388 Comments

"The seed oil theory is something of a successor to the (mostly leftwing) concern about “trans fats” that popped up 10 to 20 years ago."

That's a weird spasm of both-siderism on your part, Matt.

The campaign to reduce trans fats was not primarily directed against obesity but rather against heart disease, because transfats have an outsized impact on atherosclerosis, I.e. the deposition of fatty plaques on coronary arteries.

And so far as I know, the research that showed that transfats caused greater atherosclerosis was extensive, solid, and still holds good today.

So: you are comparing speculative, YouTube conspiracy theories about "seed oils" making us obese, to well -established research showing that trans-fats cause heart disease, all so that you can say, "the leftwing does it too!"

Not good.

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I didn't realize that people were waging war on seed oils now, nor did I think people were conflating trans fats (which are a byproduct of hydrogenation) and the source of the oil. So I did a quick search and... wow, what a load of speculative nonsense studded with scary-sounding language about 'free radicals' that makes absolutely no sense.

"Low energy? Brain fog? Mood swings? It might be the oil you're eating." Riiiiiight, that's the likely culprit. It has nothing to do with the fact that the oil is inside the ultra-processed "muffin" you eat with your 1500 calorie "coffee" from the Starbucks drive-through.

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You only think that because the seed oils you consume manipulate your brain into thinking SOMETHING ELSE is causing your brain fog and low energy. Big Seed has gotten to you man!

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75% of the drinks at chain coffee shops should be illegal.

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Not illegal, just with a nice big Pigouvian tax reflecting their unhealthiness.

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Is Coffee that bad and high in calories or are you referring to lattes and frappes and the other ones that I never order?

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Black coffee is ~0 calories. Lattes and frappes with a lot of syrup can get into the 400+ calorie range. It would take some doing and be insanely sweet but you could probably put together a 1500 calorie latte at Starbucks if you really wanted to.

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Tangential but I still find it wild there's a 2000 calorie milkshake on the market with 130 grams of fat. Fucking hell.

https://www.dailymail.co.uk/news/article-1281479/Americas-unhealthiest-drink-2-000-calorie-milkshake-equivalent-25-bacon-rashers.html

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Wonder how that competes with the famous Five Dollar Milkshake from Pulp Fiction.

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My favorite caffeine consumption is chai tea, but it's turned into the oatmeal raisin of drinks that society deems just *has* to be mixed with all kinds of sugar, cream, and other caloric crap. I have mad respect for any place that can just get me plain old chai with none of that added.

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The last time I ordered an espresso (instead of making one at home) the barista said: "You know that is going to come in a tiny cup, right? Like, it's just a shot of black coffee."

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My breaking point was having to request an *espresso* macchiato, because that became a coffee-flavored milkshake when I wasn’t looking.

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I saw a guy order a venti breve latte at Starbucks once, which I believe would be about 500 calories, no flavored syrups or whipped cream though.

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The only time I tried a Frappuccino I could only drink like a fifth of it. It was so sweet it was kind of gross and it made my teeth hurt. And I have been known to eat ice cream for breakfast.

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All I know is that the last time I got a coffee at Starbucks most of the drinks people were picking up were the size of a Big Gulp and had a clear plastic dome on top through which I could see whipped cream and what I assume was caramel syrup. And this was early AM at an airport. Do they also use donuts as bread on their lunch "sandwich"? I wouldn't be surprised.

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I think a much better example would be people's terror about high fructose corn syrup, which is a sweetener that the body handles and processes in the same way as regular sugar (which it is chemically almost identical to) and which is no worse (or better) than any other sweetener, but which certain subsets of the population have completely lost their minds over and blamed for all sorts of negative health outcomes.

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I think the complaint about HFCS is not that it’s inherently worse than sugar, but that it’s very heavily subsidized - or rather corn production is subsidized but then we need to do something with all that corn, so we add ethanol to all gasoline and add HFCS to everything.

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Some people may complain about that too, but the complaint that it is inherently worse than sugar is incredibly commonly stated. People believe that HFCS is uniquely harmful, and lots of gurus and major media outlets make that claim all the time. It's absurd, but very common.

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Agreed that this is a widespread belief. A charitable explanation might be that it is the confluence of an increasing understanding that sugar (in any form) eaten at the high-level often observed in the standard american diet is a contributor both to obesity and other forms of poor health, and that the mechanism through which that sugar is injected into everything is HFCS. So the logic is: "Sugar everywhere is bad + HFCS everywhere => Thus HFCS everywhere is bad" which is probably true, but gets abbreviated to "HFCS is uniquely bad" which is probably not true, but is a reasonable approximation of the current situation.

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Even that is a huge oversimplication. The relative proportion of sugar consumption in our diets is not going up over the decades- it's the calories that are increasing,. IIRC (last I checked this particular statistic was a little while ago) sugar consumption is going up, but not as much as fat, and all macros are increasing, so calories are increasing decade-over-decade. Sugar consumption is not uniquely bad independent of excess calorie consumption, and HFCS is not further uniquely bad. It's the increasing consumption of hyper-palatable foods that is driving the increase in calories. Those foods (like donuts, pizza, etc.) are a delicious combination of sugars, fats, salt, etc.. Those foods are combinations of many different ingredients, macros, etc., so blaming a single macronutrient for the size of the American public is a red herring. People point to the sugars in things like a donut or cookies but ignore that donuts and cookies have tons of fat too- if they didn't, they wouldn't taste great. It's all of the ingredients and macros as a whole that cause the overconsumption, which is why you don't see anyone just main lining sugar out of a bag.

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There seem to be two orthogonal ideas - that proportion of sugar in overall American diet is not growing, and that this proportion is the same for American diets as for other places. Purely anecdotally, American food is much sweeter - especially desserts, and i remember seeing this mentioned in travelers’ accounts from like the 18th century.

The storefront cupcakes are pretty close to mainlining sugar out of a bag :)

A somewhat related anecdote about mainlining is the sugar content in champagne. Historically, the sweetest grade of champagne would have 200-300 g/L of sugar. For comparison, Coke has about 100 g/L

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Belief that HFCS is worse than sugar is *wrong*, but it was not made up out of whole cloth, there were logical reasons to believe it was true pending the data. And the data really only came in about 10 years ago or so.

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There were certainly good faith reasons to look into it, but I disagree that there was ever a logical reason to believe it was true pending the data. The differences between high fructose corn syrup and regular sugar are miniscule, so the mechanistic rationale for how it could be qualitatively different in its impacts on humans was always a dubious proposition. Dubious propositions sometimes turn out to be true, but our default assumption should be skepticism until evidence comes in rather than credulity. Not to mention that the evidence has come in and been incredibly clear for years and years and years at this point, yet the same people that were worried 15-20 years ago are still singing the same tune. This was never about a rational analysis of the evidence- it's always been about the naturalistic fallacy and the demonization of anything that can be claimed to be "synthetic" or "man-made"- it's the same reason those same people attack GMOs and other developments.

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I don’t disagree but think you’re overstating things somewhat. The real culprit is, I think, something Matt has talked about before. If it bleeds, it leads. “Your cane sugar substitute is killing you!” is a story that’s going to get more traction than “Actually, your cane sugar substitute is not killing you any faster than the old stuff” will.

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As I understand the story, there's an enzyme for cracking disaccharides into their components, and production of that enzyme is connected to production of a hormone that signals satiety -- so consuming something with sucrose (which is a glucose bound to a fructose) does produce more satiety than eating something with the same number of grams of sugar in the form of fructose. But this effect is pretty marginal, because basically for all sugars, we eat them too quickly for that kind of signal to matter. _Maybe_ it will make a difference if you're kind of grazing on a box of something over the course of an afternoon.

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Regular sugar is 50/50 glucose/fructose. HFCS is typically 55/45. That extra 5% fructose is tiny and has no impact on humans relative to sugar- there is no evidence whatsoever that switching from a product made with regular sugar to an otherwise identical one made with HFCS will induce you to increase your caloric intake in a day, which is what would need to happen to induce weight gain. When you look at people's diets and then wonder why they're gaining weight, focusing on something like sugar vs. HFCS is akin to thinking that moving to a house across the street from where you already live will be great because the weather is probably nicer there.

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That doesn't seem impossible, although a quick search seems to indicate that there's no different in satiety between the two either. And it reminds me of the idea that drinking diet soda will make you eat more, so it's pointless.

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That's my complaint. Corn is heavily subsidized resulting in corn syrup being in a whole lot of products that it shouldn't be in.

