Being Fit May Be as Good for You as Not Smoking
nytimes.com
nytimes.com
Portugal legalized drugs and made them safer to use and... people were generally healthier and better off.[1]
People have unhealthy habits because of issues in their life. Poverty, abuse, mental health issues, lack of access to healthcare and healthy foods.
If you want people to get better you need to stop vilifying them, e.g fat shaming or war on drugs, and start accepting and helping them. Same for drugs, same for weight, hell, I’d say it’s the same for many “criminals” too.
The stigma of a heroin user is strong there.
You know why? Because we don't want heroin users.
I'm a libertarian. 100% in favor of allowing people to own their own body (i.e. they can put in whatever they want)
Being fat isn't a crime.
There is no war on fatness.
There is simply a stigma.
A stigma to dissuade people. It works. It worked for me. I know other people who got their shit in gear because they were tired of not getting the respect they felt they deserve. I come from a hard background.
The Healthy while Fat is just an excuse to want to gain acceptance of unhealthy behavior.
No it won't work.
Sure, cigarette smokers come from shitty backgrounds (I was one). But getting looked down on was a major reason for me to quit.
Are there weak people who will forever smoke and feel bad?
Yes.
I have no answer for them.
But I know we can't start accpeting cigarette smokers. Or more people will smoke.
That is a totally different thing than using VIOLENCE to make it so someone can't access their vice.
I 100% support people engaging in vices.
I also think we should as a society be more accepting of vices.
Because they have good and bad. Some of the best chefs I've known are fat. Some of my favorite music was made on heroin.
Should we accept them openly and be proud of having vices? No.
Should we be tolerant of other people's vices? Yes.
Basically: having vices is bad, having vices doesn't make you bad. Vices should not be a source of pride.
I would agree that the HAES movement does get at something that needs fixing: America dehumanizes people. It's hard to explain, but having lived in other countries, I can say there is a dehumanizing element here against those that are deemed less (druggies, ex-cons... and to a lesser extent those who are overweight)
It's obviously more complicated than that, especially at the individual level, but if you aren't hitting those three you're missing out on some serious quality of life improvements (both in the short term and long term).
Realizing when to let a problem be organizational rather than a personal sleep deficit is also key in those positions. They'll say your a rock-star for trading your sleep and life for their bottom line. It's debt impounding interest and unless your luckier than a power-ball winner they won't be there when that payment is due.
Do things that engage you emotionally, mentally, and socially. Do things that are fun, and adventurous. Compete, even if it's at a beer league level. You need more robust and tangible fitness goals than looking good in the mirror in 6 months.
Fitness gyms hate you. They want your annual fee and then they don't want to see you again until next year. It you're trapped in the mindset that keeping fit is some kind of chore that you have to add on to an already busy life, you're doing it wrong. When you see people in their 70s who are still kicking ass, it's because using their body is at the centre of their life, not at the margins.
Of course there are plenty of reasons to do sports. But my understanding was that for losing weight, it's mostly about how much you eat.
I encourage you to have empathy for these people. Because what it takes: Going to the gym, going hiking, getting physical activity, is not available for a lot of people. It is a huge privilege to live somewhere AND HAVE THE TIME to do these activities.
Most people live paycheck to paycheck, a gym membership is a meal they cannot put on the table. Their houses are small and working out inside of them is miserable. Or they are working multiple jobs and they choose not to spend the 2 hours of free-time they have a day working out. Who can really blame them?
Outside there could be violence, or the constant threat of being harassed by the police. Or, it could just simply be a paved-over wasteland where the community did not think that maybe people will want somewhere to walk around for a while.
My anecdote: I used to live in Chicago, and I was a serial "join the gym and never work out" person. I got pretty overweight at 190 lbs, 5'10. I moved to Portland, Oregon. And something interesting happened: Portland is smaller, and getting to the gym means meandering down a few tree-lined lanes until I reach a huge converted warehouse that now serves as a gym. The gyms I had seen in Chicago were squat-ceiling converted office space. I found going to the gym MUCH EASIER, due to the quality of the gym and the environment around me.
