I think this is important to note: exercise will not let you live longer. It can help you to live happier, to be independent longer, but longer? More often than not the opposite is true as exercise places stress on our bodies, and it can easily be too much stress.
I haven’t chimed in on the whole diet or anti-diet as it seems to be making a complex and nuanced question into a false boolean of either paying attention to what you eat or just giving up and ingesting stuff that triggers our reward centres in our neue-chemical networks. Maintaining an unsustainable pace of consumption because not doing so feels like punishment and dieting and working towards unrealistic ideals.
The thing is, it all feels like a big distraction from the main thing making us all unhappy: the constant pressure to snack out, to eat, to drink, to buy sugar and salt in brightly coloured packages. It may not be as bad in Germany as it is in the USA, but I still see that the majority of ads are for snacks or booze or other things you consume. And if you’re not healthy? Well, you should just buy more to compensate. And don’t blame us for all the crap we put in your happy snacks, you want us to add them as our addiction taste tests prove, and our lobbyists experts have also done their work.
So yeah, I get a feeling this “movement” is sneaky somehow, like an attempt to herd off regulations and keep consumption and profits high. But if I could see the fnords I wouldn’t be here, so take it as a general distrust, a feeling that it’s the same pattern of dirty tricks as tobacco and oil companies use.
Oh, and I am all for preaching more self acceptance and turning away from diet as a religion. I myself am comfortable with my weight, with my old man’s gut not going anywhere any more, as I am also aware that the fat tissue is also sequestering poisons over time. That my gut biome seems to be happy. And I can lead an active lifestyle of casual sports for fun, not for some ideal. I just wish more could reach this stoic ideal of acceptance.
Sorry for going off the rails like that. It was supposed to be agreement, but I got carried away.
I think one of the biggest things is that if one is not taught at a young age how to shop and cook at home, maintain some basics, etc… then that follows through when you’re older.
We were most certainly not well off when I was younger, particularly after my parents divorced, but my mom cooked for us every day and/or cooked with my brother and me.
The other problem is that folks who are struggling with more than one job, trying to take care of children, etc… are further burdened with less time to buy, prep and cook.
This is the FDA’s fault, mostly. Doesn’t matter if the same drug is available for <10% the price, you need to spend billions to get it approved for a new use. Individual docts can prescribe off label, but most won’t without institutional backing.
@TornPaperNapkin I apologize for my wording in this thread. I was being insensitive in my zeal to sound smart and share a thing I know about cholesterol. Your lived experience is important and I’m glad you’re sharing it here.
I agree this is a good analogy. It also feels a lot like the anti-littering campaigns that the beverage companies created so they wouldn’t be held accountable for their waste. Pushing their responsibilities onto individuals and blaming their choices is Corporate Shenanigans 101. We’re seeing it again with climate change. Oil companies and power companies back ad campaigns that say climate change is happening because us consumers aren’t recycling hard enough or buying enough reusable bags.
I’ve recently been trying to keep a close eye on what I eat because my weight keeps creeping up as I get older. My usual methods for managing it are no longer working. I starting reading labels closely and holy crap is there a lot of sugar in everything now. A single-serving container of a prepared clam chowder at the deli counter in my grocery store has more sugar in it than a can of Coke. Why does clam chowder have any sugar in it, never mind that much?
I don’t see how individuals can be held responsible for their weight when there’s a huge corporate organism working against all of us like this. Short of growing and cooking everything yourself from scratch (and realistically it’s a privilege to have the time and skills to do that), I don’t see how anyone can be expected to get their calorie intake down.
I suspect (just my uninformed opinion) that this has something to do with people overall getting bigger over time. Look at family photos and such from the 1970s, and people were much thinner generally. I have to think it was just easier when there wasn’t double-digit grams of sugar in everything.
This seems to be difficult to fix though. The solution to this sort of problem is normally government regulation. A few jurisdictions have tried this on the easiest target- regular soda. New York City and Toronto have both tried size and sugar limits on what can be sold, and people freaked out about it. Practically rioted in the streets. So I don’t know what the solution is.