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Feeding animals for cheap meat is probably the least bad thing we do with all that subsidized corn. If political reality says you can't kill the commodity title, can we maybe subsidize vegetables!?

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What's an example of a product that "shouldn't" have sweeteners in it? There's a whole bunch of junk food on the market- I'm not sure that we can make moral statements about which ones should and should not exist at all.

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Just to take a random example that came up for me recently -- it is surprisingly difficult to find an unsweetened apple butter. Like I couldn't find any even after checking both a large Safeway and a Whole Foods. I had to special order it through Amazon Fresh. (At the WF of course things were sweetened with brown sugar, maple, or plain white sugar, rather than HFCS. But I think the widespread availability of cheap sweeteners does tend to set the baseline that _everything_ is sweetened. I don't understand why so many store salad dressings have sweeteners in them -- I don't add any at all when I make a vinaigrette from scratch. Unless you count white miso, which is mildly sweet, as a sweetener. I generally use that as an emulsifier.)

I don't know that this is a "moral" thing, exactly, but it does seem like we could do better things with government money than subsidize sweeteners.

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As someone not resident in America but who's visited regularly and read a lot of american cookbooks, it's absolutely the case that America has greatly broadened the set of foods that are believed to benefit from added sugar.

Salad dressings, below, are a great example, but it middlebrow cookbooks almost every dish calls for a bit of added sugar in a way that I don't see in cookbooks from other nations. I have a savory recipe featuring roasted nuts that calls for the nuts to be simmered in sugar first so they "taste more of themselves".

American cuisine declaring open season on most of the constraints and asceticism that underly most other cuisines is definitely a real thing, and probably not unrelated to weight gain.

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Yeah you shouldn't add sugar to chili.

That's what Peeps are for!

https://www.youtube.com/watch?v=2c-AawAKZ14

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As Alex P. mentioned I don't think the HFCS concerns were completely made up. I remember when the 2010 Princeton study dropped and got a lot of press. I haven't followed up since - maybe it was a terrible study - but the major response came from the Corn Refiners Association so - yeah I'm going to discount that one.

https://www.princeton.edu/news/2010/03/22/sweet-problem-princeton-researchers-find-high-fructose-corn-syrup-prompts

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Here's a nice rebuttal of the claims in that study from researcher Marion Nestle: https://www.foodpolitics.com/2010/03/hfcs-makes-rats-fat/

So no, HFCS on its own, independent of calories consumed, does not prompt more weight gain. And no research supports such a claim. Not to mention that even if that study DID find some sort of relationship, it is 13 years old- there's an entire body of literature looking at the claim since that time, and it uniformly points in one direction. Relying on one study in the body of research is always a bad idea, and that's even when the study supports the claims made. In this case, the study did not support the claims.

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Trans-fats may cause heart-disease but are they responsible for obesity?

In any case, Matt is sequentially giving theories for "why we're getting fat". That's not the same as equating all of them or attempting to "both-side" the political spectrum. I think you're unfairly drawing that inference.

What I think was weirder was giving either a political label at all. These aren't particularly political theories and the average person that hears either of them and changes their diet probably isn't very partisan.

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The. American Conservative article that Matt linked to doesn’t blame seed oils for obesity, rather it points out all sorts of other bad effects. It does mention, however, that seed oils “have become a popular target for the very online right.”

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Feb 2, 2023
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The way I read it, MY is talking about competing theories for obesity, specifically, and he notes a half-dozen of them, some with a political correlation, some without. He's not trying to say which side of the aisle is associated with more crazy health theories or that the two sides are equal in that respect.

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Yea, whereas the seed oil folks must be astonishingly ignorant of cooking practices basically everywhere else in the world.

WTF, do they think we invented peanut and soybean oils in 1980?

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Using sesame oil is why the Japanese are so fat!

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Yeah there’s lots of high quality evidence about trans fats. the best analogy to seed oils on the left would probably be GMOs. Or maybe the Forks Over Knives thing where relatively low quality observational evidence about vegetarian diets is turned into “meat causes all cancer”.

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Have you noticed that both sides feed on each other, no pun intended? One side says vegetarianism is good and wholesome so the other side says eating ridiculous quantities of red meat cures you of [vague malady].

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Also cherry-picking on both sides. For example some studies have shown eating only _cured_ meats probably does have some poor health impacts, same as extreme vegan diets. Both sides can be correct in the criticism ... but then they extrapolate beyond what the evidence supports.

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To be pedantic, a vegan diet itself is not extreme or unhealthy. A completely vegan diet can be perfectly nutritious, protein-rich, and hit all the necessary vitamins and minerals (maybe requiring a B12 supplement). It does take some planning—which is why a lot of people who just cut out animal products without replacing them with other nutrient sources often have health problems—but it's completely doable. Now if by "extreme vegan diets" you mean "weird nutrient-poor diets that also happen to be vegan" (like "only eat lettuce and drink lemon juice") then yes, that will cause health problems.

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I deeply doubt that vegan diets are as doable as you claim. I once read a firsthand account by a former vegan who thought she was doing everything right but was actually wrecking her health, and she got way better once she resumed eating meat. There are no vegan diet traditions anywhere in the world - many traditional diets exclude some kinds of animal products, but *never* all of them. Humans are omnivores, and we evolved to eat a diet that includes animals.

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Any nutrient necessary to humans can be found in plant/mineral/synthetic form. The most important nutrient which is almost exclusively found in animal products is vitamin B12, but you can take a pill or injections for that (it's not naturally occurring in animals either, but farm animals are typically supplemented with it, which is why animal products contain it). There are species like cats which are obligate carnivores since they can't synthesize their own taurine (an amino acid), but humans and other omnivorous species can synthesize our own taurine. Barring some very unusual health situations: whenever people go vegan and start to have health problems, it's because their diet isn't adjusted properly, and it can be fixed by getting a blood test to determine any deficiencies, taking supplements, and/or adjusting your diet to include a wider array of foods (including fortified foods) which contain the nutrient that was lacking.

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Agreed. My understanding that the evidence against trans fats is pretty solid.

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As are trans fats at room temp!

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Yes, exactly.

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Don't you hate it when you make a subtle, easily-missed joke, and someone else gets the likes for retelling the joke and making it unsubtle and obvious?

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You have to meat your audience where they are.

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Is there evidence that they are contributing to obesity specifically or that they are unhealthy in general? I don't know the answer so I'm genuinely curious.

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I am not an dietician or expert by any means, so take what I say with a grain of salt.

But, my understanding is that the biggest concern with transfats is that they contribute to cardiovascular problems and specifically coronary artery disease. And while there are concerns that transfats may contribute to obesity and diebetes, that there isn't a scientific consensus.

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If you keep taking things with a grain of salt you're going to screw up your blood pressure.

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Agreed, I don't associate trans-phobia with the left.

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Sigh... Someone had to go there....

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it is peak irony tho that we forced McDonalds to ruin their fries and in the process caused them to make thrm taste worse but aslo be worse for us, 'idinit? Ain't that America?

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BRING BACK LARD

BRING BACK TALLOW

My mom used to make a spaghetti sauce that involved cooking ground beef, then putting it through a colander to get rid of the fat. I took over the stovetop, and added some flour to bind the fat instead of getting rid of it before putting in the tomato sauce. The result was WAY better - not only more flavorful, but also more filling, and sticks to the ribs better.

FAT IS GOOD

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If you want to add a political valence to weight issues, discuss what role looks should play in hiring.

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Feb 2, 2023
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The NYT has written a bunch of articles on different explanations for obesity and how to lose weight, including a plug for the Mediterranean diet. I assume there’s been a flurry of articles because it’s January.

On the Mediterranean diet, I always think of the NYT article I read maybe ten years ago where they interviewed a bunch of skinny Greek people. The interviewees uniformly said it was because they didn’t get enough food, and they were hungry all the time.

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Feb 2, 2023
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It is always interesting to look at the more moderate apologists that try to steel-man the crazy on either side. On the left, you have people that will acknowledge the science and then say, sure obesity has health problems, but isn't stigmatization a problem too? On the right, the more sane people seem to have melted away, but to the extent they exist tend to couch their defense less on the merits and more on allowability. Sure the right-extremists are crazy, but shouldn't they have the right to their craziness, why are we forcing X upon them? Be that vaccines, environmental-protection, well-researched-history, or whatever.

