddd 4y ago
    • gadders 4y ago
      Life is like a box of chocolates. It doesn't last as long if you're fat. --Joe Lycett (British Comedian)
    • derefr 4y ago
      The point of the quoted sentence from the psychologist was that people who aren't obese, but who are "large" ("Big and Tall", in the clothing phrasing) and who have body-dysmorphic disorder, might pursue this drug, and, due to being "large", get it prescribed — and that that's a bad thing, because they'd end up with an unhealthily-low BMI.
      • balfirevic 4y ago
        > people who aren't obese, but who are "large" ("Big and Tall", in the clothing phrasing) What's the difference, just the degree of being overweight? And the height of course, but drugs won't make anyone shorter.
        • derefr 4y ago
          The taller you are, the larger your build can be + more mass you can carry while still having a very low body fat percentage. This is why BMI is normalized by height. Someone who weighs 150lbs — but who is 6'8" — is actually underweight. To be that weight at that height, they'd have to have so little fat and muscle that they'd be positively scrawny-looking, and would be experiencing many of the same problems (e.g. always being cold, muscle spasms, brain fog, paresthesia from demyelination of nerves) that someone who is 5'8" and 90lbs does. Someone who weighs 200lbs at 6'8" looks, and is, healthy; just like someone who weighs 140lbs at 5'8".
          • balfirevic 4y ago
            Yeah, sure, I didn't get that you were talking about tall people with normal BMI.
    • abeppu 4y ago
      The article specifically points out that the link between weight and health on its own is in question: > Some researchers also worry that by offering a weight solution in societies that prize thinness, these drugs could also inadvertently reinforce the disputed link between excess weight and health. One study found that nearly 30% of people who are considered obese are metabolically healthy. The abstract from that article also points out that a significant share of non-obese people are metabolically unhealthy: > Nearly half of overweight individuals, 29% of obese individuals and even 16% of obesity type 2/3 individuals were metabolically healthy. Moreover, over 30% of normal weight individuals were cardiometabolically unhealthy. Further, the way that study measures (cardio)-metabolic health is itself multi-dimensional: > Using the blood pressure, triglyceride, cholesterol, glucose, insulin resistance and C-reactive protein data, population frequencies/percentages of metabolically healthy versus unhealthy individuals were stratified by BMI. https://www.nature.com/articles/ijo201617 https://www.nature.com/articles/ijo201617 I think we may need to admit that weight is a low cost and highly visible variable which is a poor proxy for actual health and as in business, optimizing for the wrong metric will eventually lead to dysfunction.
      • hombre_fatal 4y ago
        Maybe that paper just shows that BMI isn’t the best metric. For example, would the results look different if the participants were stratified by bodyfat%?
        • abeppu 4y ago
          An earlier study looked at BF% vs BMI-based obesity definitions, when you adjust for fitness (as measured with a treadmill test). They compare the all-cause-mortality risk for normal weight + metabolically healthy vs obese (for each definition) metabolically healthy. When adjusting for fitness, the risks / hazard ratios are not significantly different. I.e. if you do someone's bloodwork and a treadmill test, and they look metabolically normal, knowing whether their BF% is high (or if their BMI is high) doesn't seem to tell you more about whether they're going to die. If they're fat but fit, trying to lower their BMI or BF% doesn't seem to be about making them healthier. If we're talking about interventions which might involve putting someone on medication with side effects for the rest of their lives, just do the extra tests! There's no reason to reduce the decision input variables to just "are they obese?" when better indicators are known. https://pubmed.ncbi.nlm.nih.gov/22947612/ https://pubmed.ncbi.nlm.nih.gov/22947612/
    • fnordpiglet 4y ago
      Obese doesn’t mean unhealthy. Correlation isn’t causation. There are many obese people who are extremely healthy. I for one have had no health issues of any sort, have great blood panels, and am in decent physical condition but sit stubbornly at a 31BMI. The only “issue” I face is psychological, and it’s rooted in precisely this statement you made.
