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In aggregate it seems pretty clear the science is in for living a healthy life: get enough sleep, exercise, don't eat sugar.

It's obviously more complicated than that, especially at the individual level, but if you aren't hitting those three you're missing out on some serious quality of life improvements (both in the short term and long term).

Can't obsesses over the get enough sleep and exercise thing. Even more important working a sedentary office job mixed with a always alert/ops style job (some of us may be familiar with).

Realizing when to let a problem be organizational rather than a personal sleep deficit is also key in those positions. They'll say your a rock-star for trading your sleep and life for their bottom line. It's debt impounding interest and unless your luckier than a power-ball winner they won't be there when that payment is due.

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Such a shame that the "healthy at any size" BS is so popular these days. Literally killing people.
HAES is not BS. Here's the deal. For lots and lots of people, being not fat is very very hard. So hard, that even though there is enormous social pressure that they've had basically from ~12 years old to however old they are, they still haven't managed to become non-fat for any significant length of time.

HAES is a reaction that says "What if we accepted that some people are just going to be fat, and then tried to come up with ways of being as healthy as possible given the circumstances". You may not like the packaging that HAES comes wrapped up in, and the most vocal proponents of it are often the least interested in making it palatable to you. But it's not BS.

Consider that there is essentially nothing that medical science has for people who are chronically fat except a gastric sleeve. Shit is hard, yo.

> being not fat is very very hard

Irrelevant. It is not more healthy to be fat than it is to be not-fat because it's hard. Acceptance is not going to change a damn thing about the health risks inherent with being fat.

You have all my sympathy. One of my closest friends is a very large guy, and I want him to be around when we get old, but the stats tell me that's less and less likely every year he stays obese. Me accepting him (and I do) won't keep him on this planet. :(

Damage control might be a smart way to improve health.
The data doesn't say it is. Sure you can improve on other axes, but weight is a leading indicator of mortality.

I wish you were right, it'd be great to be able to be obese and healthy, but that just isn't how it is.

That's not what damage control is. I am not claiming that there is a way to be fat and absolutely healthy. I am saying that there are ways to be healthier while being fat. That is damage control, like the ones applied to drug addiction. And that is proved to be a good decision in some cases.
> And that is proved to be a good decision in some cases.

No it hasn't, because it doesn't exist as you describe. It exists as I've described. Everything you can do, while obese, you can also do while not-obese.

Why do you think I'm fat? I'm not

> Irrelevant. It is not more healthy to be fat than it is to be not-fat because it's hard. Acceptance is not going to change a damn thing about the health risks inherent with being fat.

You are entirely missing the point. The issue is "given that I'm going to be fat, perhaps I should work with what I have, rather than beating myself up over the fact that I'm fat". Once you do that, you can start to look at what else you might change about your life that would improve your health.

"You" here being a stand-in for anyone reading this who is fat. It's not really relevant if you're fat.

And I'm not missing the point, you're making up some kind of generalization that doesn't A) fit the facts as we know them, and B) doesn't actually address the issue.

You're saying, "What else can I do to be healthy?" but you can/should do those things as well as work on losing weight. Giving up on losing weight doesn't lower your risk at all.

You can stop beating yourself up about being fat and keep trying to lose weight, as well. I think we can agree the moralizations aren't helping here, but you can't wish away the unhealthiness of obesity, like this stupid movement tries to do.

Sometimes I see comments like this and it's like someone is posting from another galaxy.

I've literally never heard of a movement that says that can be healthy. How did that even happen?

Edit: link for HAES https://en.wikipedia.org/wiki/Health_at_Every_Size

On the internet, there is a supportive community for every possible opinion humans can have.
So it's the same logic as, "Well, we should let them do heroin -- just try to make it as safe as possible"?

Seems like a meme we should minimize the transmission of, to me.

> Consider that there is essentially nothing that medical science has for people who are chronically fat except a gastric sleeve.

It also yields ridiculous statements like this. Medical science has some very clear advice for fat people: eat less and exercise more.

They're making an entire movement to justify why they're lazy and undisciplined.

What do you think Safe Injection sites are, if not exactly that?
Yes -- that's the logic I was referring to.

However "safe injection sites" are anything but safe to the surrounding community, and may increase usage rates while only mildly decreasing fatality rates.

By keeping the sickly ones around, we're actually making the whole herd less healthy -- particularly when we enable them spreading their illness.

I think the medical professionals involved in "safe injection sites" should be seriously questioned about their medical ethics: they're failing to quarantine sick patients, and in treating them without that buffer, spreading the disease to the healthy population.

It's quack "medicine", just like HAES/HAMS.

Are you implying we kill/let die the "sickly"?

Seems extreme...

> Are you implying we kill/let die the "sickly"?

What's the choice? Make other people ill and have the original sick people die anyways?