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You have the argument wrong. Most left-wing people I know agree with the statistics-- that regardless of how we define men, men are on average physically stronger and more muscular than women. The argument used regarding sports is much more precarious-- that any evidence showing men perform better at sports than women is inherently biased by accessibility to sports, sports medicine, and kinesiology theory. Notable points in favor of this argument are historical outperformance of men in sports such as jockeying or chess. Jockeying requires an athlete to be short and less muscular to perform well, so given equal accessibility, since women are on average shorter and less muscular, would likely have average higher performance. Meanwhile, chess would be a 50-50 split by the above argument. A notable point against this argument is the relationship between testosterone, adrenaline, and aggression which then can increase competitiveness.

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Chess is a totally different story. Seems that at the *extreme margins* there are just a lot more males with uber-talent required to be grand master. Like if you look at the world rankings it’s not even remotely close (best woman in the world currently ranked about 100(!) overall). Pretty clear it’s not merely a sociological explanation. Of course this is not a difference that is meaningful for 99% of the population, which is very different from the physicality/sports question.

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"if we define "woman" as "anyone who identifies as a woman" then yeah, those physical differences disappear." just to be pedantic for fun - the differences do not disappear, because ecen if you accept the "trans" defintion of gender you can still observe that the great majority of women are female, and females are on average weaker than males, a differential transpeople may mitigate somewhat but by no means make disappear. Put differently, however you define "man" (or "woman")-whether the traditional/"gender critical" or identitarian/"woke" definition- it remains valid that statistically men are physically stronger but that it does not follow that every man is stronger than every woman.

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>>I remember a galaxy brain thread on Twitter about how we only sex-segregate sports to protect men's fragile egos because women would whoop their ass if it weren't.

I am genuinely curious if 100% of peple presenting this take were trolling/conforming or if anyone genuinely believes it. If the latter, I wonder whether it ought to be simly categorized udner "there must be some idiot somewhere who thinks so and so" or if there is more to it. I honestly cannot imagine how someone (over 12 years of age, say) can be *so* out of touch with reality to honestly think this. it's a shocking disconnect.

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Is it too mean to suggest that the take about women being stronger is influenced by the sample of males in the post graduate academy?

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I found what I think is the reference, and it is 100% earnest and 100% stupid https://twitter.com/shereebekker/status/1504899936843935746

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IIRC that was part of the point of that Atlantic article that Matt did Bad Takes episode on.

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I like to think of how each decade’s reputation is really just about baby boomers’ point in their life (50s idyllic boring suburb life, 60s a time of discovering drugs and sex and music, 70s partying a bit too hard, 80s time to make money) and adding in the 80s/90s oh no we’re gaining weight in our 30s and 40s is funny to me.

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Considering that historians peg the actual end of the Great Depression to the 1950s, when most Boomers were born, perhaps there is an historical coincidence operating here, that Boomers were the first generation born into the age of food abundance--that there was never a time in their lives that there were widespread food shortages, that food supply just went up and up and became less expensive adjusted for inflation.

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Pre-1950 America was a fat nation trapped in a thin body, yearning to be set free!

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I have never seen any consensus that the depression didn't end until the '50s. In a quick google the closest I could come to was some libertarian outlying economists saying it didn't end until after the war when government spending dropped and the free market was able to be free again.

What definition would you use that would include in the depression both the war and then another half a decade or more after the war?

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Agreed. This seems like a corollary to "don't attribute to generational trends what can be attributed to time of life"

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Whoa I never even realized that. Less music becomes as "classic" as classic rock now because the boomers aged out of their "open to liking new things" phase.

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Idunno, I've definitely heard Nirvana, Pearl Jam and Radiohead on my local classic rock station. Stuff from the 2000s, like early Arcade Fire or Killers, will get in there sometimes, too.

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Yeah - the stuff from the youth of the next great generational bulge, the children of the Boomers

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An illustration of this -- my grandmother was a phenomenal cook and one of her best dishes was fried chicken. I would try to re-create her fried chicken but the first step in the recipe as it has been passed down to me is "get all the grease you can afford." I'm not sure how to approach this as -- not to brag or anything -- I can afford a lot of grease.

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Ooh, get a load of this guy!

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No, no -- she wrote, "get all the grease you can; a Ford's worth should do."

A "Ford of grease" is the amount of grease needed to lubricate an F-150 -- roughly 9 oz., give or take a zirk.

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“‘Give me five bees for a quarter,’ you’d say.”

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First read the rest of the recipe to figure out if this is a pan-fry or deep-fry recipe. Then estimate how much grease you need to make it happen. Try it and see if it works. If it's not right, adjust the amount of grease next time you make it.

The secret to becoming a phenomenal cook is trial and error and adjustment over time. Every time you make a thing, critique it. Ask yourself how you can make it better, then do better next time. Eventually you'll perfect everything you make regularly.

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"Lisa, there's absolutely no record of a hurricane hitting Springfield."

"Yes, but the records on go back to 1978, when the hall of records mysteriously blew away."

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Take the obesity rate among children:

https://www.ahajournals.org/cms/asset/a6938350-dbde-492b-b304-935b841fcb27/zhc0391212230001.jpeg

It’s quadrupled since 1980. And it’s not some smooth increase over decades. It’s pretty flat and then it starts rising in 1980.

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Yeah, I think the basic thesis of this piece -- that recent increases in obesity are merely continuations of centuries-old trends -- is fundamentally wrong.

You'll notice we were not provided with charts and stats for the increase in height, eg. Those would show that Americans have also grown taller since the Civil War. But our height has not increased in the last few decades at anything like rate at which our weight has.

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"I think the basic thesis of this piece -- that recent increases in obesity are merely continuations of centuries-old trends -- is fundamentally wrong."

Strong agree. I think the whole article is wildly off-base. Also we have a lot of correlated problems of modernity that are significantly more consistent with something like widespread environmental contamination--e.g., of phthalate and plastics, many of which are known endocrine disruptors--than they are with the null hypothesis. Most obviously declining sperm counts and testosterone levels and decreasing anogenital distance in males. It would be weird if, for example, ubiquitous microplastic contamination *didn't* have negative effects.

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I don't know anything about the anogenital distance, but

"Most obviously declining sperm counts and testosterone level "

are factors associated with obesity.

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"I don't know anything about the anogenital distance..."

I feel like I would pay good money not to learn anything about "anogenital distance". WTF.

But I have noticed among some online commenters a shrinking anocranial distance when they get their heads in the wrong place.

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Have a like for "shrinking anocranial distance"

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Why, thank you! Don't mind if I do.

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anogenital distance is a measurement typically taken in newborns where lower number is generally correlated with being "more feminized" and seems to be on a secular downward trend for newborn boys.

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But height is compensated for in the BMI calculation, in fact it is squared. Weight can increase in the same proportion as height and the BMI would be going down - ie if a 5% weight gain happened along with a 5% growth, the BMI would be lower compared to the original measurement, pre-growth.

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Well that's the point, weight doesn't increase linearly with height. You see normal BMI distributions among people with the sane height. It's not like all the 6'6 people get classified as obese.

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Height increases are seen as a consequence of improved malnutrition. It's why lords generally towered over the peasants in the middle ages. Nothing genetic, just getting the calories you need to grow.

Interestingly median heights decline from the Civil War to 1890 or so as we rapidly industrialized/took a lot of poor immigrants/had extreme income inequelity

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I thought the same thing! It would be interesting to see the charts consider changes in the average height, because it seems obvious to me that taller people would have more mass and weight.

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Feb 2, 2023
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"Also, your height thing is a red herring."

I'll try to rephrase it so that it does not sound like a red herring.

Matt notes that weight has been going up for over a century, and infers that recent weight gain is simply a part of that background trend.

But the background trend was largely one of people's nutrition catching up with their genetic ceiling for both height and weight, i.e., healthy or proportionate weight. People used to be both shorter and lighter than they were genetically capable of -- their poor nutrition prevented them from being taller and also having a greater healthy proportional weight.

What we see with height is that it grew for decades as nutrition improved, and then plateaued when the genetic limits were reached.

If we did not have a problem with obesity, then this same plateau is what we would have seen with weight, too. When height plateaus but weight keeps growing, then we have an obesity problem.

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BMI tells you how fat someone is when you control for height. The main chart in the post uses BMI. Height is not a confounding factor here.

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My daughter came home from a play date with something that looks like roll-on deodorant, but is really a device that dispenses flavored high-fructose corn syrup through a ball that you lick. Plus a back of bubble gum that is so pungent we could smell her chewing it from six feet away. And some sort of over-sized Cheeto. I have no idea what else she ate while she was there. But we started talking about what their friends eat and, wow... just, wow.

