I wish people would stop attributing weight to self-worth and instead look at it objectively. Being fat is unhealthy, and generally being obese makes it difficult to exercise unless you are...
I wish people would stop attributing weight to self-worth and instead look at it objectively.
Being fat is unhealthy, and generally being obese makes it difficult to exercise unless you are extremely muscular. People who are overweight in body-fat should seek to lose weight as it will almost always improve their health.
But being fat doesn't make you a bad person. It's not even necessarily your fault, there are rare conditions which make your body feel "starving" (most people probably haven't experienced genuine starvation, it's not hunger or even fasting), not to mention unequal access to healthy food and health education. And losing weight shouldn't be about willpower, which is a means not an end. Until somewhere around the past 50 years most humans have maintained their weight without even really trying, and there are many unintentionally thin people who struggle to gain weight.
Culture in at least the US is really bad and most people have a skewed perception on weight and health. I'm pretty sure there are a lot of people who genuinely don't know what a calorie is. Most of the population is overweight so there's the general perception that "weight loss = healthy", yet most people don't know how to lose weight in a healthy or sustainable way.
The reality is that people should work to maintain a healthy amount of fat and muscle for their body type, which means losing weight if they are very overweight and gaining muscle if they are skinny. But it's their choice and shame doesn't really work anyways, so people shouldn't be shamed if they don't do those things (and especially not when they do). Most people should do things like eat whole foods and average at least 30 minutes of exercise per day, which are generally healthy regardless of your weight. And people should view being underweight or overweight as an objective trait, not a moral failing.
The cutoff for a healthy weight might be higher than you think. Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories But how can this be? At...
Exemplary
Being fat is unhealthy, and generally being obese makes it difficult to exercise unless you are extremely muscular. People who are overweight in body-fat should seek to lose weight as it will almost always improve their health.
Conclusions and Relevance
Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.
But how can this be? At this point, I think it's useful to go back in time.
Fat=bad got it's start (IIRC) in the 1800s, and, like most things of that time period, was deeply rooted in racism. It was only later, once the concept was firmly established, that people began trying to justify it scientifically, starting with a predetermined conclusion and working backwards from there. This is a terrible way to do science, which generally leads to the desired conclusion at the cost of any actual scientific merit.
But that was a long time ago, so things must be better now, right? Unfortunately, science and medicine aren't immune to the same human biases that plague other areas. We're still trying to root out the notion that black people feel less pain than white people from the medical profession/the populace at large, and that isn't a fiction that the multi billion dollar diet industry needs to be true.
Am I saying you should start packing on the pounds if you're at an average BMI? No. But neither am I saying that fat people need to lose some weight; the question of what constitutes a healthy body weight is significantly more open than people think.
The best thing to do, IMO, is to forget the scale entirely, focus on proper nutrition and regular exercise, and stop fat shaming people. Which is essentially the same place as Jakobeha, but I thought it was important to bring up the historical context and why the idea of the one healthy body type that's been fed to us our entire lives is inaccurate.
I’ve recently binged a bit on fat acceptance content because I don’t like how judgmental I am of overweight people. This is a fact I’ve heard stated a few times but I haven’t yet heard an...
overweight was associated with significantly lower all-cause mortality
I’ve recently binged a bit on fat acceptance content because I don’t like how judgmental I am of overweight people. This is a fact I’ve heard stated a few times but I haven’t yet heard an explanation for why. I can absolutely believe that having some extra body fat isn’t going to hurt you. But why would an overweight body be healthier than a “normal” weight body?
This seems difficult to study because unintentional weight loss is often a symptom of a serious health issue, and people often lose a lot of weight before they die. If you're losing weight without...
This seems difficult to study because unintentional weight loss is often a symptom of a serious health issue, and people often lose a lot of weight before they die. If you're losing weight without trying, see a doctor!
To figure out whether trying to lose weight leads to better outcomes, scientists would have to distinguish between "good" weight loss and "bad" weight loss. I wonder if the studies looked at in that meta-analysis accounted for how and why people's weights changed?
Something I wondered was if they’re considering people that are skinnier because of a suppressed appetite from smoking tobacco or some other substance.
