What physicians get wrong about the risks of being overweight

There's also a big difference between "life expectancy" and "quality of life". Being overweight is uncomfortable, limiting, and can be a burden on people around you. I have no way of knowing if I'll live longer, but my life has become immeasurably better since I went from nearly obese to normal weight.

Additionally, I think the biggest factor to control for is socioeconomic status. A well-off fat person is probably going to have better life expectancy than a poor skinny person.

Being overweight is uncomfortable, limiting, and can be a burden on people around you.

The amount of times I've heard this used as fat-shaming rhetoric is shocking.

"You're immoral, you're selfish, why can't you think about everyone around you who has to put up with, and is affected by, your obesity."

It's inexcusably vile. It's hateful rhetoric. I'm sure you don't mean it that way, but that's what it is. And the problem is that such hateful language toward fat people is so, so pervasive, accepted, and woven throughout our society, that people say things without even realizing how harmful they are.

Also, socioeconomic status is probably the most important factor. As you said, a fat person with access to affordable health care with competent doctors that don't blame everything on weight, is going to be much healthier than a poor skinny or poor fat person. Further, if you're in a marginalized community, it makes it even more challenging. Then you have food deserts, long working hours, poor wages, lack of affordable child care. Lack of affordable education to help get out of your situation. Lack of social mobility depending on who you are.

It's almost like the person's body weight is barely even a factor in deciding their health.
- It's not fat shaming, it's stating the truth. And I say that as a former fat person.
  
  Being fat is not just fate or lottery, it's a challenge one can and should overcome. All that sugarcoating of language does nothing for fat people and rather works against them, since it normalizes a willfully unhealthy state.
  
  Let me be very clear here: being fat is nothing to be positive about. There's zero, literally zero benefits, but tons of disadvantages and problems.
  
  People aren't "wilfully" fat. People struggle to prevent weight gain/lose weight to the point of self harm and eating disorders. It's not sugarcoating to say you should treat people with respect if you really want to help them.
  
  The main message of being "fat positive" is mostly just "don't be a dick to fat people". Because a) don't be a dick anyway, and b) being a dick doesn't do anything except make people feel like bad. If your intent is to be harsh in order to help, the data proves that when people are fat shamed, it usually causes them to gain even more weight.
  
  So if you really want to help people be healthier or have better quality of life, be encouraging and positive.
  
  There's a difference between shaming and telling the truth.
  
  Fat positivity may have been intended to mean "no hate" at some point, but today it is used as "no criticism". It's the same principle as free speech ultras claiming that someone else infringes their free speech by criticizing what they're saying.
  
  Again, being fat is not positive.
  
  And you're making a value judgement on these people that they haven't put in enough effort to make themselves not fat, ignoring the differences in our bodies and experiences. It's simply not nice to keep pushing the same rhetoric all over this post. We get it, you managed to get healthier and you wish to extol the virtues of how you managed to do it. For many people, they already tried all the things it took you so long to adopt and telling them that they need to try harder or have no excuses is not helpful to them.
  
  You need to be nicer on our instance.
  
  You need to understand that sugarcoating everything is not helpful.
  
  Seriously, what is so hard to get about that? You jumped directly from "not lying" to "hateful insult" and that's just not a valid point. If a doctor tells you, that you will die sooner because you smoke, drink, or eat too much that's not hateful, but simply a factual statement.
  
  Just tell me: how will any obese person benefit from simply ignoring their actual problems? You want to be super cushy positive, I get it. But in reality, you're just advocating for deadly silence.
  
  Accusing anyone who disagrees with you of being hateful is either lazy, evil, or stupid.
  
  I'm not saying you're being hateful, I'm asking you to be nicer. You don't seem very receptive to being told by an admin or a mod to follow our only rule, so you're getting a 7 day ban to think things over. If you show up again and keep violating our only rule, you'll get a permanent ban.
  
  Well, regardless what you think of fat positivity and how others interpret it, you should still treat people with understanding and respect.
  
  And again, if you're trying to convince someone to lead a healthier lifestyle, (even though you are making assumptions about that) a negative approach is only going to be counter-productive.
  
  Ah, I see. So you read my comment and was like "hm, the person they replied to probably wasn't being hateful. Let me swoop in there and make sure I make my bigotry clear."
  
  Perfect echo of "I'm not racist. It's just science..."
  
  I'm not going to validate your bigotry with a discussion. Enjoy being blocked.
  
  Sure, because telling you from my own experiences is bigotry.
  
  This behavior, ignoring the problem, is BTW exactly how people get fat. No, it's just a few kilos too much, that's fine. No, that tub of ice cream is perfectly fine, I walked to the store.
  
  Sometimes I come down with 'i did it why can't they' but my circumstances and options were and are different from theirs. There are times when I have to actively remind myself that the things I do to manage my weight don't always align well with being a good friend; I have to meet people where they are, eat what works for me, and offer to share some guilt free. It's about providing pathways for someone to adopt healthier habits and encouraging successes.
  
  @storksforlegs has some great advice regarding adjusting your language to help make your message of healthier lifestyles more accessible, so others can have the kind of success you've had (congrats, btw; great job!) but, you know... in their style of body positivity for them.
  
  Sorry, but that's apologetic crap. Eating less is not that hard, you won't become a social outcast and it's not like you can never ever eat anything with your friends.
  
  There are always hundreds of excuses, but hardly any of them are reasonable.
  
  I'll absolutely concede that our western environment isn't exactly healthy and a lot of people are interested in us overeating, but blaming everything on external factors is addict behavior. And we shouldn't fuel that behavior.
  
