garden in the void

I gave my soapbox speech about how weight loss is mostly bullshit to two different patients in a row yesterday and so help me I’m pretty sure one of these days someone is going to say “but SURELY you agree I’d be HEALTHIER if I lost weight!” bc you can see the disbelief in their eyes. And like. Sure, maybe! You might see some improvement in biomarkers like LDL and A1c, and your knees would probably feel better. But you would be amazed at how much more good you can do for yourself by focusing on things you can actually meaningfully change without resorting to making yourself miserable. Eat more fresh fruits and vegetables—it’s hard bc they’re more difficult to prepare and more expensive per calorie and go bad faster than other foods, but they’re what we evolved eating the most of so they’re what our bodies need the most of. And walk around more; sure, cardio is great for you, but if it sucks so bad you don’t do it, it isn’t doing shit for you. And we evolved to walk very very long distances, a little bit at a time, so our bodies respond actually very well to adding walks into our schedules, which is vastly easier than adding workouts that are frankly designed to be punishing when the definition of punishing is “makes you less likely to do it again in the future.”

You get one life. It is shorter than you can begin to imagine. Don’t waste it hating yourself because somebody is going to make money off that self-hatred. You deserve better than to be a cash cow for billionaires who pay aestheticians and dermatologists to make them (or at least their trophy wives) look thin and beautiful no matter what they actually do.

And ONE MORE THING—listen. We are NOT evolved to lose weight, we are evolved to hoard it. We came about in a world of famines. Not only does your brain have MULTIPLE failsafes built in SPECIFICALLY TO PREVENT WEIGHT LOSS, but there are epigenetic factors—factors that are not DNA but travel with it and affect how it is expressed. So if your parents or grandparents lived through a famine, like, oh, say, the Great Depression, YOU are more likely to gain weight and more likely to have difficulty losing it. AND! We live in a world highly affected by industrial pollution—there is no corner of the world free from it, micro plastics and industrial chemical pollution have been found literally everywhere ever studied—and many of those pollutants affect our endocrine systems. Looking at records of lab animals going back to the 1960s, where we have excellent records of what genetically essentially identical animals ate, we know that LAB ANIMALS FED THE SAME AMOUNT OF THE SAME CHOW WEIGH MORE NOW THAN THEY DID THE IN SIXTIES. So no. You’re not fat because your willpower is somehow busted. (Willpower, fun fact, can be depleted! By DEPLETING BLOOD SUGAR! Baumeister’s work in the 2000s demonstrated that.) You’re fat because your body wants you to live, and because the ultra rich have knowingly poured poison into the world because they don’t care if you die.

So YOU need to care if you live. And how you live. Please love yourself, because the billionaires will never give a shit about you. Weight Watchers has a 96-99% failure rate. Weight loss is a scam that makes billions of dollars every year. Love yourself too much to fall for that. Don’t wait until you’re thin to love yourself or to start living, because a) that day may never come and b) it’s okay if that day never comes. You are worthwhile and enough right now. I promise you that.

Did I mention that all studies on the subject are very clear--like, we do not need more studies on this, which is a bananas thing for a scientist to say--exercise does not lead to weight loss. It just doesn't. Anyone who tells you it does is wrong. It's good for you because it's good for you, not because it makes you thin. It improves your blood vessel health; it improves your heart health; it improves your body's ability to manage blood sugar; it improves your muscular health. It does not make you thin.

Reducing calories can reduce weight, but your body, as previously mentioned, is trying REAL HARD not to lose weight. I see a lot of recommendations for 1200 calorie a day diets. Google "starvation study" and look at how much the men in that study were given. It was over 1500 calories a day, and they were miserable. They became skeletal. They felt awful, depressed, foggy--because your brain is the single biggest user of calories in your body. It is so metabolically active that your brain uses around 30% of all the calories your body uses. Guess what happens when you starve your brain? You feel like shit. You feel stupid and depressed. Don't starve yourself. It doesn't work and it makes you feel awful and you will get rebound weight gain above whatever you lost, guaranteed, and then you'll blame yourself for "letting yourself go" because our society is built on lies.

