I worked in a hospital for several years, 99 percent of the patents were elderly or obese. I agree that attractive and worth should have nothing to do with weight, but this bizarre world where obesity is trumpeted as edgy and awesome is just another symptom of a society off the rails.

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There are two iron laws of weight loss/maintenance the podcast guests did not mention, which really disappointed me.

First, we have to do everything in our power to avoid becoming overweight in the first place, especially when we are children. Once a person is overweight, it is incredibly difficult to lose weight and keep it off for all kinds of psychological and physiological reasons. American children are some of the fattest in the world and this sets them up for a lifetime of difficulty managing their weight and OCD issues around food.

Secondly, although the guest mentions intermittent fasting, I wish she would’ve instead focused on what is far more important, and this is fasting in between meals! Intermittent fasting “works” because it’s typically just skipping breakfast, which thin women have done for decades to maintain their weight! It’s also a great way to set yourself up for an eating disorder unless you are a mature adult with a solid understanding of nutrition and healthy body image. Teens and children cannot safely use the IF “hack” to weight loss like some adults are able to do. However, they can learn to fast in between meals without it becoming a compulsion.

Americans are constantly snacking and stuffing our faces with food at the slightest tinge of hunger, anxiety, or stress. This goes doubly for children because parents are constantly cramming snacks in their children’s faces whenever they become cranky.

The podcast guest recommends that people eat these whole healthy food which is fine, but then you see people who are overweight constantly grabbing handfuls of cashews in between meals and it quickly becomes apparent why they will never lose weight.

Any person who eats three healthy meals a day and keeps snacking to a minimal while fasting in between meals will lose weight. Whoever came up with the idea that people should eat five small meals a day or some snack constantly is as much to blame for our obesity crisis as the processed snack food purveyors.

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Sep 17, 2022·edited Sep 17, 2022

The most successful diet is the one you can stick with. And I mean for the rest of your life.

Long term studies of people who have lost weight and kept it off long term have shown two important behaviors—these people are always mentally tallying their caloric intakes and they exercise 5 times a week.

Lizzo and obese people like her who argue that fat is beautiful and should be celebrated are no better than people pushing cigarettes. She flaunts her obesity in yoga pants and it’s, uhhhh, gross.

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This story hit very close to home. Since November of 2021 I have lost 70 pounds of scale weight and over 50% of my body fat, after being diagnosed with insulin resistance and being treated for the condition. My BMI is now in the normal range and my percent body fat is down from 49 to 30 — and it continues to drop gradually now. My inflammation markers and my cholesterol have dropped too.

When I talked to my family doctor about wanting to lose weight, I told her I did not want to be told to eat fewer calories and exercise more. This is a perspective I see in these comments, which misses the point of Dr. Means’ comments about the obesity epidemic.

The doctor my GP referred me to takes a medical approach to treatment that involves modifications to my diet, that do not require calorie counting, as well as medication to help my brain understand that it is not starving. She did not tell me I was fat because I was lazy or a glutton. She helped me understand what caused my obesity and that my weight was one of the symptoms of insulin resistance, not the cause.

The physical transformation has been radical. My husband finds the change in my appearance hard to believe. I ran into my former boss at a gallery opening this past week and he did not recognize me. That’s all very nice and I do look great in clothes now, but why I did this was to feel better and that transformation has been significant also. My disease has been reversed.

I am fortunate to live in the same city as my doctor. Her approach to obesity is not common in the medical profession. I am also fortunate that we can afford to pay for the program which, despite its many health benefits, is not covered by our public healthcare in Canada or my private insurance. A missed opportunity to save on treatments for expensive, chronic conditions in my opinion.

Thank you for this story.

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When I was in medical school, one of the profs—Charlie Dunlop, then chairman of the Tulane pathology department—said that, “in America, the most common form of malnutrition is overnutrition.” That was 52 years ago. It’s still right.

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Sep 17, 2022·edited Sep 17, 2022

Americans are fat due almost entirely to the consumption of wheat and grain products and sugar - due largely to our own government pushing these things for decades - Food Pyramid anyone? Now aided and abetted by the same fat and slovenly progressives who push other ruinous and insane ideas. I laugh every time I pass a local gym in NYC that proclaims (virtuously) that "in this gym we believe that all bodies are beautiful." Seriously? Then why the f would someone need to go to gym to work off the jiggling pounds they know are ugly every time they look in a mirror? Stop eating crap that's killing you. Eat healthy meat, fish and vegetables. Or soon enough you'll be eating bugs like that globalist rat Schwab gloatingly predicted.

We have an epidemic of obesity and diabetes in America not least because we are ruled and dictated to by a very evil group of grasping people and because we have become credulous fools. Look no further than our sheepish response to moronic lockdown orders and diktats to take a vaccine after it was proven not to work on later strains of the virus.

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I am a physician.

I want to emphasize that the problem is the Health Insurance Lobby & the Pharmaceutical Lobby.