I'm not blaming or shaming parents; they're just feeding their kids what the grocery store sells. And once our kids got a taste for it, they started bumming junk food off of their friends and school and coming home with uneaten lunches. That stuff is literally addictive and kids lack impulse control; they are helpless against it.

I'm generally pretty libertarian about these sorts of things, but it is not ethical to market this kind of "food" to kids. It's designed to trick your lizard brain into eating too much of it and, as with nicotine, adults are free to consume it with that knowledge. But not kids. We shouldn't let them get hooked on ultra-processed lab-designed sources of calories any more than we should let them vape nicotine.

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We are *attempting* to give my kid enough exposure to mass-produced junk, eaten sparingly, that she can withstand this shit when she goes out into the world without us hovering over her shoulder. And also to cook enough *better-tasting* "junk" at home that she sees the value in DIYing it, which is a natural brake on stuffing one's face with sugar.

"Yea, I had those once, they're pretty meh, but mom and I are making tiramisu this weekend, you should come over." is my hoped-for response when she receives a roller ball of corn syrup.

That said, one of my major reasons for making damned sure she's in an out-of-catchment school on the other side of Philly is to get her into a school where her peers are likely to be eating much less of that crap. If she goes to the local, dirt-poor catchment elementary school, we're going to have to threaten to shoot her on a weekly basis to keep the shit food to a dull roar. I'm way more confident in my ability to make up for the terrible academics at that school than the dietary and bullying issues.

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Peer influence is terrifying.

I'm struggling with providing my kids just enough exposure to the 'bad' kids so that they develop immunity to their pathologies, but not so much that they fall victim to them, and not so little that they become ignorant coddled wimps.

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I have this misguided notion that my kids should have the same kind of upbringing that I did. My mom's theory was that you eventually return to the food you were raised on and fed me the same hippie nonsense she ate. Starting at the age of 16 I sustained myself entirely on fast food and continued right through college. Now I eat hippie nonsense that my mom hasn't even heard of and feed it to my kids.

In the same vein, we send the kids to the local elementary school that serves a big, rural community in addition to our suburb. The other day my daughter said "I don't need no jacket" and has spent the whole week begging for a sleepover at her new friend's house so that she can gorge on their junk food. We're edging ever closer to asking her if she notices anything, uhm, distinct about the bodies of all these lucky kids who get soda pop and Doritos in their lunches.

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Ugh, and teachers using candy as rewards instead of gold stars or whatever it used to be. So well behaved high performing kids come home with candy pretty much daily. It's ridiculous.

Speaking of vaping nicotine...the other big thing that happened in 1980 was people started quitting smoking, en masse. Tobacco, awful as it is, is an appetite suppressant, and supermodels will vouch for the fact that smoking keeps you thin.

Not suggesting we go back to widespread smoking -- obesity is less harmful than tobacco -- but it's a natural consequence when we have widespread food and sedentary jobs.

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But if you assume that weight is roughly a bell curve, and that obesity is a fixed threshold to cross, a long-term trend of the bell curve increasing will cause an increasing number of people to be above that obesity threshold.

That graph is at least plausibly compatible with a steady long-term weight-increase trend.

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If overall weight has been increasing steadily over time, any given *threshold* will have been low for a while and then skyrocket at some point.

Matt zooms out, and looks at the whole picture of weight instead of just obesity (which is defined by a particular threshold, namely BMI over 30) to reach his conclusions. I think they are sound.

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That’s because obesity has a fixed definition. This neither proves nor disproves Matt’s thesis, because you’re looking at a binary, obese or not, and he’s looking at the value of BMI over time. Whether or not we gained 50 lbs over 2 centuries or 50lbs in the last 30 years, your data (obese or not) would look the same.

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Feb 2, 2023
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I don’t think that’s what’s going on. Check out a YouTube video of Disneyland opening in the 1950s or Disney World opening in 1972 and look at a video of Disney today.

You could make an argument that you didn’t see morbidly obese people being pushed around in wheelchairs in the 70s but they still existed and it was the invention of mobility scooters that brought them out in public. But that’s not what happened.

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Why don't you think that's what happened?

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Feb 2, 2023Edited
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What percentage of calories consumed consist of microwaved “delicious” food?

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Wouldn't it be better to ask - did the microwaved "delicious" food replace other calories or was there a substantive net add? I'm guessing some of the former, but a lot of the latter. Which means that even if its only 15% (I would suspect higher) but it replaced 5% other calories and added 10% more calories, that 10% adds up over time.

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I think this data is consistent with the layperson narrative: We’re fatter because we can afford more food—including less healthy food, rich in previous luxuries like sugar and fat—and we work more sedentary jobs due to technology advancements. The seed oils, chemical obesogens, and other mystery causes are generally fringe theories. And I imagine that people who care enough about these false narratives to act on them are likely also engaging in other more productive behavior such as avoiding sugar and exercising more.

Nonetheless, a proper understanding of the cause hasn’t led to widespread success in solving the problem. I think most people know that we should eat less and healthier, and also exercise more. (And we should!) Yet knowledge alone is insufficient. I get the impression that most people who put this understanding into practice have their own obsession with diet and exercise, in a manner with some similarities to the seed oil nuts who incidentally also practice some actual healthy behavior.

Speaking from my own experience and that of my friends, maintaining a healthy weight requires a fair amount of conscious focus. It’s certainly do-able, but it demands dedicating a significant amount of time and effort, which seems to be best facilitated by compulsion. I’m thankful that I’m once again addicted to cycling and home cooking, yet I wouldn’t generalize that as advice for the broader population.

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Yeah, I remember in the fall I was hanging out with some dudes and one of the guys said he was trying to get into the gym and asked me my routine, and I told him that I work out 6 days/week, in the mornings, count my calories and watch what I eat like a hawk. There's no secret sauce to this stuff, it's just hard work and discipline.

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I'm in a similar (lucky) boat. But the fact that only 1/4 of adults in this country are able to maintain sufficient discipline to stay at a healthy weight (https://www.cdc.gov/nchs/fastats/obesity-overweight.htm) suggests a societal problem that is out of the hands of most, that should be met with serious interventions that are equal to the task. I'd like to see politicians put together a Green New Deal style vision for improving health outcomes for Americans (especially children), with an accompanying policy framework.

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We designed our cities to inhibit walking. Therefore exercise is something you only get with intentional effort, time taken out of your normal activities, instead of something built into everyday life.

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I'm not in good shape because of luck; I'm in good shape because I put the time in

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Same reason most (not all) people become rich and successful.

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Sounds like you have to work harder at it than I do. But I don't think that's because of genetics, it's because I was raised by parents with good food/exercise habits that 1. Ensured I was a healthy child and 2. Inculcated similar healthy habits that stuck with me when I moved out of the house. But that all happened because I grew up in a relatively walkable/bikeable area with abundant options for purchasing healthy food (nearby Whole Foods/Trader Joes/etc.) and my parents were well off/educated enough to be able to take the time think about nutrition, prepare healthy meals, and be resistant to the sensory blitz that the processed food industry visits upon us via marketing/advertising/general ease of access. Meanwhile my girlfriend grew up in a household somewhere on the other end of the spectrum (nice parents, they just didn't know any better/had more pressing issues to consider in their day to day) and only now in the second half of her 20s has finally managed to shake off the vestiges of the negative nutritional/activity habits that were a feature of her childhood. In my opinion, there's no reason this disparity should exist and we should do everything in our power (on a societal, not just individual) level to ensure that's the case going forward.

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Everything you say is right but ... it's also *genetics*. Both muscle strength and lean mass are highly heritable traits. The reason both Nick and Joey Bosa are in the NFL isn't surprising.

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Of course, all of this is easier when you come from/reside in a culture where healthy habits are the norm rather than the exception (aka almost anywhere besides the US).

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Just last week, I had a couple of people telling me they figured I was a skinny person all my life! I showed them a picture of me 15 years ago, and they couldn't believe it (I went from 210 lbs -> 130 -> 150 now). It's infuriating because, as I told them, I actually work out six days a week (including 20-25 miles running) and watch what I eat to stay this way - it doesn't just happen!

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What's weird is that "working out" even in my lifetime went from a thing a few eccentric weirdos did to something like flossing where even the people who don't do it know that they're supposed to.

And then there's people like me who have approximately zero self-discipline and stay relatively thin, even nearing 50 years old. I haven't forced myself to exercise in more than a decade and rarely go a day without an afternoon pastry, and I still have to wear a belt with the smallest pair of pants that Costco sells.

