> Conflating health and weight-loss is an unhealthy (pun intended) obsession of the media and society writ large.

Being overweight and diabetes are comorbidities of nearly everything, and are comorbidities of each-other for that matter. People are more overweight than ever. If anything there is not nearly enough alarm, and far too much normalization of the increasing status quo.

> Lots of people do in fact need to gain weight to become healthier.

Approximately 1.5% of US adults are underweight. Approximately 73.6% are overweight or obese.

There's so much to unpack beyond these surface-level statistics, though. Like how there's some evidence that the health risks associated with increased BMI are partially an artifact of weight loss diets being really bad for your health, plus selection bias. People with lower BMIs are significantly less likely to attempt these health-destroying weight loss diets in the first place. Which would then imply that an approach to the issue that focuses primarily on how to get people who are already fat to lose weight, rather than as a prevention-focused public health initiative, may be doing more harm than good.

Or how lumping the overweight and obese groups together is a great example of lying with statistics by gerrymandering the BMI quantiles that seem to be healthiest together with those that have the poorest health outcomes, and away from a group that was arbitrarily defined the better part of two centuries ago based on one person's aesthetic standards rather than any health indicators, most of which weren't even known at the time. In other words, it's the crux of a pervasive piece of statistical circular reasoning.

And the moralizing statements like "normalization of the increasing status quo" that politicize the issue, thereby making it harder to have a nuanced, thoughtful discussion about the topic, and instead push it toward always being yet another pea shooting contest between the "personal responsibility" and "fat positivitiy" caucuses. Which only serves to drown out any attempt to really contend with the full magnitude of the nuances and unknowns that surround this issue.

This is nonsense. Obesity doesn’t cause health issues because of crash diets - the link between obesity and several bad health outcomes (insulin resistance/diabetes, hypertension, joint damage, to name a few) is extremely well established, and has nothing to do with diet and everything to do with the accumulation of superhuman levels of fat relative to the conditions in which humans evolved. You’re right that there is some controversy about where exactly the line for “overweight” should be, but there’s no question that when you get into the obese category (41% of Americans) it is extremely bad for your health, irrespective of what diet you’re on - humans simply aren’t designed to handle the amount of fat we now routinely accumulate.

> humans simply aren’t designed to handle the amount of fat we now routinely accumulate.

Maybe so, but like with all other evolution, presumably we'll either adapt or die?

Maybe fat accumulation via material prosperity is the Great Filter.

Yes, over the long term (tens of thousands of years?) evolution will probably come up with adaptations to material abundance assuming it lasts. Cold comfort to the people that suffer from it today though. Evolution can't do anything to help anyone who is alive today.

The link between many health issues and constant failed, and increasingly desperate attempts to lose weight is also extremely well established. Why do you dismiss the connection as if it were nothing in order to frame fatness as moral failure and disease as punishment?

> as nothing to do with diet and everything to do with the accumulation of superhuman levels of fat relative to the conditions in which humans evolved

This is a religious belief. Evolution doesn't visit judgement on human behavor, and any number of things that we do now that we didn't do in the Stone Age fail to have negative health consequences. Some might even be good for you, judging by the comparative lifespans of prehistoric humans and modern ones.

Look, if you care about people losing weight instead of wallowing in the cruelty and definitely something that looks like jealousy (e.g. that happy feeling some people get when they hear that people who have sex caught a venereal disease) - if you really care, then the health consequences of crash diets would concern you. The consequences of repeated failures to lose weight would concern you. None of this would be dismissed if your concern were health instead of moral superiority.

Sorry for the accusatory tone. To preempt, I'm 6', 175lb..

edit:

> Or how lumping the overweight and obese groups together is a great example of lying with statistics by gerrymandering the BMI quantiles

This is the fucking worst because it's conscious dishonesty. It's intentional deception.

I said nothing about the link between crash diets and health issues in my post. I only addressed this point in the OP:

> there's some evidence that the health risks associated with increased BMI are partially an artifact of weight loss diets

which is misleading at best - there is a huge amount of evidence that fat accumulation directly leads to health issues.