1) Every yr, Health Insurance companies force Doctors to spend less & less time with patients. The Hospital Chains pay 6-figure salaries to business people whose job is to yell at Dr's for spending too much time w/ patients. Their job is to make us into assembly-line workers. Every yr, they decrease our pay & decrease the amount of time per patient.

2) Obamacare has destroyed medicine in many ways. One way is by tying physician compensation to patient reviews. If Dr's want to be paid, they have to get good reviews. Which actually makes patients sicker. Dr's tell the pt what they want to hear. (which is not actually in the pt's best interest!!!). Interestingly enough, Obamacare has also sky-rocketed the opioid crisis, b/c Dr's prescribe more Narcotics to get better reviews. The Hospitals with the Best Reviews have the highest Morbidity & Mortality.

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When a country coins the phrase, "All You Can Eat," as a restaurant come-on, you know you're in trouble. Everyone wonders how Italians stay so slim. Don't they eat pasta every day? Many do, but they don't eat half a box of spaghetti themselves doused with too much sauce and soaked up with bread.

As a child of the fifties, my mother was typical of most Italian American housewives in Brooklyn. She bought meat at the butcher; fruits and veggies at the produce store; fish from a fish monger, etc. This might seem extravagant for a family with limited means, but my mother planned what she would be cooking for the week and shopped accordingly. There was no waste. "I'm not running a restaurant here." She was right. Portions were plentiful but we were not overstuffed and we did not have dessert-maybe a cookie an hour or so after dinner.

Of course, we were just naturally more active and were able to play outside. Even dressing Barbies was a distraction from snacking. Kids today sit in front of a screen and it's only natural that they snack-it's simply an outgrowth of gaming.

We also have to check this new "Body Positivity" nonsense that's going on. There's a reason the term is defined as morbidly obese-it kills you.

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As a neurosurgeon now in my early sixties, I found many aspects of this article interesting. Perhaps I can add some insights:

1. It is enlightening that the doctor had a health crisis during her residency, that got better during her 6 month research stretch. I would argue that the surgical life did not agree with her. Residency was hard, but also exhilarating. It becomes part of your core, your reason for being. I suspect she is much happier for not pursuing it as a career.

2. Yes, surgeons treat disease processes, not health. I don’t pretend to be solving the world’s obesity crisis. I’m picking up the pieces, one patient at a time. Whether its a ruptured disc or a lumbar fusion, I’m trying to improve my patient’s quality of life, even as I understand their lifestyle choices probably contributed to the problem.

3. Including patient satisfaction as a metric for physician reimbursement is absurd. I gave up long ago telling my obese patients with back pain to lose some weight. It makes them angry and of course they do not comply. Instead I stress core exercises - yoga etc, hoping I can get some buy in. I am routinely flamed on social media sites by patients who are upset that I won’t operate on them or adequately explain why they have back pain.

4. Most of our social problems, in my opinion, stem from failure to absorb (or be taught) basic life lessons in childhood. To the now familiar list of “rules” for successful life:

Get an education

Get a job

Get married

Have children, in that order, could be added:

Don’t eat junk food.

Practical advice. Only individuals exercising their own agency to do this and pass it on to their kids will break the chain. God knows the government and the medical establishment will not do it.

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One think to point out about Michelle Obama's "Let's Move Campaign" is that it's the health campaign that replaced her original food-focused campaign, where she outright said that veggies are good and processed foods are bad. When she initially went that route (i.e., discussing the quality of the food), the food lobby FREAKED OUT. What a surprise! She switched to "let's move," appeasing the junk food lobby and their claims that Coke, Doritos, and Snickers can be part of a "healthy diet." This is BS; while exercise is great, you cannot "out-exercise" a bad diet. Sure, young athletes get away with it early on -- but wait until age catches up with you.

Another point: I have many friends who are overweight and some who are obese. I love these people with all my heart and I believe they have many beautiful qualities. However, we are deluding ourselves if we begin to claim that beauty and weight have NOTHING to do with each other. Harmony and proportionality are related to beauty (in human bodies, art, and architecture). After a human body gains a significant amount of weight, it loses its natural proportions. It becomes deformed -- massive midsections bigger than backsides, eyes that sink behind facial adipose tissue, folds of fat dripping over joints. Sometimes the deformities are so extreme that people cannot walk with a normal gait or walk at all. People these days talk a lot about "fat phobia" as something inherently bad; however, in some cases, it seems appropriate and natural to look at morbidly obese people and have a natural sense of fear. I never want to become that big and unhealthy (I also never want to become a meth or opioid addict; I have a healthy sense of fear re: these powerful drugs too). Of course, don't treat mistreat fat people because they are fat. Yet, I must wonder, what constitutes "mistreating them" according to fat activists? If it means yelling obscenities at their face or denying them employment for which they are qualified, then I oppose that. If it mean telling them that their weight is unhealthy and that having a different body would be better for their health, then I support this. This is not mistreatment; truth hurts sometimes and the reality is that a body weight in the normal range is (all other things being equal, of course; don't come at me with the example of the normal weight person on chemo) objectively and undeniably better for human health than a morbidly obese body.

