this post was submitted on 30 Jun 2025
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Pharmacology aside, there's so much wrong with the way we handle obesity, which should be treated as a structural, societal disorder rather than an individual issue. Why does almost everyone relapse? Well, it's not like the carbohydrate snack hell at the grocery store got any better, and the advertising hell just keeps worsening apace. Protein is expensive, carbs are cheap. You can't walk anywhere and everything is built around cars and jobs where you sit around for 9+ hours and come home too exhausted to do any exercise. You try to create positive lifestyle changes, but everything around you is trying to push you into doing the exact opposite of that. Trying to push individualistic management rather than overall societal change is wholly ineffective as we've seen.
Obesity is absolutely a disease that dramatically worsens a person's quality of life and health in basically every way. The impact of body mass on joints and of bodyfat percentage on cardiovascular health are undeniable and there is simply no truth to the concept of "fat but fit." It's better to think of obesity as a progressive degenerative disorder, in that it takes a toll over time and its effects are more dramatic the longer a person is affected and the older they get.
While hopefully these therapies will help people, ultimately it's basically a problem of slapping a bandage over the actual problem: highly processed diets with little nutritional value and sedentary lifestyles made more or less mandatory by industrial capital.
I have some nitpicks, firstly vegetable based protein is extremely cheap in most places I've seen. I think when you say protein you really mean animal products?
Re obesity and health it's more complicated. At extremes being fat is inarguably detrimental, but a lot of medical focus is myopic and population trends cannot necessarily be directly applied to individuals. Like personally I'm thin, have been my whole life, I'm also active and almost every joint in my body is shot because I'm hypermobile and weak. Meanwhile my wife is a bit chubby and has been her whole life, she's inactive but strong. Her skeleton is in much better condition. Bloodswise we're ok but my liver is slightly damaged from alcoholism. If you looked at us you'd probably say that I look healthier, but that's because fatness of overemphasised. She is definitely much healthier and will likely outlive me and enjoy much greater quality of life.
She might be even healthier if she lost some weight, maybe she would develop an ED and be way worse off. She'd probably be much healthier if she started each day with 5 km run but no doctor ever asks her about that, or me whether I've considered started running or weight training at a regular health check. Many doctors talk to her about weight loss. This bias, and focus on something visually apparent is not really justified.