Comment by borski | Hacker News Reader

Comment by borski | Hacker News Reader

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Nobody sees being fat as something to celebrate. Fat people don’t like being fat. Source: I’m obese.

The thing that you are misunderstanding is that people don’t want to be humiliated about their weight. It isn’t that they want to be fat, but that they don’t want to be thought of as disgusting or “less than human” for being fat.

In fact, most people who struggle with their weight have worked harder to try to lose it than you can imagine. If you think “just eat less and move more” is something they’ve never heard before, you’re living in an alternate universe. It’s not always quite that simple; people have baggage, trauma, genetics, and so on.

It’s not that they’re proud of being fat. It’s that they’re proud of who they are despite their weight, not because of it.

The issue with doctors isn’t that they can’t tell patients they are obese and need to make dietary changes or lose weight; it’s that people will come in with unrelated issues and doctors will refuse to look past their weight to diagnose what the underlying issue might be, using weight as an easy answer to blame it on. Sometimes it’s weight; but sometimes it isn’t.

I am sympathetic to what you say. I agree with it all. Nonethless, I see where people want to celebrate it --now this could be industry taking advantage of folks and it's some perverse indoctrination, but it's there in commercials, on social media, etc.

I think it’s just a response to many decades of literal shaming. I have so many friends that were put on unhealthy fad diets by their parents because they were overweight kids, and that led to them having eating disorders when they got older that many of them still struggle with, hating themselves the whole time.

The goal of those ads (which I agree there are too many of today) is to help people hate themselves a little bit less. There’s a reason obesity is often comorbid with suicide.

> The thing that you are misunderstanding is that people don’t want to be humiliated about their weight.

But shaming is effective. There are of course fat Japanese people, but for the average person, shame is an effective deterrent against weight gain. That makes sense. Food doesn’t act on people’s rational senses. It targets pleasure centers. The cold logic of non-judgmental medical advice is powerless to do anything against that. Medical professionals, after all, are nearly as likely to be overweight or obese as the general population. Shaming, by contrast, targets a different, more primitive part of the brain. People will change their behavior in an effort to avoid shame in a way they won’t for abstract good advice.

Lots of things are effective that are also bad solutions, especially in a different context.

So you’re right, shame works. But, for the sake of argument, if it leads people to suicide, eating disorders, or depression, while obesity is no longer technically the problem, you’ve just created another problem.

Shame works for Japan (for now, at least) because they are a wholly different society than ours, based on a wholly different set of morals and upbringing.

But is a Japanese salaryman happier than an obese American? Most are miserable, for most of their lives, and simply don’t talk about it to anyone outside their close circle, if at all. Remember that mental health in Japan isn’t really a thing that gets discussed very much, by doctors or anyone else.

It’s just trading one thing for another.

We’ve learned a lot about reinforcement learning from training animals, and specifically that positive feedback tends to lead to better results long-term, even if negative reinforcement may lead to quicker changes in the short-term.

I’m not convinced the same ideas don’t apply to mammals like us.

Moreover, what gets lost in the shame / blame game is the concept that people can work really hard at changing themselves and still have a long way to go. That is, if someone is 200 lbs overweight and has spent the last two years losing 100 of those lbs… someone who sees them in a “shame” society would still shame them, with zero context given to the fact that they’ve had a massive success over the last twelve months that should be celebrated even if they’re not where they want to be yet.

Without positive feedback, it’s exceptionally difficult to “stay the course,” and that is the point. Shame only gets you so far.

Supporting someone on their journey to a healthy weight gets them much further, and if you genuinely care about someone, that should generally extend to their mental health as much as their weight, imho.

> But, for the sake of argument, if it leads people to suicide, eating disorders, or depression, while obesity is no longer technically the problem, you’ve just created another problem.

Part of the problem with discussions in many societies now is this false equivalency. Yes, some people might be driven to suicide due to shaming, but this is not the vast majority of people. However, NOT shaming people about their weight leads to a much larger portion of the population being fat and unhealthy, which has incredible downstream health and societal impacts.

So I disagree with your equivalency here - shame is a good social tool for the majority, and while we should certainly be on the lookout for the extreme minority who have mental health issues, we should not be throwing out good general social tools just because of a few edge cases.

The issue with this thought process is that its not possible to silo a shame culture around just the things you think should be shamed. Once you accept that the government encourages shaming people for things you think people should be shamed for you need to accept that other people have the power to get the government to shame you for things you dont think you should be shamed for too. For example in the US if the GOP came into power and shame policy was seen as acceptable theyd immediately institute a shame policy around abortions. Suddenly youre in a full blown thought police society

We had such a policy before in America, and the average person was better.

What about the converse example of yours, eg: if there is a shame policy around being pro-life and perhaps suggesting on some specific week criteria after which abortions should not be allowed?

What you're calling "thought police society" is basically another way of saying that "there are social norms in a particular society". This is true anywhere.

You may not like the social norms of a particular place and time, or think your rival political tribe is from the dark ages (I recommend going outside to touch grass if you're in a Western country and believe this), but the base point is that any group of people that has any sort of group cohesion has preferred social behaviours and disliked antisocial behaviours.

I dont think the government should be enforcing social norms. I prefer the US style of weak social norms where there are less consequences for breaking them.

> So you’re right, shame works. But, for the sake of argument, if it leads people to suicide, eating disorders, or depression

But do those hurt the median person, or does that social policy just increase those problems at the margin? If the median person is made better off overall then it’s worth the trade off.

And is the Japanese salaryman more or less happy than the obese American service worker?

What you describe is average utilitarianism and it has many known very negative failure modes: https://en.m.wikipedia.org/wiki/Average_and_total_utilitaria...

This also ignores a very basic premise in medicine: nobody will willingly go to a doctor they do not believe has their best interests in mind. It’s one of the reasons the Hippocratic oath exists.

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