Noom is a diet app in an anti-diet moment

April 9, 2022 5:47 AM

The Noom paradox: A diet app, claiming to be not a diet app-- and the current anti-diet cultural war around food, weight, bodies, and health. "There is no other product that could have a 5 percent efficacy rate and be peddled as hard as diets are peddled."
posted by dancing leaves (100 comments total)

I’m really glad to see this here. As a request to other commenters, could we please avoid posting in great detail about “diets that worked for you”? (I’m glad if you’re happy with your health, but it’s hard to read if you struggle with disordered eating; there’s no guarantee it will work for others; and all the specific detail doesn’t add a great deal to the conversation.)
posted by Concordia at 6:38 AM on April 9, 2022 [101 favorites]

I think I said this the last time we had an FPP about Noom: I tried it once, but very VERY quickly got frustrated with the calorie-tracking side of things because I tend to make 98% of my own food, And for whatever reason Noom couldn't handle that; if I had eaten a particular fast-casual restaurant's sandwich or salad for lunch, or a mass-market food item for dinner (like, tacos using Ortega products), I could pull that up in the app easy. But if I ate something I'd made, like a meal-in-a-bowl thing with couscous, chick peas, carrots and a chorizo link, it seemed to break down and need to grill me on every single part of it - exactly how many grams was the couscous after cooking? What was the species of chick pea? Where did the cow live where they got the meat for the chorizo? Exactly how much salt? Pepper? Paprika? Did I stand to the left or the right of the stove while cooking?....

Not only was that way too fiddly, it said something about what the makers of Noom assumed its customers would be eating.
posted by EmpressCallipygos at 7:11 AM on April 9, 2022 [64 favorites]

I tried Noom bc it advertises that it has support, both from other members and life coaches. The support was a joke. The group was just a few a few people texting random things that didn't seem useful or directed to anyone in particular and the coaching was utterly generic and sporadic. The diet "psychology" was generic, shallow and filled with time consuming but useless jokey little quizzes. The one thing that made it work for a while was that it was a tool for tracking my food but I can do that on cronometer for free. (And on edit: Agree with comment above, i don't eat brands and it was difficult to enter regular whole unprocessed food so you just have to try to approximate with a brand, which is not accurate or helpful)
posted by barnowl at 7:30 AM on April 9, 2022 [14 favorites]

I want to mention a pet peeve about the article: The claim that diets "can even damage your metabolism in the long run." This is something you will hear constantly when reading anti-diet material, but what's missing is any proof of the claim, or even any explanation of what the claim means. What is metabolic damage? What exactly is the harm? It's never laid out for you, even though it is apparently important enough to mention in every discussion. The "damage" phrasing in the article leads to this press release, which does not address metabolic damage at all.

Later in the Vox piece, we see what does appear to be evidence of metabolic damage from dieting...until you look more closely. This NYT piece is referenced, but it's a study of gastric bypass patients compared with Biggest Loser contestants...not exactly representative of most of us who would turn to an app for diet support. While the research did show a lower metabolic rate for the contestants, they were able to successfully keep weight off if they kept their exercise up. But how applicable is that to the general population? Is it proof that repeat dieting, in a normal, non-television-show, non-surgery-patient population, results in a lower metabolic rate, thus future difficulties in keeping weight down?

But wait! Vox also says there is a study showing frequent dieting "can double the risk of death by heart disease in patients with coronary artery disease." Which is surely proof? Except the study is careful to point out that that's not quite what it is saying: "the study did not assess whether the body-weight fluctuations were intentional or unintentional." Which...is a much different point than Vox is making. And again, indications are that drastic weight changes are more dangerous than smaller weight changes (at least among the patients studied here--again, who had pre-existing coronary artery disease).

None of which is meant to defend Noom or the diet industry generally, just to express how much I hate the generalized claim of diet-induced metabolic damage. Obviously the diet industry provides plenty of psychological damage of its own.
posted by mittens at 7:30 AM on April 9, 2022 [52 favorites]

"Better than that" is still a 50% chance to not even lose 5% of initial weight after 8 years in a group that has type II diabetes, and is therefore strongly motivated to do so, and who have intensive medical support in doing so.

Having basically a coinflip on whether you will see any noticeable results when you're in a highly motivated group with a high level of medical support is not what you can call "works for most people."

Contrast this with something like exercise and strength. I started lifting weights about 8 years ago. I never went super hard at it, just managed to keep up a steady habit of putting myself in the position where I can get to the gym a couple times a week and spend an hour or two exercising. I am about 100% stronger than when I started. I don't think that's unreasonable results for most people to expect if they keep things up for so long and are fortunate enough not to have injury or other life circumstances intervene. And that's just showing up consistently, not being gung ho about things or optimizing anything. A diet means you have to be disciplined many hours every day, forever.

"Diets don't work" may not be true for everyone, but it's a lot more truthful than pretending "eating right" will make you thin in the same way going to the gym will make you strong.
posted by Zalzidrax at 8:45 AM on April 9, 2022 [46 favorites]

At some point, "diet" became a bad word, and every weight-loss program in the world started claiming it wasn't a diet. Even Weight Watchers claims it's not focusing on weight loss, but on "overall health and wellness" (per Wikipedia article - I looked at the Weight Watchers site to see if they addressed the word "diet" - they sure don't seem to use it, except in saying their program is for people tired of yo-yo dieting).

So nobody is going to start an app and call it a "diet" app. People have had it drilled into their heads that "diets don't work," which sounds good but doesn't hold up except with specific definitions and assumptions, one being that you will immediately go back to your old way of eating and blame the subsequent weight gain on the "diet." (I don't want to discount how extremely, extremely difficult it is to not go back to your old way of eating or how lifetime dieting can really mess people up psychologically - just saying it's way more complicated than people on both sides of the diet debate are willing to admit).

Anyway, since "diets don't work" is something everybody "knows," an app called a diet app probably won't be successful. So things that are clearly diets get called not diets.
posted by FencingGal at 8:56 AM on April 9, 2022 [20 favorites]

The well is so poisoned on What To Eat (in the US at least) that in my opinion it’s going to take a generation to get to the point where we can have real public conversations about it. But certainly, the first step is continuing to fight the diet industry’s efforts at selling shame and fear in the service of ‘health’. Like many adults, I pay attention to what I eat, a little for longevity and a little (a lot?) for vanity. But I’m fighting a constant rear guard action trying to keep food as food to my kids and not make it something less.
posted by q*ben at 8:58 AM on April 9, 2022 [10 favorites]

Since opening this thread, the Noom youtube ads have started...
posted by subdee at 9:07 AM on April 9, 2022 [1 favorite]

The article lost me at the second sentence: "Imagine that you could repair your broken relationship with food, with hunger, with your own skin, and in the process shed those 10 pounds you’ve been wanting to lose." 10 pounds! Ah ha ha ha ha ha ha ha ha ha! (sobs a little under my breath) That's a rounding error; that's the water weight that comes off, again, whenever I try something new.

And I'm also going to push back against this: "The problem with getting Fat Acceptance Activists to review Noom is that it's like getting a detailed criticism of Scientology from a member of the Moonies." Really? Fat acceptance is just another cult? BothSidesDoItism is what's on your plate? Shame on you. Fat acceptance activism isn't trying to sell me something, unless it's Aubrey Gordon's book, the cost of which is, again, a rounding error on any and every commercial diet scheme, in the long run. I don't think that it's particularly radical (or, heaven forfend, "culty") to suggest that the last thing that the diet industrial complex wants is for people to have an actual healthy relationship with food, eating, and their bodies, because then the revenue stream dries up.
posted by Halloween Jack at 9:07 AM on April 9, 2022 [85 favorites]

I had never heard of the Minnesota Starvation Study before now but it leaves me utterly convinced that the rise in obesity has to have something to do with environmental changes. A "normal" daily diet for these men was 3,200 calories? Although I work a sedentary job, I exercise regularly, walk the dogs a few miles a day, and expend plenty of mental energy, am taller than the average 1940s male, and 3,200 calories would have me probably gaining 20 pounds a year. It really does seem like people could just eat more and not gain weight 50 years ago, and I don't think it has much to do with the rise of, say, office work, since the most obese populations are the working class who expend tons of calories in their daily labors...
posted by dis_integration at 9:11 AM on April 9, 2022 [36 favorites]

I had a conversation with a dietitian a couple weeks ago for Reasons (middle age is beginning to disagree with me). I went in with some trepidation, more or less expecting to encounter a food zealot. Instead I found a very practical person who kept emphasizing the importance of not removing pleasure or normalcy from the process of eating. She did sound very tired, though. At the end of the conversation I said, you know, this sounds doable; the last fifteen years I’ve heard so much about all these fad diets that just sound impossible, but I think I can do this. And wow, did that get her started on the ills of the present moment: “I look at all these people declaring that what you eat is what makes you a good or bad person and I just wonder, what on earth are we doing here?!” Suddenly I understood the tired sound in her voice. I agree, we made some missteps somewhere, and I wonder if the root of it is (artificial, uneven, inequality-driven) abundance.
posted by eirias at 9:32 AM on April 9, 2022 [32 favorites]

Well, one thing that’s changed is overall better health. You lose a lot of weight being sick. You need more calories if you have low level parasitism or infection or get food poisoning more than once or twice a year. You also have to look at the average age of participants - men in their 20s sure do seem to be able to eat 5,000 calories and shake it off pretty easily. That doesn’t say anything about what was happening with older cohorts…
posted by Bottlecap at 9:34 AM on April 9, 2022 [11 favorites]

I am shocked at that price tag, after using free MyFitnessPal for so long.