It's probably also likely that the more highly fit someone is, the more likely they are to have other factors that increase longevity - ie. it means they have the leisure time to exercise and maintain a high level of fitness, it means they likely watch what they eat etc. I wonder how much of this is direct causation vs correlation.
Rest days are key to improving fitness. This doesn't conflict with "there is no such thing as being too fit in terms of longevity and health."
The article's summary of the study said that being unfit is as bad for you as not smoking. Thats very different than just replacing every word with the negation.
Its almost like a machine learning algorithm made this title as the most attention getting group of words
HAES is a reaction that says "What if we accepted that some people are just going to be fat, and then tried to come up with ways of being as healthy as possible given the circumstances". You may not like the packaging that HAES comes wrapped up in, and the most vocal proponents of it are often the least interested in making it palatable to you. But it's not BS.
Consider that there is essentially nothing that medical science has for people who are chronically fat except a gastric sleeve. Shit is hard, yo.
Irrelevant. It is not more healthy to be fat than it is to be not-fat because it's hard. Acceptance is not going to change a damn thing about the health risks inherent with being fat.
You have all my sympathy. One of my closest friends is a very large guy, and I want him to be around when we get old, but the stats tell me that's less and less likely every year he stays obese. Me accepting him (and I do) won't keep him on this planet. :(
I wish you were right, it'd be great to be able to be obese and healthy, but that just isn't how it is.
No it hasn't, because it doesn't exist as you describe. It exists as I've described. Everything you can do, while obese, you can also do while not-obese.
> Irrelevant. It is not more healthy to be fat than it is to be not-fat because it's hard. Acceptance is not going to change a damn thing about the health risks inherent with being fat.
You are entirely missing the point. The issue is "given that I'm going to be fat, perhaps I should work with what I have, rather than beating myself up over the fact that I'm fat". Once you do that, you can start to look at what else you might change about your life that would improve your health.
And I'm not missing the point, you're making up some kind of generalization that doesn't A) fit the facts as we know them, and B) doesn't actually address the issue.
You're saying, "What else can I do to be healthy?" but you can/should do those things as well as work on losing weight. Giving up on losing weight doesn't lower your risk at all.
You can stop beating yourself up about being fat and keep trying to lose weight, as well. I think we can agree the moralizations aren't helping here, but you can't wish away the unhealthiness of obesity, like this stupid movement tries to do.
I've literally never heard of a movement that says that can be healthy. How did that even happen?
Edit: link for HAES https://en.wikipedia.org/wiki/Health_at_Every_Size
Seems like a meme we should minimize the transmission of, to me.
> Consider that there is essentially nothing that medical science has for people who are chronically fat except a gastric sleeve.
It also yields ridiculous statements like this. Medical science has some very clear advice for fat people: eat less and exercise more.
They're making an entire movement to justify why they're lazy and undisciplined.
However "safe injection sites" are anything but safe to the surrounding community, and may increase usage rates while only mildly decreasing fatality rates.
By keeping the sickly ones around, we're actually making the whole herd less healthy -- particularly when we enable them spreading their illness.
I think the medical professionals involved in "safe injection sites" should be seriously questioned about their medical ethics: they're failing to quarantine sick patients, and in treating them without that buffer, spreading the disease to the healthy population.
It's quack "medicine", just like HAES/HAMS.
Seems extreme...
>Blitzer pressed the point. "But, Congressman, are you saying the society should just let him die?" At that point, the rabble erupted in cheers and whoops of "Yeah!"
What's the choice? Make other people ill and have the original sick people die anyways?
That's all slowing mortality down in heroin abuses does, and it's definitely not how we treat other kinds of diseases, particularly those which have reached epidemic proportions, where the prime objective is arresting transmission.
So, yes -- I think we should follow standard medical practices, and it's unfortunate that strong measures are needed to confront an epidemic level problem. Just like it always is when you have to make medical triage decisions.
But we have to prioritize maintaining the healthy population ahead of the comfort or longevity of the already ill, in broad strokes.
And no, we don't have to prioritize maintaining a healthy population, not to the degree that treating the ill is excluded. That implies a limitation of resources that simply does not exist. We can and do both.
Care to share any sources on the ineffectiveness of these sites?