I am not moralizing in any way, I don't see anything in my original comment which indicated I'm passing moral judgement at all. I am simply stating that the health consequences of obesity are well known, and the causal direction is clear - obesity itself causes health problems. Again, I'm not passing judgement here - in fact I find the common refrain "eat less, move more" to be an extreme oversimplification of the problem, and I'm well aware that diet change is neither easy nor sufficient to solve the obesity problem. I'm just pushing back on the idea that crash diets are what cause the primary health issues associated with obesity - it's simply not true, and there's a mountain of evidence to back that up.

You have set up a false dichotomy. Why do you ignore that word "partially" in the sentence you quoted?

When someone proposes a partial cause, then pointing out the existence of other causes does absolutely nothing to challenge the premise that there might be multiple contributing factors.

This is not a particularly controversial idea among health researchers. I've been casually following obesity research for decades now, and one of the big themes I've seen is one of scientists being frustrated at their inability to get journalists and popularizers to give a proper accounting of the level of nuance in the knowledge we have. Your use of the phrase "the causal direction" implies that your knowledge is informed by these same popular sources that perennially frustrate the research community, because a proper accounting of the science does not permit the use of a definite pronoun in such a statement.

Because the magnitude of the effects isn't the same. The evidence is very clear - obesity _causes_ several negative health conditions. To suggest that crash dieting somehow reduces the relevance of those conditions is to deliberately mislead. Some links:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC380258/

https://pubmed.ncbi.nlm.nih.gov/33882682/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038894/

I would love to see any research you're aware of that would show evidence that crash diets cause significant health issues (I don't doubt that there are some diets that cause weight loss while being bad for health in other ways) but to suggest that the side effects of those diets compare in magnitude to the side effects of obesity itself is extremely misleading. If you have any reputable sources that provide evidence to the contrary I would be happy to read them, but I think you're misleading people, deliberately or inadvertently.

> there's some evidence that the health risks associated with increased BMI are partially an artifact [sic] of weight loss diets being really bad for your health

Citation needed.

Without fail when an article about health, weight loss and diet appears on hacker news these comments appear. Suggesting obesity isn't dangerous, and that we should be careful about addressing it due to normative standards, bias, demonisation etc.

In reality the severity of the impact of obesity on health is enormously underplayed in mass media - especially in the United States where are you admit there is a 'fat positivity' lobby.

There are lots of nuances around how and why this epidemic has happened. From food deserts to the promotion of fast food and high fructose corn syrup to shift work to sedentary lifestyles. But the impact itself is scientifically uncontroversial.

Sharing pragmatic articles about how to address this in our communities and our own lives is literally life saving.

I failed to find a citation in your own comment.

Not at all. The science is very clear and has been for quite some time - being overweight is bad for your health and increases all cause mortality.

I could link meta analyses about how strong the link between increased weight and CVD is as one example, but I don't think you're really looking to change your mind.

Instead I'll just make it as simple as possible. Increased weight = increased metabolic demand = more stress on the heart and other organs.

> I could link meta analyses about how strong the link between increased weight and CVD is as one example, but I don't think you're really looking to change your mind.

You could not say that you could do something if you don't plan to do it, and you could avoid blaming the person you're arguing with for your failure to produce evidence that supports your point instead. Try making it complicated.

your advice makes your own comment pretty ironic, don't you think?

but no. I really don't have to provide evidence that the sun is hot, that Washington D.C. is the capital of the United States, or that being fat is bad for you. I understand HN is for a technical audience, but in the nutritional and health field, this is an accepted fact.

> Being overweight and diabetes are comorbidities of nearly everything

https://www.independent.co.uk/life-style/health-and-families...

The only reason people treat statements like the ones you're making as obviously settled is because it plays into Protestant bullshit about being punished for enjoyment i.e. the worse it tastes the better it is for you.

The science of health vs fat is complicated, it's not some abstract moral tale of the gluttons being punished by god for their immoderate behavior.

* * *

I understood the post differently. For example, I am not overweight, never have been. I am interested in reading about healthy eating. I'm not interested in losing weight, as that would be unhealthy for me.

Yet, all I can ever find is how to eat in order to lose weight. Thus the two issues (health and weight loss) are conflated.

Generally people conflate health and weight because globally, for a very large number of people, this is the main problem. As societies move to western diets, the average person becomes overweight and is diagnosed with one or more health problems directly related to obesity (pick one or more from my list above).

This is the easy problem to diagnose.