Definitely not. First off, large clinical trials required for drug approval cost millions, not billions. Second, for smaller drug and device companies there are programs that help simplify the trials and reduce that cost. Thirdly, the primary cost of bringing a “blockbuster” drug to market is marketing & sales, not regulatory. And drug company profits/executive pay. Fourthly, the cost to society of unproven drugs reaching the market and hurting or killing people is much higher than the cost to make sure new drugs are safe and effective.
I can hardly belive I’m defending the FDA here; they can be slow, they can be biased, and they can be frustrating to work with, but they are necessary. Big pharma companies use regulation as a scapegoat for their high prices, but the real reason is greed.
Yep, and why did they practically riot? Because they were told to riot, by NewsCorp, by Sinclair Broadcasting, and by other billionaire-owned media sources. Not that I can see the fnords, mind. I’m just spreading conspiracy rumors.
Yea, it’s kind of crazy the amount of ADDED sugar in stuff. Even Italian dressing, FFS. Spaghetti sauce, mass produced bread, etc…
And to points above per expense - lets say you want to make spaghetti for the family. It’s easy enough to make a sauce quickly yourself, but it does cost more. I do it, but if you’re on a tight budget or if you penny pinch in general, you’re going to buy a jar for a couple bucks instead. And get all the added sugar.
“Our diets are poisoning us” is a different serious issue from “diet culture is harming people”. True, the making and selling of foods that are filled will unnecessary sugars, salt and fats make it much harder than it should be to get healthy foods at an affordable price, but that’s quite separate from the societal pressures to be thin, the othering of fat people leading to all kinds of discrimination, the physical and psychological harm done to (mostly) women and POC because they are or might become fat which comprise diet culture.
We need to change both what kinds of foods are available in stores AND change the way society views fat people and fatness in general.
Shifting the conversation to personal dietary choices isn’t quite victim blaming. It just continues with the idea that personal choice is the most important factor in personal weight-ignoring economic status, genetics, other health issues (many thyroid drugs and antidepressants cause weight gain), age and so on.
Winning a marathon is about running faster - within the specific constraints and conditions that a marathon entails. Weight loss is about reducing your calorie intake below your energy requirements, and when you succeed in doing so, you will lose about a pound of fat per 7000 calories of deficit or something in that region. Just like a marathon involves constraints and complications upon the basic idea of just running faster, successfully altering your diet involves managing constraints too - aiming for a deficit that is not so large as to impact your physical ability, mood, everyday lifestyle, or slow your metabolic rate excessively, ensuring that nutrition is maintained, etc. However the basic problem that the vast majority of people are dealing with is consuming excess calories relative to their activity levels and overcomplicating the solution doesn’t help this. Because people do feel shame, and are often battling deeply habitual, normalised, and acculturated behaviours as well as an industrial food system that is almost sabotage-like, I think that as simple as possible a model is necessary - complications often become excuses.
A few people recommend doing weight loss as slowly as possible in order to minimise the noticeable impact of diet changes, but I think for many people that has to be balanced with the tangibility of results - it’s hard to stay rigorous if you’re losing 100 grams a week. However it might help with the whole maintaining habits thing.
This is a belief (interestingly, I think Trump is a proponent of the idea that exercise wears the body out) that is totally unsubstantiated. Of course, people who exercise, whether moderately or with great intensity, sometimes die. However the net effect of exercise is almost universally positive when it comes to longevity, not only because of the improved functioning of the body and the mitigation of the ill-effects of inactivity, but in unexpected forms of anti-aging effect.
Creating the FDA’s predecessor in 1906 was absolutely the right thing to do, it did great work. Expanding its mandate to safety and efficacy in the 1930s was also an important and needed step. It’s post-thalidomide that they lose me. The FDA, unlike agencies in Europe, correctly didn’t approve it, then tightened approval requirements anyway. It’s since then that we’ve seen dramatic slowdowns in approvals, shifts in what drugs and treatments get developed at all away from things like antibiotics and vaccines, and rising spending on marketing and higher prices to compensate for the higher costs and longer timelines of approval. I’ve seen lots of data pointing towards the delays and things-never-developed costing more, in both lives and money, than the FDA saves by rejecting unsafe, ineffective treatments. I’ve never seen similarly strong data pointing in the opposite direction, but I’d like to if you have.