However, looking through NIH reports --
The site in Vancouver appears to lower the fatalities marginally (1-10 less fatalities per year). Several other studies indicate that fatalities related to opioid overdose, ambulance calls, etc decrease in the immediate area of various sites.
I can't find anything on the Vancouver site in the last decade, it's all circa 2006 or 2007 -- and seem to recall in my earlier research that the initial results looked good, but later studies basically reported that we saw a decrease in fatalities that was offset by an increase in usage, and the whole thing came out as sort of a wash.
RAND seems to suggest that supervised consumption is not settled in terms of scientific study, even now. [0]
> We conducted our own assessment of the individual studies and found that the evidence base concerning the overall effects of SCSs is limited in quality and location. Although we identified 65 outcome-related articles (as opposed to commentaries or studies that gauge opinions), none involved an RCT, and just nine employed a quasi-experimental design with control groups. These nine studies were based on just four SCSs in three cities: Sydney (five studies), Vancouver (two studies), and Barcelona (two studies). There was considerable overlap in the design, methods, authorship, and data employed, so that four of the nine are arguably superseded by later studies using better methods or longer time series, in some sense reducing the effective number of quasi-experimental studies to five.
Worth noting, however, that many of these seem to indicate reduced petty crime in the area immediately around the site. Indicative I might be wrong, but not conclusive because of problems in the methods used, samples chosen, etc.
Looking at a compilation by Brookings, broadly on the topic [1] --
> New work by Packham and Wells (2018) suggests that syringe exchange programs—a staple of harm-reduction efforts—reduce HIV rates as intended but unintentionally increase opioid-related mortality by making it easier, cheaper, and safer to use heroin.
> Another popular harm-reduction effort is distributing naloxone, a drug that can save someone’s life if administered during an opioid overdose. Recent work by Doleac and Mukherjee (2018) finds that broadening naloxone access had mixed results. While some states saw beneficial effects of these policy changes, broad naloxone access increased opioid-related mortality by 14 percent in the Midwest, the region hardest-hit by the opioid epidemic.
So reports that I do find seem to suggest that this is a concern that is valid, at least in some contexts, and that the studies purporting to show outcomes are a) very narrowly done, b) often don't measure what I'd consider to be the complete set of externalities, and c) aren't particularly scientific.
It certainly seems reasonable that narrow focus on improving the outcomes of the addicts, particularly a narrowly defined set of metrics, actually lowers the group outcome.
Sorry I can't provide better sources to support that, though.
[0] -- https://www.rand.org/pubs/research_reports/RR2693.html
[1] -- https://www.brookings.edu/blog/up-front/2018/12/07/research-...
You can't provide any that prove it doesn't. Even the few that you posted seem to be at the least, pointing to a possibly effective situation. Mentioning increased ODs in the immediate surrounding area is... I'd say kinda expected. That's kinda the whole idea, get all the ODs in the same place.
I mean, your own data shows that it reduces HIV rates (not possibly, it does)... and 'POSSIBLY' has unintended consequences.
Despite the data, you won't change your mind.
At least admit that like the anti climate change people, you just don't want to believe. It has nothing to do with data.
I disagree with essentially everything you have said. While SIS may not be a panacea, they are definitely on the right track.
It costs society money for ambulances to be running around to OD people.
Safe injection makes sense.
It doesn't promote heroin.
No one is saying: Heroin in a Healthy Manner.
They are simply saying: Let's spend a stitch in time. You don't even have to think of it as being kind, just rational.
You might not like the way HAES or fat acceptance is packaged, but this is exactly the same thing.
Safe injection sites don't.
Both being fat, smoking cigarettes or being a heroin addict are things to be, at the least, slightly ashamed of.
*exceptions go out to anyone with thyroid or other such medical conditions, just as to people who are opioid dependent due to pain management.
That's the goal of "Safe Injection Sites" that are being build in a few cities.
I've been to countries where there are 'tolerance' zones. But that doesn't mean there isn't stigma to doing it.
Stigma is a strong social disincentive.
The Healthy as fat is trying to remove stigma for something that is unhealthy. But it is not trying to re-assign social resources in a logical way.