Something I wondered was if they’re considering people that are skinnier because of a suppressed appetite from smoking tobacco or some other substance.
My understanding is that your body is more able to effectively regulate certain systems when it has an abundant supply of energy readily available at all (or most) areas of the body. In addition,...
My understanding is that your body is more able to effectively regulate certain systems when it has an abundant supply of energy readily available at all (or most) areas of the body. In addition, it keeps you warm and makes you less likely to sustain certain kinds of injuries if you suffer a minor fall or collision, which helps with all cause mortality!
This kind of meta-analysis doesn't seem very convincing to me. BMI is already incredibly broad and not controlling for what type of mass you're measuring seems likely to produce middling results...
Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.
This kind of meta-analysis doesn't seem very convincing to me. BMI is already incredibly broad and not controlling for what type of mass you're measuring seems likely to produce middling results like these.
I agree with this, one thing though: I think the problem is actually the opposite. Most people have a concept of what calories are, but the perception is wrong. There's this idea that it's simple...
I agree with this, one thing though:
I'm pretty sure there are a lot of people who genuinely don't know what a calorie is
I think the problem is actually the opposite. Most people have a concept of what calories are, but the perception is wrong.
There's this idea that it's simple math, but all calories are not the same. Calories of broccoli are not the same as calories of refined sugar. The refined sugar is going to cause a blood sugar emergency resulting in the release of insulin as an instruction to cells to quickly store excess sugar as fat. The effect is similar, though a bit less extreme, with white flour and other refined carbohydrates.
Whereas the calories from broccoli, even if they far exceed the amount of calories needed, are much less likely to end up stored as fat.
So a person focusing on how many calories they're consuming but not what kind of calories, is probably going to be confused that they aren't able to lose weight.
Which isn't to take away from your point that the focus should be on health rather than weight, and that guilt and shame are ineffective motivators.
The same things that contribute most to obesity (refined carbs) also play a part, according to an ever growing body of research, in the majority of the diseases that are the top killers in modern society.
Putting sexiness and fitness aside, a lot of processed food is, objectively, poison.
I agree that most people know what calories are, but I doubt they actively think about them as they make food decisions. Instead, I think that food culture and physical environments create health...
I agree that most people know what calories are, but I doubt they actively think about them as they make food decisions. Instead, I think that food culture and physical environments create health sorta-Schelling points.
Processed food makes up a bigger share of the average diet in Japan, which has arguably a far more aggressive "convenience culture" than the US. But Japan has a very low BMI for a developed nation. Same go for Taiwan and South Korea. All three of these countries have the highest convenience stores per capita.
But in those countries:
People walk and take public transit a lot. Burning a hundred calories or two a day adds up significantly over a lifetime.
Cultural attitudes and norms shape choices around portion sizes, food choices, etc.
American food culture normalizes overconsumption, whereas other food cultures emphasize moderation. Consumption of meat, which is calorie-heavy, is astronomical in the US. The average American eats 120 kg of meat a year, whereas the average Japanese person will eat 50 kg.
Different cultures offer and prioritize different food choices.
Also, East Asian societies are shame-based (as opposed to guilt-based in the West). Biases against fatness have potency in those societies, and social policing around bodies is very powerful.
Edit: I also want to add my personal anecdote as a Taiwanese-American who's lived in the US, Europe, and a few countries in East Asia.
Growing up I noticed a big food-cultural divide between my Asian-American friends and me, and my non-Asian American friends.
I grew up in a family that ate for dinner: steamed rice, vegetables (often steamed or pickled), and a little bit of meat. My Asian-American friends did the same. We all were and still are thin. Now that we're adults, our diets are more adventurous — but I think that our childhoods have strongly informed how we think about our food choices and portion sizes.
My non-Asian American friends had heartier diets that had meat at the center of the meal. Visiting their homes, I saw that their families would have pizza bagel bites and hot pockets as snacks. And their homes would have liter bottles of soda stocked. Now as adults they're very enthusiastic about checking out BBQ and burger joints.