I recently started using a different app for my disordered eating (lolsob) that is designed for bodybuilders. IT’S WILD. It’s intended for people who will alternately be trying to lose weight and the regain it with active ‘reverse diets’. Since I started listening to health podcasts for weight lifters (or is it strength podcasts from doctors? Both I guess) it’s like stepping through the looking glass. Everything is reversed. Instead of focusing on low calorie foods this population is trying to figure out how to cram more grams of protein into their diet. Instead of debating what type of cardio burns the most calories I’m listening to a review of the scientific literature on whether doing cardio on Leg Day will Kill Your Gains (conclusion: no).

I found this shit sideways by looking for cholesterol podcasts and it’s been quite the experience.
posted by bq at 9:39 AM on April 9, 2022 [13 favorites]

That doesn’t say anything about what was happening with older cohorts…


super dead
posted by ominous_paws at 10:13 AM on April 9, 2022 [6 favorites]

The anti-diet versus pro-diet battle is such a depressing symbol for everything that just doesn't work in our society where we have to pretend everything systematic is in fact a problem of personal responsibility. There's clearly a massive rise in obesity over the past decades, one that we can see spreading around the world as countries get richer and change their ways of eating and of living. And obesity and associated ills like diabetes, etc are still increasing rapidly, even in countries like the US where they have been going up for many decades.

It's clear that something is very wrong. It could be something in our environment, it could be something in our food supply, it could be something psychological, like stress or even advertising, it could be something in our lifestyles — or most likely some combination of these factors. But instead of trying to figure these problems out together and make incremental systematic improvements where we can, we focus our energy on this stupid pro- and anti-diet fight. Of course it's not helpful to focus on individual responsibility when it is clear that the problem is systematic on a societal scale. But neither is it helpful to claim that people can't change their eating habits or lifestyle with positive effects on their health (even if this is very difficult for many people) — or to claim that obesity doesn't have health risks at all.
posted by ssg at 10:16 AM on April 9, 2022 [34 favorites]

Your diet certainly affects your health a great deal. But the mechanism is not diet affects weight affects health. Almost all of it is a direct effect of your body getting the nutrients and resources it needs to operate at 100%. The obesity part is a red herring if you want to eat healthier.

It's worth it to eat lots of fruits and vegetables in your diet even if it doesn't make you thinner (which it probably won't.) But that's not sort of diet we're talking about. The subject here is clearly the restrict calories to lose weight type diet. This Noom app has lentils on their yellow, eat with caution list for goodness sakes.
posted by Zalzidrax at 10:38 AM on April 9, 2022 [16 favorites]

I totally agree that people can make positive changes in their health; over the previous three months or so, I brought my a1c score from 10.7 down to 6.1, and any MeFites who are diabetic or caring for someone who is will know what that means. (Everyone else: it's a good thing.) Maybe a better way to look at this is: will this attempted lifestyle change actually improve your life in significant and sustainable ways, or is it intended to create and maintain a revenue stream for the diet industry, which has a vested interest in maintaining and maximizing its profits? (The estimated size of the diet industrial complex varies from $72 billion to $192 billion (and growing), depending on who's counting.) The two don't necessarily have to be mutually exclusive, but if you find a way that works without having to pay a membership fee forever, or don't have to keep trying new diets when the old ones fail, that's less money for them.
posted by Halloween Jack at 10:45 AM on April 9, 2022 [6 favorites]

I had never heard of the Minnesota Starvation Study before now but it leaves me utterly convinced that the rise in obesity has to have something to do with environmental changes.

there was an interesting series of blog posts summer last year (previously) that looked into the evidence for environmental factors behind obesity (and talks some about the Minnesota Starvation Study). The conclusions were basically 'we can't conclusively say it's lithium but... it's lithium.'
posted by logicpunk at 11:03 AM on April 9, 2022 [15 favorites]

I think the conundrum with the diet industry is that the question of “How should you eat?” can be answered in a single line, that Michael Pollan quote: “Eat food, mostly plants, not too much.” There’s nothing to sell there. Nothing to turn into an algorithm, or fill ten chapters of a diet book. The problem is: “why is it HARD to do that?” and the answer is: largely for reasons beyond your individual control.

Because cooking real food takes time, and you work 80 hours a week, and sugar is an effective short term tool to manage stress. And also lots of people live in food deserts, and advertising is incredibly effective, and healthy prepared food costs more than cheap food, etc etc etc.

And there’s nothing to sell there, either, because a diet book that told you to quit your job and move somewhere you can easily get your 10,000 steps in without thinking about it instead of spending two hours a day commuting would ALSO not sell, even if that’s the truthful answer about what would probably be necessary for you to lose twenty pounds. So instead it’s this shell game, where they make what to eat seem way more complicated, when it’s actually simple, (colors! points! eat only during these hours! eat like the French! eat like the Greeks! Eat like the Japanese!”) while ignoring the things that are actually hard.

In doing so, it’s selling you an illusion of control, while blinding you to the small ways you DO have control, and probably could choose to eat in ways that would make you feel slightly better, if you weren’t dizzy from hunger and mentally exhausted by trying to calculate how many calories were in the irregular shaped chunk of “red” butter you put on your toast.
posted by Merricat Blackwood at 11:12 AM on April 9, 2022 [26 favorites]

The problem with getting Fat Acceptance Activists to review Noom is that it's like getting a detailed criticism of Scientology from a member of the Moonies.


This is a bullshit hot take. Body shaming is not an effective health intervention. All it does is create eating disorders. It is cruelty for cruelty's sake. The fat acceptance movement's message is "we already know you don't want to us to be fat; please stop yelling at us". Equating that with a cult is ridiculous.
posted by agentofselection at 11:14 AM on April 9, 2022 [85 favorites]

I lost a bunch of weight using Noom, and I kept it off. But I just used it for weight tracking and food journaling. Really any of those apps will do just fine.
posted by panama joe at 11:20 AM on April 9, 2022 [3 favorites]

But the mechanism is not diet affects weight affects health.

My visceral fat would like a word with you.

Anyway, since we're veering into philosophy, let me build off Merricat Blackwood's excellent comment and say there's this thing, right, this enlightment idea of property, built into our notions of our bodies and our health. Your body is yours, it's your thing to do what you want with--a premise that comes up a lot when we talk about various rights. But when we come up against this particular issue, we're stymied--we're told we have control! Our entire society is based on the notion that we control our bodies, it's what our laws are based on! So why don't our bodies respond the way we order them to? We have all this understanding, all this science! We have math, why isn't math working, the app clearly shows if I eat X calories and burn Y calories, then I will lose weight, so why did the math stop, why did the science stop?

The idea of the body as an object you control, which underlies so much of our day-to-day understanding, is just completely wrong. That's not to say we need to get back to some pre-enlightenment idea of rendering our bodies unto God (that didn't turn out very well for bodies either, although I do wonder how much guilt there is about one's shape, if one's idea of the cosmos is entirely God-driven, without any notion that it is under your control?). But we could certainly stand to bring back a sense of mystery to the body--an a priori assumption that we're not going to know how it works in any useful way, that we don't have that kind of control over it, it isn't ours. It's not a separate thing, it is more like a sentence, it's an expression, a conversation between myself and my environment. A big round speech-bubble. But what about fatness? What about heart disease? What about (oh god) my blood pressure and its effect on all the little vessels in my brain and kidneys? But that worry is, again, a trap, an illusion of control. Sure, there's stuff one does about blood pressure and whatnot. But it could be understood as clumsy intervention, rather than control. More like asking for directions in another language, than writing the perfect epic poem in your native tongue. You don't feel guilty over stumbling in the other language, because you don't have that same assumption of ownership. (Then again, I feel like I'm veering into 12-step territory here, and that also feels like the wrong approach.)
posted by mittens at 11:48 AM on April 9, 2022 [17 favorites]

I was really interested that my dietitian recommended against food tracking apps. She said she'd seen them lead too readily to disordered relationships with food. I've used them before and mostly noticed the same thing that barnowl complained about, how anything barcoded is easy, but entering an actual g-d meal you made yourself is bananas hard.

Full agree with Merricat Blackwood on sugar as cheap stress management. In my case it seemed to also be leading to tachycardia somehow?? Which is not a net positive for life stress, it turns out. I don't love diet culture at all -- I have so little patience for ideology about sugar -- but I really didn't love getting lightheaded and confused after eating. It's been a couple weeks of this "whole grain, protein" life and I miss the high-GI stuff about as much as I miss Facebook after five years, which is to say, not never, but not as much as I like feeling better.

