The human race faces many dire threats. War, famine, disease, terrorism, giant asteroids, Donald Trump. But the ever-alert readers of the Men Going Their Own Way subreddit know that all these threats pale in comparison to the greatest threat of all. I am speaking, of course, of fat chicks.
In a post with the thoughtful title “Dear obese women I f*king hate you,” a Reddit MGTOW calling himself iamlikethewindbaby outlines his case against these horrible monsters. Speaking fluent SARCASM, he addresses fat chicks directly.
“Thanks for turning average chicks into supermodels and ugly chicks into average chicks,” he declares.
Thanks for filling up my newsfeed with memes about how beautiful fat chicks are. Do you even know how attractiveness is determined? The more healthy and fertile a woman is the more attractive she is. Being obese makes you unattractive, period. F*ck you.
Er, I’m pretty sure attractiveness is determined by whatever the hell people happen to think is attractive. Some people find skinny people attractive; some find fat people attractive; some people don’t pay much attention to weight. There are even a few perverse souls who find Donald Trump attractive, if you can believe that.
Thanks for making a generation of men feel bad about themselves because a fat chick is the best they can do, it’s not their fault 70% of you are overweight.
That’s actually not quite right. According to the most recent National Health and Nutrition Examination Survey conducted by the Centers for Disease Control, the percentage of American women classified as overweight or obese isn’t 70%; it’s 64%. The percentage of men classified as overweight or obese? 74%.
That’s right, fellas; there are more fat dudes than fat chicks in the US.
The percentage of American adults classified as obese? 36% — exactly the same for men and women.
Now, there may be legitimate reasons to wonder if these categories really make sense as they’re currently defined. But one thing is clear: for every fat chick out there fat chick-ing, there’s a fat dude to match.
Thanks for being 400lbs and yet somehow still unable to cook. That’s great. It’s a good thing we did away with those sexist home economics classes.
Dudes, given that you’re all devoted to GOING YOUR OWN WAY and all, shouldn’t you be learning how to cook your own damn dinner?
Thanks for being so fat that being 20lbs overweight isn’t even considered fat anymore. Nothing is sexier than a 5’3 150lb women.
According to some number I found on the internet, the 5’5″ tall Marilyn Monroe saw her weight fluctuate from 115-150 lbs at various points in her adult life. I don’t know why we know this, or if we should, but apparently we do. Here’s a picture of her at one of her more voluptuous moments, in Some Like it Hot.
What a hideous monster!
Thanks for having personalities that match your appearance. It’s important for people’s insides to match their outsides.
Based on iamlikethewindbaby’s personality, I can only assume he looks something like this:
I can’t wait until all your cold-giant-black-hearts explode.
What a lovely fellow.
Iamlikethewindbaby also blames obese women for rising insurance premiums, and snickers a little at the thought of obese women dying before retirement.
It’s true that obesity can increase health care costs and lower life expectancy. But you know what else increases health care costs and lowers life expectancy? Being an angry dickhead.
“There is a direct connection between being constantly angry, competitive, and aggressive, and early heart disease,” notes an article on the “health costs of anger” on mentalhelp.net.
[R]ecent research suggests that men who have poor anger management skills are more likely to suffer a heart attack before age 55 than their more emotionally controlled peers. A separate study indicated that older male subject’s hostility ratings (how hostile and irritable they tend to act towards others) predicted heart disease more accurately than other known risk factors including cholesterol, alcohol intake, cigarette smoking and being overweight. …
The evidence from numerous studies is clear: constant chronic anger, hostility, and aggression raise your risk of developing various deadly forms of heart disease by as much as five times the normal rate. The more hostility you tend to express, the more prone to heart disease you are likely to be.
And the lovely iamlikethewindbaby is hardly the only Reddit MGTOW who fits the angry dickhead profile, as a quick skim through the comments on his post reveals.
Indeed, the lovely fellow who calls himself lordjedi may have cut several weeks off his life expectancy with all the anger in this comment alone:
Not that I haven’t tried a couple times, but my policy for many years has been my bedroom is off limits to fats.
I’m sure the “fats” of the world feel just awful they don’t get to partake of lordjedi’s charms. He continues:
That means no easy money for fatties either. Get a f*cking job, Porkins, if you want to sleep indoors. Every dollar you spend in your short worthless life will be earned by you with your fine arts/wymyn’s studies degree and your $90K student loan debt, while stocking shelves on the 3 AM Walmart shift. Enjoy your Cool Ranch Doritos. Why don’t you f*cking marry them if you love them so much?
If you love your hatred so much, lordjedi, why don’t you marry it? Oh, wait, I guess you have.
MTGOStark, who has clearly never spoken to a woman in the real world, offers this thought.
If being not obese is literally the only thing they have to do in their life to succeed, and they still fail at it (and complain on top), it’s just truly pitiful.