Last year I moved back to the US after living abroad for several years in the Netherlands. Back in the NL, it was pretty easy for me to keep my weight stable. When I moved back, my weight rose by 5–10 pounds. I noticed that food choices here are significantly richer and the portions are much larger. A typical meal at Chipotle has 1070 calories and can quickly shoot up to 1700 when you add chips and sides. In the NL, fast food options were more limited, so I often bought to-go sandwiches or premade meals from Albert Heijn, a grocery store chain there. But they were almost always between 400–800 calories.
Did you know that Japan has a law about obesity? A former co-worker of mine talked about how he had to get his waistline measured. (He is Canadian but has Japanese citizenship or residency I...
A former co-worker of mine talked about how he had to get his waistline measured. (He is Canadian but has Japanese citizenship or residency I think.)
He took up running again.
Edit: It's unclear to me what the penalties are. People who are overweight have to attend counseling?Apparently if you're overweight your company or local government could be fined. It sounds embarrassing.
Since we already have two comments discussing how "discipline" is the key to losing weight, I want to encourage everyone on this thread to engage with the systemic factors which lead to obesity in...
Since we already have two comments discussing how "discipline" is the key to losing weight, I want to encourage everyone on this thread to engage with the systemic factors which lead to obesity in addition to any discussion of personal responsibility. Obviously, choosing to take in more calories than you use will lead to weight gain. However, the most recent, wide-ranging survey paper on the topic says:
The obesity epidemic is the outcome of a multifaceted intricate interaction between environmental factors, genetic susceptibility, and human behaviour. The effect of genetics and disease on weight gain has been well illustrated in several studies. However, environmental factors are likely to be the main factors driving the rise in the obesity epidemic.
By "environmental factors" they mean both environmental toxins and weather conditions, and systemic factors impacting the ability to access safe, fresh food at a reasonable price. It is indisputably true that poor people and people of color are less likely to have access to food that has few calories per nutritional value, and such food is disproportionately more expensive in both money and time spent on preparation.
Until we have equality of access to all the factors that make it harder to keep a healthy weight, discussing weight without discussing inequality is essentially meaningless - and people who are unable to maintain a healthy weight, whether or not it's because of these factors, deserve to be able to pursue muscular, cardiovascular, and bone health without being shamed for being fat.
I visited my hometown last summer after spending the past 10 years in upscale/college towns that gave me a lot of variety, and I was blown away just by how awful the food selection and options...
By "environmental factors" they mean both environmental toxins and weather conditions, and systemic factors impacting the ability to access safe, fresh food at a reasonable price. It is indisputably true that poor people and people of color are less likely to have access to food that has few calories per nutritional value, and such food is disproportionately more expensive in both money and time spent on preparation.
I visited my hometown last summer after spending the past 10 years in upscale/college towns that gave me a lot of variety, and I was blown away just by how awful the food selection and options were between grocery stores and restaurant choices. Food deserts are awful and gave me a new perspective on the ability of people within them to be able to make good choices for eating habits. Sure, they could spend money on produce that is plastic-wrapped and terrible quality, at a high price, and requires them to prepare it into a meal. Or, they can spend $1.50 on a McDouble at McDonald's and satisfy that need right then and there while meeting their budgetary needs. It is crazy to me that food deserts are even a thing in America when there is so much farmland that could often be used locally to provide high quality food to people without having to deal with supply chain issues that plague these areas.
The society-wide, public health view (as an epidemiologist would see it) is important, but taking a personal health perspective also seems meaningful? Sometimes it's the job at hand. Doctors and...
The society-wide, public health view (as an epidemiologist would see it) is important, but taking a personal health perspective also seems meaningful? Sometimes it's the job at hand. Doctors and personal fitness trainers treat one person at a time. Inequality is going to show up for them as seeing a variety of people from different environments. (And also not seeing people from some environments, depending where they are and who walks in. Businesses often specialize. Just being able to afford their service is a filter.)
The article seems to be about some fitness trainers doing a bad job of listening to and catering to their clients, maybe due to a lack of experience or perspective. Or maybe it's just bad customer service and the customer would be better off looking for someone better regardless?
I don't have any experience with fitness trainers but I've done physical therapy and in my limited experience, they seem to be pretty good at meeting people where they are, perhaps because they're more used to dealing with people of all ages and fitness levels.