(ymmv, I am not proselytizing, I have no idea why my body is doing this at this time, maybe it's some weird long COVID thing, maybe it's aging, maybe my sense of a connection between these things is entirely illusory; love mittens' idea about embracing body-as-mystery.)
posted by eirias at 11:55 AM on April 9, 2022 [7 favorites]

Less a diet than a subscription to an eating disorder.
posted by rhamphorhynchus at 12:04 PM on April 9, 2022 [5 favorites]

Along similar lines as the fpp and relevant to the direction the discussion has taken:
Well, Actually: The Thin White Men Who Rebranded Dieting as “Wellness”
posted by eviemath at 12:04 PM on April 9, 2022 [7 favorites]

The fat acceptance movement's message is "we already know you don't want to us to be fat; please stop yelling at us".

That part of the message is great, and the people who argue with it are infuriating. You can find them if you're stupid enough to read the comments on any NYT article about weight - there are always a few people who think the obesity issue would be solved if people ate an occasional apple and walked around the block. People who are naturally thin have absolutely no idea how much effort it can take a fat person to lose five pounds.

But there's also the "fat isn't actually unhealthy" message that some fat acceptance folks proclaim, and that is not great and not true. Though there are many people who claim to be concerned about health when it's actually aesthetic, and people who shame others for being fat should be flung into the sun, there are health risks that come with obesity even if you're exercising and eating well.

I have a rare cancer that has obesity as its only know risk factor (aside from exposure to industrial chemicals, which I don't have). I really regret the time I spent believing the "obesity isn't unhealthy" people. I don't know if things would be different if I hadn't been morbidly obese for twenty years, and maybe I wouldn't have been ready to lose weight earlier in any case, but I'll always wonder.
posted by FencingGal at 12:04 PM on April 9, 2022 [33 favorites]

This discussion is going about as well as I thought it would. Anyway, Noom is nothing special, it's just one diet among many. What you think about diets in general is a separate issue.

You know what I'd like? More discussion about fat and what it does in the body, its mechanisms and chemistry and all that good stuff. Did you know there are three different kinds...white, brown, beige? And we don't really understand what they all do? That fat can signal your body to increase blood flow to build it, acting like an organ?

This thing we hate and fear is clearly very critical to our bodies, undoubtedly part of our evolutionary journey. Our bodies build it easily and lose it reluctantly or not at all. Why?

We also have a hard time accepting that there's variety in how different bodies store and use it. We don't know why.

We don't know much at all, really. If we are getting fatter, what does that mean? Hard to say. It's probably not that we are much lazier and more gluttonous than our ancestors. Maybe it's an inflammation response to stress and pollutants. Maybe it's something else.

Understanding fat is not helped by treating fat as a disease, or a badge of shame. Or as a bad habit we can all easily drop or control. I wish we could approach this topic with interest and curiosity, not blame, shame and defensiveness.
posted by emjaybee at 12:17 PM on April 9, 2022 [33 favorites]

If anyone has research on separating the health effects of obesity from the health effects of stress, I’d love to see it. We know that stress kills. And if you look at any review of the biggest health effects of stress, they mirror those of obesity. And yet I almost never see it as a control in any of the research.

My partner has a condition with significant research showing that weight loss is associated with improvements to the condition both in terms of symptoms and in actual measurable numbers. They lost 25 lbs due to a months-long stomach illness, and never gained it back. The condition got worse both symptomatically and by the numbers, and they had to increase their meds (which came with some significant side effects). Doctor said, “Yeah, for some people, weight loss actually makes it worse. But keep losing weight anyway.”
posted by brook horse at 12:36 PM on April 9, 2022 [19 favorites]

I first started following the fat acceptance movement in the early 2000s via the Big Fat Blog. But it's changed a lot since then, especially in the social media age. It's become a lot more extreme and a lot more commercial.

In the early days the movement encouraged fat people to exercise for health, rather than weight loss. But that's now seen as "healthism" and is often discouraged. Lindo Bacon basically had to disown that aspect of their original "Health At Every Size" book. (Not that it helped, ASDAH has now trademarked "Health at Every Size" and is in dispute with Lindo Bacon over it).

There's now a whole grifter ecosystem around Fat Acceptance. You can pay $1297 for the Fierce Fatty Academy program, or $358.80 for Body Positivity University. It seems like everyone's selling something.

Meanwhile the diet industry has seized on Fat Acceptance slogans. Noom does it. Pilot is using the language to promote an anti-hunger drug. And everyone selling weight loss surgery is happy to tell you that "diets don't work".

I used to think of the Fat Acceptance movement as a basically positive thing, though it always had a small element of denial about the health impact of being fat. But in the social media world with its conflict-boosting algorithms, and opportunities to monetize views, it seems to have become something darker. There's bullying, there's grifting, and there seems to be a relentless pressure to get more extreme or risk getting cancelled.
posted by TheophileEscargot at 12:45 PM on April 9, 2022 [22 favorites]

None of which is meant to defend Noom or the diet industry generally, just to express how much I hate the generalized claim of diet-induced metabolic damage. Obviously the diet industry provides plenty of psychological damage of its own.

A lot of this comes down to the successful attempts to keep the blame focused on individual choices. Our society – especially in the U.S. but not exclusively — doesn’t want to acknowledge the degree to which the obesity rates are linked to external factors: car-centric design, unhealthy food being heavily subsidized, people locked into work/travel/living arrangements which both favor unhealthy food and reduce options for exercise, healthy cooking, lowering stress, etc. It’s not easy to accept that most of us are living in unhealthy systems and don’t have good options for making structural changes.
posted by adamsc at 12:50 PM on April 9, 2022 [13 favorites]

TheophileEscargot, if those are your actual issues, why did you drop such low-quality links? The first was over 20 years old, the second is downright dismal once you look at how success is measured, and the third says that dieting slows your metabolism and makes it easy to regain weight, which is exactly what people mean when they talk about a "ruined" metabolism.


There's now a whole grifter ecosystem around Fat Acceptance. You can pay $1297 for the Fierce Fatty Academy program, or $358.80 for Body Positivity University. It seems like everyone's selling something.

There is a grifter ecosystem around EVERYTHING. EVERYTHING. I don't think houses are bad just because there are people making millions by selling real estate get rich schemes. I don't think romance novels are bad because some authors sell publishing courses that have never graduated a successful writer.

Stop hanging out at r/fatlogic. If you want to get your hate on, the crypto bros are right there.
posted by betweenthebars at 1:17 PM on April 9, 2022 [21 favorites]

Lord what a great thread. This is why I joined Metafilter. Cheers to Merricat, mittens, and Eirias, wonderful contributions.
posted by BlunderingArtist at 1:47 PM on April 9, 2022 [3 favorites]

There are already so many societal influences that make people hate themselves, do we really need another?
posted by tommasz at 1:49 PM on April 9, 2022 [3 favorites]

There is a grifter ecosystem around EVERYTHING. EVERYTHING.

And a huge difference between a few people doing little bespoke workshops and the $72 billion (or more) weight industry. It's like someone comparing the enormous right wing noise machine to a few teenage SJWs on Tumblr. There's something called "Fierce Fatty Academy"? Wow, that sure is a challenge to the innumerable fat kid camps that have been operating for decades!
posted by Halloween Jack at 2:02 PM on April 9, 2022 [10 favorites]

As someone who has struggled with weight, and seen multiple perspectives on it, it's interesting how some people are fiercely and angrily ready to offer their takes on the topic as facts, instead of their own personal viewpoint, shaped by experience. Thankfully not all, and less so here than in other places.

I think multiple perspectives have been helpful for me. Fat acceptance has helped me not shame myself for stretch marks and thick thighs. Wellness efforts have helped me focus on exercise and diet changes not as a tool of weight loss but as a way to connect to my body. Diet plans have helped me find foods that I can enjoy that nourish me and assess foods for their benefit. Mindfulness has helped me taste and enjoy each bite of food and the way it delights my senses. I take from each.

I think I'd find Noom overwhelming though. It seems like a lot at once. I think if you are charging money, there's this impetus to help people make changes quickly, rather than make sustainable changes. Smaller changes have helped me with my personal goals.

I wonder who benefits when these topics become caustic arguments and value judgments, rather than people looking to support each other with kindness and compassion. I think there's a lot of anger, and a lot of that anger is rooted in the deep pain many folks have felt, the trauma so many of us have experienced based on our bodies and how we are treated.
posted by Chrysopoeia at 2:33 PM on April 9, 2022 [20 favorites]

realized at some point that the weight I gained during peak COVID lockdown was indicative of my body doing a great, efficient job of preparing to keep me tf alive

like some subsystem went "ok idk exactly what's happening but our movement seems restricted, our social inputs have drastically gone down, & we're surrounded by 20-pound bags of rice, I am gonna store the SHIT out of some fat"

which, like, can't fault you for that call at all, little buddy; great job

I haven't seen (which doesn't mean there isn't) a lot of discussion of fat storage as an adaptive process that was working just fine before the food environment changed & it became actually difficult to not eat corn syrup

like even fat positivity stuff is all "fat is morally neutral," no, fat means your body is doing a good job at this thing it evolved to do for the survival of the species

your body's not doing broken shit because it hates you, it's doing the correct shit & overachieving at it
posted by taquito sunrise at 2:39 PM on April 9, 2022 [51 favorites]

I believe the fantastic Casey Johnston said it best: "Why pay Noom's prices when any celebrity's Instagram will give you the same questionable advice for free?"