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I'll give some personal anecdote seconding your "conscious focus" point. I suffered a pretty severe bout of depression my sophomore year of college; had to take medical leave and go to therapy as a result. One of the first big recommendations from my therapist? Go to the gym. But not because he looked at me and was like "you're depressed because you're overweight, go lose 20 lbs". It was the mental health benefits; release of endorphins, sense of accomplishment, healthy way to relieve stress etc. So started going 5-6 days a week. And have been going to the gym pretty consistently 5-6 days a week ever since barring illness/vacation or necessary rest. My point about this anecdote is I have had to very focused on the importance of going to the gym for a good portion of my life now. Knowing the importance to my mental health has been a very motivating factor in my diligence with this*. Work busy? Stop at 5:30, go to the gym then come back to work. Have had to be very upfront with previous girlfriends and now my wife that going to the gym consistently is a big part of my daily routine. I orient my daily routine A LOT around making sure I go to the gym. It's a real effort and I completely get why this is something not easily done by may people.

*Not going to lie. When I came back to school, I was a bit worried that I was lose my focus regarding going to the gym so often. Thought to myself, I wonder if I'm going to need some other motivating factor to keep me going to the gym. Went to a party before the semester started. Talked to a girl at that party and then noticed she was feeling up my bicep and there was the extra motivation I needed.

Which actually leads to kind of a serious point about this topic. Let's be real here, a big reason people focus on the need to lose weight is not health, it's looking more physically attractive.

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That’s young people. People of a certain age, after getting some sort of health scare (heart issues, pre-diabetes A1C, etc.) are doing it for health.

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To add some folk health advice: consider taking a fiber supplement to control appetite.

I started taking metamucil thrice-a-day over the holidays to deal with some indigestion from unhealthy meals. Since I bought an entire tub, figured I’d continue working through it. Over the course of January, I’ve lost 5 pounds with no conscious change in diet. Previously I was averaging 2 pounds a month. On reflection, notice that I am eating less without intention. Further, haven’t noticed any loss in athletic performance; my cycling FTP continues to slowly rise and my weight lifting stats are just as pathetic as before.

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Will second the fiber recommendation. Really don't want to make this into some "silver bullet" by any means, but adding more fiber to my diet has definitely lessened by appetite (among other health benefits). Big reason eating bananas is a consistent part of my diet.

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Every time I add fiber to my diet, I’m on the toilet frequently.

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A drawback for sure. lol

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I do the same, but with psyllium husk capsules. Less disgusting.

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Things that mechanically expand your stomach minus calories will stave off hunger for a bit. Part of the reason to drink a lot of water is that it can stave off the desire to snack.

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That's interesting. I've long made sure to eat a lot of fiber, but I've never gone so far as to try a supplement. I've actually got some Metamucil at home that was left by a guest. Maybe I'll give it a whirl.

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I agree. Biology and chemistry plays some role in this but at the end of the day it is a matter of calories in, calories out. There's no ignoring that we have made calories in easier than ever and calories out less convenient, and something a person really has to make a conscious effort to prioritize, with exercise and diet. One of my big hopes is that the WFH revolution will help people in this regard. Before the pandemic I used to leave the house at 5 AM to weight train or go on a run. Now without the office panopticon looking over my shoulder it's easy enough to slip out for a quick jog or trip to the gym midday, meaning more consistency and fewer missed workouts. That plus bike rides with my son in the evening instead of sitting in gridlock has me netting way more physical activity. It's also allowed more meal planning flexibility for the family. Not that we don't still have the occasional pizza night, of course. After all we aren't monsters.

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I don’t think the question is so much what the cause of obesity is, as much as what medical interventions will pop up to reverse it (if any).

Im more interested how obesity intersects with culture myself. There has been a great push to destigmatize obesity, yet it’s still looked as a problem to solve.

My personal interest is in the relationship between testosterone and weight gain among men. Last year I found myself gaining weight. Long story short, I got diagnosed with low testosterone, went on oral testosterone pills, and basically had my life changed. My belly fat is virtually gone after 6-months.

I am also hearing about other drugs (one for diabetes) that many people are using off-label to lose weight.

Anyway... fitness is my thing now.

Oh and hi guys. I’m on my way to Michigan State with daughter for a visit. She is checking out colleges.

So

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Well Ozempic and Wegovy are the same drug just different doses so it's "off-label" only in a superficial sense.

You can get insurance to cover "Ozempic" (diabetes drug) much easier than you can get them to cover Wegovy (higher dose version targeted for weight loss).

Get yourself a diabetes diagnosis and bam, weight loss drug.

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I was all in until I found out it had to be injected.

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Those are them!

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I live a few blocks from MSU campus. Tell your daughter that if she likes the campus now, in the dreariest days of February, it will only get better from here :)

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Do you need us to bring u some heat! We just checked out the weather!

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Yes plz my hair is freezing

(Narrator: The fun part is that weather forecast for East Lansing for February 3rd 2023 could be a copy paste of any day in any February)

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Ha. We heading there now.

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Low testosterone is a known consequence of obesity (much more common than the other way around).

Hopefully your doctor is treating you for hypogonadism, but there's been a fad of writing testosterone scripts for just about anything. Testosterone supplementation has several negative long term side effects including increased heart disease, impaired fertility, etc.

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I work in admissions, Rory -- let me know if you have any questions about the college process!

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For nearly seven decades I’ve not only seen kids get fatter, I’ve seen the ways in which thinness itself has changed. No American and few Europeans are thin AND flabby; they are thin and well-muscled (and a bit haggard in the face). At first, I thought this was a purely American phenomenon but returning to the UK every few years, I’d notice how kids were getting fatter there, too. To see a truly scrawny young adult now, you have to watch a film from the 70s.

To me, it has long seemed obvious that the primary cause for this change was cheap calories. The decline in food costs has corresponded to a change in child-rearing practices generally. Half a century ago (when, as David Sedaris says, was a time when your parents told you to put yourself to bed), food was a budgetary item appropriate to the child’s status in the family. For the parents, it was left-over stew with actual meat; for the kids, it was box pizza stretched out to the thinness of a cracker. But hey, it was pizza and that was cooler, so we wanted it. That would be followed by a dessert of pennies-a-box jello salad. If a kid wanted more, she got cereal if she was lucky, or something else dull and cheap and which made you think you weren’t all that hungry after all.

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Oh man. It’s going pretty well

So far. What school?

Accepted:

Alabama

Clemson

USC (South Carolina)

Wofford

Charleston

Michigan State

ST Louis Polytechnic

Rejected:

Texas

Optimistic:

Duke (interview went very well)

Waiting:

Carnegie Melon

Boston U

University of Pittsburgh

Yale (reach school)

Rochester Institute of Technology

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biased but pittsburgh is great

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I agree. My office is in Pittsburgh, and I travel up there pretty regularly. I just left today. So it would mean that I get to see her a lot. University of Pittsburgh needs to put up some scholarship money. Carnegie Mellon would be hard to say no to. But it’s a long shot.

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Got another 15 years before I’m on that part of the dad journey. Good luck! I hope y’all create some great memories touring the schools.

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Lol. I’m sure we will. I got two daughters after her that seem to be college-bound. Retirement is not in the cards for me pretty much ever.

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Always root against Alabama.

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Me too! It’s not in the top 3.

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You may already know this, but on that list, Carnegie Melon has the best reputation for computer science. However, I've heard from some grads that the profs aren't always that invested in teaching CS (even if they are great researchers). Not to say that doesn't happen at other schools tho.

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Yep. She probably should of applied for a different major. So we aren’t super optimistic.

But looking at the income projections, Duke isn’t far behind.

She only applied because my Dad got his Masters in Mathematics there.

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Does she have a major picked out yet?

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My daughter is crazy. Computer science was her major at most schools. But it’s some she just picked random things like bio systems engineering.

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Haha, I remember those days. I think I applied for MechE at most schools but applied to Architectural Engineering at a few?

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Yeah. Like who knows what they want to be at 17. All I wanted was beer and women at that age (thus my 22-year detour in the military)

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Best of luck to you both. Affordability aside, my unsolicited advice is the school that "just feels right, dad" is the best reason for a decision.

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She read this comment in agrees with you. Unfortunately, my wallet disagrees.

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Yeah. Totally get that. Why I began w "Affordability aside". Easy to talk when I'm not writing the check. Best to her and you,

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Thanks! I talk tougher than I am. Luckily she is pretty level headed as well.