Aanarchist apparently spends much of his Going His Own Way time scanning through profiles on online dating sites.
i see those online profiles where the woman is like 50 lbs overweight and she puts down average. a few extra pounds means 100 lbs overweight. big and beautiful means THAR SHE BLOWS. the funny thing is they want you to ignore their weight, like it has nothing to do with who she is. it’s like she wants you to watch her eat an entire f*cking cake with her bare hands, and treat her as if she’s eating salad and a water.
Huh. That actually sounds like a fun date. Who doesn’t like cake?
Hey Joekster!
Hmmm, I really don’t feel like you’ve answered any of my questions, so maybe I can rephrase them.
1. How many people have you seen keep the weight off 5+ years? I don’t expect an exact number, but would you say it’s more than 5%?
The only studies I’ve seen re. bariatric surgery and long term weight loss stopped following people at the 2 year mark and the success was *still* only 10% for a relatively small amount of weight loss.
2. You never gave your thoughts on the people who gain the weight back, and are much worse off than before. If the studies are to be believed, that’s most people.
3. Why would you prescribe weight loss, which is unattainable for most people, for joint pain, instead of strengthening exercises? What would you prescribe for a thin person?
4. When you prescribe weight loss, how do you feel, knowing that the treatment you’ve prescribed is most likely to leave them in worse health than before you saw them?
@Everyone – Thanks yous guys. I’ve just been reducing the nic in my vaping until I hit .5mg/ml, and then 0. Nic is the thing that keeps my anxiety in check so I’m a little all over the place, but otherwise it’s been fairly easy.
@Sarity: My favorite detail on the Venus of Dolní Věstonice (second from right in the last row of images in your post) is the little lines indicating soft rolls of flesh on her back.
http://www.ancient-wisdom.com/Images/countries/Czech%20pics/venus.jpg
Pffft. As if they could. Crème brulée is an absolute good.
http://66.media.tumblr.com/tumblr_m4y7kjOcia1rvhjgto2_500.gif
@Crys T:
While your points about difficulty of losing weight are taken, you left what appears to be an important phrase out of joekster’s original comment:
Given that it was noted previously that certain knee and ankle problems are among the few things that can be reasonably certainly linked to weight, I would think that advising people with those joint problems to try losing weight is nowhere near as bad as the general doctor-induced fat-shaming that you’ve been talking about. Though I should hope that his advice includes referrals to actual doctors who focus on nutrition rather than just throwing them to the likes of Jenny Craig.
I fully agree with you about the paleo diet, however.
@ Sarity:
I have had a taste of that…mostly from people who don’t know what I look like assume that I’m fat just because I insist that fat people are NOT pathetic leeches. I’m not a toothpick but definitely not fat either.
Another dismissal I got was when some guy said “Don’t blame the holidays when you were fat in July”…I called him out and he said “Oh no, I’m not talking about you. *You* look great. I’m talking about the people with all the rolls of fat”
iamlikethewindbaby:
Well, he got me there. I’m 5’4 and fluctuate at the 150 lb level. There is nothing unhealthy about that. It’s great that women are becoming more comfortable with our bodies regardless of silly men like iamlikethewindbaby.
@Scildfreja
*cough* aHem, I’ll just be over….here…cleaning things up. *wink*
Kinda reminds me of the time I asked the mister to explain “heavy water”.
@Jenora Feuer, I think the problem is Joekster prescribing something impossible for most people and then patting himself on the back for doin’ some good doctorin’
I mean, I could reduce my risk of diabetes and high blood pressure by not being black, but I would be pretty pissed if a doctor asked me if I just tried not being black.
@kupo, I’m so sorry. I was nervous about commenting and read it completely wrong. Thank you.
@Dash
I know that feel. Even in feminist spaces, any hint of “hey, fat isn’t necessarily so bad” is viciously attacked by people concerned* about health**.
*disgusted by
**fat
@cleverforagirl:
Which is why I added my hope that the advice was followed up by actual references to somebody who might be able to help, rather than just dropped into their laps. Just saying ‘you should lose some weight’ is obviously unhelpful by itself.
Maybe I shouldn’t have bothered sticking my nose into this. I just thought that the fact he had mentioned this specifically in the case of joint problems shouldn’t have been elided, because that’s one of the rare cases where it could actually make a difference.
@Jenora, I do get what you’re saying, but we come back to the point that there is really no proven way for people to permanently lose weight. As has been pointed out above, the only people who seem to be able to do so in any numbers are those people who only have a little bit extra to lose. And they are probably not the ones whose joints are going to to suffer the most.
And for those with significant amounts of excess weight, it’s highly likely that weight-loss attempts will actually backfire, with them gaining back even more than they managed to lose, plus other negative effects to their health depending on what diet method they used.