The connection between nutrition and health, if obesity is not your concern, seems indeed to be far more nuanced and complex. I'm not sure if anyone has come up with anything better that every expert could agree on except "eat little bit of everything".

I suppose fasting seems to improve biological markers even for non-obese people so it's not only about weight loss as such, though.

Look up the book perfect health diet

> I am interested in reading about healthy eating.... Yet, all I can ever find is how to eat in order to lose weight.

I suspect that this is largely due to the fact that industrial food owns the food science in this country, and in most of the developed world. For decades, we were fed (no pun intended) a Food Pyramid that is a blatant lie, because it correlated to how monied interests wanted to feed the nation.

I had my annual physical last week, and my doctor told me that the consensus is now "eat whole, natural, unprocessed foods as much as possible, and probably cut back on meat." That seems reasonable, on its face. It also seems prohibitively expensive for many people.

I'm afraid that there isn't a great solution to this problem in this country, almost by design.

The older I get the more I am pretty convinced that at the margin, every bodys digestive system and metabolism responds a little differently the time/frequency of meals, precise content of meals, amount of exercise, amount of sleep, etc.

Therefore there is no "one size fits all" solution outside of the general "eat a bit less, move a bit more" guidance.

It's kind of like when they interview 100+ year olds for "the tricks to a long life" and it's just inane random stuff.

One does not become 100lb overweight because of "margins". One becomes 100lb overweight because they are doing 100mph in a 35mph zone so "slow the hell down" is a great advice.

You also don't become 100lb overweight because you eat your first meal at 12pm instead of 8am. That's what that comment was saying; the only obvious advice is eat less and exercise more, and it works 100% of the time for all bodies.

Yes, thank you, lol.

And of the two eating less is more important. The human body is remarkably efficient when it comes to exercise.

Also important is eating your food in a manner (e.g., smaller portions more frequently) that you don't ever get really hungry. Extreme hunger leads to binge eating which can easily undo any calory deficit you managed that day.

Of course you do. That's like saying that you don't end up $100 in debt by having a deficit of $1 a day.

> Of course you do. That's like saying that you don't end up $100 in debt by having a deficit of $1 a day.

You do not. 100lbs is excess of 350000 calories "stored" and for every extra lb one's BMR increases. By the time someone is 100lbs overweight just to maintain that weight they would need to consume another gallon of ice cream a day just to maintain their 100lb extra.

You are playing with margins when you are 1-5lbs overweight.

Given the Washington Post is based in the US and has a majoritarily U.S.-based readership, and that almost 3 out of 4 adults in the U.S. are overweight, the general advice to lose weight is sound...

Comparatively, less than 2% of the U.S. population is underweight. And even for these people, simply gaining weight by tricking your biological clock would not be a good advice either.

> Lots of people do in fact need to gain weight to become healthier.

I'm sure given 7-8 billion people in the world this might be "true" for some value of "lots", but I'm curious where data backs this assertion for the audience for which this article is intended; where food is overabundant and mostly overprocessed.

> Lots of people do in fact need to gain weight

This is obviously technically true, but it's like reading "domestic violence" and thinking "ah, this must be about women beating their husbands". Yes, both directions of the problem actually exist, but one is orders of magnitude more likely.

Incorrect (by orders of magnitude). Both directions have about equal rates of occurrence. Female-initiated domestic violence is somewhat more frequent than male-initiated domestic violence.

https://domesticviolenceresearch.org/domestic-violence-facts...

Look, I don't want to get into a fight over that because it's completely out of topic, but to claim that "25.3% of individuals have perpetrated [violence]" and "80% (sic) of individuals have perpetrated emotional abuse" means using definitions of "violence" and "abuse" very different from ordinary English.

Perhaps you live in a bubble (high income, high education) if you find it completely unbelievable that a quarter of the populace will engage in domestic violence at some point in their lives.

I grew up in rural Appalachia, and I can tell you that the most common response to someone, say, being called a stupid bitch, is not to channel the eternal words of Marcus Aurelius or to center ones self like the Buddha, as might be the case for your average HN poster.

Men are continually trying to paint sexism as symmetric. Doesn't matter that 99% of the corpses that result from domestic violence are women, that 1% means that it's actually a back and forth tennis match. Meanwhile, one of the most common types of mass killings is when men just decide to kill every woman they see.