Grifts are indeed everywhere, and I can't think of a better example of one than a glorified food journal charging 60 USD (????!!) a month for the privilege of being told that cookies are a sometimes food. Good lord.
posted by TinyChicken at 3:10 PM on April 9, 2022 [9 favorites]

I would like to suggest that people interested in this stuff will probably be interested in the Maintenance Phase podcast.
posted by BlahLaLa at 3:43 PM on April 9, 2022 [22 favorites]

It really does seem like people could just eat more and not gain weight 50 years ago, and I don't think it has much to do with the rise of, say, office work, since the most obese populations are the working class who expend tons of calories in their daily labors...

People smoked a heck of a lot more back then, for one thing.
posted by Artifice_Eternity at 3:49 PM on April 9, 2022 [7 favorites]

I think multiple perspectives have been helpful for me. Fat acceptance has helped me not shame myself for stretch marks and thick thighs. Wellness efforts have helped me focus on exercise and diet changes not as a tool of weight loss but as a way to connect to my body. Diet plans have helped me find foods that I can enjoy that nourish me and assess foods for their benefit. Mindfulness has helped me taste and enjoy each bite of food and the way it delights my senses. I take from each.

Agree with all this 100%. Also agree completely with the recommendation for Maintenance Phase, even though I don't agree with absolutely everything they say. (I'm still on the fence about listening to the one about keto, because that's been one of my tools for bringing my blood glucose levels down.)
posted by Halloween Jack at 4:13 PM on April 9, 2022 [2 favorites]

It really does seem like people could just eat more and not gain weight 50 years ago

Several of the adults in my family were pretty fat back then, and my mom joined Weight Watchers and TOPS in the 60s. TOPS (Take Off Pounds Sensibly) relied heavily on shaming that would be appalling now, including singing insulting pig songs to members who gained and having them wear pig necklaces throughout the meetings. Hell, in the 70s, so about 50 years ago, I had a friend who weighed over 400 pounds (weirdly, his obstetrician father made my mother cry over her pregnancy weight gain - my mother refused to believe he had a fat son). Looking at a picture of my great-grandmother from the 1910s, I'd say she weighed close to 200 pounds. I understand that statistics now show increases in obesity, but it's not like everyone used to be thin.

I read an interesting book on the history of dieting years ago, but I can't find it now (hell is trying to search for books about dieting that aren't weight loss books). Dieting to lose weight goes back a long, long way.
posted by FencingGal at 4:17 PM on April 9, 2022 [11 favorites]

My dad smoked a lot but he was still fat. Lots of fat people smoked.
posted by emjaybee at 4:24 PM on April 9, 2022 [2 favorites]

Obesity didn't decrease as smoking increased in the middle of the last century, so it seems unlikely that smoking is a huge factor. We know that smoking is associated with lower BMI, but the effect is not nearly large enough to explain the rapid rise in BMI over the past decades. Even if everyone was smoking in 1970 and no one smoked now, that wouldn't be enough to explain the increase in BMI.
posted by ssg at 5:54 PM on April 9, 2022 [4 favorites]

since the most obese populations are the working class who expend tons of calories in their daily labors

I have worked on construction sites, and other similar working class environments, and I can assure you that while most everyone in those environments does some back breaking labour most days, virtually nobody is doing that solidly all day. The energy expenditure is peakier, in that the work is concentrated in small sections of the day, or a few intense days followed by a week of tatting, etc.

Basically, virtually nobody works as much physically as you might imagine, and the bigger guys you see will be typically be very strong, but spend a lot of their work day sat around or leaning on a shovel. They're not really putting an extra couple of thousand calories away, nobody on site is, even though most of them go to the gym after work.
posted by Dysk at 1:09 AM on April 10, 2022

They're not really putting an extra couple of thousand calories away, nobody on site is,

Just missed the edit window - I mean they're not doing another couple thousand calories worth of exercise over a normal day of being awake and metabolising.
posted by Dysk at 1:15 AM on April 10, 2022

People really need to look at the links in logicpunk's comment above. Here is a tiny sample from the first link:

The nonprofit ourworldindata.org has data from the WHO covering obesity rates in almost every country in the world from 1975 to 2016. In every country in this dataset, the obesity rate either stayed the same or increased every single year from 1975 to 2016. There is not one example of obesity rates declining for even a single country in a single year. Countries like Japan and Vietnam are some of the leanest countries in the world (about 4% and 2% obese, respectively), but in this dataset at least, even these super-lean countries don’t see even a single year where their obesity rates decline.

The case against lithium is looking stronger by the day, and its health effects in general are dire yet subtle because of the synergism that results from changing the functioning of so many systems in the body simultaneously.
posted by jamjam at 1:31 AM on April 10, 2022 [4 favorites]

Mod note: One earlier comment deleted; the offensive analogy torpedoes the whole thing.
posted by taz (staff) at 2:22 AM on April 10, 2022 [3 favorites]

Another thing that happened in the past 50 years is the rise of fast food, and that has happened all over the world. Countries like Japan and Vietnam have seen increases in obesity as McDonald's and Kentucky Fried Chicken have moved in, displacing traditional healthful diets. People studying the long-lived Okinawans (the population with the longest living women in the world) have noted big changes in how the younger people eat because fast food has become so popular. Very smart people literally have jobs making this stuff as addictive as possible, and smart, creative people have jobs designing advertising that makes fast food seem synonymous with fun and love.

I can also say that fast food orders in the US have changed in that time. When I was a child, even adults went to McDonald's for one hamburger, a regular order of fries (large did not exist), and what we'd now call a small drink. McDonald's kept adding higher calorie items to the menu, and those higher-calorie items became "normal" orders, as was clear when I worked at McDonald's in the 80s. In the 60s, people did not eat fast food or any restaurant food every single day, and now many people do.

I know weight gain is not as simple as the old calories in, calories out, but there has definitely been an increase in normal serving sizes and how much people eat out since my childhood. Soft drinks are another example. When Coke started coming in 16-ounce bottles, those seemed absurdly huge. An old Pepsi jingle referred to 12 ounces as "twice as much."
posted by FencingGal at 5:39 AM on April 10, 2022 [11 favorites]

(What's the deal with lithium? I tried reading the 'chemical hunger' post but it kind of went on and on without establishing cause and effect?)
posted by mittens at 6:21 AM on April 10, 2022 [4 favorites]

A Chemical Hunger has been discussed previously. tl:dr: it's an interesting set of blog posts but it's not rigorous, makes giant intellectual leaps, and confuses correlation with causation repeatedly. It's the sort of thing where if they are wrong they can say "I was just looking into the evidence" and if they're right they can say "look how right I was!" In that sense it's a bit like people predicting recessions: no one will remember if you're wrong but you get to claim to be a genius if you're right.
posted by Tehhund at 7:32 AM on April 10, 2022 [12 favorites]

I know weight gain is not as simple as the old calories in, calories out, but there has definitely been an increase in normal serving sizes and how much people eat out since my childhood.

Also in snacking between meals.
posted by Halloween Jack at 7:46 AM on April 10, 2022

So, how exactly, did a post about an app's misleading branding turn into a grab bag of everyone talking about their pet theories about weight gain?

So I had this long snarky rant about how weird it is that, no matter what, any conversation about diets will have the a few people sticking their heads in to make sure we all remember that "fat is unhealthy". I think we can safely assume that everybody has heard that message, my kids literally started getting nutrition stuff in preschool. I can't go to the Doctor about my chronic illness without getting a handout about weight-loss (to be fair, the nurse did have the good grace to be embarrassed and said something along the lines of "you don't need this, but the computer beeped at me to offer this to you"). And like, hey I get it, there are some negative health effects that are associated with weight, but they're even more directly associated with other things we can measure.

I don't know, but I can't help but feel that at this point, if you REALLY cared about population level health, you'd be working to REDUCE the amount of stigma and focus on this one particular thing that in most cases is at most a sign that "hey, we should check for this other thing that really is the cause of health problems". Like, there's a whole population out there that doesn't go to the Doctor because they know that they'll likely just get a lecture about their weight and have their actual unrelated health problems ignored. We know that lack of medical care has a GIANT impact on long term health. I guess what I'm saying is that if you want to get to a place where we can have a nuanced conversation about the effects of weight on health, then first we have to get to a place where every conversation tangental to weight doesn't induce the stress response of "I'm about to be shamed", which means every now and then letting people talk about things around food/diet/exercise/accepting their body without jumping in reflexively to say things that amount to"yeah, but you know fat's bad right?"