In my experience, this is true of physical therapists but not of most personal trainers. Certainly there are some, but when the medical advice for a large number of (mostly, honestly, unrelated)...
I don't have any experience with fitness trainers but I've done physical therapy and in my limited experience, they seem to be pretty good at meeting people where they are, perhaps because they're more used to dealing with people of all ages and fitness levels.
In my experience, this is true of physical therapists but not of most personal trainers. Certainly there are some, but when the medical advice for a large number of (mostly, honestly, unrelated) medical issues is "lose some weight", we need to either have cheap, effective medical interventions for weight loss, or a better, cheaper physical training industry.
When I was a teenager, I was quite overweight, partly because I refused to exercise very much. My parents sent me to a personal trainer monthly for about two years. I saw very little progress and endured a great deal of pain and self-hatred before I finally talked to a doctor and realized that I have a joint disorder. I got some pretty effective physical therapy and I'm doing a lot better, now (and have lost some weight), but I have essentially zero patience for "just apply yourself" as weight loss advice.
I understand and empathize with I took away as the core arguments of the article: Fat has been demonized, fitness has become a "moral" pursuit, and the fitness industry exacerbates all of these...
I understand and empathize with I took away as the core arguments of the article: Fat has been demonized, fitness has become a "moral" pursuit, and the fitness industry exacerbates all of these issues. I completely agree, the perception and use of "fitness" is another way for those with resources to be "better" than those without.
What I think this article leaves out, is the underlying cause of weight gain and its effects on humanity at large. The value chain around our food systems is completely out of whack. I feel like the author ignores the fact that as a population we have been steadily getting heavier decade on decade since the 50s. And the ends of the weight spectrum, both morbid obesity and extreme skinniness, carry real health risks. But that said, the drivers of weight gain and loss are almost entirely external. Eating today is a minefield. There are more calories in 1 Poptart than in a pound of carrots. Our ability to process food into extremely calorie dense packages is the problem. In turn, how do we access food. How many produce sections are there in low income areas? How much more time does cooking take rather than stopping at McDonalds? All of these factors compound to make it so that only those with means or really, really, really focused attention can avoid it. So what do we push? Fucking exercise. Fuck that, address the real issue.
The response of the fitness industry (and I'd say it's entire business model) to a heavier population is built on the premise that you are fat because you are lazy and worthless and you need to buy our product/service to be better. Shame is a real motivator and they pedal in it. I completely agree with the article on this point. It is a fucked up value proposition. Body positivity is great too. We live in a fucked up system and the folks who are being harmed by it should not be bearing the brunt of our frustration. However, I still think we should address that morbid obesity does effect the health and quality of life of those who live with it. Let's not punish them but instead change the food systems that got us here.
Something like 90% of the industry built around fitness is built not around the central column of helping people achieve healthier bodies. instead they build it around people who are already...
Something like 90% of the industry built around fitness is built not around the central column of helping people achieve healthier bodies. instead they build it around people who are already attractive as a means of staying attractive. When's the last time you've seen an advertisement for a fitness product or service that included people with 'average' physiques, let alone someone with extra padding. If you can even think of one, were they there as a joke? Heck, even when you see advertisements for weight training equipment, the models they choose are all body builders - people who work out to 'sculpt' their bodies - rather than weight lifters - people who work out to build the strongest muscles, and have a thick body as a result.
Partially as a result of this, there's a lot of missing information for people who really need fitness instruction. If you are Obese, your musculature is different from people with average BMI. Your body does not have the same range of motion because it is a different shape. Even if you are otherwise completely healthy, your best source for training is to hire a drammatically more expensive physical therapist.
I can point out one that I have worked with on and off over the years, and that is DDP Yoga. It started off as something to do ironically as a joke in front of my partner (the guy is over the top)...
If you can even think of one, were they there as a joke? Heck, even when you see advertisements for weight training equipment, the models they choose are all body builders - people who work out to 'sculpt' their bodies - rather than weight lifters - people who work out to build the strongest muscles, and have a thick body as a result.
I can point out one that I have worked with on and off over the years, and that is DDP Yoga. It started off as something to do ironically as a joke in front of my partner (the guy is over the top) but actually found it to work really well. Most of the videos and workouts involve people of all shapes and sizes.