People have unhealthy habits because of issues in their life. Poverty, abuse, mental health issues, lack of access to healthcare and healthy foods.
If you want people to get better you need to stop vilifying them, e.g fat shaming or war on drugs, and start accepting and helping them. Same for drugs, same for weight, hell, I’d say it’s the same for many “criminals” too.
You seem to be mistaken about how their policy operates.
You're also working from a different premise than me: I believe people fundamentally have agency, and so they're influenced by their circumstances, but their problems are not causal from them -- they made a choice to adopt that habit as a coping strategy.
And frankly, I disagree with you about how to confront that: I think we should be accepting of how they got there, but I absolutely disagree with things like HAES which suggest that their choice isn't a problematic one.
To borrow a phrase from a friend, and use it somewhat out of context: I can love a sinner without enabling or accepting the sin.
I think they have a huge responsibility for unhealthiness and fat shaming doesn’t address that cause. Saying “oh people just need to make better choices” seems pretty shallow.
You're also confusing several issues:
- There's no reason that people can't be responsible for their choices and it be unethical for junk food companies to do what they do. Your entire premise is hinged on that being the case.
- I've never met a fat person that wasn't aware that junk food was bad. I'm sure they exist, but talking about the bulk of people, the 95% in the middle, they're aware that their diet impacts their health. They're simply choosing a self-destructive coping behavior of drugging themselves with food. I'm sympathetic to that, but I don't see any reason to pretend it's anything but what it is. Addiction and substance abuse, in a self-destructive behavior.
- I don't believe that ads are causal, just influential. Again, they're making a choice to act this way, even in the presence of ads. What bothers me about people in your camp is that you treat other humans like some kind of animal you own, can decide what's best for, and manipulate or control. You refuse to accept them in their capacity as human persons, who have agency and the capacity to self-direct, then have the gall to turn around and talk about me being the shallow one.
The drug vilification issue becomes a problem when the state gets involved in enforcing that moral compass -- the danger of drugs predominately derived from its users/product existing solely on a black market, with no regulation, and no verification of the product you're purchasing. It's not that hard to avoid overdose when you have pure heroin, it's much harder when you have heroin cut with unknown quantities of unknown alternatives. It's much harder to seek legal help, when it requires you to admit to criminal activity.
It's not the vilification at issue for drugs, it's the criminalization. Presumably portugal still does not have a positive outlook on drug usage (it's still vilified).
And afaik, being fat is no crime.
Congratulations. You are literally the reason why this movement exists.
Don't forget that in many circumstances cooking and hobbies like working out and hiking and such can be privileged.
Someone working two jobs to get by probably doesn't have the funds for a gym membership or to go out hiking, and might not even have the mental energy to.
And then cooking healthy food is surprisingly expensive and time consuming when compared to processed foods.
So yes, absolutely, we should push for a healthier society, but at the same time we should accept that there are valid reasons someone might not be fit, and we shouldn't shame them for that. Instead, we should try to improve the situations that cause it as much as we can within our abilities.
I don't have an answer. I was fit until I hit university and now I'm struggling with my weight constantly. I'm committed to trying. Losing weight. Getting in a healthy habit. Relapsing. Dozens of times in a decade. But what I don't ever want to do is declare that I'm just healthy at any size and therefore throw in the towel.
The grim reaper doesn't give a crap what I think healthy means.
Consider that being fat might be better for you than alternating between eating disorders and being fat, which is the choice that a non-trivial number of fat people are faced with.
If that was all it was saying, I'd be onboard.
But it also says things like "losing weight is literally impossible!", and "there is no evidence that obesity is unhealthy!" and then cherry-picks and misconstrues research so that it seems to give scientific backing to those conclusions, which are deeply harmful lies.
Healthy on Heroin. HOH
HOH is not BS. Here's the deal. For lots and lots of people, being not addicted to heroin is very very hard. So hard, that even though there is enormous social pressure that they've had basically from ~18 years old to however old they are, they still haven't managed to become clean for any significant length of time.
HOH is a reaction that says "What if we accepted that some people are just going to be heroin addicts, and then tried to come up with ways of being as healthy as possible given the circumstances". You may not like the packaging that HOH comes wrapped up in, and the most vocal proponents of it are often the least interested in making it palatable to you. But it's not BS.