That's all slowing mortality down in heroin abuses does, and it's definitely not how we treat other kinds of diseases, particularly those which have reached epidemic proportions, where the prime objective is arresting transmission.

So, yes -- I think we should follow standard medical practices, and it's unfortunate that strong measures are needed to confront an epidemic level problem. Just like it always is when you have to make medical triage decisions.

But we have to prioritize maintaining the healthy population ahead of the comfort or longevity of the already ill, in broad strokes.

What you're suggesting is not standard medical practice, to be clear. Treatment for heroin addiction is to get that person off of heroin, not let them die.

And no, we don't have to prioritize maintaining a healthy population, not to the degree that treating the ill is excluded. That implies a limitation of resources that simply does not exist. We can and do both.

Every bit of research I've seen contradicts this. I'm talking about NHI in the UK and several peer reviewed papers which seem to support safe injection sites as being a cost effective way of dealing with social addiction issues (we already know the war on drugs hasn't worked)

Care to share any sources on the ineffectiveness of these sites?

I came across most of my sources while studying for proposals to open another one, and don't have them convenient anymore.

However, looking through NIH reports --

The site in Vancouver appears to lower the fatalities marginally (1-10 less fatalities per year). Several other studies indicate that fatalities related to opioid overdose, ambulance calls, etc decrease in the immediate area of various sites.

I can't find anything on the Vancouver site in the last decade, it's all circa 2006 or 2007 -- and seem to recall in my earlier research that the initial results looked good, but later studies basically reported that we saw a decrease in fatalities that was offset by an increase in usage, and the whole thing came out as sort of a wash.

RAND seems to suggest that supervised consumption is not settled in terms of scientific study, even now. [0]

> We conducted our own assessment of the individual studies and found that the evidence base concerning the overall effects of SCSs is limited in quality and location. Although we identified 65 outcome-related articles (as opposed to commentaries or studies that gauge opinions), none involved an RCT, and just nine employed a quasi-experimental design with control groups. These nine studies were based on just four SCSs in three cities: Sydney (five studies), Vancouver (two studies), and Barcelona (two studies). There was considerable overlap in the design, methods, authorship, and data employed, so that four of the nine are arguably superseded by later studies using better methods or longer time series, in some sense reducing the effective number of quasi-experimental studies to five.

Worth noting, however, that many of these seem to indicate reduced petty crime in the area immediately around the site. Indicative I might be wrong, but not conclusive because of problems in the methods used, samples chosen, etc.

Looking at a compilation by Brookings, broadly on the topic [1] --

> New work by Packham and Wells (2018) suggests that syringe exchange programs—a staple of harm-reduction efforts—reduce HIV rates as intended but unintentionally increase opioid-related mortality by making it easier, cheaper, and safer to use heroin.

> Another popular harm-reduction effort is distributing naloxone, a drug that can save someone’s life if administered during an opioid overdose. Recent work by Doleac and Mukherjee (2018) finds that broadening naloxone access had mixed results. While some states saw beneficial effects of these policy changes, broad naloxone access increased opioid-related mortality by 14 percent in the Midwest, the region hardest-hit by the opioid epidemic.

So reports that I do find seem to suggest that this is a concern that is valid, at least in some contexts, and that the studies purporting to show outcomes are a) very narrowly done, b) often don't measure what I'd consider to be the complete set of externalities, and c) aren't particularly scientific.

It certainly seems reasonable that narrow focus on improving the outcomes of the addicts, particularly a narrowly defined set of metrics, actually lowers the group outcome.

Sorry I can't provide better sources to support that, though.

[0] -- https://www.rand.org/pubs/research_reports/RR2693.html

[1] -- https://www.brookings.edu/blog/up-front/2018/12/07/research-...

I can provide at least a half dozen studies that prove it does work.

You can't provide any that prove it doesn't. Even the few that you posted seem to be at the least, pointing to a possibly effective situation. Mentioning increased ODs in the immediate surrounding area is... I'd say kinda expected. That's kinda the whole idea, get all the ODs in the same place.

I mean, your own data shows that it reduces HIV rates (not possibly, it does)... and 'POSSIBLY' has unintended consequences.

Despite the data, you won't change your mind.

At least admit that like the anti climate change people, you just don't want to believe. It has nothing to do with data.

I'm glad you are willing to come out and state your positions clearly. For that I thank you.

I disagree with essentially everything you have said. While SIS may not be a panacea, they are definitely on the right track.

Safe injection sites are a socially responsible way of using resources.

It costs society money for ambulances to be running around to OD people.

Safe injection makes sense.

It doesn't promote heroin.

No one is saying: Heroin in a Healthy Manner.

They are simply saying: Let's spend a stitch in time. You don't even have to think of it as being kind, just rational.