I wish people would stop attributing weight to self-worth and instead look at it objectively.
Being fat is unhealthy, and generally being obese makes it difficult to exercise unless you are extremely muscular. People who are overweight in body-fat should seek to lose weight as it will almost always improve their health.
But being fat doesn't make you a bad person. It's not even necessarily your fault, there are rare conditions which make your body feel "starving" (most people probably haven't experienced genuine starvation, it's not hunger or even fasting), not to mention unequal access to healthy food and health education. And losing weight shouldn't be about willpower, which is a means not an end. Until somewhere around the past 50 years most humans have maintained their weight without even really trying, and there are many unintentionally thin people who struggle to gain weight.
Culture in at least the US is really bad and most people have a skewed perception on weight and health. I'm pretty sure there are a lot of people who genuinely don't know what a calorie is. Most of the population is overweight so there's the general perception that "weight loss = healthy", yet most people don't know how to lose weight in a healthy or sustainable way.
The reality is that people should work to maintain a healthy amount of fat and muscle for their body type, which means losing weight if they are very overweight and gaining muscle if they are skinny. But it's their choice and shame doesn't really work anyways, so people shouldn't be shamed if they don't do those things (and especially not when they do). Most people should do things like eat whole foods and average at least 30 minutes of exercise per day, which are generally healthy regardless of your weight. And people should view being underweight or overweight as an objective trait, not a moral failing.
The cutoff for a healthy weight might be higher than you think. Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories
But how can this be? At this point, I think it's useful to go back in time.
Fat=bad got it's start (IIRC) in the 1800s, and, like most things of that time period, was deeply rooted in racism. It was only later, once the concept was firmly established, that people began trying to justify it scientifically, starting with a predetermined conclusion and working backwards from there. This is a terrible way to do science, which generally leads to the desired conclusion at the cost of any actual scientific merit.
But that was a long time ago, so things must be better now, right? Unfortunately, science and medicine aren't immune to the same human biases that plague other areas. We're still trying to root out the notion that black people feel less pain than white people from the medical profession/the populace at large, and that isn't a fiction that the multi billion dollar diet industry needs to be true.
Am I saying you should start packing on the pounds if you're at an average BMI? No. But neither am I saying that fat people need to lose some weight; the question of what constitutes a healthy body weight is significantly more open than people think.
The best thing to do, IMO, is to forget the scale entirely, focus on proper nutrition and regular exercise, and stop fat shaming people. Which is essentially the same place as Jakobeha, but I thought it was important to bring up the historical context and why the idea of the one healthy body type that's been fed to us our entire lives is inaccurate.
I’ve recently binged a bit on fat acceptance content because I don’t like how judgmental I am of overweight people. This is a fact I’ve heard stated a few times but I haven’t yet heard an explanation for why. I can absolutely believe that having some extra body fat isn’t going to hurt you. But why would an overweight body be healthier than a “normal” weight body?
This seems difficult to study because unintentional weight loss is often a symptom of a serious health issue, and people often lose a lot of weight before they die. If you're losing weight without trying, see a doctor!
To figure out whether trying to lose weight leads to better outcomes, scientists would have to distinguish between "good" weight loss and "bad" weight loss. I wonder if the studies looked at in that meta-analysis accounted for how and why people's weights changed?
Something I wondered was if they’re considering people that are skinnier because of a suppressed appetite from smoking tobacco or some other substance.
My understanding is that your body is more able to effectively regulate certain systems when it has an abundant supply of energy readily available at all (or most) areas of the body. In addition, it keeps you warm and makes you less likely to sustain certain kinds of injuries if you suffer a minor fall or collision, which helps with all cause mortality!
This kind of meta-analysis doesn't seem very convincing to me. BMI is already incredibly broad and not controlling for what type of mass you're measuring seems likely to produce middling results like these.
I agree with this, one thing though:
I think the problem is actually the opposite. Most people have a concept of what calories are, but the perception is wrong.
There's this idea that it's simple math, but all calories are not the same. Calories of broccoli are not the same as calories of refined sugar. The refined sugar is going to cause a blood sugar emergency resulting in the release of insulin as an instruction to cells to quickly store excess sugar as fat. The effect is similar, though a bit less extreme, with white flour and other refined carbohydrates.