Consider that there is essentially nothing that medical science has for people who are chronically addicted to heroin except a detox. Shit is hard, yo.
Have you ever heard of methadone? Its literally accepting that someone will be addicted to opiates for a long time or life and then giving them a healthier alternative that doesnt try to change that.
https://www.crchealth.com/addiction/heroin-addiction-treatme...
Be proud of your true heroin addicted self. Show it to the world. IF they don't accept your heroin addiction THEY ARE wrong.
See. If any movement said that, I'd be against it. Because they are trying to remove stigma from something that SHOULD HAVE IT.
Such a shame that the "healthy at any genetic condition" BS is so popular these days. Literally killing people.
The healthy while fat movement specifically tries to remove a stigma that IMO should not be removed.
There is a segment of the population that is addicted to a substance that is illegal. They die because they hide to satiate their addiction.
If fast food were illegal, and fat people sat under bridges eating fast food and occupationally chocked on an illegal KFC chicken bone, I'd advocate for fatty eating centers.
Comparing saving lives to removing stigma is... beyond absurd.
Fat people aren't being sent to jail for being fat.
Heroin addicts are being judged and looked down on. No one is fighting that.
No one is saying 'be proud ye heroin addicts'.
I have hear fat people basically say 'be proud of ye 'curves'"
If HAES is just an excuse to not try and be fit, it is going to kill people.
What's changed: every morning I wear an ab belt while getting ready for work. With every greasy mean I pop an orlistat. I wear a couple of electrodes on my chest/back/arms under my shirt while at work, instead of a workout most days. 5'11, 170lb, 6% bodyfat, bench 300 20 times.
This is 100% because of medical science, because I'm a lazy 40yo slob. Just a really fit one despite the daily cake and pizza before bed.
So I've started referring to them as "Healthy At My Size", which is their real argument -- that their overweight size is healthy.
It also yields a more appropriate initialism.
There are plenty of people who are against body shaming, unrealistic beauty standards etc...
Very few who think that being very overweight is actually healthy.
Even if this were true, your argument doesn't follow from the evidence. The existence of clothing for overweight people doesn't imply that people believe that being overweight is healthy. It only implies that overweight people exist, and someone wants to make money selling clothes to them.
Vanity sizing is a thing because female sizing completely arbitrary and stores want to make women feel better about their weight. If anything this is evidence that fat acceptance hasn't caught on--if it had, people wouldn't be ashamed to wear a larger size.
Regardless, I'll say it again--the fact that overweight people exist says nothing about the assertion that many people believe that being overweight is healthy.
1. https://jeatdisord.biomedcentral.com/articles/10.1186/s40337... This 2017 study did a survey and found that 100% of the female mannequins they examined represented an underweight woman.
Some people are ectomorphs. I have friends who are hardgainers, and believe me, it is a struggle for them to bulk. You have to eat a massive surplus of calories per day and most of that has to be protein.
Conversely, some people are endomorphs. It’s very difficult to cut (in my case). I need a big caloric deficit relative to others, and do cardio on my rest days in order to keep my body fat at a reasonable percentage.
Eugenics should be actively encouraged. We have the technology to make it so many will never have to suffer metabolic issues or chromosomal abnormalities.
For me, I’ve found 400-500 below my maintainence works best.
> It is must more useful to classify based on muscle fiber composition. People with a lot of fast twitch muscle fiber build muscle quicker, etc.
I agree with you here. I needed labels to bin the two (very general) categories of body composition types, so I chose those two.
The point of the body positivity movement is literally crystal clear - to end shaming of people for the size of their body.
There's no "BS" to it. People's health is their own concern. Whether or not someone decides to change for a healthier lifestyle, there's nothing wrong with them at least loving their self throughout the process.
It's also really not that popular of a sentiment. Just ask any overweight person the things they hear on the regular.
Come on now.
That's every single non-optimal health decision though. You shouldn't have gone into construction because now you need a knee replacement. You should've used a treadmill desk instead of sitting for so long. If you'd just had a child before you were 30 you probably wouldn't have gotten breast cancer etc...