It may be a fact that weighing less would be better for these people’s situation, but that’s a moot point as there’s no way to safely and permanently make that happen.
Given all that, how does it help to tell someone to lose weight? What does that accomplish? Is it worth pushing them into something that will most likely leave them worse off in the hopes that they may be a rare exception to the rule?
It sucks, but until we can get past looking at fat the way we do, we’re doomed to be stuck in a loop where the only actions anyone can suggest are useless, and the medical establishment isn’t interested looking for answers that might actually help.
Okay, taking a break from writing notes at the VA to review this thread and type out some responses. I would like to preface this by emphasizing, once again, that obesity and health is an extremely complex subject, and appears to be a quite sensitive one. I don’t think it has any right to be, and I think that the phenomenon David posted about of ‘fat shaming’ has made it a far more touchy subject than it should be.
Also, reviewing my post from last night, there is one thing I mentioned specifically that I wanted to highlight:
Where your particular body stores fat is, arguably, more important to your health than how much of it there is. Abdominal fat is more metabolically active and much easier to lose, while fat stored in the hips, legs, and chest is less active, and much harder to get rid of. The great irony here is that men tend to store fat in the abdomen, while women are much more likely to store it in the hips and thighs. So, the people ranting about ‘fat women’ are more likely to benefit from taking their own advice than the women they are shaming.
To the posts.
@Crys T:
Before I start, I would like to say that I am sorry about your father’s passing. It’s never easy to lose a parent, and no one should die from a hospital acquired infection. I was in a hurry this morning, and I neglected to say that, but it was insensitive to skip over that and neglect the fact that we were, after all, speaking of your own family.
Now, to the issues you raised:
‘You advise your patients to lose weight?’: Actually, I make a habit of never discussing weight on the first visit. From what I’ve seen, a blunt discussion about obesity with a total stranger is unlikely to be beneficial, and is quite likely to offend the patient so much that they disregard everything I have to say. I have the same practice with smoking cessation, alcoholism, tanning booths, and all the other ‘lifestyle’ issues that influence a person’s health. I don’t bring them up with the patient until they know me well enough to know that I am not judging them for any lifestyle choices they may or may not have made, and that usually doesn’t happen until the second or third visit.
When the patient is suffering from, specifically, osteoarthritis of the low back, hips, or knees, and is morbidly obese, I will ease into the subject of weight loss only after I’ve sent them to physical therapy for muscle strengthening exercises and worked with them a little bit on pain control. And I never just say ‘you need to lose weight’. In these cases, I take the time to chat with my patient and try to identify what, exactly, is stopping them from doing so. Of course, I’m a geriatrician, so I get half an hour for a follow-up visit instead of the standard 15 minute block. It helps.
‘I’d have thought it would be much more productive to teach them exercises that would help with their symptoms, and also improve their overall health’: As I said in the original post, I start with the strengthening exercises. The first step in management of OA is always going to be ‘send to PT for strengthening exercises’. The weight discussion comes later.
‘Also: paleo diet? FUCK OFF with that stupidity’: I agree with you. The weight loss doctor in question had a few notions that I find rather sketchy, including the paleo diet and phentermine. He did seem to get results, but it’s not something I do in my own practice. The diet I usually recommend is some version of the Dietary Approaches to Stop Hypertension (DASH) diet. It’s been around since the late 90’s, and is extremely well validated to help with HTN, as well as diabetes, CVD, and all the other systemic diseases I’m trying to treat or prevent. It doesn’t get a great deal of press, because it does not have dramatic effects on weight loss, but it is extremely healthy, and not at all difficult to work into your own life.
‘Yes, joekster, I knew you would try to turm it around to “but his faaaaaat.”’ Actually, it would be more accurate to say that I ‘tried to turn it around to “but his diabeeeeeeetttteeeess”’.
Obesity doesn’t make you more likely to die from random infections. Untreated diabetes does, and while obesity does play a significant role in type II diabetes specifically, there are a large number of obese people without diabetes, hypertension, or heart disease, and they have about the same ability to fight off random infections that the rest of us do. Just to be clear, from what you said above, it was an infection that killed your father (I may not have been clear about this, but I do agree that it’s a tragedy when anyone dies from an infection they catch in a hospital. Actually, it’s a tragedy when anyone dies, period, but especially when it’s because they came to the hospital for help). He may have died from it even if his diabetes were well controlled. Without knowing more about the infection, I cannot say, and ‘what if’ is a fools game anyhow. His odds of surviving, however, may have been greater if he were taking insulin. That’s all I was getting at.