And yes, bringing a successful drug to market doesn’t cost billions. Testing enough drugs to get that one through, though, does. And time costs money as well. ROI needs to be high enough relative to other industries for people to invest in drug development at all. Delays mean drugs have patent protection for less time after release. That adds up to higher prices, and lots of orphaned diseases or cheap interventions that go unrealized indefinitely.
mRNA vaccines are, I think, one of the best examples of where the FDA costs us way more than it has saved in all the unsafe treatments ever kept off or taken off the market. The tech has been in development for well over a decade, but was mainly being used in trials for cancer treatment. It’s societal value as a near-universal-preventative for infectious disease, able to update for new strains in a matter of days, manufacturable at low cost, was an economic non-starter. Without COVID I doubt we would have seen it come to market in less than another decade at a minimum. The FDA is still so slow to approve updates that we’re chasing multiple-year-old strains at best. At the same time, even when it quickly became clear in 2020 that the initial-best-guesses for dosages and timings for two shot sequences were far from optimal, there was no reasonable way for anyone to run the studies needed to change them. And in the meantime we still have to wait longer for more effective vaccines for flu, malaria, and all the other things we could have much better solutions for with current technology.
Alternatively: if you want to have the FDA as is, it shouldn’t be private companies funding drug development at all. “Which drug can make the most money” isn’t the right incentive in that distorted of a market. Not just because of the FDA, but because the one who decides what to buy, the one who decides what and whether to pay, and the one who benefits are three different entities. But that’s what markets do, they focus on the profitable pathways, because if your company doesn’t, someone else’s will, and they’ll take market share and eventually destroy you.
And I don’t buy the greed explanation, for a simple reason. If returns on investment are that high, where are the new market entrants bringing treatments to market and undercutting them on price? This is not a rhetorical question. If I grant all your assumptions, then I want to know where they are if they exist, or why rich people with money to invest are leaving so many billions of dollars on the table if they don’t.
Alas, that it was as simple as calories in-calories out! The mechanisms that govern how the calories in are stored and used are complex, not well understood and work differently in different individuals. And it’s been shown time and time again that people who exercise may live healthier lives, but they may not lose much, if any weight. Some mass is converted to muscle, but some is stubborn and stays. Look at the people who were on the TV show the Biggest Loser- under a grueling regimen of high intensity exercise they all lost some weight, but as soon as they cut that down to an amount a person living a “normal” life could sustain, the weight returned. The expectation that people should want to undertake the type and amount of work required to maintain that weight loss is part of the problem.
Ok but at least recognize that “calories in” includes medical issues like absorption problems that prevent calories from getting out of the food and into the body.
Calories out can also mean a lot of things. For a while I was loosing most of the protein I was eating though my kidneys and into my urine.
Also thyroid regulation is real.
I wasn’t under eating when my thyroid was overactive but I was hovering above my lowest safe weight. I had to start counting calories to keep my weight up so I could be treated for my kidney issues.
Now I’m overweight, I have the same small appetite I’ve always had and I eat more produce and less junk food than I did before I got sick.
For 40 years I never put on weight and then I got sick.
There’s a simple exercise that shows that this is due to greed rather than the FDA. If a company develops a drug that simply helps people but won’t make much money, there is not just one but two pathways they can choose to get it approved at significantly lower cost. There is the Humanitarian Exemption pathway and the Orphan Drug pathway. A company can make a little bit of money but basically foregoes marketing the drug. In addition, FDA is currently pushing drug companies to develop new antibiotics with incentives and faster review cycles.
You are correct about the decreases in new drugs that just help people, but you’ve reversed the causality. Most drug companies aren’t developing these drugs because they aren’t profitable enough to satisfy executives and shareholders, not because approval timelines are unreasonable.