We also cannot and should not ever suggest that anyone can lose more than 5-10% of their body weight and keep that off. It's just not possible. Bariatric surgery is a WHOLE other can of worms, I don't have the energy to explain why I almost never recommend it to my patients, but just know that if anyone has ever suggested you lose more than 10% of your body weight through behavioral changes, they are bullshitting you.

Getting a lot of notes on this post! Many of them are people going "oh thank God" and then there are people going "but SURELY you agree I'd be healthier if I lost weight!" and people going "well I lost weight so it IS possible!" and like. Buddy. That's like two people out of the 10,000 notes on that. You are that rare statistical exception. Feel morally superior if you want to. (Right up until you hit that health problem that leads you to gain weight and suddenly realize, with great shock, that it WASN'T immorality that led you to be sick and fat.)

Lotta people asking me medical questions! No! Ask your doctor. Real professionals need a lot more details than you're going to send me in an ask. Giving you medical advice without knowing your chart and being your doctor puts me at actual legal risk.

Also people going "cite your sources!" No! I spent 10 years working in research before I went back to med school. You know how I find papers on stuff? Google! Learn to fucking Google! If you can find research that convincingly demonstrates that exercise leads to weight loss, shoot it my way, because on my way in to work last week I was listening to a national conference board prep lecture and the speaker very specifically told thousands of family physicians, out loud in words, "Exercise does not lead to weight loss," so you can either assume you know more than me and go prove it, or shut the fuck up.

Also people saying, "Wait, I thought I could lose weight, and now you're telling me I can't?" No. I'm telling you that weight is not the benchmark for how healthy you are, and if you let your eating disorder tell you that thinness is the only thing that makes you valuable as a person, that is a very different disorder--that you can recover from--than being fat.

Also people with just no reading comprehension going "you're saying there are ZERO benefits to weight loss?" to which I say go re-read the first two paragraphs of my first post.

I am literally an expert--on the brain, on bodily health--and if what I'm saying is unsettling, you need to think real hard about why. Examine your attitudes towards fatness. Ask yourself whether you'd still like yourself if you were fat. Ask yourself what you have to offer the world besides thinness. Why do fat people being happy threaten you? Why would you be happier in a world where fat people deserved the things fatphobia does to them? How much of your self-esteem is based on being thinner than someone else?

Okay, I am ADDING THE BARIATRIC SURGERY POST HERE. You can STOP ASKING ME FOR IT.

You know what, while I'm at it, my post about Ozempic/Wegovy:

And let's address the only two meaningful criticism of my original post series:

So, now no one can complain I didn't address those issues. I am actually grateful to the people who pointed out the Baumeister thing. I'm just annoyed at people going "he was BARELY hungry enough that he CUT HIS OWN FINGERS OFF AND DIDN'T KNOW WHY" as if that is, you know, in any way a defense for why we continually hear advice to go on a 1200 calorie a day diet.

​Evolution and my body has kept me safe when people and misinformation has not.

Medical professionals and whole scale systems acting on research motivated by discrimination has almost cost me my life many times. I lost so many years and the trauma will be with me always.

But my fat body who remembered the famines my ancestors survived would not let the last of my fat reserves be squandered. By body fed me from them when I lay bed-bound unable to move or eat. My fat body was ready for my own famine and did everything to make sure I survived.

When fat people die younger than thin people it is because of discrimination, our bodies are designed to survive. (There’s research on that too)

A surprising article to find on the Huffington post. I think, especially towards the end, there's still a saturation of healthism and diet talk (just of the "clean eating" variety), but the information about weight discrimination is absolutely on point, especially within the medical field ignoring decades of research.

Not only do we know that weight loss isn't sustainable or possible, we also know that weight discrimination kills, in a myriad of ways. If you actually care about "health" then start unlearning your weight bias NOW and realize that fat people are just people who are a different shape.

And this article doesn't even touch on "the obesity paradox"(the fact that fat people survive heart attacks and injuries BETTER THAN thin people) or the fact that dieting, especially "yo-yo dieting," is a better predictor for heart disease than weight, and that many of the fat people who have cardiovascular diseases have a long history of dieting that (understandably) didn't work.

encouraged to rb but fatphobes will just be blocked.