I mean, look, I've gained a significant amount of weight this year, and I'm in the middle of struggling with the fact that I don't like what I currently eat. But I'm also in a place where I cannot even handle the cultural and emotional baggage I have around trying to "eat healthy". The thing is, I don't like what I eat right for reasons that are at best tangential to health, but I can't just say "oh, I don't actually enjoy eating ______ as much as I used too" because I've been trained to beat myself up over my weight when it gets this high. Not to mention, good luck trying to find weight agnostic resources about changing the way you eat. I mean other than super food geeky cookbooks, which I love, but don't really have time or energy for that right now.

So, maybe it'd do us all good to step back and think "is this a conversation about what I want to talk about, or just about something adjacent" and letting the adjacent stuff go on without our input. Like I think there's a really interesting conversation that could've been had about how main stream culture will assume the language of a movement as a way to protect itself from actually having to do anything about the problem the movement's trying to address. Or the way that the pressures to make a certain approach scale up can lead to compromises that work against the stated goals of the thing you're trying to scale. Or even just that companies are chronically understaffed in an effort to keep profits high and so fail their customers. Like there are TONS of things to talk about that completely avoid another lecture on how unhealthy people are.
posted by Gygesringtone at 8:03 AM on April 10, 2022 [33 favorites]

To the people pointing out that serving sizes have increased: Yes, people eat more.

...

If everyone around the world has decided to keep eating more every year for some unknown reason, perhaps this is not the gotcha against systemic change that you think it is?
posted by tigrrrlily at 8:14 AM on April 10, 2022 [10 favorites]

So I had this long snarky rant about how weird it is that, no matter what, any conversation about diets will have the a few people sticking their heads in to make sure we all remember that "fat is unhealthy". I think we can safely assume that everybody has heard that message

Well, yeah, everybody has heard that message, but there's a more recent message in the fat-acceptance community that fat actually isn't unhealthy, and that's the context in which it's been brought up in this thread. I'm not seeing people harping on it, and a few people have stated that obesity isn't actually unhealthful, so that's represented as well. And I'm not seeing anything here that I would describe as fat shaming (as a person who was morbidly obese for twenty years, it's not like I don't know what that looks like - I have literally had children yell "look at that fat-ass lady" in the street).
People bring a lot of baggage to a thread like this - lots of people contributing have also struggled with weight and body image and self-hatred and real fat shaming. But if this level of discussion is too much, then maybe this just isn't the thread for you.

You could also introduce the topics you want to see without trashing other people's responses (thread shaming?) and maybe that will spark some discussion that is more what you're looking for.
posted by FencingGal at 10:30 AM on April 10, 2022 [12 favorites]

there's a more recent message in the fat-acceptance community that fat actually isn't unhealthy, and that's the context in which it's been brought up in this thread

No one in this thread expressed a view that being overweight was healthy. Everyone chiming in on the health front was doing so to state otherwise, using the "fat acceptance says fat is healthy tho" fig leaf to justify tut-tutting about their concern for fat people's health.
posted by tigrrrlily at 10:41 AM on April 10, 2022 [12 favorites]

FencingGal: You seem really tremendously "concerned" that somewhere, someone might think that there's aspects to their personal health more important than the fact that they're fat.

That attitude, writ large on society, is why I am a person in their 40s with what doctors routinely describe as "amazing cholesterol" and who they "can't believe weigh [x] because you wear it so well" who has likely had undiagnosed and untreated ADHD and depression for decades because literally every conversation with a medical provider I have ever had starts and ends with my weight and how obviously we should only be focusing on that, to the degree that I am completely unable to even start the conversation with them about how I spend my life waking up each day wondering if today I'll be functional or not (with the answer turning out to be "no" more often than not, the older I get).

The horror of "oh no, fat acceptance advocates might lead people to think about something other than fatness!" is a fucking grain of sand compared to absolute black hole of terror that is how the medical community views fatness as the only possible discussion to be had with a patient.
posted by a faithful sock at 10:44 AM on April 10, 2022 [44 favorites]

As I recall, some of the shift away from the older HAES/Health At Every Size ideas to fat activism/fat acceptance is influenced by like disability theory and other ways of thinking about health.

In my experience, the position "fat actually isn't unhealthy," is extremely, extremely rare compared to "health, dignity, and moral worth shouldn't be related."

Even if someone doesn't exercise, ever, and they eat badly and watch lousy television and don't visit the doctor and dress badly, they might still be an excellent coworker, a considerate and caring friend, a patient and generous customer, etc.

In my view, "value your body for what it can do - like how far you can hike, swim, or bicycle in an hour" is better than "value your body for what it looks like and conventionally attractive it is" because most people can improve the first thing more effectively than the second. We're all getting saggier and wrinklier every day - but we're not all getting slower.

This said, the first framework here still has serious limitations. Some people are never going to be able to hike for an hour no matter how badly they want to, and those bodies - those people - still have worth and importance and the capacity for goodness.
posted by All Might Be Well at 11:08 AM on April 10, 2022 [32 favorites]

Also, like, human bodies are different.

...but there's a more recent message in the fat-acceptance community that fat actually isn't unhealthy...

If you're saying that because someone is fat, they are definitely unhealthy, your view is not only harmful, but wrong. Ask yourself why its so important for you to mention this when weight is a topic.
posted by tiny frying pan at 11:18 AM on April 10, 2022 [26 favorites]

The thing is, there isn't much effort to tease out how much of what we consider to be the effects of obesity from the effects of disordered eating, stress, medical negligence, fear of seeking medical care, poverty, racism (including environmental racism), the use of drugs both prescription and non-prescription for weight control, etc. Like, people still trot out the early death of Cass Elliot as an obesity casualty, totally ignoring that she had spent years using drugs and crash diets and actually had lost a considerable amount of weight before she died--not to mention how terrible she was treated due to her size.
posted by LindsayIrene at 11:47 AM on April 10, 2022 [14 favorites]

but there's a more recent message in the fat-acceptance community that fat actually isn't unhealthy, and that's the context in which it's been brought up in this thread.

...O.k.

But, does that mean that the people selling Noom were being honest in their advertising?
Does it mean that they weren't, by their own goals, chronically understaffed?

Like, I understand that that is an important topic to you, but it's not the only topic people could possibly want to talk about, and all we're asking is that occasionally we get to talk about stuff that's related to health and weight without having to also talk about if fat is actually healthy.
posted by Gygesringtone at 11:55 AM on April 10, 2022 [8 favorites]

FencingGal: You seem really tremendously "concerned" that somewhere, someone might think that there's aspects to their personal health more important than the fact that they're fat.

I knew when I made my post that it was going to be misread and misrepresented, but this level of deliberate misreading is startling.

Let me tell you how I literally almost died from doctors seeing me as "fat" and not "maybe we should check for incurable cancer" (spoiler: that's what I had). Beginning in January 2016, I saw six doctors for (a) an upper respiratory infection that would not go away, (b) a whooshing sound in my ears, (c) increasing shortness of breath to the point where walking across a room left me winded, and (d) extremely fast heart rate. Not one doctor ran a simple blood test that would have shown I was in trouble. I was told to take more vitamin D, was given drops for a possible ear infection, and finally given a stress test that showed what the cardiologist was sure was a blockage (it was not). I had been getting worse on a strict heart-attack prevention diet, my total cholesterol was 114 (not a typo), and my doctor's answer was to put me on statins. I was sure that was wrong, so I paid $500 out of pocket to see a cardiologist I heard on a podcast, who said my symptoms were consistent with anemia. So he tested my hemoglobin. It was 4.3, which if you don't know, is a medical emergency. I went straight to the ER for multiple blood transfusions. He said and others have since affirmed that I'm very lucky I didn't die from the stress test. What I had was multiple myeloma (bone marrow cancer). So yeah - I don't need anyone to tell me that the medical community sucks when it comes to fat people. I am damn lucky I survived that particular prejudice, though I'll never know the long-term effects of having my cancer go untreated for so long.

I have not remotely said anything to the effect that fat is the only thing that matters in terms of a person's health. Not even close. I brought it up because there are fat acceptance activists who say it doesn't matter at all, and I think that is not supported by data. I'm fine with people disagreeing with me, but please disagree with what I actually say, not a straw man you create because you're angry at the way fat people are treated by people who are not me.
posted by FencingGal at 12:28 PM on April 10, 2022 [18 favorites]

I wish they would've asked Amy what response she believes that the company should've had to the article. Once you decide that you're done with marketing to people who want to change their appearance for social reasons, you're competing for a smaller pool of potential customers who are probably going to be more interested in/require a local credentialed dietician's practice than an unorthodox impersonal approach they heard about on a podcast ad.
posted by Selena777 at 1:06 PM on April 10, 2022 [1 favorite]

I brought it up because there are fat acceptance activists who say it doesn't matter at all

Are these people in this thread? Are these people in any way contributing to this discussion, in a way that requires that you keep participating just to make this point?