      • jobs_throwaway 4y ago
        > There are many obese people who are extremely healthy I don't believe that's true. There are some cases (like powerlifters) who can be at an obese BMI but still have strong cardiovascular fitness, but unless you are in that narrow category, if you are obese you do not have strong aerobic fitness. 'Decent physical condition' alone belies that you are not 'extremely' healthy. Decently healthy maybe, but certainly not extremely. Even if you are still metabolically healthy, you are at increased risk for adverse long-term outcomes (source: https://pubmed.ncbi.nlm.nih.gov/24297192/ https://pubmed.ncbi.nlm.nih.gov/24297192/). That is more than just a psychological issue, no matter how much you try to handwave it away.
        • fnordpiglet 4y ago
          Your belief in a fact is unnecessary. The issue with these studies is they don’t control for lifestyle and diet. The notion that you can not be fat while eating a high quality low calorie diet and exercising is simply false. A valuable study in this space would be measuring the impact of diet and exercise on health outcomes while holding BMI constant, then comparing across stripes. In studies where diet and lifestyle are controlled for, metabolically health overweight are not at greater risk. The issue is we are pointing to fatness and not diet and exercise. It’s causing people to seek ways to get thin assuming it’ll help. But some people are thin no matter what they do, some are fat. However there’s a correlation between poor lifestyle choices and being fat and good life style choices and being thin. This skews uncontrolled studies towards fat is bad even with good metabolic health, because having a good metabolic health but maintaining it with poor inputs will have a long term bad outcome. In one of the reference below, the conclusion is: (i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype. (ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals. https://academic.oup.com/jcem/article/97/7/2482/2834446?login=false https://academic.oup.com/jcem/article/97/7/2482/2834446?logi... https://academic.oup.com/jcem/article/97/7/2482/2834446?login=false https://academic.oup.com/jcem/article/97/7/2482/2834446?logi... https://diabetesjournals.org/care/article/28/2/391/24045/Metabolic-Syndrome-Obesity-and-MortalityImpact-of https://diabetesjournals.org/care/article/28/2/391/24045/Met...
    • watwut 4y ago
      Strongly depends on how much they weight in the end and what is the price of weight loss. Loosing too much weight makes you less healthy, sometimes very damagingly so. It also depends on what is the price of that weight loss. Quite a few diets make you loose weight and simultaneously make you much less healthy or less fit - because your body is missing nutricients it actually needs.
  • __blockcipher__ 4y ago
    The correct answer is because it's become very taboo, particularly in academic circles, to make any statement that implies that it's not good to be fat. So articles like these always must include at least one generic quote about how being thin is not an end in itself.
• carrotcarrot 4y ago
  A professor I follow once said Nature isn't as prestigious as people think, they just publish such a high volume that people have gotten that impression
  • xkbarkar 4y ago
    I subscribed to Nature for a couple of years and although I am not a proper academic and maybe not the best judge, the articles in Nature sometime looks like they belong on vox.com or wired and not in a scientific paper. As in opinions presented as evidence, from an almost random person, without actually providing any. Especially around social subjects like the BLM protests. One thing I loved about 60 minutes back in the day, was their ability to present a story from multiple points of views. When I started reading Nature at my former employers, many many years ago, I felt their articles were like that. At some point it started to look like cherrypicking a single viewpoint, often with obvious political taint. Maybe it was always like that and I just used to idolize it. I still very much love the magazine though but stopped subscribing. Its really expensive. When I get my hands on a copy these days I just filter what I perceive as woke crap from the rest and skip those articles. I wonder if that is such a good thing… Edit: typo and context
• carapace 4y ago
  Psychology is an epiphenomenon of biology.
• gumby 4y ago
  My comment on another thread (https://news.ycombinator.com/item?id=34251033 https://news.ycombinator.com/item?id=34251033) addresses this. Psychological issues are real health issues.
  • tgv 4y ago
    Yes, but this researcher's field is body image and weight stigma, not mental health issues. In the paper that appears first if you google-scholar her name, she writes in the first sentence of the abstract "Weight bias [or the stigma towards and negative stereotypes about individuals who have large bodies] is a form of stigma with detrimental effects on the health and wellness of individuals with large bodies." So making people thinner will actually improve their health and wellness. If she's worried about other negative outcomes, such as people not being able to afford the drug, she should say so. It might be an editorial fuck-up on Nature's side, of course: they just want to print some soothing words to demonstrate their neutrality.
• asdff 4y ago
  Its an article about weight loss and that plays into body image which is a huge mental health issue. People purging themselves need a psychologist, not a biologist, and I'm sure a number of people affected with bulimia will be buying this drug.