It is an opportunity to say "Ok, we can't stop these people from doing heroin. But we can make it as safe as possible, and we can provide a vector for additional health care interventions". It also means that you aren't psychologically torturing addicts by telling them that if they were only 'strong enough' they could cure their addiction.

You might not like the way HAES or fat acceptance is packaged, but this is exactly the same thing.

The key difference: Social stigma. HAES seeks to remove stigma.

Safe injection sites don't.

Both being fat, smoking cigarettes or being a heroin addict are things to be, at the least, slightly ashamed of.

*exceptions go out to anyone with thyroid or other such medical conditions, just as to people who are opioid dependent due to pain management.

> "Well, we should let them do heroin -- just try to make it as safe as possible"?

That's the goal of "Safe Injection Sites" that are being build in a few cities.

The HUGE difference is that one is asking to use resources in a smarter way (safe injection sites). They are not destigmatizing drugs.

I've been to countries where there are 'tolerance' zones. But that doesn't mean there isn't stigma to doing it.

Stigma is a strong social disincentive.

The Healthy as fat is trying to remove stigma for something that is unhealthy. But it is not trying to re-assign social resources in a logical way.

Portugal legalized drugs and made them safer to use and... people were generally healthier and better off.[1]

People have unhealthy habits because of issues in their life. Poverty, abuse, mental health issues, lack of access to healthcare and healthy foods.

If you want people to get better you need to stop vilifying them, e.g fat shaming or war on drugs, and start accepting and helping them. Same for drugs, same for weight, hell, I’d say it’s the same for many “criminals” too.

[1] https://en.m.wikipedia.org/wiki/Drug_policy_of_Portugal

> The new law maintained the status of illegality for using or possessing any drug for personal use without authorization. However, the offense was changed from a criminal one, with prison a possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.

You seem to be mistaken about how their policy operates.

You're also working from a different premise than me: I believe people fundamentally have agency, and so they're influenced by their circumstances, but their problems are not causal from them -- they made a choice to adopt that habit as a coping strategy.

And frankly, I disagree with you about how to confront that: I think we should be accepting of how they got there, but I absolutely disagree with things like HAES which suggest that their choice isn't a problematic one.

To borrow a phrase from a friend, and use it somewhat out of context: I can love a sinner without enabling or accepting the sin.

Here’s what I don’t get about people from the “personal responsibility” camp: food companies spend billions of dollars on marketing research and ads to sell their products. The products they seem to be most easy at selling are any form of junk food. The easiest to target are the poor and people who don’t know better.

I think they have a huge responsibility for unhealthiness and fat shaming doesn’t address that cause. Saying “oh people just need to make better choices” seems pretty shallow.

I'm confused by what you're confused by -- you seem to be attacking a strawman rather than anything I said.

You're also confusing several issues:

- There's no reason that people can't be responsible for their choices and it be unethical for junk food companies to do what they do. Your entire premise is hinged on that being the case.

- I've never met a fat person that wasn't aware that junk food was bad. I'm sure they exist, but talking about the bulk of people, the 95% in the middle, they're aware that their diet impacts their health. They're simply choosing a self-destructive coping behavior of drugging themselves with food. I'm sympathetic to that, but I don't see any reason to pretend it's anything but what it is. Addiction and substance abuse, in a self-destructive behavior.

- I don't believe that ads are causal, just influential. Again, they're making a choice to act this way, even in the presence of ads. What bothers me about people in your camp is that you treat other humans like some kind of animal you own, can decide what's best for, and manipulate or control. You refuse to accept them in their capacity as human persons, who have agency and the capacity to self-direct, then have the gall to turn around and talk about me being the shallow one.

Tying together legalizing drugs and fat shaming is a huge reach..

The drug vilification issue becomes a problem when the state gets involved in enforcing that moral compass -- the danger of drugs predominately derived from its users/product existing solely on a black market, with no regulation, and no verification of the product you're purchasing. It's not that hard to avoid overdose when you have pure heroin, it's much harder when you have heroin cut with unknown quantities of unknown alternatives. It's much harder to seek legal help, when it requires you to admit to criminal activity.

It's not the vilification at issue for drugs, it's the criminalization. Presumably portugal still does not have a positive outlook on drug usage (it's still vilified).

And afaik, being fat is no crime.

> They're making an entire movement to justify why they're lazy and undisciplined.

Congratulations. You are literally the reason why this movement exists.

Most people in history were _not_ fat. It used to be _hard_ to be fat. Modern society and sedentary jobs make it harder to not be fat, so it takes discipline and hobbies like hiking and working out to actually get physical activity, and healthy diet is the key element. When everyone is eating processed food and doing very little during a typical day, it is hard to not be fat, but that doesn't mean we should accept that, we should push for a healthier society. There are things about lifespan, but also quality of life, ability to think, dealing with stress, _huge_ mental health effects, etc. Our entire society would improve if we decided to change things instead of giving up.
How well is your strategy of "blaming individuals" working out? Should we blame them even harder to see if that works more often?
Obviously we should push for a healthier society, but that doesn't necessarily mean we should shame those who do not have a fit body size.

