Comment by Barrin92 | Hacker News Reader

Comment by Barrin92 | Hacker News Reader

>I found an advocate for rationality in Richard Sloan, a professor of behavioural medicine at Columbia University. He said that when it comes to hypertension and other health problems, Americans put too much faith in the power of personal agency.

Isn't that the truth. Another example came to mind immediately which is the treatment of alcoholism. AA is really big in the United States but has abysmal recovery rates, whereas preliminary studies with muscle relaxants have shown great promise.

Yet in public discourse diseases are treated like one's 'personal demons', a 'challenge that has to be overcome' and so on. It almost seems like a personal growth lifestyle change rather than an objective medical assessment with programs like AA suggesting opening oneself up to 'higher powers' in their official guidelines.

There really needs to be a big culture shift that moves health debate from a sort of Puritanism to objective medical evaluation that keeps the personal angle out. Especially when it comes to drug abuse and dietary related illnesses. Obesity is a big issue as well.

What are you talking about? There's plenty of stories out there of obese people who lost weight on their own and got their life back into shape (myself included). This ivory tower elitism is nonsense. They are worried that if enough people took actions into their own hands they'd be out of business.

The percentage of people who manage to successfully lose and keep off a significant amount of weight is tiny. No one disputes that some people manage it. The concern is that depending exclusively on willpower clearly doesn’t work for most people.

Who is "they" and what does Columbia have to gain from keeping people fat?

I think a lot of people could "will" to fix some of these problems in an ideal world, but other factors beyond their control prevent them.

I "beat" obesity in the last year. My BMI was low 30s and it's now low 20s. Knock on wood, after some time I don't seem to be regaining it like a lot of people do (as suggested by my sibling post). Without getting into too many personal details, the biggest thing to cause that was a radical re-shift of my work habits. A vast majority of people do not have the luxury of chosing when and how they work. I do not fault them for not replicating what I did. I struggled with it myself for a long time, before my recent success, until I was able to make these latest changes.

In general I think things which lead to judging other people for their circumstances is a bad idea. There are probably people who could will it away. Is it their fault that they don't? Honestly, probably not usually.

Out of curiosity, what did you change about your work habits?

Quit a job, replaced it with zero commute, making room for daytime exercise and better meals.

Agree with most of what you say, but the underlying reasoning around successfully using willpower to fight addiction is that it leaves one in a much stronger state to deal with other "demons" they might encounter.

Muscle relaxants may fix a addiction to alcohol at a higher rate, but likely do nothing to change an addictive personality.

>Muscle relaxants may fix a addiction to alcohol at a higher rate, but likely do nothing to change an addictive personality.

addictive personality traits are to a considerable degree genetic, and even the learned parts are usually solidified in adulthood. It is almost impossible to change one's personality, this isn't a good pathway.

Stopping people from engaging in addictive behaviour is really hard, that's why the most effective way of managing addiction should be chosen. It is not a battle to be won, it is a disease to be treated.

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