‘You need to be aware of that tendency of doctors to take the position that fat people are liars’: Truth is, the majority of physicians assume all their patients are liars (to quote the medical drama ‘House, MD’, ‘everybody lies’). It’s not exactly limited to fat people, although I can understand it may seem that way sometimes. Personally, I think that position is a bit harsh. I take the position that we human beings (definitely including myself in that) are not wired to view ourselves objectively. I’m not even sure it’s at all possible to do so. Therefore, when discussing our own health, we’re all going to say some things that are not, precisely, true. Not because we’re deliberately lying, but because we just remember things differently.
@Kupo: based on the current state of medical knowledge, I’d have to conclude that the tincture is less dangerous than the NSAIDs. Keep in mind though, study of marijuana products is still somewhat in it’s infancy, so that may change as we discover more.
@Scildfreja: Thanks for the discussion on confounders. It always bothers me a little when I read a study, realize that there were significant differences between the test populations, then read ‘yeah, population A was about 5 years older than population B, but we adjusted for that’. The discussion on PSA helps with that, a little.
Also, thanks for the discussion on post-WWII food industry shenanigans. The only thing I have to add to that discussion is high fructose corn syrup. It’s highly addictive, it spikes your blood sugars more than actual, pure sugar does, and it’s injected into many foods that you wouldn’t even expect it to be in (like bread). If anyone here is struggling with diabetes, you could do a lot worse than to work to reduce the high fructose corn syrup in your diet, if you can. As DaliLama pointed out, that can be easier said than done, but that’s no reason not to try.
@cleverforagirl:
I’ll take your questions one at a time.
1: 1. How many people have you seen keep the weight off 5+ years? I don’t expect an exact number, but would you say it’s more than 5%?’ I’ve only been out of med school for four years, so I personally have seen no people keep the weight off for five years However, I have seen a number of people who weighed over 10% of their body weight more than they do now 5 years ago, and that’s not even counting my cancer patients. Also, there are a number of people in my clinic with ‘diet controlled diabetes’. That is, people diagnosed with diabetes, started on medications, lost weight (mostly as a normal part of their own aging process, true, but occasionally intentionally), then no longer need the medications. It does happen. As you pointed out, there are no good studies evaluating ANY weight loss technique beyond 2 years, but if anyone is interested, below there are two Cochrane reviews going over the evidence available as of 2014 regarding both bariatric surgery and non-surgical weight loss techniques.
http://www.cochrane.org/CD003641/ENDOC_surgery-for-obesity
behaviour-changes-for-dietary-and-physical-exercise-modification-in-overweight-and-obese-adults
2: ‘You never gave your thoughts on the people who gain the weight back, and are much worse off than before. If the studies are to be believed, that’s most people.’ Actually, I’d like to see your studies. I’ve seen a few patients who did ‘gain the weight back’, but I’ve also seen quite a few who managed to keep it off (as a personal aside, I have an aunt who is in the latter group).
As a rule, I don’t like bariatric surgery for two reasons. First, too many people treat it as a ‘quick fix’ without looking at whatever issues (genetic, metabolic, psychological) are actually underlying the weight. Second, it totally bypasses the exercise and dietary changes that I view as the source of the true benefits of weight loss. Do you have data supporting the notion that people who gain the weight back ‘are much worse off than before’? If you do, I’d love to see it. I can bring it up the next time a patient asks me to refer them to a bariatric surgeon.
3. ‘Why would you prescribe weight loss, which is unattainable for most people, for joint pain, instead of strengthening exercises? What would you prescribe for a thin person?’ See above. Also, the exact quote: ‘I actually do advise my obese patients with degenerative joint disease to lose weight. After I send them to physical therapy for strengthening exercises and after I start them on at least scheduled acetaminophen (titrating up as needed) to help with the pain’ You may have been mislead by the sentence break between ‘weight’ and ‘after’, which was a typo on my part.
4. ‘When you prescribe weight loss, how do you feel, knowing that the treatment you’ve prescribed is most likely to leave them in worse health than before you saw them?’ In my (admittedly limited) experience, it actually doesn’t, if approached correctly (again, I’d like to see any studies you have to the contrary). It is vitally important to approach all lifestyle modification issues in a way that does not give the impression that you are judging or condemning your patient for their decisions. The physicians job is not to pass judgement on their patient, but to give that patient the best advice you can. You are correct that pushing weight loss itself is often a losing battle, especially given today’s culture. What I’ve most often found is that if I push aerobic exercise and the DASH diet, many of my patients lose weight on their own. Without being given a goal. Without being told that any of their problems are caused by the weight until AFTER they start to lose weight and feel better. And if my patient does not make it down to their ‘ideal’ body weight by BMI? Who cares, as long as they feel better, their diabetes is controlled, and their blood pressure is good?
One point, please:
‘I think the problem is Joekster prescribing something impossible for most people and then patting himself on the back for doin’ some good doctorin’’ While getting down to the ‘ideal’ BMI may be impossible for many, increasing aerobic activity and significant diet modification are not. I appear to have mis-represented my own approach to what we call ‘therapeutic lifestyle change’, and I apologize for that.