Because what is in this thread is you, doing what what feels an awful lot like Twitter likes to call, "making up a person and then getting real angry at them".
posted by a faithful sock at 1:25 PM on April 10, 2022 [9 favorites]

There are a few people saying we can't separate the effects of obesity from other factors, which I'm taking to mean we don't know whether obesity is unhealthy. But is there a rule that we can only comment on attitudes expressed in this thread? I've read enough fat activist literature to run into people saying this in the real world. I believed those people for years, to my detriment. I am not making it up.

I keep bringing it up in response to other people who keep bringing it up with unfair attacks and misrepresentations of what I say. It's hard not to respond to that kind of personal attack, but it's clearly time for me to nope out of this thread.
posted by FencingGal at 1:37 PM on April 10, 2022 [5 favorites]

which I'm taking to mean we don't know whether obesity is unhealthy.

Well there's your problem: reading something into the text that may or may not be there.
posted by Tehhund at 2:45 PM on April 10, 2022

Just for the sake of argument, let's say those who say being obese is unhealthy are right. Yay! Let's consider that in light of this other fact: we don't have a way to make people lose weight reliably without starving them. So in essence, what you're saying is "You might not have been reminded yet today that being fat is unhealthy, so here's your reminder. Even though, statistically, you can't do anything about it other than live a life of starvation. I just wanted you to think about how unhealthy you're being, and maybe agonize over whether you should start depriving yourself again so that I'll stop".

Even if being fat is "bad", we don't know how to fix it. If you want people to stop being so fat, you should lobby for science funding, not shame people for their lack of thinness.
posted by tigrrrlily at 3:25 PM on April 10, 2022 [25 favorites]

"Fat acceptance activists refuse to accept being fat is unhealthy" feels like even more of a dog whistle these days because the movement seems to be being outmanoeuvred and heavily outspent by "body positivity".

Companies have realised that if you strip issues like medical/employment/housing discrimination from fat activism, hire attractive midsize models as spokespeople, and reframe it as fat people feeling good about their own bodies you can use it to sell shit.
posted by zymil at 7:55 PM on April 10, 2022 [8 favorites]

I think an apt analogy is being light skinned makes you much more susceptible to certain skin cancers. If I walked up to every white person and expressed my concern over their very obvious and visible risk factor for cancer *that would be wrong of me.* White people can’t help being white, the pigmentation of their skin isn’t something they have control over. It would probably behoove them to take measures like wearing sun protective clothing and being aware of their actions, but that’s their business *not mine.*
posted by Bottlecap at 9:18 PM on April 10, 2022 [3 favorites]

I used the free version of Noom for a little while to be more mindful about food and exercise in the face of some pretty typical sedentary middle-aged-lady expansion of my waistline. I liked the way it adjusted my calorie goal and step count dynamically, and the aesthetics of the app are pretty good at giving a satisfying little hit of dopamine.

The way the green-yellow-red food categories are set up was an immediate red flag, though. If the app is "smart" enough to adjust my step count for my recent exercise and diet habits, why can't it seem to discern an extremely consistent pattern of consuming nutritionally-dense foods in very modest portion sizes? I was often barely hitting my calorie goal for the day (because stress and hyperfocus) so hey, Noom, stop telling me that a 2 ounces of hummus with a few whole-grain crackers and a small piece of cheese is problematic. What the everloving fuck?
posted by desuetude at 9:32 PM on April 10, 2022 [7 favorites]

If I walked up to every white person and expressed my concern over their very obvious and visible risk factor for cancer *that would be wrong of me.*

But not even as wrong as doing the equivalent thing with weight, since fat people are subject to social disapproval rather than being a historically privileged group.
posted by Dysk at 12:28 AM on April 11, 2022 [2 favorites]

(On rereading my last comment, I feel I should clarify that I did not mean to imply that white people are not currently a privileged group, though I think my phrasing inadvertently does. Apologies if anyone read it how it was written rather than how it was intended, entirely my bad.)
posted by Dysk at 2:48 AM on April 11, 2022

"I think an apt analogy is being light skinned makes you much more susceptible to certain skin cancers"

The comparison I thought of was between fatness and old age. Old age is natural; old people cannot be turned into younger people, and ageism is responsible for much of the increase in frailty and disease that comes with getting older. (E.g, medical professionals brushing off older people's symptoms as "normal aging," often until the point that curable conditions can no longer be cured). Yet I don't think that many of the people who say that "weight has no impact on health" would claim that there aren't also biological reasons that old people are more likely to get sick.
posted by cinchona at 5:08 AM on April 11, 2022 [2 favorites]

I think it's really interesting to see how "diet culture" is evolving to survive the backlash against its own lack of efficacy and unpleasantness.

No longer do virtuous people eat low fat foods, we must now do Whole 30s, and eat "clean". Diets? No sir, not here. This is about mindfulness and intuitive eating. (which we are selling on the promise that it will make you skinny). It's like a Scooby-Doo cartoon where the villain was Old Man Diet all along, just wearing a costume.

Honestly, if I was less morally inclined I'd be so tempted to get my grift on in this space. The potential is so vast.

I had never heard of the Minnesota Starvation Study before now but it leaves me utterly convinced that the rise in obesity has to have something to do with environmental changes. A "normal" daily diet for these men was 3,200 calories? Although I work a sedentary job, I exercise regularly, walk the dogs a few miles a day, and expend plenty of mental energy, am taller than the average 1940s male, and 3,200 calories would have me probably gaining 20 pounds a year. It really does seem like people could just eat more and not gain weight 50 years ago, and I don't think it has much to do with the rise of, say, office work, since the most obese populations are the working class who expend tons of calories in their daily labors...

So I'm going to do what comment one in this thread asked us not to do, talk about how I lost weight - I promise there's a point to it!

When I lived in Dubai, I, like most fatties, occasionally went through periods where I was super disciplined about eating, went to the gym, tracked my intake, workouts, and weight in elaborate spreadsheets. My weight went up, it went down, it sort of oscillated.

Later, when I lived in London, I did the same stuff but the point around which that weight oscillated was about 10kg less.

Since then, I have spent an extended interval back "home" in The Netherlands (where I remained a big boi) and that mean weight was lower yet. When I went back to London, it trended back up.

Note that over this time I was actually getting older.

Conclusions from my n of 1:

1) Good news, it is possible to lose weight and keep it off.
2) Bad news, it requires moving countries to a place which is radically and completely different and you still won't be a lean, mean, hardbody. So it might as well be impossible and this seems to be borne out by every scientific study that has looked at a large number of people.

I think there's a sort of semantic satiation thing that happens with the phrase "lifestyle change" where we all nod and agree, yeah, that's the thing. What that misses is that a "lifestyle change" can mean changing almost everything about your environment and how you live your life. Expecting that from people is just nonsense.

But there's also the "fat isn't actually unhealthy" message that some fat acceptance folks proclaim, and that is not great and not true. Though there are many people who claim to be concerned about health when it's actually aesthetic, and people who shame others for being fat should be flung into the sun, there are health risks that come with obesity even if you're exercising and eating well.

I guess my view on that is: what's the point? Like I agree with you that the medical science says that there are all kinds of metabolic syndrome issues which are all very bad (although which of them are causing which seems to be pretty complex) but if it is the case that it is close to impossible to do anything about it, then what? Might as well ignore it and get on with our lives. It would appear that medicine has little to offer apart from dire warning of inevitable metabolic fuckage. So, yeah. I get it, but what is to be done. If we're all going to be big ol' fatties, we might as well love ourselves and each other.

"Diet culture" is completely wild to me because fat people, variously conceived, are not a small minority but a super-majority in the US and on the way to being so globally. We've literally created a culture where we all hate ourselves for something that we individually don't seem to be able to do anything about and for a characteristic that most of us share.
posted by atrazine at 5:35 AM on April 11, 2022 [12 favorites]

"Might as well ignore it and get on with our lives"

So, I don't know your situation or which, if any, health issues you may be dealing with personally, but this statement does sound a touch callous. There are so many people experiencing terrible suffering from the "metabolic syndrome issues" you mention. Yes, it's overwhelmingly corporations and governments who are to blame for this suffering, but the fact that people aren't "making themselves sick" doesn't mean that it should be ignored that they are sick.
posted by cinchona at 5:59 AM on April 11, 2022 [3 favorites]

Apart from being fat, I am otherwise healthy, although my blood pressure is on the high side. Probably because I'm still relatively young, I am not otherwise affected by metabolic syndrome cluster diseases.

I'm sorry if it sounds callous, I am very keen for medical research to continue and rid us of the scourge of TDM, hypertension, and all the assorted unpleasantness that gets bundled together before they do come for me.

However in the absence of a medical solution for being fat, I fail to see the utility in reminding lay fat people of the consequences of it. We know, it sucks. What am I meant to do with this information?
posted by atrazine at 6:58 AM on April 11, 2022 [13 favorites]

the fact that people aren't "making themselves sick" doesn't mean that it should be ignored that they are sick

Thing is, the only people we seem to insist pay attention are the fat / sick people themselves, who are basically powerless to do anything about it other than performatively hate themselves. Not the corporations, not the entities actually responsible.
posted by tigrrrlily at 7:02 AM on April 11, 2022 [10 favorites]

I feel like a lot of people are getting/feeling hurt in this thread because they're talking around/past each other. I'll put forward what I think and feel, and please keep in mind that these are just the opinions of a fat person who has struggled with weight, health, and body image issues for some time now, trying varying things with varying levels of success. I am not a doctor or other clinical professional; I just have a lot of knowledge of and experience with myself and my own stuff.