That was true in the 1980s. By the early 2000s, companies could screen hundreds of drugs in the time it took to screen one a decade or so before. By 2010, that was tens of thousands. Now it’s millions of drugs screened for efficacy across multiple disease cell lines per year per lab. With high throughput screening, companies can test drug candidates at an incredible rate.
An then there’s the opposite approach - designing drugs for the desired effect and building them from the “ground up.” Need to block a receptor? Design the molecule in CAD and print it instead of searching the Amazon for new compounds in plants and animals. That dramatically reduces the cost and time of drug discovery as well.
Sorry, but this example is where your argument really goes off the rails. A new, customized vaccine was developed and released in just over a year. This was a mind-blowing achievement, in both scientific endeavor and in regulatory collaboration. Previously, such an effort would take over a decade. And new releases are coming out 6 months or so after the strain they are targeting! I…just…can’t even.
Agreed, but I still think you’ve got the wrong root cause. This must be solved on the market side of the equation, and the fastest way to get there is through single-payer healthcare. When drug companies are negotiating with a single payer entity, they just can’t gouge like they can when it’s a hundred or a thousand individual hospitals and dozens of insurance companies. That, and making sure that drugs and devices that are developed with public money are automatically price-controlled. Look at California, producing insulin in order to cut out the price-gouging drug companies. It works! And it has the benefit of driving down the actual primary driver of drug costs - marketing budgets and profit margins.
You’ve (obliquely) cited two above: Moderna and Bio-N-Tech. Bio-N-Tech felt like they needed to distribute through Pfizer’s network, which is probably true for the speed and scope of what they were trying to do for the COVID vaccine, but the drug development was all Bio-N-Tech.
Also, the greed explanation is why drug companies do what they do. They focus on the blockbuster drugs for chronic conditions, that require patients to take them for decades rather than treating and curing the underlying condition. To bring it back around to the topic at hand, drug companies prefer to develop drugs like statins that require large patient populations to take the drug every day for decades on end. They reject drugs that prevent disease and cure long-tail disorders exactly because they can’t milk them for profit. However, there are a lot of smaller drug companies that do focus on those kinds of drugs and utilize the pathways I mentioned above. It’s just that people don’t know them. They aren’t household names, because they often only have a few hundred employees and they don’t have fancy product launches or Super Bowl commercials. But they exist and they genuinely help people.
Er, I wasn’t being anti-exercise, mind. I find exercise good for the health, really good in fact, I feel good about it. It just doesn’t improve longevity. Accidents, going too far over your limits, things like that are what I meant. And as @PsiPhiGrrrl pointed out in her anecdote, it won’t prevent cancer or stuff like that (though even that is nuanced, as there is some help, just not as much as we think).
I feel exercise will help you enjoy your life to its normal length, but it won’t add years like the gurus say. Not exercising will definitely subtract as your immune system suffers, you fall into the vicious circle of depressed boredom, and so on. But add years? No. It stops you from losing years.
Heinlein was an asshole when he wrote “moderation is for monks”.
Even then, there was a range of sizes in my family. Most were not thin, except for the kids. All of them worked, walked a lot, and most prepared food from scratch. I can look back further and see the range of body types in photos from the '30s through the '60s. Very few started thin and stayed that way throughout life. They were teased for it and fed more because that wasn’t considered to be healthy. The attitudes of people towards those who were not thin changed.
We only have to look at the toxic comments about celebrities trying to raise awareness of the problem and body positivity to see how far we have to go. I’m on the small side, but most members of my family are not. As an adult, most of my enraging moments in life were due to racism. What comes second were fat-phobic people aiming haterade at my loved ones in public. Having noticed when it started, and knowing it was created, motivates me to work on seeing it end* in my lifetime.
Or at least crawl back under the rock where it came from.
I think one of the reasons discussions around weight are so fraught, even in a room like this one where everyone is trying, is that there are two facts that can seem at odds to some people:
Humans have always come in a full range of sizes
Overall, though, people have also gotten bigger in the past 50 years.
I think a lot of people confuse #2, which is arguably fixable, with #1 which is not a problem, nor does it require fixing (beyond an attitude adjustment from thin people).