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Sep 17, 2022·edited Sep 17, 2022

I truly appreciate the discussion happening, in the comments section.

There is no one-size-fits-all solution, because the causes are many.

Some things I wanted to contribute:

1. Healthy food is too expensive and it's taken on a pretentious air that makes it undesirable to some. Produce, in our grocery stores, is outrageously priced and has been for years. A lot of the fruits are bland and their textures are unpleasant. Not the produce I grew up eating. It's really hard to convince a kid to eat something that tastes lousy, based solely on it being good for them. We are surrounded by junk food and they seem to come up with dozens of new flavors, every time I turn around. Produce just gets more expensive. I'm supposed to pay $3 for a single artichoke? $1 for a single peach, that probably tastes blah? I make my own foods and do opt for the very healthy, read labels, etc. But, my adult sons are living on fast food, despite my best efforts. We need better food and healthy food needs to be accessible, affordable, and seen as desirable to younger people.

2. Sensory issues with food textures and tastes. We have a very large population of people with Autism. #1 Autism diet is chicken nuggets and french fries. No one is talking about this. There are significant sensory issues with food taste, smell, and texture, when it comes to people who have Autism. I've fought this battle, with my youngest son, in every way imaginable. Beyond really figuring out what is ACTUALLY causing Autism...not just conveniently saying it's genetic because someone else in the family is on the spectrum (what else do they have in common aside of DNA?). This issue is significant and largely ignored. I work in the Special Education community and food issues are very, very real. They are definitely impacting life expectancy and rising health care costs.

4. What are the impacts of hormones in food, as far as our bodies?

3. The culture of overwhelm and stress and disconnect leading to coping through food. I'm currently a Special Education Teacher and the palpable levels of stress and tension are ridiculous. The demands on time and the impossible expectations are unacceptable. To make people feel appreciated, teachers are satiated with boxes of donuts or staff breakfasts of huge empty carb bagels. Students are given snacks for behavior control, because there are kids who, quite honestly, are absolutely not capable of being in a school setting (exacerbated by the last 2.5 years of madness) and are not ready for the demands and expectations placed on them. This is exceedingly true in Special Education. Goodness, during the last 2.5 years of misery and stress, that is our country's toxic climate, I found myself reaching for childhood candy favorites out of a need for comfort that was nowhere else to be found. My gym access was taken away and, well, you try power-walking in the Summer humidity and heat of the Metro DC area. Not possible, after work, unless I wanted heat stroke. I put on weight, too. With the mess that our schools are in, I've found it very hard to will myself to go exercise. My job duties/courses I teach, have profoundly changed 4 times in less than 1 month. I've come home wanting to just..not exist, too many days. I've got no family around and it's hard to make friends in 2022.

We've broken up family connections, taken mothers out of the homes because 2 incomes are needed to pay the bills, and there's very little time or opportunity to find people to build meaningful relationships with. People are coping in many unhealthy ways.

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Got transcript?

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Decent podcast but very basic. Good for people to under metabolic health but that’s about it. No mention whatsoever about the heath benefits of grass-fed meat and saturated fat and the evidence debunking their demonization over the past 50 years and the USDAs complicity.

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Sep 17, 2022·edited Sep 17, 2022

Looking at myself, I wonder how many others have centered (or focused too much) on food for power, security, wisdom, and guidance. I'm hoping that by turning back to religion that I can find power, security, wisdom, and guidance in God/Jesus/Holy Ghost to show me on what to focus. When I walk into a place of beauty, like a cathedral, it seems to have a calming effect in a way that eating something sugary does for me. I'm deeply saddened that some churches, or at least the perception of them, may have tried to exclude exceptions.

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One of my pet peeves is "body mass index" (BMI). My understanding is that the study this is based on was mainly funded by companies producing weight loss products. At 6'1"/190 lbs, I'm considered overweight, but 140 lbs would be considered "normal"...at which I'd look like a concentration camp survivor.

This podcast is well worth the listen.

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Much of this is not new or ground breaking, as others point out here.

It's also been pointed out in several places that perhaps our COVID deaths were so high compared to other Western countries because we have such a high rate of obesity. 15 years ago a CEO friend of mine asked me to predict what would become the next big trend and I said obesity advocacy.

I love Bari. I love reading her. But I wish Common Sense (and most of the other Substacks I subscribe to) had someone who really knows about food. For example, "seed oil is bad". Is that canola, which is highly modified, very refined, rapeseed oil? Would regular rapeseed oil be okay? What about flax seed oil? And if flax seed oil is unhealthy what about flax meal. Or is that bad? Would it be okay if I just used whole flax seeds? What about various flours. And that is just one topic they covered. But also, Bari and Dr. Casey had a limited amount of time.

Studies of what people eat and how it affects them are notoriously unreliable. The studies are either of small groups over a short time so the subjects can be monitored very closely or they are large scale longitudinal studies that rely on people keeping journals and being honest. And we lie because we are embarrassed about what we eat.

So is the doc really just telling us to eat better and get more sleep?

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