Don't forget that in many circumstances cooking and hobbies like working out and hiking and such can be privileged.

Someone working two jobs to get by probably doesn't have the funds for a gym membership or to go out hiking, and might not even have the mental energy to.

And then cooking healthy food is surprisingly expensive and time consuming when compared to processed foods.

So yes, absolutely, we should push for a healthier society, but at the same time we should accept that there are valid reasons someone might not be fit, and we shouldn't shame them for that. Instead, we should try to improve the situations that cause it as much as we can within our abilities.

Not shaming, but that is a false dichotomy. I don't want to go around condemning people; I just don't think telling them everything is okay and letting them die young is a good idea. There are many other options to take; better education on the topic, better culture around work, better pay, better childhood involvement in activity, less videogames, etc. It isn't just a poverty issue and it is getting worse in all levels of society.
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It's complicated. On one hand you don't want to foster mental health issues by constantly reinforcing to people that their weight is wrong and bad. On the other hand, you probably don't want to excuse a physiologically unhealthy condition by calling it "healthy".

I don't have an answer. I was fit until I hit university and now I'm struggling with my weight constantly. I'm committed to trying. Losing weight. Getting in a healthy habit. Relapsing. Dozens of times in a decade. But what I don't ever want to do is declare that I'm just healthy at any size and therefore throw in the towel.

The grim reaper doesn't give a crap what I think healthy means.

I think you are seeing what I'm trying to say. It's not like most fat people are not aware that they're fat, and not aware that that is a problem. They are just exhausted with trying to change it. Particularly for people who have "always" been fat.

Consider that being fat might be better for you than alternating between eating disorders and being fat, which is the choice that a non-trivial number of fat people are faced with.

>HAES is a reaction that says "What if we accepted that some people are just going to be fat, and then tried to come up with ways of being as healthy as possible given the circumstances". You may not like the packaging that HAES comes wrapped up in, and the most vocal proponents of it are often the least interested in making it palatable to you. But it's not BS.

If that was all it was saying, I'd be onboard.

But it also says things like "losing weight is literally impossible!", and "there is no evidence that obesity is unhealthy!" and then cherry-picks and misconstrues research so that it seems to give scientific backing to those conclusions, which are deeply harmful lies.

No, people say these things. This is cherry-picking as well. Again, lots of fat-acceptance people aren't stupid, they have just decided to pick their battles.
Let's reconsider this position using some other example:

Healthy on Heroin. HOH

HOH is not BS. Here's the deal. For lots and lots of people, being not addicted to heroin is very very hard. So hard, that even though there is enormous social pressure that they've had basically from ~18 years old to however old they are, they still haven't managed to become clean for any significant length of time.

HOH is a reaction that says "What if we accepted that some people are just going to be heroin addicts, and then tried to come up with ways of being as healthy as possible given the circumstances". You may not like the packaging that HOH comes wrapped up in, and the most vocal proponents of it are often the least interested in making it palatable to you. But it's not BS.

Consider that there is essentially nothing that medical science has for people who are chronically addicted to heroin except a detox. Shit is hard, yo.

You chose a pretty poor example.

Have you ever heard of methadone? Its literally accepting that someone will be addicted to opiates for a long time or life and then giving them a healthier alternative that doesnt try to change that.

https://www.crchealth.com/addiction/heroin-addiction-treatme...

Yeah, see, no one is bothered by that because no one is saying:

Be proud of your true heroin addicted self. Show it to the world. IF they don't accept your heroin addiction THEY ARE wrong.

See. If any movement said that, I'd be against it. Because they are trying to remove stigma from something that SHOULD HAVE IT.

Let's reconsider this position using some other example:

Such a shame that the "healthy at any genetic condition" BS is so popular these days. Literally killing people.

Genetic conditions cannot (currently) be changed, so not trying to change them is a reasonable approach.
Addiction to opioids is also partly genetic. Should being a heroin addict be fine?

The healthy while fat movement specifically tries to remove a stigma that IMO should not be removed.

Unsure if you're trying for a parody here, but HOH isn't actually that absurd. Numerous public health policies - methadone clinics, needle-exchange programs, Narcan syringes on every EMT - are based on the assumption that addicts are gonna be addicts, and until they are in a place in their life where they can do the work needed to kick the addiction, they might as well not be spreading HIV, committing petty crimes to support their habit, living on the street, or dying. All of these interventions make it more likely that they will eventually get to a place in their life where they will be able to do the work to actually kick the habit.
You are stretching VERY far.

There is a segment of the population that is addicted to a substance that is illegal. They die because they hide to satiate their addiction.

