[vundercind]

Behavior modification has been failing for decades. It had its shot.

Skinny foreigners move here and gain weight. That’s a pretty strong indication that individual willpower doesn’t have much to do with why skinny countries are skinny. Why would we expect that to work here?

Our options that have any hope of actually working are a huge overhaul of probably a lot of things, including our food culture, zoning and city layouts, farm policy, and social safety net, to name a few—or, a miracle drug.

Realistically, if we want results this century, that leaves only the latter option.

[tuatoru]

GP is victim blaming, a perennial favourite with a certain type of person. The fundamental attribution error[1].

1. https://en.wikipedia.org/wiki/Fundamental_attribution_error

[akira2501]

> Behavior modification has been failing for decades.

What are you basing this assertion on?

> Skinny foreigners move here and gain weight.

Do you have any data to back this up?

> including our food culture, zoning and city layouts, farm policy, and social safety net, to name a few—or, a miracle drug.

Why do you think that only extreme solutions are available?

> Realistically, if we want results this century

I don't think there's anything realistic in what you've proposed.

[vundercind]

Google either of those first two things. The answers are in the first page, no need to provide a citation and open up “well I don’t like that citation” cans of worms, pick your source, there will be a mountain of them. Dig a little on any of them and you’ll be on actual meta-studies and such. Neither is a controversial claim, or even close to it.

“Why only extreme solutions?” 1) because zero non-extreme ones have worked, 2) because the root cause appears to be deeply embedded in a complex web of systems, which means addressing the root cause within a human lifespan is necessarily extreme, 3) the drugs arguably aren’t really extreme, and 4) supporting #3, the alternatives we’re currently reaching for are drugs to treat the outcome of the pattern of failures in behavior modification / willpower approaches, so this is really what we’re already doing just applied before things get extremely bad.

[edit] here, a couple examples, why not:

https://pubmed.ncbi.nlm.nih.gov/19538440/

Maybe it’s just me, but the last sentence of the abstract reads like a punch line:

“Future research is needed to identify the specific mechanisms through which living in the USA may adversely affect health outcomes.”

I chuckled. “Uh well we know it’s real bad but as for why, look, it’s fuckin’ complicated and probably gets political way faster than you’d expect”

(The paper appears to recommend weight gain prevention intervention programs for immigrants, because what else are you gonna do?)

https://www.nature.com/articles/s41366-024-01525-3

Paywalled but the summary provides some good info. Between this and others (also appearing on the first page of my ddg searches for this) one puts together a consistent picture

1) thanks to a ton of research and spending we’re getting better behavior modification programs! Hooray!

2) the ones that kinda work are a lot higher-touch than you probably expect. I.e. expensive and not accessible to lots of folks, for a variety of reasons.

3) despite all that the expensive state-of-the-art isn’t good enough to tackle the obesity crisis. It helps, but not enough, even if we could provide that help to everyone who needs it.

4) comically (again) this particular summary ends on a “… but now that we have really good weight loss drugs, maybe it’ll work!” note.

(“Just do a diet” without ongoing professional support is basically not effective at all for long term weight loss, on a population level)