Saturday, 25 April 2015

Pile-On Your Voice

Okay, enough of this Jamelia pile-on. This is later than it should have been and things have kind of moved on-in more ways than one- but I still felt the need to say it.

Jamelia was raring to go and didn't even catch the warning of the chair, Ruth Langsford when she mocked her suggesting segregating small and plus sizes out of the high street, into specialist backwaters. She felt otherwise was facilitating unhealthiness-if you are unhealthy, you should feel unhappy, said she.

I was enraged up to that. I'd imagined remonstrating with her and it wasn't nice. That last bit surprised me though, that's exactly what the @besity construct is for. To place and keep fat people in a state of permanent dis-ease. I usually dismiss whining about how difficult it is to broach this subject, but I'm begining to wonder whether there's too much of a contrast between the acceptance of medicalized notions of @besity and what that really means.

The social media pile-on changed the way I felt. It's one of those cases where you end up, not so much feeling sorry for the target, but recognizing they're taking too much flak for the wrong reasons, i.e. not a white coat.

That Jamelia could so accurately, however unwittingly depict the essence of a crusade, reminded me of the instigators and propagators of this whole canard. I'm not even sure I can say she's a bigot. A tool of the establishment, yes, but she did not stand on casting most of the usual aspersions about fat people being of bad character.

She even started with her belief that people should celebrate themselves, be able to look good etc., and yeah, I do believe that because it has a deep cultural underpinning, especially in resistance against racism's degradation of Black people's humanity. Along with meme of celebrating life.

Like everyone else though she ends up not being able to end the thought she started with and going back over it. That's caused by the inherent bankruptcy of the @besity construct. It's not compatible with humanism. When people eventually catch on that they're doing this. I doubt they'll be best pleased.

As I've spent a lot of time explaining how fat people are taking it for everyone's disappointment about the distance between their internalized abstraction of humanness and their actual humanness, you may get why my ire was stopped in its tracks.

To those who called her out I ask, where are you when all the usual bullshit is going down with so called 'scientific' findings? I don't ask that you take fat haters on directly, on the contrary, I see your reluctance/disinclination as a positive virtue. The exposure of their irrelevance is long overdue.

All I say is learn to keep making your presence felt and your voice heard in this way. Don't read comments that upset you. Just address your feelings to articles and do not be intimidated by any so-called bandying of science. Speak your mind, i.e. Where is my voice in this? Why am I continually shut down/ sidelined from my own life? How does this help me? When are you going to talk to actual people about how they feel/the effects of all this on them and their health? etc.,

I'm sure you can come up with waaaay better. Just whatever you feel you want to say or what you want to be heard. A couple of lines is more than good. Say something of your feelings. Maybe even how much those close to you are on at you.

How long they've been on and you. How long you've been on at yourself and what that has done to you.

Pile-on your real voices wherever cold dehumanizing @besity is banded about as if its some theoretical abstract. Make it impossible to forget this is an assault on real people. Make others hear from you. And try not to take @besity noise personally, or feel you have to answer any personal questions or justify yourself. Do not be on trial. You are not on the witness stand. You do not have to defend yourself. Say that if you want. "I'm not here to beg or plead or persuade you or any. Just to say my peace thank you, bye."

In fact, start asking other people questions. Ask them if they'd appreciate having to answer to everyone, justify their existence, whatever. Move it out of weight and on to other examples. And don't be discouraged if you run out of words or don't know what to say. Let go and come another time. Learn to put words to your feelings away from the heat, so that when its on, you can garner some thoughts.

For bit of context, here's virtually the whole conversation, ignited by this programme;



The whole discussion such as it was, was much of a muchness, consisting of participants repeatedly making points and going on to contradict them in the same breath/sentence that's a construct-related cognitive distortion -thought or sentence bending as I call it. 

i.e. "Diets don't work unless you keep on them." The end doesn't simply contradict, it jettisons the initial recognition that they don't actually work.