If fast food were illegal, and fat people sat under bridges eating fast food and occupationally chocked on an illegal KFC chicken bone, I'd advocate for fatty eating centers.

Comparing saving lives to removing stigma is... beyond absurd.

I don't know what you think you are proving here. I accept everything you just wrote and agree with it 100 percent (except for detox. I think I would say for heroin we now have buprenorphine which might be useful way to manage this specific addiction, but I'm not claiming to be an expert on heroin addiction).
Expect fat people can eat KFC in the open.

Fat people aren't being sent to jail for being fat.

Heroin addicts are being judged and looked down on. No one is fighting that.

No one is saying 'be proud ye heroin addicts'.

I have hear fat people basically say 'be proud of ye 'curves'"

You can be fit and still be fat though. I've been working out with a personal trainer for a couple of years now and I'm significantly healthier and stronger than I was before I started but I haven't lost the gut (yet).

If HAES is just an excuse to not try and be fit, it is going to kill people.

Some people will use it for that. Others won't.
I don't see what else the "movement" would be used for. If you are obese than you are unhealthy. It might be hard to be hard to maybe impossible to improve that but it doesn't suddenly become "healthy" because of that.
Plenty. I'm very fit all my life, but as I have gotten older, metabolism slowed down, less time and energy, I am still exactly as fit as I was, and still eat w/o a diet, often before bed.

What's changed: every morning I wear an ab belt while getting ready for work. With every greasy mean I pop an orlistat. I wear a couple of electrodes on my chest/back/arms under my shirt while at work, instead of a workout most days. 5'11, 170lb, 6% bodyfat, bench 300 20 times.

This is 100% because of medical science, because I'm a lazy 40yo slob. Just a really fit one despite the daily cake and pizza before bed.

It's impossible to create matter out of nothing. Dieting works and will always work. Not saying it's easy, but waving off obesity as incurable is crazy.
It's not "popular". It's a strawman created by anti-feminists. It doesn't really exist in the real world.
A Wikipedia article on the subject doesn't mean that it's not a strawman.
I don't know what to say. It's not a global media conspiracy. For decades there have been actual fat acceptance activists and communities. Good luck.
"Doesn't exist" was hyperbole. If you want to be literal, what the OP was saying is that it's an extremely small fringe group that isn't large enough to matter, and the response to it created by internet outrage culture makes it look like a much bigger issue than it actually is.
Yes that was my intention. Please note that I didn't say "doesn't exist", I said "doesn't really exist", which is not the same.
I've noticed that they don't actually believe "Healthy At Any Size", because they routinely skinny- or fit-shame people.

So I've started referring to them as "Healthy At My Size", which is their real argument -- that their overweight size is healthy.

It also yields a more appropriate initialism.

It's not popular. There are far more people making fun of fat acceptance than there are people who are making the claim that being fat is healthy.

There are plenty of people who are against body shaming, unrealistic beauty standards etc...

Very few who think that being very overweight is actually healthy.

You claim this, but now if you goto a department store, you'll find the mannequins are all a little bit heavy, as in, overweight.
If you go into department stores, the vast majority of mannequins aren't clinically overweight unless you are specifically shopping in a plus size store.

Even if this were true, your argument doesn't follow from the evidence. The existence of clothing for overweight people doesn't imply that people believe that being overweight is healthy. It only implies that overweight people exist, and someone wants to make money selling clothes to them.

Duck 'vanity sizing' sometime.
Google 'average mannequin size'. The average female mannequin is underweight, not overweight. One study did a survey and found that 100% of the female mannequins they examined represented a clinically underweight woman.

Vanity sizing is a thing because female sizing completely arbitrary and stores want to make women feel better about their weight. If anything this is evidence that fat acceptance hasn't caught on--if it had, people wouldn't be ashamed to wear a larger size.

Regardless, I'll say it again--the fact that overweight people exist says nothing about the assertion that many people believe that being overweight is healthy.

1. https://jeatdisord.biomedcentral.com/articles/10.1186/s40337... This 2017 study did a survey and found that 100% of the female mannequins they examined represented an underweight woman.

Depends on your genetics. If you don’t have high blood pressure, dyslipidemia, or diabetes, and you’re clinically healthy, it’s fine.

Some people are ectomorphs. I have friends who are hardgainers, and believe me, it is a struggle for them to bulk. You have to eat a massive surplus of calories per day and most of that has to be protein.

Conversely, some people are endomorphs. It’s very difficult to cut (in my case). I need a big caloric deficit relative to others, and do cardio on my rest days in order to keep my body fat at a reasonable percentage.

Eugenics should be actively encouraged. We have the technology to make it so many will never have to suffer metabolic issues or chromosomal abnormalities.

What is a "big calorie deficit" relative to others? I am just curious because the general physiology is pretty simple and I have read some things that pretty thoroughly debunk endomorph vs. ectomorph. It is must more useful to classify based on muscle fiber composition. People with a lot of fast twitch muscle fiber build muscle quicker, etc.
What is a "big calorie deficit" relative to others?

