I think that’s a good message. I certainly feel badly for obese people because, however they got there, they’re going to have a hell of a time getting back to a healthy body size.

I do agree that many people lose that key part of the message when they pass it on.

Feeling bad about your weight is a good motivator to lose weight. It might be bad for your mental health and it could do absolutely nothing for some people but the vast majority of people who keep their weight in check and/or are motivated to lose weight do so more for social reasons than they do for health reasons.

Compared to something like alcoholism, being overweight (which can be similarly deadly) is treated much differently. For alcoholism, the attitude has been changing from "alcoholics are degenerates with weak wills" to "alcoholism is a disease and these people need help" where the attitude toward obesity is going from "fat people are disgusting people who have no self control" to "big is beautiful".

The difference is with alcoholism the message goes from disdain to support but he solution remains the same, a great deal of personal work to solve the problem. With obesity, the message goes from disdain to acceptance and the solution is to just not bring it up.

Educationalist here, actually it isn't :) For many people, this just makes you feel bad - and that's it. For that feeling to result in meaningful action a bunch of conditions have to be met, e.g. the absence of eating disorders (including things like stress eating etc.), a concept of self-efficacy (the idea that one actually is able to change out of one's own will), impulse control, knowledge about food and dieting, the time and money to eat healthier and so on. Often people are perfectly aware that their behaviour is unhealthy, but they lack one or more of those conditions. It therefore is better to focus on providing people the actual means to change (knowledge, methods, better food in school and at work, a supportive environment, taxation to make unhealthy food/drugs more expensive (a thing in the EU)).

Note that I'm fully in support of emphasizing the unhealthy aspects of obesity, though. Providing the facts often just isn't enough.

Are you just asking overweight people or are you asking all people? The people who are overweight today are obviously the group of people for which social pressure is ineffective. I'm talking about all people including the people who are successfully at a healthy weight.

So even though shame might not work to get fat people to lose weight, it could still work to keep people from ever getting fat. Getting shamed for a few pounds means that you can fix the source of shame by dieting for a few weeks, very doable for average people.

They also gave us insight into the mind of the gay anti-gay politician.

I think it's important to not lose sight of the fact that maintaining a healthy weight is a challenge for nearly everyone and undermine what is currently working for those who are not overweight.

Furthermore, I think obesity has somehow found it's way to be more in line with the LGBT style movements of acceptance/tolerance instead of the changing view of addictions as disease instead of character flaws when it clearly should be much more like the latter.

Only if you think you have realistic chances of loosing that weight.

Otherwise that bad feeling will ... get eaten up.

Be anxious, not too much. Mostly over things within your control.

Then it becomes (well, became) the next taboo that nobody wants to touch with a 10 feet pole since its playing with a PR suicide.

And so we have the world we have, and we reached it step by step by exactly this logic. Simple thing is, fat people need help from society just like drug addicts, yet everybody desperately tries to avoid this framing, and thus help is often not deemed necessary/worth the risk of offending. Thus people die needlessly just that somebody doesn't have hurt feelings.

I deal with chronic pain and I’m at the hospital or clinic frequently, often multiple times per week. As someone who is in that environment quite a bit, I can assure you that the dangers of obesity are very clearly and openly discussed; frankly, you can’t walk two steps in a hospital without seeing some sort of PSA about the dangers of obesity.

Your mental model just doesn’t track with what I’ve seen again and again in reality.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565398/

The people being told to shut up about it are usually abusing strangers or enemies, and feel very abused and targeted for being criticized for targeting and abusing people. If you were talking about being fat with someone you obviously care about and cares about you, they'd take it in that spirit. If you shamed them for it, they'd hopefully end that fucked up abusive relationship. The only thing I would ever shame a loved one for is their abuse of other people. Otherwise, I want to lift them up, not tear them down.

https://doi.org/10.1111/joim.12251

https://www.outsideonline.com/health/wellness/sunscreen-sun-...

This is coming from someone who spends a lot of time in the sun. Melanoma was never going to have much of an impact on mortality at the population level, the incidence of high grade melanoma is far too low.

Is it coming from someone with a lot of experience evaluating the protocols of epidemiological studies? Sunlight (whether too much or too little) affects us in all sorts of poorly-understood ways; that's why it's useful to do a big correlation study instead of just examining melanomas.

It is, but I prefer to not involve my own credentials as a boring appeal to authority and focus on the argument at hand. I mentioned spending time in the sun to show I have no horse in the race. I only bring up melanoma because the cohort is “Melanoma In Southern Sweden”, but I think your point is fair regarding likely multifactorial causes.

“Sunlight (whether too much or too little) affects us in all sorts of poorly-understood ways; that's why it's useful to do a big correlation study instead of just examining melanomas”

Still, if I were designing a study to measure the impact of exercise on all cause mortality, I would not have a question like “Do you frequently jog to the farmers market to pick up vegetables?”. Half of the questions ask about going on vacation, maybe we are seeing that people who have enough time to “go abroad” twice a year live longer, I would believe that. I hope this is obvious and that even someone who doesn’t have “a lot of experience evaluating” these studies can see the flaw.

The study didn’t include any men!!! A study of women only might not generalize to the whole population, especially when it comes to all cause mortality. One obvious example: men have 1.5x higher risk of dying from melanoma than women. The study excluded individuals with a history of malignant melanoma.

The no-exposure group exercised less and had lower education, and there is a large risk for residual confounding that could have likely been accounted for by using categorical variables with more than 3 options.

Further criticisms include the “no exposure group” having much more women aged 55-64 (with likely much more comorbidities). They used length to follow up time to account for this which has no place in an observational study. The study excluded women who had a history of cancer.

I appreciate the work the authors did, but remain unconvinced that it is sunlight that caused lower mortality in their study.

First of all, they explicitly mention controlling for income disparity. Second, the questions seemed reasonable to me. One for sunbathing in summer, one for sunbathing in winter which mentions travel, one for tanning beds, and one for specifically about vacationing in sunny places.

Keep in mind the context. This study was not designed to answer "is sunlight good for you" or "do people who sunbathe a lot live longer". AFAICT it was designed to answer "is avoiding sunlight bad for you." Those questions seem reasonable to suss out how much someone seeks/avoids sun exposure. There might be better ones, but it seems hubristic to just assume so, so casually.

> The study didn’t include any men!!!

I don't know why they limited the study to women. I assumed it was to make it easier to control for confounds, but they could've had some other reason. Maybe sunscreen ads are mostly targeted towards women in Sweden, and they thought a larger number of women would turn out to be sun-avoiders. In any event, this isn't a problem with the study, this is just complaining that they studied something different than what you're interested in knowing.

> [differences between the most-sun and least-sun in education, exercise, age, etc]

Of course there were differences, those things correlate with pretty much everything worth studying. Are you saying that the authors didn't control for them (then why collect data on them and include it?), or that they did so badly (why do you think that), or something else?

> I appreciate the work the authors did, but remain unconvinced that it is sunlight that caused lower mortality in their study.

I don't think epidemiological studies ever prove that anything causes anything, we're talking about correlations here. The conclusion was that avoiding sun is associated with higher all-cause mortality among women. I'll believe that until there's a reason not to.

"Are you saying that the authors didn't control for them (then why collect data on them and include it?), or that they did so badly (why do you think that), or something else"

Yes, I addressed this above, see my comment on residual confounding, amongst my many other criticisms.

Not when there is a functioning ozone layer.

The thing with UV light though is that it also kills surface bacteria and is involved in vitamin D production. It's very like minerals in that way. Not enough kills you, but it's easy to go from too little to way too much.