To be absolutely, 100% clear: weight is a part of the puzzle of a patients overall health. It is only one piece, and in many cases (maybe even most) not the biggest one, but it does play a role, and should be addressed in the context of everything else that goes into that puzzle. Also, while random dudebro’s on the internet have no business talking to anyone about their weight, your personal physician does, if, in that physician’s judgement, your weight (over or under) is having an impact on any particular health issue you have. That is his or her job. A good physician will do so in the greater context of your overall health, and in a way that does not leave you feeling judged, while a bad physician will focus entirely on your weight at the very beginning and leave you thinking you’re a bad person for being obese. I feel terrible for all of you who have left your physician feeling judged for something you cannot control. That is not okay, and it happens too often.
I am from the UK, and so use the NHS, and I am happy to report I have NEVER been fat shamed by any doctor. I am about 90lbs heavier than my 25yo pre children self, but have no ailments that are supposedly fat peoples problems.
I attribute this to being a vegetarian, not smoking, barely drinking, exercising every day, laughing a lot and not worrying about much. I am guessing that the first 4 of those are in my medical notes, and doctors can see that I am looking after myself pretty well.
Yes, I have had breast cancer of a type that is more prevalent in obese women, but even through that time *not a single doctor* told me – even very indirectly – that I had cancer because I was obese, because of course no self respecting doctor would make such a statement!
As someone else has pointed out fat shaming does not just hurt fat people. I was fat shamed quite a lot when I was a young woman – not overweight up to 15lbs overweight (I am never fat shamed now). The media standard for young women is to be underweight – at least once you get older that pressure is no longer common.
@Ellesar: I am delighted that at least British doctors get the message. I know many American ones do as well, but they don’t seem to have interacted with any of the other commentators.
Is your handle a LOTR reference?
@joekster If most physicians do assume all their patients are liars, that’s a pretty damning indictment of the medical profession. Maybe time to really dismantle everything from top to bottom regarding the patient-doctor dynamic and start over? Because you guys are causing masses of unnecessary emotional and physical damage, as well as straight-up causing people to die out of that arrogance. The myth of the doctor who can go in, look at a patient’s symptoms, and make the correct diagnosis without carefully listening to and taking on board what that patient says is dangerous and irresponsible.
You’re still not really explaining how you believe it’s helpful to pressure people into doing something that your own field’s research has shown time and time again isn’t possible for most. In your reply to clever’s questions, you keep pushing the party line about results as if there weren’t mountains and mountains of research already indicating that what small results you see will be short-lived. Four years isn’t long enough to really get the real picture: most papers I’ve read have put the time for judging weight loss effective at 5+ years.
You also never answered my questions about controlling for poor/no medical care and societal stresses in weight loss research. Do you or do not think studies that don’t bother to consider whether actually receiving proper medical care might impact on outcomes are valid? And if you do think they’re valid, why? If medical care has no impact on outcomes, why bother with it?
Also, you bring up BMI as if it had any relevance to anything. Why? What do you think it shows? If you put me and a bodybuilder (not that I consider them healthy, quite the contrary) of the same height together, our BMIs might very well be the same. Does that mean our body compositions are the same? If not, then why keep on about this ridiculous, pointless, useless measure?
Never heard of the DASH diet till now. It does seem somewhat less stupid (though the descriptions I’ve read go on about antioxidants – thought that was pseudo-science?) than other diets I’ve seen, but unless some miracle has happened that we’ve not been informed of, it’s still got a failure rate of about 90%. And, though I could be wrong, I’m assuming there has been no miracle, because if there had, why aren’t the medical establishment & the world’s press screaming to the heavens about this wonderful, wonderful new method that ensures we’ll all be thin forever? So there’s that.
There is a very important point that most people who didn’t grow up surrounded by doctors often don’t know: so often I hear MDs described as “scientists.” This is incorrect. Most practicing MDs are “people who have studied science,” and have certain, usually quite specific, scientific knowledge. But they are not scientists themselves, in that they do not have any real interest in science, don’t carry out research, and do no scientific study other than the continuing education required to keep on practicing. They are by no means experts in everything regarding the human body, and patients need to be more aware of that in order to protect themselves from doctors who overstep the boundaries of their expertise.
Doctors of any sort seem to be perfectly comfortable in handing out dietary recommendations despite the fact that most of them have had minimal training in nutrition. Although the profession doesn’t seem to think so, this is no more ethical than giving a patient advice in any other specialty that you’re not qualified to practice in. Unless you’re a nutritionist who’s qualified at a reputable institution or have some serious-ass extra training in nutrition, you have no business handing out nutritional information to patients. Ever.
Bottom line is that the jury is still out on whether being fat is unhealthy. And, even if that weren’t true, there is no healthy, sustainable way known to humanity that guarantees permanent weight loss for a majority of overweight people. So….
