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Can someone help me understand what the science says about obesity, because it seems to change daily. We're being told that people are healthy at any size. So

Can someone help me understand what the science says about obesity, because it seems to change daily. We're being told that people are healthy at any size. So why sell people Ozempic? How is it okay to encourage weight loss with an expensive and possibly (likely) harmful drug, but not okay to encourage weight loss with a sensible diet? Is being overweight a bad or a good thing? Despite all of the research, that part is unclear.

sexy_seedbox 3y ago
> We're being told that people are healthy at any size Who told you this? Where are you getting your news from?
- tonymet 3y ago
  this is disingenuous. There's plenty of examples of this messaging in evening news, commercials, "body positivity", social media campaigns. If you're not noticing this messaging, I would ask where you are getting your news from.
flgb 3y ago
Being overweight is unequivocally a bad thing. https://www.nature.com/articles/s41366-022-01165-5 https://www.nature.com/articles/s41366-022-01165-5
SamoyedFurFluff 3y ago
As far as I know, healthy at every size was originally a motivating saying to encourage fat people to still eat healthy and exercise, even if they don’t actually lose weight. This on its face makes a ton of sense, otherwise a fat person can just give up entirely which is obviously bad.
alphazard 3y ago
Healthy is a nebulous term, but most of the goals humans have e.g living long enough to meet your grandkids, or perform cognitively well enough to earn a living, implicitly include the instrumental goals of staying lean, and using your muscles regularly and vigorously. This is uncontroversial among scientists, and only called into question in the media. No one is quite sure why obesity has become such a problem, but I'll give you several hypotheses all with reasonable mechanisms, and each with at least some data for you to argue about. All of these things have changed in the last 100 years. - Base metabolic rates have declined. We burn fewer calories doing nothing. Body temperatures are lower. No one is sure of the cause, it might be downstream from one of these other ones. - We are more sedentary. - Antibiotics have caused extinction of gut microbes, which were previously endemic, and passed through the maternal line. - We take seeds, heat them up to extract oil, and put that oil in pretty much everything. This has significantly shifted the kind of fat in the food supply.
tjohns 3y ago
> We're being told that people are healthy at any size. Literally nobody in the medical community is saying this. Obesity is unequivocally bad for your longevity. There is a healthy range, which is a little fuzzy. Some people are healthy at a slightly heavier build, and we know there's some flaws in the way the BMI calculation works for certain groups of individuals. However, there is still always a point where you are medically obese and health problems begin. It absolutely kills people. Heart disease, stroke, diabetes. There's some studies that suggest it might even be a causal factor for Alzheimers. > How is it okay to encourage weight loss with an expensive and possibly (likely) harmful drug, but not okay to encourage weight loss with a sensible diet? First, weight loss through diet and exercise is certainly encouraged. The exercise is intrinsically good for you. Improving your diet is intrinsically good for you. The weight loss adds even more benefits on top of that. If this works for someone, that's literally perfect. However, diet and exercise clearly do not work for many people. Lifestyle modification is hard, for a whole lot of reasons... some social, some biological. We know this as fact. If diet and exercise fail, then using drugs to combat the biological (hormonal) drivers of obesity is the current second-line option. And even if there's some side effects, the overall increase in life expectancy makes it worth it. > Is being overweight a bad or a good thing? Despite all of the research, that part is unclear. Medically, it's very bad. The research is very clear. Now, that said, if somebody's overweight they should still feel good about themselves as a person. Shifting the conversation from "you're overweight because you're not good enough, and you should feel bad about yourself" (which is both bad for mental health and counterproductive) to "you're overweight because obesity is a disease, not a personal failing - and the fitness+medical community is here to help you be a better you" is a much better approach.
- tonymet 3y ago
  > Literally nobody in the medical community is saying this. This is disingenuous . Healthy at any size and body positivity are both significant movements with noticeable media campaigns on commercials, TV news, social media. Dismissing the confusing messaging is only adding to the confusion. American's don't absorb messaging through scientific journals, their beliefs are first distilled through the above media channels. Plus there are plenty of bogus journals pushing "healthy at any size" and "body positivity" Is being fat good or bad? If it's bad enough to take a drug, then we should also encourage other ways to discourage it. Just because people don't diet, doesn't mean it's hard to do. People do a lot of unhealthy things where choosing the better alternative is just as easy.
belltaco 3y ago
Found the bully the article was talking about here: > an adolescent who has been mercilessly bullied for her weight arrives in an emergency department with suicidal thoughts
loeg 3y ago
Exercise improves health outcomes even more than going from obese to non-obese, so we want to encourage even fat people to exercise. But it is also good to not be obese.
- tonymet 3y ago
  I personally agree with you, but why is the messaging ( media, commercials, social media) so inconsistent about this?