The U.S. leads the world in military spending, has one of the largest incarceration rates per capita, and is floating around the idea of a new border wall, and you're mad about... People not being skinny...?
Well, you do still have to worry about those, but earlier than expected.
"Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."
https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
I disagree wholeheartedly. So many diseases today are preventable when you consider that most people take no action to improve their health through any kind of diet or exercise. Its a probabilities game. If you eat fast food frequently, drink/smoke too much, and don't exercise you cannot expect to have the same odds of a long life as someone who is doing those things.
Now if we accept the above argument, even if only to a small degree, than we can conclude that individual decisions have should result in a widespread increase in demand for chronic healthcare needs, such as heart disease. This in turn causes insurance rates to go up for those individuals taking care of their health. Furthermore it funnels more and more human capital away from the rest of the economy by raising demand for doctors, nurses, and all other kinds of medical staffing/machinery.
Its inconvenient to believe that your health has a larger effect on the world you live in, but it does.
Sure it does, but what do you want to do about it. Do we scold people for picking careers that are bad for their health. Do we shame women who don't have children because it increases their chance of developing breast cancers?
>Furthermore it funnels more and more human capital away from the rest of the economy by raising demand for doctors, nurses, and all other kinds of medical staffing/machinery.
And choosing to watch youtube videos funnels money into advertising and away from the rest of the economy.
Nearly every single individual decision that you make impacts someone else.
Do you shame people from not getting enough vitamin d? Do you shame them for going into careers that are bad for their health? Do you shame sky divers because its bad for their knees? People who don't use treadmill desks?
Furthermore, it's not clear that obese people actually consume more healthcare dollars.
"Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained."
https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
I don't wish ill health or discomfort on anyone but ones physical condition, appearance and personal health are one's own business.
Provided that you rise to a minimal standard of civic responsibility...
I owe it to you to be able to run for help. I owe it to you to be able to perform chest compressions for 3-5 minutes. I owe it to you to be able to carry or drag an adult a few hundred feet to safety. I owe it to you to be fit to join a group standing in physical defense of others.
If you can't do those things, you have something to answer for - regardless of the diet/fitness/health/appearance fads of the day.
There's no mention of"healthy at any size" in the article and no mentions of "fat", "obesity", or "overweight."
Something along the lines of "Not Exercising just as bad for you as Smoking"
Explaining it is easy, these folks generally understand, it simply doesn't matter because they're hooked.
This situation is pervasive, it's no different than people being addicted to activities unnecessarily burning fossil fuels, despite their rational understanding of how it's slowly ruining their habitat.
I am not convinced that it is "immeasurably" so. Being fit is not going to change some of the most unpleasant things in a lot of people's lives. A commute is still a commute. A bereavement is still a bereavement. A boring job is still a boring job. Debts are still debts etc etc.
Being fit is not going to change any of those, so I am not sure how life gets immeasurably more enjoyable if you are as fit as an Olympian but your partner just died and you've got to go work in the Amazon Fulfilment center 90 minutes bus ride away to pay for your medical/student debts and still just about have enough left over to pay for basic food and heating. But hey I can run 100m in under 10 seconds so wow my life is immeasurably better as a result!</sarcasm>
It changes your baseline level of comfort and happiness, every single one of these things is less unpleasant than it would be otherwise.
Speaking from experience as a formerly obese person, now capable of hundreds of pushups and running numerous miles in my 40s. It seems every moment of every day is better this way, except perhaps the sometimes annoying unwanted attention from the opposite sex.
I was almost obese (BMI: 29.8). I'm on my path to being at a normal weight (BMI: 25.5). I would say it is immeasurably better. I can walk up stairs without losing my breath. My knees don't creak. Random aches and pains are gone. I'm generally healthier (less common cold etc). I can participate in many activities such as sports without tiring myself and taking a couple of days to recover. I can go on longer hikes and see many things which were quite impossible before. I much more comfortable at all times now. All the negative things add up in a person's mind. A commute + shitty health is worse than just a commute. If I'm working in a fulfillment center, I'm not uncomfortable while exerting physical effort.