The slightly different tack here was to focus on "young girls" who were in their estimation, shockingly fat.  A grab-your-smelling-salts, size 20-22, as opposed to a size 14-16, so its not as if we're being unreasonable

On the one hand, it was recognized that this was about tapping an undeserved  market, on the other that the glamour images of beautiful women used to sell these clothes would hide the truth of 'obesity' which was physical infirmity and health breakdown years later on.
 
This may portend a slight shift in assault. That middle aged spread is one thing, but being fat at a young age is another. It's also increasing the concentration on the most visibility fat BMI 40 +. It's weird to see fat phobes trying to actually think. To recognize on some level that here are real human beings whom they have to attempt to persuade in some way.

Rather than their usual triumphalist rah, rah, rah obesitah. This represents a chink of vulnerability. A sense that things maybe slipping away from them. Now powerful forces, in the pursuit of lucre most filthy are threatening to bypass their tyranny of unthink.

They're not quite so cocky.

Tuesday, 21 April 2015

Sour Grapes

Well, the sour grapes about one little deviance from the de rigueur fat=bad folklore continues. I suspect some people put @verweight and @besity on their must view list, because it took fat haters a little while to catch onto an opportunity to vent their unhealthful spleens. 'Underweight' threw them.

All the study stumbled over, whilst reviewing GP's records was there were more diagnoses of dementia among people with the lowest weight;
Earlier this month, a major study in the Lancet seemed to suggest that obesity protects people against dementia. 
It did not "suggest" any such thing;
Our results contradict the hypothesis that obesity in middle age could increase the risk of dementia in old age. 
[My emphasis] That's pretty clear. Being fat in middle age is associated with decreased diagnosis of dementia. Anything more than that would come out of  describing how underlying metabolic function is causative of potential differences in health outcomes amongst weight classes (rather than individuals). That's beyond the scope of epidemiology.

And as we all know, correlation ibid.

I don't object to criticism of these findings, far from. It's nice to see some genuine rigour applied to weight-related epidemiology. Change 'under' for 'over' weight and you can hear missing critiques of 'obesity' hypothesizing fall like spring rain.

These findings don't alter the fact of contriving generalizing outcomes by category, partitioning these into individual units, claiming this determines health outcomes, has neither merit nor relevance.

Finding out how to alter metabolic outcomes, via tweaking metabolic function has nothing to do with using weight for the purposes of social larceny engineering.

Anyhow, back to the cause of all the sulking;
....this contradicts previous studies that show that if you are obese, you are more likely to have diabetes, high blood pressure and high levels of cholesterol, all of which contribute to the development and progression of dementia.
 Indulge my reiteration of the key flim-flam here;
Overweight and obesity in mid-life, measured by BMI, have been associated with a higher risk for late-onset dementias on the basis of epidemiological reports.
The use of "association", "risk" especially are weaselly and loose in the extreme. As is most @besity nonsense, built as it is on a stack of cards.

As one critic of this finding pointed out risk is not deterministic. The rest of that little summary goes;
Adipose tissue, the main contributor to overweight and obesity, lends biological plausibility to increased risk because it is the largest endocrine organ in the human body and because it increases vascular risk.
Ha, ha, ha, @besity wallahs are not only obsessed with food, they're fixated on fat cells as vandals. A reminder that @besity's a metaphor, with its villainous adipose cells, round, yellow with pencil moustaches to twirl the ends of as they wreak havoc on innocent organs-the ones @besity professionals haven't turned into offal. Because erm what? They just intrinsically baaad? No, that's silly. They turn baaad once your BMI passes 24.99999999999999........

Trez science.

And erm, no to this hypothesis lending "biological plausibility." Even if it did, proper standards of defining actual, rather than mythological causality, apply.