For those of us who experienced even the most fleeting moment of self-loathing after reading that toxic bullshit, I have provided this (credit belongs to Lara Frater)
http://fatchicksrule.blogs.com/fat_chicks_rule/2015/09/dear-fat-people.html
Hope this helps you and counteracts some of the ugliness you’ve read.
@ Crys T
‘ The myth of the doctor who can go in, look at a patient’s symptoms, and make the correct diagnosis without carefully listening to and taking on board what that patient says is dangerous and irresponsible.’
I was taught that 80% of diagnoses hinge on the patient history, that is, what the patient tells you when you talk to them, and that the physical exam and lab tests should act to confirm that diagnosis. Although many doctors do assume that patients will lie about some things, that does not mean they don’t listen (sometimes it does, but less often than you seem to think). It just means they don’t take anything their patients say at face value.
‘You’re still not really explaining how you believe it’s helpful to pressure people into doing something that your own field’s research has shown time and time again isn’t possible for most’ Please cite? Mountains of data should have at least some quality reviews, and I’m not finding any.
‘Also, you bring up BMI as if it had any relevance to anything.’
BMI is a less-than-ideal measure of obesity. I’ve mentioned that repeatedly. However, it’s still easilly, and it is safe to assume that someone with a BMI>40 probably is carrying more weight around than the average person, and likely does have central obesity as well. The extremes of obesity are reliably picked up even by less sensitive measures such as BMI. It’s the less extreme measures where BMI falls short.
‘though the descriptions I’ve read go on about antioxidants – thought that was pseudo-science?’ No. I suppose it could have been considered that 20 years ago, but the role of the various anti-oxidants, while no more clear-cut than anything else in medicine, is well validated. Of course, you’ll find plenty of alt-medicine people going on about how their particular treatment affects your ‘anti-oxidants’ or how it uses anti-oxidants to ‘cleanse’ your system, but they’re usually not using it in the dietary sense that the DASH diet is.
‘but unless some miracle has happened that we’ve not been informed of, it’s still got a failure rate of about 90%’ Again, cite? Also, depends on what you mean by ‘failure’. As I mentioned above, the DASH diet doesn’t actually help much with weight loss. It isn’t designed for that. It was designed to help control hypertension, and a simple PubMed search will show that it has demonstrate efficacy in this, as well as a whole host of other health problems, many of which have no correlation with obesity. That’s one of the reasons I like it, in fact: it takes the emphasis off of ‘weight loss’ and puts it back on ‘health’, which is where the emphasis should have been in the first place.
‘why aren’t the medical establishment & the world’s press screaming to the heavens about this wonderful, wonderful new method that ensures we’ll all be thin forever?’ A: it’s not new. B: It’s actually being taught in most medical schools. C: Thin does not equal healthy. I thought that was the entire point of this comment thread? The DASH diet promotes health, not weight loss.
‘ they are not scientists themselves, in that they do not have any real interest in science, don’t carry out research, and do no scientific study other than the continuing education required to keep on practicing. ‘ True, at least to an extent. The physicians whom you will be seeing out in the private sector generally do not have time to do bench research or clinical research. They are far to busy taking care of patients, which is what most of us went to medical school for in the first place. There are physicians who both see patients and do clinical research, but they generally have significantly reduced patient panels in order to take the time to do so. Both are full-time commitments. That doesn’t mean we ‘don’t care about science’, and it usually doesn’t mean we don’t keep up on the research. I have noticed, however, that working docs out in the private sector do tend to fall behind on the latest data the longer they’re in practice and the more burnt out they get. I can only hope I’ll find a way to not be one of them.
Incidentally, I’ve heard that in Europe you don’t get to call yourself a doctor until you have published research of your own. Not sure if that’s true or not.
‘Doctors of any sort seem to be perfectly comfortable in handing out dietary recommendations despite the fact that most of them have had minimal training in nutrition’ One of the cool things about geriatric medicine is the multidisciplinary approach. That means we get to work closely with nutritionists, physical therapists, occupational therapists, pharmacists, and social workers, and we get to draw on their expertise as well. It’s a model that is gaining steam, but we’ll have to see if it’s sustainable. On my part, I actually did do some extra training specifically in nutrition in medical school (it was of interest to me, and I was actually awarded a ‘special qualification in nutrition’ for the work I put into it, and that’s how I wound up working with the weight loss doc in my third year), so I personally am better trained in it than your average working stiff.
However, nutrition is starting to be better represented in medical education, although it is proving difficult to work it around all the other things medical students have to cram into their craniums. Change is slow.
‘Bottom line is that the jury is still out on whether being fat is unhealthy. And, even if that weren’t true, there is no healthy, sustainable way known to humanity that guarantees permanent weight loss for a majority of overweight people’ Cite? I’ve at least made an effort to back up most of what I’ve said above. I would warn you, however, that it’s deucedly difficult to prove a negative.