  Eating less is not that hard
  
  There are always hundreds of excuses, but hardly any of them are reasonable.
  
  but blaming everything on external factors is addict behavior.
  
  Okay, I 'll give it a go too. Even though @storksforlegs@beehaw.org already mentioned what I am about to say, obviously to no effect.
  
  You say you are speaking from experience. That you 've lost some weight. And then you make claims that go way beyond your experience, that are far tοo general. I won't go so far as to say that the position you support is ignorant. This won't be nice. I will assume you are more educated than I am. But I will point out, that your experience alone hardly constitutes solid ground to speak for everyone. There is room there for you to be mistaken.
  
  Addictive behavior is not rational. People get addicted to stuff, whether there are inherent addictive qualities to whatever they get addicted to or not, not because they choose so, but because they are vulnerable to addictive behavior. This, more often than not, is something indicating other psychological issues that need to be addressed. It can be insane amounts of stress, it can be depression, it can be many other issues that need to be addressed in order for someone with addictive behavior to get to a place where that person no longer needs crutches to function. Attacking how an addict rationalizes the addiction, not only doesn't address the issues that lead to this behavior but it probably adds to to them.
  
  So, since you can't know why someone is displaying addictive behavior, implying, for example, that a person with severe anxiety that turns to food for comfort is lazy, is actually neither nice nor helpful. It's not even speaking the truth as you said. It's just negative, probably adding to the problem causing the unhealthy relationship with food.
  
  I won't bother with the rest of the generalizations you 've already made, but I will suggest this. If you want others to respect your experience when you speak about it, try to consider its limitations before you draw assumptions that include other people's lives.
  
  I'm glad it was easier for you than for me but this feels diamissive. Other people don't have your life, they have theirs: social pressures, economic pressures, food access pressures, schedule pressures and a host of other things impact how well a person is able to change their habits. Advocacy that doesn't take these factors into account is less effective, because it won't address drivers of habit.
  
  Actively losing one third of the weight I was carrying involved arguments with family and uncomfortable meals. It involved having to skip out on going to places with friends who just wanted dive bar grease food and drinks, and then explaining that we were still friends and why it was worth changing up the group's routine. It involved huge amounts of drama with my partner at the time, who felt that my weight loss was a judgement of them. Friends were dismissive when I voiced how I struggled with these challenges, saying I was making excuses and that it wasn't that hard if I was trying, which was incredibly demotivating.
  
  There were just two people who acknowledged my feelings and experience, who understood that if I perceived something as a challenge for myself then it was. They would encourage me to continue overcoming it and offer suggestions and support. I encourage you to do what they did, because I think it will make you a more effective advocate. If we want people to achieve the kinds of successes we have, it has to be about them and not about us.
Being overweight is uncomfortable, limiting, and can be a burden on people around you

While I am not disagreeing in any way, I believe it's important to point out that there's also a distinct difference between obese and overweight. Often times overweight is being used as an adjective to indicate that someone is outside the normal weight range, but in the context of medicine and the context of this article, it's a range of BMI values between the normal and obese categories.

Quality of life measures generally find little to no negative effects with the overweight category, but decrease as you continue into obese categories.
High five on changing your trajectory. That's great.

I too have a similar story, where last year I read "patient appears overweight" for the first time on a doctors chart, and decided to get back into shape.

This is about the overweight BMI category, not obese categories. It's also talking about how it's actually not associated with an increase in overall mortality, but rather the opposite. This observation has been around in literature for quite some time, predating the obesity crisis.

What are you trying to even say with this comment?

America is getting really fat. Reading the article reminded me of how fat this country is getting.
- While I appreciate your concern for how fat America is, I'm struggling to see how this comment is helpful or leads to a productive discussion in any way 🤷‍♀️
  
  Lots of discussion going on around my comment right now.
  
  The discussion trying to process your extremely vague statement is not productive.
  
  I think you're being a bit of a buzzkill.
  
  We're not a space for low effort reddit/twitter style gotchas. Be better.
  
  Reducing my feelings to a "gotcha". Yeah, I don't want to browse a community with Reddit style moderation either, thanks.
  
  Reddit style moderation isn’t a conversation. It’s where someone deletes your comments and makes it so you’re the only one who can see them, or shadowbans you from the entire community.
What are you trying to even say with this comment?

Haven't you heard? America bad.
- You're suggesting that all fat people are bad?
  
  No
  
  Were you being hyperbolic, as a mild defensive response to a perceived slight against your country and the people in it, when the real problems are public education failure, health system failure, political corruption, and a food industry that intentionally gets your youth hooked on things like HFCS at an early age?
  
  Permanently Deleted
  
  Clearly it's a problematic thing, I haven't said anything to the contrary. I'm American, so my observation was domestic.
  
  Bad faith is pulling the bullshit "America bad" card because you can't process criticism, when it points to something that seems endemic to the current state of your country.
  
  Gonna stop the conversation here, this isn't going anywhere. In order to operate in good faith you need to be willing to put some thought and effort into your comments. A vague "America bad" statement as a criticism of your vague "America is fat" is completely justified. Back and forth bickering isn't going to help, please disengage.
  
  America was founded on faith, so I can respect this.

Pictures and home movies from the 1970s are shocking. People were so much leaner then than now. And going further back, the silent movie actor “Fatty Arbuckle” was considered so fat it was his nickname, yet he wouldn’t look at all extraordinary today.

Seems like it’s the snacking culture, so much snacking “3 meals and 3 snacks” is normal. It didn’t used to be.