For me, I’ve found 400-500 below my maintainence works best.

> It is must more useful to classify based on muscle fiber composition. People with a lot of fast twitch muscle fiber build muscle quicker, etc.

I agree with you here. I needed labels to bin the two (very general) categories of body composition types, so I chose those two.

Makes sense. I have had my RMR tested and I am dead average. I have never had success with small deficits because I am not disciplined enough to maintain -700 net cals per week or whatever.
Do we really have to go through this on this site...?

The point of the body positivity movement is literally crystal clear - to end shaming of people for the size of their body.

There's no "BS" to it. People's health is their own concern. Whether or not someone decides to change for a healthier lifestyle, there's nothing wrong with them at least loving their self throughout the process.

It's also really not that popular of a sentiment. Just ask any overweight person the things they hear on the regular.

Come on now.

People's health is their own concern to the extent that they do not burden society with their health care costs, nor the people in their life due to their poor condition.
>burden society with their health care costs

That's every single non-optimal health decision though. You shouldn't have gone into construction because now you need a knee replacement. You should've used a treadmill desk instead of sitting for so long. If you'd just had a child before you were 30 you probably wouldn't have gotten breast cancer etc...

It's not true that people's health is their own concern. Especially not when my taxes pay for your treatment when you've deliberately not taken care of yourself and not when your lack of regard in this manner promote similar thing happening to other people (children, for example).
If you're actually concerned about "your taxes" you should celebrate the over weight and otherwise unhealthy. The lion's share of health care costs are end of life treatments; don't have to worry about those if you die of a heart attack at age 45.
Besides, I think taxpayer dollars are being spent on things that are far more shocking...

The U.S. leads the world in military spending, has one of the largest incarceration rates per capita, and is floating around the idea of a new border wall, and you're mad about... People not being skinny...?

Not everyone lives in USA, you know. ;) And I'm not mad, far from it, I'm simple pointing out the argument was false.
>The lion's share of health care costs are end of life treatments; don't have to worry about those if you die of a heart attack at age 45.

Well, you do still have to worry about those, but earlier than expected.

Overweight people are actually cheaper to care for in the long run.

"Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."

https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

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'People's health is their own concern'

I disagree wholeheartedly. So many diseases today are preventable when you consider that most people take no action to improve their health through any kind of diet or exercise. Its a probabilities game. If you eat fast food frequently, drink/smoke too much, and don't exercise you cannot expect to have the same odds of a long life as someone who is doing those things.

Now if we accept the above argument, even if only to a small degree, than we can conclude that individual decisions have should result in a widespread increase in demand for chronic healthcare needs, such as heart disease. This in turn causes insurance rates to go up for those individuals taking care of their health. Furthermore it funnels more and more human capital away from the rest of the economy by raising demand for doctors, nurses, and all other kinds of medical staffing/machinery.

Its inconvenient to believe that your health has a larger effect on the world you live in, but it does.

>Its inconvenient to believe that your health has a larger effect on the world you live in, but it does.

Sure it does, but what do you want to do about it. Do we scold people for picking careers that are bad for their health. Do we shame women who don't have children because it increases their chance of developing breast cancers?

>Furthermore it funnels more and more human capital away from the rest of the economy by raising demand for doctors, nurses, and all other kinds of medical staffing/machinery.

And choosing to watch youtube videos funnels money into advertising and away from the rest of the economy.

Nearly every single individual decision that you make impacts someone else.

Simply incorrect. We shame people for smoking don't we?
Because it has a direct negative impact on the health of other people.

Do you shame people from not getting enough vitamin d? Do you shame them for going into careers that are bad for their health? Do you shame sky divers because its bad for their knees? People who don't use treadmill desks?

Being overweight is a choice that makes our healthcare system enormously more expensive. None of the things you mention are remotely comparable to it.
Sitting too much is at least in the same league as being overweight, but the extent to which being overweight increases healthcare costs is largely down to the number of people who are overweight. There are many choices that an individual can make that are just as costly that aren't ridiculed.

Furthermore, it's not clear that obese people actually consume more healthcare dollars.

"Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained."

https://journals.plos.org/plosmedicine/article?id=10.1371/jo...

"Such a shame that the "healthy at any size" BS is so popular these days. Literally killing people."

I don't wish ill health or discomfort on anyone but ones physical condition, appearance and personal health are one's own business.

Provided that you rise to a minimal standard of civic responsibility...

I owe it to you to be able to run for help. I owe it to you to be able to perform chest compressions for 3-5 minutes. I owe it to you to be able to carry or drag an adult a few hundred feet to safety. I owe it to you to be fit to join a group standing in physical defense of others.