I have a brother who’s a doctor, and I had lost a ton of fat–three dress sizes’ worth (through exercise and eating more but better)–when he gave me a very, very long lecture about how fat kills, fat kills, fat people just need to eat better and exercise more, eat less, it’s your responsibility, you’re costing all the rest of us lots of money with your fatness, you’ll die a horrible painful death because you’re fat, etc. etc.
It lasted a very long time, as I was trapped in a car with him. At first I tried to argue back about how healthy I was getting, how I felt better, and that you can still be fat and be healthy and that’s what I was going for. This didn’t help, and after a while I just let him lecture me for a while.
He’s always been very very thin (he often has trouble finding pants) and I have always been fat, and when I exercise, I don’t lose much weight but put on muscle fairly easily.
Which of us do you suppose has a house full of sugar cereals? Which of us do you think drinks a lot of soda? Which of us has been known to eat a whole box of powdered donettes in a sitting? Whose exercise machine was draped with laundry and never used? Who didn’t have a gym membership at all, much less exercise daily?
That’s right. It’s Dr. Skinny.
But I’m the one ruining everything by being fat.
Because science, I guess.
Joekster, you’ve just shown that you haven’t actually read up on weight-loss research, other than maybe some simplified stuff handed out tó practitioners. The figure of 90%+ failure rates for diets has been published ad nauseam in a plethora of sources since at least the early 1990s, and to date I’ve not seen new research that contradicts it. So really any professional who hasn’t seen it must be taking active steps to avoid it.
Or, yet again, since it doesn’t follow the narrative you’re trying to construct, you’re trying to gaslight us into thinking that it’s some sort of offbeat niche theory that only amateurs bandy about rather than a widely accepted one held by a large number of experts in weight-loss studies.
And btw, links to sources were provided upthread (sorry, can’t remember by whom). I suggest you get up to speed before continuing to try and debate with those of us who have been dealing with this stuff since you were still in grade school.
Seriously, other than a sense of moral superiority over the stupid, weak fatsos who just want excuses for their failings, what are you getting out of this?
Plus, you STILL didn’t answer my question about controlling for social stigma-related stress and poor/no health care in weight-loss research.
@Bina:
Is it bad that I laughed? Karma’s a bitch…
@Chris T
‘The figure of 90%+ failure rates for diets has been published ad nauseam in a plethora of sources since at least the early 1990s’
Of note, there have been significant advances in bariatric surgery, our understanding of how physiology responds to caloric restriction, our overall understanding of dietary science, and our understanding of how obesity and various health conditions relate to to each other in the past 20 years. As to new evidence contradicting those numbers, please see the cochrane reviews I linked to above. There’s not great data, but there is data.
‘Or, yet again, since it doesn’t follow the narrative you’re trying to construct’ I’m not, actually, trying to construct a narrative. I try not to push particular agendas, and I really don’t have any skin in this particular game. In fact, I’d have much better job security if everyone reading this stayed on the couch all day and ate a steady diet of fast food. I’m posting here because the actual science fascinates me, and I do feel a need to share what I know and hopefully learn from others.
‘you’re trying to gaslight us into thinking that it’s some sort of offbeat niche theory’: If you’re referring to your number that 90% of people fail at attempts to lose weight, you just admitted that it’s an outdated number. Seriously, in residency, we weren’t allowed to reference any study over five years old in our official presentations, and we were strongly encouraged to stay within the last 2-3 years. I’ll grant you that most physicians aren’t researchers, but medicine is a science, and the very nature of science is that it is constantly changing. That’s the whole point of continuing medical education (which is seriously flawed by the fact that big pharma is permitted to give lectures that count for CME credit, but that’s another story).
If you’re referring to the notion that weight loss is not needed for good health, that obese people are not necessarily unhealthy, or that thin people are not necessarily healthy, that’s pretty much what I’ve been saying since the beginning of this thread.
‘And btw, links to sources were provided upthread’ I missed them, but if they were posted by someone else, I may have passed them by. I’ve been focusing on people who seem interested in discussing with me. However, I asked my wife to go through the thread (she’s a much faster reader than I am). So far, she’s found a link to an Atlantic article discussing the relationship between fat shaming and weight gain, my hyperlinks to various abstracts on pubmed and cochrane review, Axcaliburs references about marijuana, and a couple random ones that don’t really relate to this discussion.