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What other colleges is she interested in?

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See my other post above

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I agree that food accessibility is surely a major contributor. What about physical activity? What percent of Americans are able to sit for 8-12 hours a day compared to 20, 40, 60 years ago? I know caloric intake is a much bigger lever on weight that caloric output, but it does seem like it would also be a factor.

And to everyone sticking to the idea that something really did shift around 1980- the nature of a complex system is that one or two inputs can continuously, gradually change over time and you can start to see exponential growth in an output variable. The appearance of a step change in an output doesn’t necessarily mean there was a step change in an input.

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One thing I was surprised about when I started exercising is how few calories you actually burn, e.g. a granola bar is worth an hour plus of moderate exercise depending on which one you get. 2020 compared to 1820 when a lot of people were doing tons of backbreaking labor probably is significantly different but compared to 1980 I am not sure people's daily lives are that much less active.

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Yeah, I've definitely read/heard* that exercise is actually not that great for weight loss. It's important for overall physical health for other reasons, and I think it's helpful for weight maintenance. But if you actually want to shed pounds, diet is way way more important.

*I don't remember where I got this from and will allow for the fact that there is a lot of crappy information floating around out there about this topic, as many posts in this thread have discussed.

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So I'll chime in as someone who's been a pretty big gym goer for 20 years now. I think the exercise is not actually great for weight loss needs to be narrowed a bit. First, I think it's a very necessary pushback to those commercials/infomercials for various exercise equipment with tagline "all it takes is 15 minutes a day". As though using boflex 15 minutes a day absent any other changes is going to give you the body of Chris Hemsworth in various Marvel movies.

Second, I think it's absolutely true that the "30 minutes a day, 3 days a week on the ellpitical" is going to lead to permanently losing 20 lbs. This is true, you're body adjusts to calorie loss and end result is you don't lose much weight absent other changes in diet*.

However, this a bit different from cardio doesn't help lose weight. What you need to do is constantly change things up (you hear "muscle confusion" a lot in this regard). Do elliptical for 2-3 weeks. Then do stair climber for 2-3 weeks. Then do bike. And then change up intensity each workout; add a few more minutes each session, up the level or how fast you go in different intervals. Second, your exercise should include a pretty decent amount of focus on building muscle. This doesn't mean deadlifting the same weight as a body builder. Things like boxing cardio, or exercises that incorporate all sorts of different squats, lunges, punching movements etc. (think PS-90). Point is, all of this is really difficult and requires an enormous amount of attention.

*my number one advice to people going to the gym is that there is only one bad answer as to why you're there. You're there to lose weight. This may be a by product of you going. But if that's your goal, it's a road to disappointment and then to giving up. Which is a shame because 3 days a week on the elliptical is incredibly good for you in so many ways that have nothing to do with losing weight.

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Edit: "Second, I think it's absolutely true that the '30 minutes a day, 3 days a week on the ellpitical; is NOT going to lead to permanently losing 20 lbs.

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Just adding here that lean mass (muscle) is metabolically active and increases your resting or basal metabolic rate. I guess in a narrow sense increasing lean mass is in tension with "weight loss". But as Ken points out -- a better goal is fat loss.

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Lifting weights is a good way to get rid of fat, which is (I think very obviously) better than merely shedding pounds.

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Yes and no - it’s kind of a nuanced issue.

Weight loss comes from burning more calories then you eat. At the most basic level, it’s calories burned - calories eaten = calorie deficit (or surplus). So if you hold calories eaten equal and burn more calories through exercise, then you’ll create a bigger calorie deficit and lose more weight. In that sense, exercise is great for weight loss! There are some complications though.

First off, the calories eaten side of the equation still counts. Exercising makes you hungry, so it’s not uncommon for people to eat back the calories they just burned (lots of endurance athletes do that intentionally when they maintain weight - it’s why Michael Phelps used to eat so much). Even not counting calories is enough to potentially make exercise worthless for weight loss - how can you know if burning 500 calories is enough to create a calorie deficit without knowing how many you ate? It’s like saying A - 10 = -2 without knowing what “A” actually is. Maybe it’s true, maybe it’s not. There’s no way to know. Exercising without controlling food intake may not do anything.

The second issue is that (as you allude to), exercise burns way fewer calories than you’d expect. I typically burn 100 calories per mile run, so a 5 mile run won’t even burn enough calories for a Big Mac. Eating a Big Mac takes 2 minutes, while running 5 miles takes 45 minutes. There’s this effort asymmetry that makes it much easier to torpedo the “calories eaten” variable than to burn enough calories to eat whatever you want.

I do think exercise can be really helpful mentally, though. Losing weight fucking sucks, so having a positive goal to distract you can be really powerful. That way, even if you don’t use exercise to create a bigger calorie deficit, you can still use it to have a positive wellness goal beyond the slow slog of weight loss.

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Burning (or eating) 50 extra calories a day for 10 years will make a 50 pound difference.

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My sense is very minor differences like 50 calories / day wouldn't make much of difference. You have ~ 500 grams (2000 calories) of glycogen storage in the liver and muscles that act as a buffer.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636990/#:~:text=In%20postabsorptive%20humans%2C%20there%20are,of%20liver%20and%20muscle%20glycogen.

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Yeah that's basically why I've been thinking the point about food continuously getting cheaper and tasting better is the major factor, you don't need to be living like a glutton to become overweight or eventually obese, just an extra bite every couple meals for a few years

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Yeah, for calorie burning duration matters more than intensity. It’s hard for a one hour workout to compare to an 8 hour shift of even light activity.

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Maybe, but as I understand it, doing a lot of physical activity can increase the rate of your metabolism.

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I agree that we are more sedentary and that has an impact, but Mexico has surpassed us for obesity, and surely they are less sedentary than we are. I think that really points to the problem being how easy it is to get cheap calories, but as far as general health goes I think our activity level is probably the thing we should worry about more.

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I missed yesterday's tax discussion due to travel. So I will weigh in on yesterday's topic today. My apologies for being off topic.

The fundamental problem with our tax code is that it is riddled with spending priorities rather than merely a tax code designed to raise needed revenue. The mortgage interest deduction, EITC, deductions for children, etc are all spending priorities.

A better solution would be to tax all income equally (or perhaps a lower rate for some types of income to spur investments) and then spend government money on people who need it, either through services or direct monetary payments. This wouldn't necessarily mean a change in the distribution of after-tax and after-transfer income -- we could design a system with either more or less progressivity as today.

The flaw in this plan is that it would make it much clearer to all Americans the level of taxation required to fund desired spending levels, which is why it wouldn't ever happen.

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You're actually sort of getting at why Bruce Bartlett went from a Reaganite supply sider to his current incarnation as a lefty. One of the factors in his ideological drift was he realized Americans were extremely committed to keeping Medicare, Medicaid and Social Security (as we're discovering today). In other words, "starve the beast" strategy wouldn't work. But also, the type of taxation you describe would not be workable for the simple reason it wouldn't raise enough revenue needed to fund these programs.

It would be extremely trite to say this is the only factor in his drift (he's written multiple books which lay out the details of his estrangement), but I think it's definitely a factor.

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My proposal doesn’t specify a tax rate. It can be set high enough to fund all programs. (Or a modest deficit)

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Sure you can make a 0 + x% income-ish tax work, but why? I think we higher consumption people OUGHT to pay a higher rate.

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On an after transfers basis they would.

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Not within the group not receiving transfers. I take it you think high marginal rates are REALLY bad.

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If they aren’t receiving transfers then they are by definition high earners.

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Agreed. We're addicted to tax expenditures. In the aggregate they're distortionary.

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Do you mean that too much goes to the wrong people or that more real recourses are expended becasue they are administered as part of the tax system instead of by SS or HHS or some other agency? If the latter, could you spell out how the inefficiency arises?

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I mean tax code complexity costs money and reduces productivity. The more complex we make it, the more it costs us. I believe the evidence suggests that, whenever possible, we should just send checks. The multiplication of tax credits increases this complexity.

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That has some a priori plausibility, but how important is it in practice? Is it really simpler to send checks to people who pay mortgage interest? Who sends the check for charitable giving? The work for the taxpayer is greater (different "returns" for charity, solar panels, EV, mortgage interest, 401K contributions and using some of the same numbers on his "simplified" 1040) unless we have a Department of Transfers. :)

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This seems like a back door way of shrinking the welfare state

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Not shrinking it, just making it transparent.

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If you really reproduced the same net income effects by sending checks instead of deductions and credits it would probably be a little less transparent as more pieces of paper would be involved to look at and keep track of.