Whereas the calories from broccoli, even if they far exceed the amount of calories needed, are much less likely to end up stored as fat.
So a person focusing on how many calories they're consuming but not what kind of calories, is probably going to be confused that they aren't able to lose weight.
Which isn't to take away from your point that the focus should be on health rather than weight, and that guilt and shame are ineffective motivators.
The same things that contribute most to obesity (refined carbs) also play a part, according to an ever growing body of research, in the majority of the diseases that are the top killers in modern society.
Putting sexiness and fitness aside, a lot of processed food is, objectively, poison.
I agree that most people know what calories are, but I doubt they actively think about them as they make food decisions. Instead, I think that food culture and physical environments create health sorta-Schelling points.
Processed food makes up a bigger share of the average diet in Japan, which has arguably a far more aggressive "convenience culture" than the US. But Japan has a very low BMI for a developed nation. Same go for Taiwan and South Korea. All three of these countries have the highest convenience stores per capita.
But in those countries:
Edit: I also want to add my personal anecdote as a Taiwanese-American who's lived in the US, Europe, and a few countries in East Asia.
Growing up I noticed a big food-cultural divide between my Asian-American friends and me, and my non-Asian American friends.
I grew up in a family that ate for dinner: steamed rice, vegetables (often steamed or pickled), and a little bit of meat. My Asian-American friends did the same. We all were and still are thin. Now that we're adults, our diets are more adventurous — but I think that our childhoods have strongly informed how we think about our food choices and portion sizes.
My non-Asian American friends had heartier diets that had meat at the center of the meal. Visiting their homes, I saw that their families would have pizza bagel bites and hot pockets as snacks. And their homes would have liter bottles of soda stocked. Now as adults they're very enthusiastic about checking out BBQ and burger joints.
Last year I moved back to the US after living abroad for several years in the Netherlands. Back in the NL, it was pretty easy for me to keep my weight stable. When I moved back, my weight rose by 5–10 pounds. I noticed that food choices here are significantly richer and the portions are much larger. A typical meal at Chipotle has 1070 calories and can quickly shoot up to 1700 when you add chips and sides. In the NL, fast food options were more limited, so I often bought to-go sandwiches or premade meals from Albert Heijn, a grocery store chain there. But they were almost always between 400–800 calories.
Did you know that Japan has a law about obesity?
A former co-worker of mine talked about how he had to get his waistline measured. (He is Canadian but has Japanese citizenship or residency I think.)
He took up running again.
Edit: It's unclear to me what the penalties are. People who are overweight have to attend counseling?Apparently if you're overweight your company or local government could be fined. It sounds embarrassing.
Your comment reminds me of the body neutrality movement, which I’m a fan of. :)
Since we already have two comments discussing how "discipline" is the key to losing weight, I want to encourage everyone on this thread to engage with the systemic factors which lead to obesity in addition to any discussion of personal responsibility. Obviously, choosing to take in more calories than you use will lead to weight gain. However, the most recent, wide-ranging survey paper on the topic says:
By "environmental factors" they mean both environmental toxins and weather conditions, and systemic factors impacting the ability to access safe, fresh food at a reasonable price. It is indisputably true that poor people and people of color are less likely to have access to food that has few calories per nutritional value, and such food is disproportionately more expensive in both money and time spent on preparation.
Until we have equality of access to all the factors that make it harder to keep a healthy weight, discussing weight without discussing inequality is essentially meaningless - and people who are unable to maintain a healthy weight, whether or not it's because of these factors, deserve to be able to pursue muscular, cardiovascular, and bone health without being shamed for being fat.
I visited my hometown last summer after spending the past 10 years in upscale/college towns that gave me a lot of variety, and I was blown away just by how awful the food selection and options were between grocery stores and restaurant choices. Food deserts are awful and gave me a new perspective on the ability of people within them to be able to make good choices for eating habits. Sure, they could spend money on produce that is plastic-wrapped and terrible quality, at a high price, and requires them to prepare it into a meal. Or, they can spend $1.50 on a McDouble at McDonald's and satisfy that need right then and there while meeting their budgetary needs. It is crazy to me that food deserts are even a thing in America when there is so much farmland that could often be used locally to provide high quality food to people without having to deal with supply chain issues that plague these areas.