‘clever for a girl’ did make the 95% claim. She referenced the following review done in 2011 (for some reason, the hyperlink failed to work in her post. Probably because she was going more for an official reference. However, I was able to find the pubmed link), referencing older studies, which introduced the ‘health at every size’ movement. I’m quite familiar with it, as that movement was part of what convinced me to go from a weight loss to a weight neutral approach.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041737/
Please note: digging through the article to the claim about dieters regaining weight, it cites that claim to an NIH expert opinion panel held in 1992. That’s almost a quarter of a century ago. And for the record, expert opinion is the weakest form of evidence, and only resorted to when better data is lacking (as it probably was in 1992. According to the Cochrane reviews, even current data on weight-loss success is pretty sketchy)
‘I suggest you get up to speed before continuing to try and debate with those of us who have been dealing with this stuff since you were still in grade school’: Are you seriously appealing to authority here?
‘Seriously, other than a sense of moral superiority over the stupid, weak fatsos who just want excuses for their failings, what are you getting out of this?’
If I were a troll, I would just declare victory and walk away. As I’m not, I’ll answer: I don’t actually get any sense of moral superiority out of this. Quite the reverse, actually: I find it useful to practice defending myself against attacks without becoming defensive or lashing out in kind. What I really wanted to do was have a discussion in which I bring out some sources, other people point me to sources I wasn’t familiar with or hadn’t heard of, and in which everyone learns things from everyone else.
‘Plus, you STILL didn’t answer my question about controlling for social stigma-related stress and poor/no health care in weight-loss research.’
Do you have data to support your argument that obese people are less likely to get healthcare than thin people? You’ve mentioned that you personally have felt slighted by your physicians because of your weight, and that you feel your father was neglected because of his weight. I’ll grant you the benefit of the doubt on that, but it’s got as much validity as my pointing out that I have yet to see a patient with a BMI>35 who does not have multiple chronic medical problems. Namely, very little. It really wouldn’t be a difficult study to do, and there are enough obese physician researchers running around (my residency program director was one of them) that someone would have published.
Also, most of the research on obesity and social stress is into how social stress predisposes to obesity, not the other way around. Before corrections can be made, the correction needs to be quantified.
You made these claims. You feel that these claims invalidate all the current research on obesity and health. You have the responsibility to validate them.
One final thing: where do people get this idea that all physicians are somehow pushing the same line? I’ve found quite the opposite is true. Physicians are generally stubborn, independent people, and most of us are vehemently convinced we know better than everyone else. If we didn’t, we’d never have been able to make it through medical school and residency. That means, if you ask ten different physicians their opinion on something, you will get ten different opinions. It also makes our various professional conferences quite heated at times.
I think my own goals have been achieved. Axcalibur gave us some excellent sources on the constituent compounds of marijuana, Cleverforagirl brought out the original review for HAES (I’d actually forgotten that acronym. These days, I don’t really think of it as such a novel idea, but it did come out the year before I started medical school, so it’s influenced pretty much all of my training), and I hope I’ve made some small contributions myself. From that standpoint, I have actually achieved my own personal goals in this discussion, and if you want to call it quits, I’m fine with that. Cris T, you’ve managed to get off some personal attacks at me, whom you seem to see as a representative of whatever cishet male WASP physician has treated you poorly in the past, and I’m actually ok with that. I wish you all the best. Good night, and good luck.
@Joekster, OK plenty of studies linked upthread, when you get through those, if you want more I will be happy to provide them.
I think the problem we’re having is that you’re conflating healthy diet + exercise = weight loss and well, none of the research backs that up. I’m going to be generous and assume you’re not insisting that fat = zero willpower/lying liars who lie about their experiences.
People change their diets long term all the damn time, diabetics, renal patients, people go vegetarian, lower their fat and all sorts of things that they manage to stick to and they don’t lose any damned weight long term.
So why can’t a doctor just say, “I want you to try to do x for your blood sugar/kidneys/hair/whatever” Why does it have to be, “I want you to eat so little your body cannibalizes itself and you feel like shit and end up sicker than before you came in here because. . .health!”
So why do people think fatties just can’t stick to a diet?
Well, Joekster, I’ll give you an example of how medical care can suck for fat people.
I’ve had high blood pressure my whole life, from when I was thinner than average to when I was a size 24 (American). When I was thinner, the doctor wrote “high blood pressure” on the diagnosis line, prescribed me high blood pressure meds and I had to come in for a blood test every year to ensure everything was still going well and get my prescription renewed.
When I gained a little weight, and moved away, I got a different doctor. I made sure to tell her that I’d always had high blood pressure, and that my father had also had high blood pressure, even when he was a skinny college kid. Instead of writing “high blood pressure,” though, this doctor wrote “obesity.”
So my insurance company did not pay for the annual blood test that I’d been having for at least 5 years by that point.
I did manage to get the company to change its mind by calling the clinic and talking to various people about what had happened. They changed the diagnosis back to “high blood pressure,” and I didn’t have to pay the $300 or so for the test.
Which was required to get the prescription again, and which, at that time, I could not remotely have afforded.
Because “obesity.”