- There are different levels and flavors of fat acceptance, both of self and of others. Not all fat self-acceptance insists that there are no drawbacks to being fat; there's very definitely a strain that says that I can accept who I am right now while at the same time seeing room for improvement. There is a lot of room between "there is no reason why I should try to lose and keep off at least some of this fat" and "I hate myself." There's a lot of room between "taking and keeping off some of this weight will improve health issues X, Y, and maybe Z" and "if I'm not super-jacked, even in my late fifties, I'm a loser." Insisting that the more radical fat acceptance types are the most important or sole voices of fat acceptance is no more justifiable than believing that, if you're not foursquare behind capitalism all the way, you must be a tankie.

- Speaking of capitalism, yes, both fat acceptance and diet (or "mindfulness and intuitive eating", per atrazine) are susceptible to marketing and monetization, although I think that the latter is generally much more heavily marketed and monetized, because of rather than in spite of their frequent limited, or complete lack of, effectiveness. There are low or no cost versions of each. (I'm currently experimenting with intermittent fasting, which has a lot of appeal, because it's simply a matter of not eating during certain times; it is, however, possible to spend money on that, whether getting electrolytes and bone broth to tide me over, or getting apps or joining support communities that require subscriptions or micropayments. Ultimately, capitalism doesn't really care which way you go; it's all grist for the mill, although some forms of grist are more productive than others.

- The best, and maybe the only real justifiable, approach to changing and/or living with fat is to find out what works for you and what doesn't, which may or may not line up with popular opinion, public advocacy, and/or whatever medical professionals you may have access to at the time. FencingGal discussed above her struggles with both the medical professionals who misdiagnosed her--'literally almost d[ying] from doctors seeing [her] as "fat" and not "maybe we should check for incurable cancer"'--and with "fat acceptance activists who say it doesn't matter at all, and I think that is not supported by data". I recently had a negative experience with one doctor who insisted that I should just go on insulin to bring my blood glucose down, and didn't have time to discuss alternatives to that, and a positive experience with another doctor who encouraged and supported my changing my diet to bring my a1c down. (Guess which one was overweight herself?) Ultimately, as with so many things in my life, it really does come down to the serenity prayer: having the courage (and finding the support) to change what I can, the serenity (and also support) to accept what I can't, and the wisdom (and knowledge) to know the difference.

- To add a shred of relevance to the FPP: Noom doesn't seem like it would help me at all.
posted by Halloween Jack at 7:10 AM on April 11, 2022 [7 favorites]

So, I worked in women's magazines for 7 years, and in a media company directed at seniors for 8. I have seen some shit.

The diet and wellness (includes exercise, yoga, etc.) industry is huge. It is huge. It funds a LOT of things that you see - now influencers but before media geared primarily to women but including magazines like Men's Health. It underpins a lot of individual businesses - life coaching, personal training - as well as huge industries like the food industry, the fashion industry, etc.

It includes really bad research (recommend Maintenance Phase's shows on Brian Wansink and BMI) and cults (recommend Sounds Like a Cult on Crossfit and if I can find this podcast run by a former yoga instructor I'll add that into the thread.)

As an editor I had a mailbox labelled "diet pitches." It was never under 50 a week. I worked for one beloved women's magazine brand where we never ran a diet story as a matter of principle and...we went under because we couldn't get enough advertising. The last year as that was happening, we were under a lot of pressure. It wasn't that we were required to run specific editorial, like we didn't have to write about Weight Watchers, say, but companies would look at our editorial and not buy ads further back in the book because we were not running those stories. We ran a TON of health stories. But not specific weight-loss content.

Noom is right in this category. This isn't a story about physical weight loss and metabolic rate. This is a story about startup cash going to advertising that suddenly makes Noom ubiquitous. Do a search on Noom online (incognito.) In my browser on the first page I get articles in: Women's Health Magazine, Forbes, and WebMD. On Page 2 I get US News, Good Housekeeping, The Toronto Star, USA Today, NBC News, etc. This is how fad diets go.

The editorial discussion goes "everyone is talking about this so we have to talk about this." But the cycle is like, 6 months to a year. So at the point everyone is talking about a diet, no one knows if it works long term. No one. Don't be fooled. Don't think this is a discussion about success or non-success. This is a discussion about a well-marketed, unproven technology.
posted by warriorqueen at 7:27 AM on April 11, 2022 [33 favorites]

Regarding the business and staffing model: as a person who works in the field, their staffing is absurd.

A 300:1 ratio of patient:care coordinator is on the outer edge of reasonable for a service that's doing monthly care coordination; think like, 1-2 short phone calls with a patient in a month, and some asynchronous comms via secure messaging, or helping work out a problem with a prescription, etc. Basically: ~30 minutes per patient per month.

A 300:1 ratio of Noom user:coach (their "planned" ratio) for weekly coaching is already insane. That's 8 minutes a week to understand a person and give advice, assuming your job involves no other overhead.

A 800:1 ratio (their "actual" ratio) is frankly fraud. That's basically 3 minutes a week for someone to supposedly understand enough about you, your diet, your goals, etc, to give advice, assuming there was no other overhead in their job.

You would get more useful, personalized advice from a horoscope.
posted by a faithful sock at 7:37 AM on April 11, 2022 [14 favorites]

Out of curiosity I tried the signup process for Noom after reading through the article and this thread. They ask a ton of questions! Lots of reassuring language, emphasizing how their system is based on cognitive behavioral psychology and how it's really easy and fun and all that, but in the end they still ask you to state the exact target "ideal" weight you want to be and how fast you want to get there, and though they claim there's no calorie counting they do indeed code foods based on caloric density so you're still going to have to follow a calorie restriction regime, only in disguise. Which is really what all weight loss diets are, after all... but anyway. Point is, I don't much see the advantage of paying so much for a Noom subscription instead of using one of the bazillion free calorie counting apps that at least are more straightforward about it.

That said, while I'm very skeptical of the pseudo scientific claims of what is basically a fancy calorie-counting system in disguise, I'm also a bit skeptical of the implications that using something like Noom in itself and by itself can cause or lead to eating disorders. That's a big leap to make because eating disorders are not simply a matter of taking dieting to extremes. They're a lot more complicated than that in terms of causes and triggers. So I'm a bit wary of placing that level of blame or responsibility on any individual app or tool for dieting.
posted by bitteschoen at 7:53 AM on April 11, 2022 [1 favorite]

and if I can find this podcast run by a former yoga instructor

Conspirituality?
posted by Lentrohamsanin at 7:57 AM on April 11, 2022 [2 favorites]

Thank you Lentrohamsanin, that's the one!
posted by warriorqueen at 8:32 AM on April 11, 2022

I’m reminded of the trend I’ve noticed on the cholesterol message boards I haunt. Someone will pop in with some scary numbers and ask what they should do about it.

Invariably they will get the advice that by totally changing their diet and lifestyle they can improve their lipid profile and they ‘really should’ try that before going on a statin. But the thing is, I’ve done that. If you’re eating fast food every day and totally sedentary, then yes, you can make easy changes and improve your numbers.

But most people who show up aren’t that person. They are living average lives where they get a moderate amount of exercise but work a sedentary job and eat a standard American diet. That person needs to dramatically reorganize their diet and lifestyle to reach the lipid profile needed for health. I’ve done that. It was expensive, it was a huge investment of time, and it was unsustainable.

I don’t doubt that some people are able to restrict themselves to a whole food plant based diet (which excludes not only all animal products but also all refined oils and flours) and exercise for an hour a day every day, but most people cannot do that. So why tell them they need to do it? Why do they need to try something that will lower their quality of life and that they are almost guaranteed to fail at before they are given access to life saving medication that is well-tolerated by most patients?

Because they need to prove their worthiness …. Or perhaps their unworthiness.

And this attitude is reflected in compliance rates for taking statins. If people know that their high cholesterol is genetic, they are much more likely to take it reliably. Whereas if they think it’s ‘their fault’ that they have high cholesterol because they don’t have a perfect lifestyle, they will punish themselves by not taking it.

Drives me fucking nuts is what it does.

I’m sorry if this seems like a derails but it’s the same culture of morality applied to health as one sees in weight loss culture.
posted by bq at 8:47 AM on April 11, 2022 [12 favorites]

The orthodox suggestion among medical professionals for high cholesterol patients is veganism now, bq?
posted by Selena777 at 9:24 AM on April 11, 2022

This isn’t coming from medical professionals, just from random yahoos who give advice on message board. That said, the three major diets I see recommended from medical professionals are the Mediterranean diet or the WFPB diet, or the keto diet with the caveat that testing is needed to make sure that you’re not in the 25% of people whose cholesterol goes up instead of down on keto.
posted by bq at 9:26 AM on April 11, 2022 [3 favorites]

It's interesting to me that immediately after saying "not everyone cures their chronic illness or gets an eating disorder", the article profiles just a random middle-aged guy who "says he grew to enjoy the feeling of hunger" -- like that's not disordered eating.