sexy_seedbox 3y ago

> We're being told that people are healthy at any size Who told you this? Where are you getting your news from?

tonymet 3y ago
this is disingenuous. There's plenty of examples of this messaging in evening news, commercials, "body positivity", social media campaigns. If you're not noticing this messaging, I would ask where you are getting your news from.

flgb 3y ago

Being overweight is unequivocally a bad thing. https://www.nature.com/articles/s41366-022-01165-5 https://www.nature.com/articles/s41366-022-01165-5

SamoyedFurFluff 3y ago

As far as I know, healthy at every size was originally a motivating saying to encourage fat people to still eat healthy and exercise, even if they don’t actually lose weight. This on its face makes a ton of sense, otherwise a fat person can just give up entirely which is obviously bad.

alphazard 3y ago

Healthy is a nebulous term, but most of the goals humans have e.g living long enough to meet your grandkids, or perform cognitively well enough to earn a living, implicitly include the instrumental goals of staying lean, and using your muscles regularly and vigorously. This is uncontroversial among scientists, and only called into question in the media. No one is quite sure why obesity has become such a problem, but I'll give you several hypotheses all with reasonable mechanisms, and each with at least some data for you to argue about. All of these things have changed in the last 100 years. - Base metabolic rates have declined. We burn fewer calories doing nothing. Body temperatures are lower. No one is sure of the cause, it might be downstream from one of these other ones. - We are more sedentary. - Antibiotics have caused extinction of gut microbes, which were previously endemic, and passed through the maternal line. - We take seeds, heat them up to extract oil, and put that oil in pretty much everything. This has significantly shifted the kind of fat in the food supply.

tjohns 3y ago

> We're being told that people are healthy at any size. Literally nobody in the medical community is saying this. Obesity is unequivocally bad for your longevity. There is a healthy range, which is a little fuzzy. Some people are healthy at a slightly heavier build, and we know there's some flaws in the way the BMI calculation works for certain groups of individuals. However, there is still always a point where you are medically obese and health problems begin. It absolutely kills people. Heart disease, stroke, diabetes. There's some studies that suggest it might even be a causal factor for Alzheimers. > How is it okay to encourage weight loss with an expensive and possibly (likely) harmful drug, but not okay to encourage weight loss with a sensible diet? First, weight loss through diet and exercise is certainly encouraged. The exercise is intrinsically good for you. Improving your diet is intrinsically good for you. The weight loss adds even more benefits on top of that. If this works for someone, that's literally perfect. However, diet and exercise clearly do not work for many people. Lifestyle modification is hard, for a whole lot of reasons... some social, some biological. We know this as fact. If diet and exercise fail, then using drugs to combat the biological (hormonal) drivers of obesity is the current second-line option. And even if there's some side effects, the overall increase in life expectancy makes it worth it. > Is being overweight a bad or a good thing? Despite all of the research, that part is unclear. Medically, it's very bad. The research is very clear. Now, that said, if somebody's overweight they should still feel good about themselves as a person. Shifting the conversation from "you're overweight because you're not good enough, and you should feel bad about yourself" (which is both bad for mental health and counterproductive) to "you're overweight because obesity is a disease, not a personal failing - and the fitness+medical community is here to help you be a better you" is a much better approach.

tonymet 3y ago
> Literally nobody in the medical community is saying this. This is disingenuous . Healthy at any size and body positivity are both significant movements with noticeable media campaigns on commercials, TV news, social media. Dismissing the confusing messaging is only adding to the confusion. American's don't absorb messaging through scientific journals, their beliefs are first distilled through the above media channels. Plus there are plenty of bogus journals pushing "healthy at any size" and "body positivity" Is being fat good or bad? If it's bad enough to take a drug, then we should also encourage other ways to discourage it. Just because people don't diet, doesn't mean it's hard to do. People do a lot of unhealthy things where choosing the better alternative is just as easy.

belltaco 3y ago

Found the bully the article was talking about here: > an adolescent who has been mercilessly bullied for her weight arrives in an emergency department with suicidal thoughts

loeg 3y ago

Exercise improves health outcomes even more than going from obese to non-obese, so we want to encourage even fat people to exercise. But it is also good to not be obese.

tonymet 3y ago
I personally agree with you, but why is the messaging ( media, commercials, social media) so inconsistent about this?