If you can't do those things, you have something to answer for - regardless of the diet/fitness/health/appearance fads of the day.

I don't think its healthy at any size as much as not shaming people for their body sizes, which are different issues. We can and should continue promoting healthy living habits while restraining from shaming those who aren't there yet.
Bad reading is killing people. The relevant info is still there it is just hidden: Being fit and not smoking is healthier than being fit or not smoking separately.
What in the article led to this comment?

There's no mention of"healthy at any size" in the article and no mentions of "fat", "obesity", or "overweight."

Since the title obviously doesn't make sense

The article's summary of the study said that being unfit is as bad for you as not smoking. Thats very different than just replacing every word with the negation.

Its almost like a machine learning algorithm made this title as the most attention getting group of words

But the being rich beats both in terms of life expectancy.
Life is immeasurably more enjoyable as a fit, healthy person. Even if it had zero impact on longevity, it's an obvious win.
It's hard to explain that to an unfit person who would argue it's immeasurably more enjoyable to eat whatever you want, whenever you want. Sometimes only after they develop heart disease or diabetes, or other obesity-related health complications do they realize maybe it wasn't such a good idea to never exercise and frequently supersize.
It's always hard to convince an addict of practicing anything vs. their addiction. This is an entirely different issue in my opinion.

Explaining it is easy, these folks generally understand, it simply doesn't matter because they're hooked.

This situation is pervasive, it's no different than people being addicted to activities unnecessarily burning fossil fuels, despite their rational understanding of how it's slowly ruining their habitat.

Any data on that?

I am not convinced that it is "immeasurably" so. Being fit is not going to change some of the most unpleasant things in a lot of people's lives. A commute is still a commute. A bereavement is still a bereavement. A boring job is still a boring job. Debts are still debts etc etc.

Being fit is not going to change any of those, so I am not sure how life gets immeasurably more enjoyable if you are as fit as an Olympian but your partner just died and you've got to go work in the Amazon Fulfilment center 90 minutes bus ride away to pay for your medical/student debts and still just about have enough left over to pay for basic food and heating. But hey I can run 100m in under 10 seconds so wow my life is immeasurably better as a result!</sarcasm>

> Being fit is not going to change some of the most unpleasant things in a lot of people's lives. A commute is still a commute. A bereavement is still a bereavement. A boring job is still a boring job. Debts are still debts etc etc.

It changes your baseline level of comfort and happiness, every single one of these things is less unpleasant than it would be otherwise.

Speaking from experience as a formerly obese person, now capable of hundreds of pushups and running numerous miles in my 40s. It seems every moment of every day is better this way, except perhaps the sometimes annoying unwanted attention from the opposite sex.

> Being fit is not going to change some of the most unpleasant things in a lot of people's lives. A commute is still a commute. A bereavement is still a bereavement. A boring job is still a boring job. Debts are still debts etc etc.

I was almost obese (BMI: 29.8). I'm on my path to being at a normal weight (BMI: 25.5). I would say it is immeasurably better. I can walk up stairs without losing my breath. My knees don't creak. Random aches and pains are gone. I'm generally healthier (less common cold etc). I can participate in many activities such as sports without tiring myself and taking a couple of days to recover. I can go on longer hikes and see many things which were quite impossible before. I much more comfortable at all times now. All the negative things add up in a person's mind. A commute + shitty health is worse than just a commute. If I'm working in a fulfillment center, I'm not uncomfortable while exerting physical effort.

Agreed. As a person who is unhealthy (chronic illness), my anecdote is that life is essentially unenjoyable, unbearable, and pointless when not healthy.
I remember seeing a similar, slightly-less-semantically-awkward title being posted recently.

Something along the lines of "Not Exercising just as bad for you as Smoking"

A thing that bothers me is that in the popular consciousness the defacto way to get fit is to hit a 24 hour fitness gym to count to ten alone under flourescent lights. You're not very likely at all to engender a lifelong fitness habit doing that.

Do things that engage you emotionally, mentally, and socially. Do things that are fun, and adventurous. Compete, even if it's at a beer league level. You need more robust and tangible fitness goals than looking good in the mirror in 6 months.

Fitness gyms hate you. They want your annual fee and then they don't want to see you again until next year. It you're trapped in the mindset that keeping fit is some kind of chore that you have to add on to an already busy life, you're doing it wrong. When you see people in their 70s who are still kicking ass, it's because using their body is at the centre of their life, not at the margins.

On top of that, isn't reducing calory intake much more important than the little amount of calories burned in the gym?

Of course there are plenty of reasons to do sports. But my understanding was that for losing weight, it's mostly about how much you eat.

People here seem to value fat shaming so I think it’s valuable to mention it doesn’t help. Reposting a reply I made:

Portugal legalized drugs and made them safer to use and... people were generally healthier and better off.[1]

People have unhealthy habits because of issues in their life. Poverty, abuse, mental health issues, lack of access to healthcare and healthy foods.