It is OK to think that if we just rolled the dice again the pieces would fall differently and maybe more to your liking. I think it would be more transparent to propose changes in the EITC or home mortgage deduction or whatever and the changes in tax rates that would go along with that. I'm reminded of the gripe one used to hear about the "withholding tax" (like it was something separate tax) becasue it "hid" how much tax the person was paying.

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I don't see any particular downsides to having a refundable EITC v a separate end of year credit given on the basis of the information in the tax form. IF it is a good idea to subsidize home mortgage payments, what is wrong with doing it with a partial tax credit ("deductions" make the subsidy regressive) instead, again of sending a year-end check/bank credit? If "deductions" were partial tax credits, we would see the level of taxation needed to fund these tax expenditures.

Oh, and I don't agree with taxing some kinds of income less to spur investment. I'd do that after the fact by not taxing some kinds of non-consumption regardless of the source of the income not consumed. In other words I'd make the progressive income tax into more of a progressive consumption tax.

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There's not much downside in any single tax expenditure program, sure. But we can't stop at just one or two. We're addicted to this kind of complexity-inducing spending.

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I want to be clear if the objection is to the expenditure itself (it is too big or exists at all becasue it is disguised in the tax code rather than an appropriated expenditure) or really just an administrative complexity? _I_ really do not see the additional complexity.

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Have replied to a few posts, but thought it worth giving some general thoughts on this post and on your recent "Bad takes" podcast as the two go hand in hand.

First, I think you and Laura are underestimating how often doctors give genuinely bad diagnosis or advise to patients regarding losing weight and/or obesity. What's especially odd, is in the podcasts Laura actually gives a personal anecdote in this regard! She notes when she was younger she had a back issue, went to the doctor to get it checked out and was then told to lose 10 lbs. She correctly noted this was not particularly good advice for a variety of reasons. But then oddly hand waved it away as some random thing that happened to her. I really think it's worth exploring that this sort of interaction happens a lot more in doctor's offices around the country than either of you might think.

Which leads me to my second point. I think we need to really distinguish here between "Hey I could stand to lose 10-15 lbs. because I put on a little weight over the holidays or I'd like to look good for my upcoming trip to the Bahamas" and "I need to lose 50 lbs because my doctor told me that my heart rate doesn't seem right and it's likely related to my weight and it's seriously increasing my risk of heart attack". One problem with this discourse is these two things get blended together. Someone with a little bit of a gut his lumped in with the person who is seriously obese as though the two are the same. In fact, there is some evidence out there that being slightly overweight is not even the worst thing health wise https://www.scientificamerican.com/article/could-a-few-extra-pounds-help-you-live-longer/

Which leads to my last point. The focus of this article and podcast was talking about obesity on a medical level. And you were specifically talking about an article in the Times decrying the new recommendations from AMA so to a certain extent I get it. But the topic of "obesity" really needs to encompass how the topic is discussed in newspapers, TV and pop-culture generally. The diet fads you discussed are popular in large part because of people like "Oprah" platforming these things (see entire rise of Dr. Oz). Furthermore, the pushback against "fat shaming" is really more about how fatness is treated in society at large. It's just unambiguously the case that lots and lots of people have been pushed to very unhealthy diets and eating disorders due to friends/family/classmates being jerks or even just making a thoughtless comment.

I actually think this is another case where having a more female prospective would be valuable. Body-shaming is definitely something that occurs to all genders, races, sexual orientations, etc. But I think I'm on pretty solid ground in saying women get it worse then men. Like, it wasn't THAT long ago that "heroin chic" became a body type in the modeling industry. Like I really don't think you can talk about this topic without talking about things like eating disorders and body shaming more generally.

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Good point about doctors not giving great advice. I think they do point to this in the podcast when they talk about how doctors don’t really get very good training about these things in medical school.

I do think they are purposely trying to avoid getting into the fat shaming discussion because it has become so poisonous. The general rule of “be polite” or “don’t be an asshole” is really all that needs to be said on the matter. Some social pressure about healthier habits is good but it can go to far.

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I think unfortunately the "fat shaming" part is unavoidable with this topic. I take your point that this can get very heated. But there really is a moral superiority aspect that undergirds this entire discussion.

I actually think it's very related to discussions regarding poverty. There is the "you're poor because you're lazy or because of your own stupid decisions" people out there. Just like there are the "you're fat because you have no impulse control, are lazy and just can't control yourself like a normal human". I'm giving some pretty extreme variations, but I don't think I'm that far off*. But I think just like the poverty debate there is decent advice on the individual level (you need to add more vegetables to your diet. Going to the gym 3 times a week is probably good for you....you need to stop using so many credit cards, buying all those lottery tickets is not a good idea..etc.) and then there is what needs to be done on a general population level (soda taxes, removing subsidies for sugar vs. EITC, SNAP, upzoning etc.).

*Maybe this is my own political biases showing but I suspect there is a pretty big overlap between the "you're fat because you're lazy" and "you're poor because you're lazy" people. Sort of undergirds my feelings towards Libertarian thinking more generally; a useful tool for examining government overreach, but as a governing philosophy I find it extremely wanting in part because I find it's just a crutch for the biggest assholes in society to justifying acting like assholes.

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I think the poverty analogy is very good, not least because it highlights the point that just like poverty is bad, so is obesity, and we should be aiming a society where nobody is poor or obese even though shaming someone for being either is usually wrong and counterproductive. What worries me though are the vibes i'm starting to hear that we should normalize obesity as a legitimate "identity" which is as absurd as doing so for poverty.

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Not sure I disagree with one aspect of this response.

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Like the man said, “Fat, drunk, and stupid is no way to go through life.”

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I’m sympathetic to the psychological foundations of this view because I lean progressive. This is sort of my general default mode on a bunch of social and economic thinking.

My struggle with weight personally is what now drives my opinion on this and depending on your struggles or your adaptive solutions, your mileage will certainly vary.

I think there is a certain amount of shame and fear that is useful. Just like criticism can be constructive or destructive. I had shame about my weight and fear about developing more serious health issues when I got older.

Part of my mental health journey has been learning how to appropriately contextualize my anxiety, shame and fear. This was a deeply personal thing that didn’t rely on what gymbros on twitter say but my ability to grow resilience and create solutions around a problem I was dealing with at the time.

What can we really, meaningfully contribute to the “far shaming” dialogue at this point? Why hyper target this issue in this way? The note of “be polite” and “don’t be an asshole” is a good position for liberals to take relative to “everyone needs to understand the complex chemical, racial and economic underpinnings of obesity in America” It’s an exhausting and annoying exercise imo.

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I think you're right to note that the "criticism can be constructive or destructive" framing is especially important regarding obesity. It's such a fraught topic and can be so hurtful to so many people it's somewhere that being especially careful with your words is probably quite important. And yet at the same, you don't want to just sit idly if someone you know and care about has an incredibly unhealthy lifestyle.

I think this is sort of similar with education. There is recently a tendency on the far left to treat things like kids being behind on basic reading and math skills as some sort of microaggression if this is pointed out. This obviously got tied up with COVID politics and school closures as well, but it seems inarguable to me that there is a dangerous tendency to treat kids being far behind on basic skills as an equity issue (given the depressing racial gaps) and results in calls for eliminating all testing.

And yet at the same time, to be blunt about it, there's just an enormous amount of racist garbage directed towards black children in schools. How many were never encouraged properly or dissuaded from taking more high level math classes because of racist feedback.

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So now comes the obvious question - Why do some wealthy countries have higher rates of obesity than others (i.e. Japan, Italy vs US, UK)? All have abundant food but the outcomes are different.

Not that you can change an entire food culture but would be a good guide to better eating.

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I read something years ago (source unknown now) about the longevity of a food culture and it’s relationship to obesity. Japan, for example, has been eating “Japanese food” for millennia. So when Japanese kids don’t have to learn how to eat, so to speak -- they just eat what their parents eat, which is what their parents ate, and so on through dozens of generations.

America is unique in that 1) it’s a melange of thousands of food cultures and 2) insofar as an American food culture exists, it’s super young and indistinct. This might help explain the persistence of fad diets -- people flit from one idea to another in search of food salvation, but at root, they really don’t know how they’re supposed to eat.

So in short, Americans are highly suggestible eaters in ways that are less true for denizens of other, more established food cultures.

Surely this doesn’t explain 100% of the variation across rich countries, but I found it compelling nonetheless.