The society-wide, public health view (as an epidemiologist would see it) is important, but taking a personal health perspective also seems meaningful? Sometimes it's the job at hand. Doctors and personal fitness trainers treat one person at a time. Inequality is going to show up for them as seeing a variety of people from different environments. (And also not seeing people from some environments, depending where they are and who walks in. Businesses often specialize. Just being able to afford their service is a filter.)
The article seems to be about some fitness trainers doing a bad job of listening to and catering to their clients, maybe due to a lack of experience or perspective. Or maybe it's just bad customer service and the customer would be better off looking for someone better regardless?
I don't have any experience with fitness trainers but I've done physical therapy and in my limited experience, they seem to be pretty good at meeting people where they are, perhaps because they're more used to dealing with people of all ages and fitness levels.
In my experience, this is true of physical therapists but not of most personal trainers. Certainly there are some, but when the medical advice for a large number of (mostly, honestly, unrelated) medical issues is "lose some weight", we need to either have cheap, effective medical interventions for weight loss, or a better, cheaper physical training industry.
When I was a teenager, I was quite overweight, partly because I refused to exercise very much. My parents sent me to a personal trainer monthly for about two years. I saw very little progress and endured a great deal of pain and self-hatred before I finally talked to a doctor and realized that I have a joint disorder. I got some pretty effective physical therapy and I'm doing a lot better, now (and have lost some weight), but I have essentially zero patience for "just apply yourself" as weight loss advice.
I understand and empathize with I took away as the core arguments of the article: Fat has been demonized, fitness has become a "moral" pursuit, and the fitness industry exacerbates all of these issues. I completely agree, the perception and use of "fitness" is another way for those with resources to be "better" than those without.
What I think this article leaves out, is the underlying cause of weight gain and its effects on humanity at large. The value chain around our food systems is completely out of whack. I feel like the author ignores the fact that as a population we have been steadily getting heavier decade on decade since the 50s. And the ends of the weight spectrum, both morbid obesity and extreme skinniness, carry real health risks. But that said, the drivers of weight gain and loss are almost entirely external. Eating today is a minefield. There are more calories in 1 Poptart than in a pound of carrots. Our ability to process food into extremely calorie dense packages is the problem. In turn, how do we access food. How many produce sections are there in low income areas? How much more time does cooking take rather than stopping at McDonalds? All of these factors compound to make it so that only those with means or really, really, really focused attention can avoid it. So what do we push? Fucking exercise. Fuck that, address the real issue.
The response of the fitness industry (and I'd say it's entire business model) to a heavier population is built on the premise that you are fat because you are lazy and worthless and you need to buy our product/service to be better. Shame is a real motivator and they pedal in it. I completely agree with the article on this point. It is a fucked up value proposition. Body positivity is great too. We live in a fucked up system and the folks who are being harmed by it should not be bearing the brunt of our frustration. However, I still think we should address that morbid obesity does effect the health and quality of life of those who live with it. Let's not punish them but instead change the food systems that got us here.
Something like 90% of the industry built around fitness is built not around the central column of helping people achieve healthier bodies. instead they build it around people who are already attractive as a means of staying attractive. When's the last time you've seen an advertisement for a fitness product or service that included people with 'average' physiques, let alone someone with extra padding. If you can even think of one, were they there as a joke? Heck, even when you see advertisements for weight training equipment, the models they choose are all body builders - people who work out to 'sculpt' their bodies - rather than weight lifters - people who work out to build the strongest muscles, and have a thick body as a result.
Partially as a result of this, there's a lot of missing information for people who really need fitness instruction. If you are Obese, your musculature is different from people with average BMI. Your body does not have the same range of motion because it is a different shape. Even if you are otherwise completely healthy, your best source for training is to hire a drammatically more expensive physical therapist.
I can point out one that I have worked with on and off over the years, and that is DDP Yoga. It started off as something to do ironically as a joke in front of my partner (the guy is over the top) but actually found it to work really well. Most of the videos and workouts involve people of all shapes and sizes.