If you want people to get better you need to stop vilifying them, e.g fat shaming or war on drugs, and start accepting and helping them. Same for drugs, same for weight, hell, I’d say it’s the same for many “criminals” too.

[1] https://en.m.wikipedia.org/wiki/Drug_policy_of_Portugal

Have you been to Portugal?

The stigma of a heroin user is strong there.

You know why? Because we don't want heroin users.

I'm a libertarian. 100% in favor of allowing people to own their own body (i.e. they can put in whatever they want)

Being fat isn't a crime.

There is no war on fatness.

There is simply a stigma.

A stigma to dissuade people. It works. It worked for me. I know other people who got their shit in gear because they were tired of not getting the respect they felt they deserve. I come from a hard background.

The Healthy while Fat is just an excuse to want to gain acceptance of unhealthy behavior.

No it won't work.

Sure, cigarette smokers come from shitty backgrounds (I was one). But getting looked down on was a major reason for me to quit.

Are there weak people who will forever smoke and feel bad?

Yes.

I have no answer for them.

But I know we can't start accpeting cigarette smokers. Or more people will smoke.

That is a totally different thing than using VIOLENCE to make it so someone can't access their vice.

I 100% support people engaging in vices.

I also think we should as a society be more accepting of vices.

Because they have good and bad. Some of the best chefs I've known are fat. Some of my favorite music was made on heroin.

Maybe I'm misreading what you wrote, but how do you societally accept a vice while at the same time stigmatizing it?
Because we all have vices.

Should we accept them openly and be proud of having vices? No.

Should we be tolerant of other people's vices? Yes.

Basically: having vices is bad, having vices doesn't make you bad. Vices should not be a source of pride.

I would agree that the HAES movement does get at something that needs fixing: America dehumanizes people. It's hard to explain, but having lived in other countries, I can say there is a dehumanizing element here against those that are deemed less (druggies, ex-cons... and to a lesser extent those who are overweight)

I too find the mantra of personal responsibility alluring but when people have been getting more and more obese you need to either accept people are getting “weaker” or the world is getting shittier, with larger ad campaigns for worse and worse food, etc.
I disagree completely. Self-loathing and the desire to be desirable was the only reason I ended up losing weight. Shame not feel nice, but it does provide social pressure, which if not addressed maladaptively can be a good thing.
The interesting part of this for me is their conclusion that that there is no such thing as being too fit in terms of longevity and health. This is surprising because a lot of athletic and fitness endeavours I've seen stress the importance of getting adequate rest days and not overworking. For example, in weight lifting circles, people often stress that lifting every day can lead to injuries and negative health effects. I wonder if this article calls that into question or perhaps they are just overlooking that the most "highly fit" people also take adequate rest days as a part of their routine.

It's probably also likely that the more highly fit someone is, the more likely they are to have other factors that increase longevity - ie. it means they have the leisure time to exercise and maintain a high level of fitness, it means they likely watch what they eat etc. I wonder how much of this is direct causation vs correlation.

Working out to exhaustion constantly doesn't make you more fit.

Rest days are key to improving fitness. This doesn't conflict with "there is no such thing as being too fit in terms of longevity and health."

People do have different metabolisms. But, the "genetically obese" thing is not true. That does not mean we should put the blame 100% on these people, however.

I encourage you to have empathy for these people. Because what it takes: Going to the gym, going hiking, getting physical activity, is not available for a lot of people. It is a huge privilege to live somewhere AND HAVE THE TIME to do these activities.

Most people live paycheck to paycheck, a gym membership is a meal they cannot put on the table. Their houses are small and working out inside of them is miserable. Or they are working multiple jobs and they choose not to spend the 2 hours of free-time they have a day working out. Who can really blame them?

Outside there could be violence, or the constant threat of being harassed by the police. Or, it could just simply be a paved-over wasteland where the community did not think that maybe people will want somewhere to walk around for a while.

My anecdote: I used to live in Chicago, and I was a serial "join the gym and never work out" person. I got pretty overweight at 190 lbs, 5'10. I moved to Portland, Oregon. And something interesting happened: Portland is smaller, and getting to the gym means meandering down a few tree-lined lanes until I reach a huge converted warehouse that now serves as a gym. The gyms I had seen in Chicago were squat-ceiling converted office space. I found going to the gym MUCH EASIER, due to the quality of the gym and the environment around me.

Eating less saves both time and money. You can save money by buying less food. You can save time by shopping for food less, preparing food less, eating less, and cleaning up less. You can eat less at home, at work, at the bus stop - anywhere, and while doing any activity. Anybody can eat less, no matter what their life is like.
Eating less takes will-power. It takes more will-power than many people have. What they need is to understand which foods they can eat that will reduce their desire to eat as much and as often.
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