I had a whole experience, some of which is probably in my posting history from the late 00s/early 10s, that definitely mirrors his but without spending $60/month. I'm still working through what it meant in my life, how I feel about food, how I judge myself and other people.

I think it's hard to pull apart what about weight and health is a function of the weight itself, the effects of other things (stress etc) that also happen to cause weight gain, the lingering effects of dieting by fat people, and the garbage treatment of fat people by medical professionals*.

Which means that something like Noom is just ... awful! 800:1 coaching ratio what the hell? I could honestly, as a person, stand to work through my Food Issues, not for weight reasons but because my executive functioning around food has gone out the window because of grief and personal history and trauma. But that's not what's on offer.

* I am ENTIRELY certain that the cancer that led to my spouse's death last year could have been detected sooner: the combination of doctors telling them to "just" lose weight, and their justified fear and suspicion of doctors that kept them from being more proactive about seeking medical advice.
posted by epersonae at 4:28 PM on April 11, 2022 [12 favorites]

That said, the three major diets I see recommended from medical professionals are the Mediterranean diet or the WFPB diet, or the keto diet with the caveat that testing is needed to make sure that you’re not in the 25% of people whose cholesterol goes up instead of down on keto.

This thread seems almost done, so I don't want to derail, but I have high cholesterol numbers due to genetics but am otherwise healthy, and only one doctor I've ever gone to has recommended drugs to lower it. Most don't due to side effects and costs, and lack of other factors (ie: my blood pressure is fine, I can exercise without difficulty, etc). Which seems like the exact opposite of what most in this thread are saying they experience when dealing with their weight. IE: doctors see one risk factor (fat) and say to work forever to fix it, no matter the costs.
posted by The_Vegetables at 8:03 AM on April 12, 2022

I mean, that actually seems quite consistent to me: doctors see one risk factor (fat) and rush to deal with it to the exclusion of all other potential risk factors (actual lipid numbers). It's my understanding that HDL numbers actually are a better predictor of heart disease than body fat and that statins are the most effective way to bring them down, but I'm on my way out the door and don't have time to verify off the top of my head--I'm just going off the memories of the last thing I remember seeing, speaking as another person with a genetic predisposition to high cholesterol, as I hunt for my car keys. Maybe someone else can check.
posted by sciatrix at 8:35 AM on April 12, 2022 [2 favorites]

There are good doctors out there, but medical fatphobia is definitely a real problem. Doctors are less likely to refer a fat person for diagnostic testing and other treatment options than losing weight.

But the perception that doctors lecture fat people more seems to be incorrect, they actually spend "less time educating patients with obesity about their health".
posted by TheophileEscargot at 8:37 AM on April 12, 2022

The thing about Noom that bothered me the most, as a veteran both of product design and of weight loss programs, was the goddamn Noomcoins.

Congratulations, you got a Noomcoin!

Great, what can I do with all my Noomcoins? Maybe a free Fitbit eventually, or a discount on sneakers?

No, you can't do anything with the Noomcoins. We'll pass your suggestions on to our product team!

WHAT
posted by chesty_a_arthur at 9:28 AM on April 12, 2022 [2 favorites]

"less time educating patients with obesity about their health".

That doesn't seem to imply they don't lecture about weight? "Health" could mean anything.
posted by tiny frying pan at 9:50 AM on April 12, 2022 [1 favorite]

Also that link is YIKES. Show less respect for the patient overall which leads to helping them the same. Awful.
posted by tiny frying pan at 9:51 AM on April 12, 2022

With helping them less. Sorry missed the edit window
posted by tiny frying pan at 9:57 AM on April 12, 2022

But the perception that doctors lecture fat people more seems to be incorrect, they actually spend "less time educating patients with obesity about their health".

Similar to tiny frying pan's point, the first statement doesn't necessarily follow from the second. It's entirely possible that on average doctors mostly or only lecture overweight patients on their weight and fail to provide other relevant information that they would provide to a thinner patient. I'm barely in the obese range (and a lot of it is muscle), and lectures about my weight are the primary thing I remember doctors telling me about my health. I can't imagine what it's like for others.
posted by Tehhund at 10:15 AM on April 12, 2022 [2 favorites]

It seems a bit off-topic to Noom but as I have said before, a friend and I had similar back issues around the same point in our lives.

Mine was due to an old gymnastic injury and when I sought treatment for it, I immediately had imaging, and then was prescribed drugs - opioids - because the pain was inevitable as well as temporary. I asked about physio, and one day I may have to have surgery, but my doctor was like "physio will help as will any core exercises, but not right now while you're in this much pain, and there's nothing you can really do."

My friend was obese at the time she had back issues and she got no imaging. She got a lecture that fat people's backs hurt. She was put on a, I am not kidding you, 600 - six. hundred. - calorie a day diet. She got a prescription to exercise more. She couldn't sleep because of the pain. She was told she was having trouble sleeping because of the weight. She went back in tears for like the 4th time, and got another lecture and finally was referred to imaging but with a lot of grumbling and "concern" that she wouldn't be able to fit. (!!!) And guess what? She had basically the same back issue I had. Nuts. Nuts nuts nuts.

I wish I could say I think this is uncommon but I think it's the norm.
posted by warriorqueen at 10:49 AM on April 12, 2022 [14 favorites]

How and why weight stigma drives the obesity ‘epidemic’ and harms health

Common wisdom and certain medical ethicists [10, 11] assert that stigmatizing higher-weight individuals and applying social pressure to incite weight loss improves population health. We argue the opposite. The latest science indicates that weight stigma can trigger physiological and behavioral changes linked to poor metabolic health and increased weight gain [4, 5, 12–14]. In laboratory experiments, when study participants are manipulated to experience weight stigma, their eating increases [15, 16], their self-regulation decreases [15], and their cortisol (an obesogenic hormone) levels are higher relative to controls, particularly among those who are or perceive themselves to be overweight. Additionally, survey data reveal that experiences with weight stigma correlate with avoidance of exercise [17]. The long-term consequences of weight stigma for weight gain, as this experimental and survey work suggests, have also been found in large longitudinal studies of adults and children, wherein self-reported experiences with weight stigma predict future weight gain and risk of having an ‘obese’ BMI, independent of baseline BMI [18–20].

The harmful effects of weight stigma may even extend to all-cause mortality. Across both the nationally representative Health and Retirement Study including 13,692 older adults and the Midlife in the United States (MIDUS) study including 5079 adults, people who reported experiencing weight discrimination had a 60% increased risk of dying, independent of BMI [21]. The underlying mechanisms explaining this relationship, which controls for BMI, may reflect the direct and indirect effects of chronic social stress. Biological pathways include dysregulation in metabolic health and inflammation, such as higher C-reactive protein, among individuals who experience weight discrimination [22]. In MIDUS and other studies, weight discrimination also amplified the relationship between abdominal obesity and HbA1c, and metabolic syndrome more generally [23, 24]. Longitudinal data from MIDUS also showed that weight discrimination exacerbated the effects of obesity on self-reported functional mobility, perhaps because weight discrimination undermines one’s self-concept as a fully functioning, able person [25].

A rapidly growing set of studies now shows that these associations cannot simply be explained by higher-weight individuals’ poorer health or greater likelihood of perceiving weight-related discrimination. In fact, the mere perception of oneself as being overweight, across the BMI spectrum (i.e., even among individuals at a ‘normal’ BMI), is prospectively associated with biological markers of poorer health, including unhealthy blood pressure, C-reactive protein, HDL cholesterol, triglycerides, glucose, and HbA1c levels [28]. Emerging evidence indicates that this harmful cycle may even be intergenerational, wherein children perceived as overweight by their parents are at greater risk for excess weight gain across childhood [29], independent of the child’s actual weight. Collectively, these findings suggest that stigma attached to being ‘overweight’ is a significant yet unrecognized agent in the causal pathway from weight status to health.

posted by brook horse at 3:49 PM on April 12, 2022 [10 favorites]

Do obese people in societies with less weight stigma have better health outcomes?
posted by Selena777 at 7:00 PM on April 12, 2022 [1 favorite]

I couldn't find any studies documenting any country as having significantly less weight stigma. This study found similar levels of weight stigma in Australia, Canada, France, Germany, the UK, and the US. This article reviews the limited research on other countries and concludes that emergent evidence suggests weight stigma is a global phenomenon.
posted by brook horse at 7:49 PM on April 12, 2022 [4 favorites]

Hypothetically, if weight stigma limits people's employment opportunities, romantic opportunities, and access to medical care, it would plausibly have an impact on their health, even aside from stress.
posted by Nancy Lebovitz at 2:36 AM on April 13, 2022 [3 favorites]

I know this thread is dead now, but here's a pertinent Twitter thread from Sarah Taber
posted by LindsayIrene at 3:25 PM on April 17, 2022 [4 favorites]