>Men are continually trying to paint sexism as symmetric

Exactly, considering that in almost every societal metric that matters men do worse than women sexism against men is much worse, nothing symmetric.

You seem to be conflating violence and murder. Yes, mens result in death more often, but data shows women and men are both comitters of domestic violence.

>means using definitions of "violence" and "abuse" very different from ordinary English

Incredible how the same critic is never moved against women when engage in the same kind of Newspeak. Let's remember that "speech as violence" was not invented by men.

"This article doesn't really explain _why_ eating earlier is supposedly better."

It does: "Because of the way our internal clocks operate, our bodies are primed to digest and metabolize food early in the day. As the day progresses, our metabolisms become less efficient."

Which should mean the opposite, that eating later in the day is better for weightloss.

why? that's not how metabolism works

They’re confused by the word efficiency. They’re assuming that if metabolism is inefficient then it must take more energy to process food. Thus, more calories burned, thus weightloss.

Digest and metabolize. This would mean that early in the day, you digest food and put it to work. Your body temperature is higher, you fidget more, your body repairs some of the damage you did when you worked out last night.

Later in the day, the food you digest sits around. Your body temperature is lower, you fidget less, your body performs less maintenance and repair. But the body isn't wasteful; it's still built to survive periodic famine. So, those extra calories that are just sitting around get stored away for later.

It also mentions ghrelin and leptin

In the US, most people are overweight, not underweight. I'm not a medical student, but I can imagine that if the average American lost 10% of their excess body weight, the improvement to their health (and subsequently public health) would be enormous. But public officials don't address this like they did when I was growing up. Now we just have this weird culture of "fat acceptance", I guess to presumably spare peoples' feelings.

>Now we just have this weird culture of "fat acceptance", I guess to presumably spare peoples' feelings.

The USA obesity epidemic has been undergoing for decades. I highly doubt "anti-fatphobia" tiktoks are to blame here.

You’re not a medical student, so you wouldn’t know, but it’s well studied that making people feel bad for being fat actually makes them fatter. So sparing their feelings about their fatness is actually the correct behavior if we want to encourage the average American to lose weight. A fat person isn’t ignorant about their fatness, but not treating them any different for being fat is actually the path to get them thin.

>It's well studied that making people feel bad for being fat actually makes them fatter.

Thanks for the downvote. That doesn't mean that doctors shouldn't tell their patients to lose some freaking weight if they're obese. Fat sympathy is a cultural problem. But also all the seed oils, sugars, and fakeness in our foods is another problem.

I didn’t downvote you. Im just telling you that displays of fat shaming actually make fat people fatter, statistically, while there’s no evidence that fat sympathy does the same (and in fact might do the opposite).

> Lots of people do in fact need to gain weight to become healthier.

Maybe in places of famine, but the target audience is western, specifically American. Emaciation is hardly a problem in the US. Obesity is. Two thirds of Americans are overweight or obese. Sure, it may not be enough to simply aim at weight reduction (most probably have bad diets to begin with), but weight loss is definitely important and healthy.

The great irony is that while emaciation is hardly a problem, malnutrition is. It's a country that is both malnourished and obese and there just doesn't seem to be much of a public policy push to change that.

I would suspect that malnourishment leads to obesity, at least in part. When you stuff yourself with empty calories, your body is left unsatisfied, because it's missing important nutrients. This leads to hunger signals, which leads to eating more empty calories, which leads to ...

This is the main problem with social media in its declining era.

"I encourage my competitors to take some really bad advice" simply becomes tiresome when the rest of the traffic has been pushed away and that's all that remains in the social media sphere.

" Lots of people do in fact need to gain weight to become healthier"

>> No. A few people. Very few. Lots need to lose weight to be healthier.

According to a BBC article from 2016 [0] there were an estimated 641 million overweight people on earth and 462 million underweight people. I wouldn't call that "very few".

[0] https://www.bbc.com/news/health-35933691

I bet most of those half a billion underweight people are not going to be reading the Washington Post, or even worrying about dietary advice it's from a us-based news outlet.

I thoroughly approve of the quibble though.

> This article doesn't really explain _why_ eating earlier is supposedly better.

I feel like it's a personal preference and I only eat later in a day, but here[1] you may find some explanations on why eating in the morning may be better.

[1] https://medicalxpress.com/news/2023-01-intermittent-fasting-...