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Super interesting to think about, whether or not it's mechanistically true.

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Hmm... maybe American culture was built by immigrants seeking better lives, adventure-seeking and motivated by finding new and improved ways of living... and that attitude has also extended to our food tastes, maybe? Making stuff up here...

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That would also explain high obesity in the UK. The UK's food culture was massively disrupted by the industrial revolution, which pushed huge numbers of people into cities *before* refrigeration or high-speed transport of fresh food existed. They ended up with a diet that was infamously gross, built entirely around preserved meats, canned vegetables and root vegetables, because that was the limit of things that could avoid spoilage with the technology they had. Anyone who touristed in London pre-1990 can and will regale you with some horror stories about how bad the food was.

But then, as the Brits managed to travel more, they started to realize how awful their food was and started demanding better. The new food culture is a lot tastier but also young and unsettled, just like in the US.

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I think this is in Michael Pollan's "The Omnivore's Dilemma"

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My understanding is that a lot of Japanese food in particular *isn't* actually that old—much of it dates to the immediate postwar period.

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And, of the older stuff, a lot more dates from the 19th century! (For example: sushi dates to 1824, curry dates to the 1870s.)

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I mean the obvious answer is massive differences in diet. Just compare how in Mexico children are getting 40% of their calories from ultra-processed products, including sugary drinks, vs. Japan.

https://www.unicef.org/stories/what-are-we-waiting-for-obesity-mexico

https://www.weforum.org/agenda/2019/11/japanese-schoolchildren-are-some-of-the-healthiest-in-the-world/

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But it is notable that nearly every country is having an increase in weight in recent decades. But perhaps this is all just a long-term trend.

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I think we can definitely improve our food culture! We will never be Japan or Italy exactly, we are way too diverse, but I've always thought the public health/diet frame isn't going to he as useful as cultivating and celebrating making good food. We have come a long way down this road already - Matt mentions the spread of quality Thai food as an example. Restaurant food is never going to be healthy per se, but I could see Americans renewing their interest in cuisine and home cooking as it continues to become a more normal part of our lives.

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Don't you need to remove changes to average height over time as a confounding factor? People have been getting taller over time due to better childhood nutrition -- and taller people weigh more. Taller people even have higher BMI for the same body shape because BMI is a very crude metric that doesn't perform well at the extremes.

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I don't think so. Height squared is in the denominator of BMI calculation, so in fact if weight was increasing proportionally to height (at the same percentile rate), BMI would be going down.

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But isn’t weight roughly proportional to height cubed, so that a bigger person should have a higher BMI?

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No, BMI is set up to control for height. If you look at the scales it adjusts pretty reasonably.

Malnutrition in youth can however lead to stunting of adult height.

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It only controls over the center of the range. The correct calculation would be proportional to height cubed, so at the top end of the range BMI is a poor indicator.

I don't want to start an argument about how bad BMI is, just want to point out that changes in average height over the time period in question definitely confound BMI trends and deserve a closer look.

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The physical meaning of BMI is:

Measure your height

Cut a square with a side length equal to your height

Stand on that square

Your BMI is the pressure, in kg/m2, exerted by the square onto the ground

More meaningfully, your BMI scales linearly with the pressure on the soles of your feet when you stand up. A baby has a very low BMI, and it's comfortable to have a baby stand on you. A 20 foot tall human with baby proportions would have a very high BMI, and if it stood on you, you would die.

For the same proportions, taller means higher BMI.

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This whole post is sort of weird. I barely mentions the problem that most people are worried about, and which jumps out in the cohort chart, which is the great increase in the percentage of the population in the obese category (BMI > 30). I have not looked up the underlying data, but the picture I see is not so much one of continuity but of a genuine increase in the slope of the top couple of curves. Why has the rate of increase of BMI increased, and why is that increase limited to the upper deciles of each cohort's weight distribution? I'd like to see a chart where the vertical axis is not BMI, but the first derivative of BMI.

Matt puts a lot of emphasis on increasing affluence as the cause of increased weight, and I am sure that is true for the lower deciles, that is, those who are severely underweight because they can't afford enough to eat. Fewer of them: Great! But what role does income play at the top end? What about all the stuff we read about weight, wealth and gender (fat rich men, thin poor men; thin rich women fat poor women)? I'd like to see some charts by income decile.

I think this needs a more nuanced follow-up. As is, it seems to be saying "nothing to see here, folks" when in fact there is a lot to see that this just sweeps under the rug.

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If the population is mostly in a normal distribution where the whole distribution is shifting upwards, and you put a cutoff at a specific point and then look at the number of people past it, that will change very slowly for a while, and then very quickly when the population mean starts to get closer to that number.

When I look at those charts you mention I see a second effect that you are mentioning, which is that the population-wide variance is increasing. But every percentile seems to be increasing, and doing so in a way that curves upwards. Interestingly, if anything, the birth cohorts around 1940 seem to have the slowest increase at the top, as though the 1990s were actually the time of the least between-cohort increase in obesity, and presumably the issue was significant replacement of cohorts at that time.

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I like "Bad Takes," but it goes on too long, gets repetitive especially when you and Laura agree too completely. Yes, some of the length is properly nuancing the initial refutation, but still, you might think about shooting for 10-15 minutes less.

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Good insight. It really does start to feel like a grind around 45 minutes in, when it seems like they’re grasping for stuff to say just to fill time.

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I confess I never manage to get through a whole episode and I’m a podcasts fan generally (heck I got to know and appreciate MY thanks to the Weeds RIP)

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Yeah, I've listened to a few episodes and generally thought they were fine but I don't feel the need to listen to it regularly. IMO the best current events/talking heads style podcast out there is The Dispatch Podcast.

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Lots of comments of what we eat, but *when* we eat is also important.

I was a child in the People's Republic of Poland in the 80s, and we as a population were much slimmer than America today. Yes, there were fat people, but you hardly ever saw the kind of extreme obesity you routinely see in the U.S.

And one glaring difference between Poland then and America now is that back in Poland it wasn't socially acceptable to shovel food in your face at any time of day outside of mealtimes. With some exceptions, it just wasn't done. And the exceptions were "go to a nice cafe, order a pastry on a plate (a real ceramic plate, not a disposable one) and a cup of coffee, slowly eat your pastry and drink your coffee while sitting at a table and relaxing, then go about your day." It was not "grab a bag of chips/candy/whatever and shovel it down while running errands or driving or whatever." I think being more mindful about when we eat would help a lot with obesity.

I say this as someone who routinely snacks on sugary food when tired or stressed, so this is definitely a "do as I say, not as I do" comment.

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I think this is an underrated point; so much of eating habits worldwide have a social and cultural aspect beyond just "I need calories right now".

If I had to guess, the thing missing from the American story is the importance of marketing. Another commentator noted that there isn't any real history of American foods going back hundreds of years. We're a mishmash of a variety of cultures and foods. Which has been a great benefit in most ways; the variety of food all of us can eat today is really remarkable and Matt is very correct to note how much better and tastier food is then even 20-30 years ago. But it also meant there wasn't a unified food culture. Enter savvy marketing that helped sell Americans on the idea that sugar water was a good use of your money or that cabinet full of crackers, cookies and snacks is part of having a wholesome middle America household.

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A friend of mine with a BMI 40+ and borderline diabetic was just rejected by his (good!) insurance for Wegovy last week.

What is it going to take to change what gets covered? What drives Medicare coverage decisions like that?

I don't see how anyone can look at the clinical trial data and think it doesn't pass a cost benefit analysis?

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Insurance companies in my experience can be really penny wise, pound foolish. Mine is pretty okay, but they wouldn't cover the cost of a CGM (continuous glucose monitor) prescription, even though the test drive I did with a set that my doctor gave me saw me managing my sugars SO MUCH better. Instead of having to prick myself multiple times a day (not fun), I just had to hold my phone up to a sensor on my arm and get a reading. You'd think that making monitoring blood sugar as painless as possible would be worth paying for to prevent more costly health issues later on in life.

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It isn’t that they are foolish. Just that their incentive is to keep you mostly healthy until you reach Medicare age. Then it is the government’s problem.

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When I last looked at this issue, insurers were keeping "members" for 1-3 years, tops. So there was no incentive for them to pay for treatments that might reduce some other insurer's costs in 10 years. The benefits wouldn't accrue to them, so they didn't matter. (Of course if all insurers paid for the beneficial long-term treatment, then the benefits would accrue to all in 10 years. But of course Wall Street cares about quarterly revenue/ROI, not decade-level outcomes).

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