The most favoured scenario seems to be fat people die before we can get demented, of course without anything so tiresome as perusing the study. I've never heard thinnest sold so effectively;
....epidemiologist Deborah Gustafson of State University of New York has challenged this interpretation and says the study design is flawed. GPs diagnose dementia with varying degrees of accuracy, and the timeframe between the age at which the BMI was recorded and the date of onset of dementia is not clear.
 "Varying degrees of accuracy," eh? That's a euphemism and a half. As for the latter, she seems to be alluding to the possibility that what? A person could be diagnosed whilst fat and slim down under the influence? So weight isn't much use as a diagnostic tool? Even more obvious, the direct connection between spontaneous weight loss, ageing, pathology, disease and ultimately death? The one that's usually cut out of the frame?
Our cohort of 1 958 191 people from UK general practices had a median age at baseline of 55 years (IQR 45-66) and a median follow-up of 9.1 years (IQR 6.3-12.6). Dementia occurred in 45 507 people, at a rate of 2.4 cases per 1000 person-years. Compared with people of a healthy weight, underweight people (BMI - 20 kg/m2) had a 34% higher (95% CI 29-38) risk of dementia. Furthermore, the incidence of dementia continued to fall for every increasing BMI category, with very obese people (BMI 40 + kg/m2) having a 29% lower (95% CI 22-36) dementia risk than people of a healthy weight. These patterns persisted throughout two decades of follow-up, after adjustment for potential confounders and allowance for the J-shape association of BMI with mortality.
Clear enough? Or in short;
Very obese people, with a BMI over 40, were 29% less likely to get dementia 15 years later than those in the normal weight category.
I say the same thing about this that I say about other findings, find out how the body produces weight. Then in this case, find out how that over time affects the production of the brain's cells and anatomy. Indeed, the former might tell you the latter, if that is indeed relevant.

One thing I'm sure we can all sense is excessive, unyielding negative stress has its part to play in undermining mental and physical well-being, so when people try and dump all the ills of being human on you. Remember to be mindful. Step back from their thought- stream and let it flow by or through you....

Just let it go......

Friday, 17 April 2015

Parental Devotion

We're so used to ugly fakery and collusion with the 'obesity' crusade, even from decent and lovely people, that we've lost sight of a genuine response. Rameshbhai Nandwana who according the the UK press is proposing to sell one of his kidneys to fund specialist assessment and diagnosis for 3 of his 4 children. Yogita aged seven, Anisha aged 5 and little Harsh a boy of a year and a half. The eldest girl, Bhavika is six years old and unaffected.

Both Rameshbhai and his wife Pragna Ben look after these children with tender devotion and a civilized understanding way outside the league of western model weight rage. Despite effectively being in service to their children's severely heightened hunger.

And its not as if 'obesity' rot hasn't penetrated India;
"A few social workers have come forward to help but it’s not just about the food," he said. "If my kids continue to grow at this rapid rate they will have major health issues.
How astute of him. This is a medical problem, not another opportunity for diet fanatics to ventilate their irrelevant compulsions. These three children obviously have some kind of endocrinal disorder. They've gained weight at a phenomenal rate and suffer from rampaging hyperphagia-or excess of hunger, the non-neurotic kind.

Their bodies are primed by something to keep storing not using energy along with disturbed hunger out of kilter with their physical needs. The parents have sought treatment but this situation needs some specialist input in the form of diagnosis for one- though what specialists can do is anyone's guess. This is out of Nandwana's price range so he's proposing to sell one of his kidneys to fund, mere diagnosis.

Few people either know or can describe how unpleasant hyperphagia is. To most, food=pleasure so a high intake =hedonism. When in reality, the intake is caused by an excess of hunger, which is unpleasant to the point of being intolerable.

People assume this is just normal hunger, though it's an extension of it- like temperature, hunger is on a gradient- when it is way beyond anything like normal.

I'm not surprised these poor children scream and cry when they're not fed, that isn't being spoilt, that is piercing discomfort. The kind that is like that serious phase of depression where the agony is so intense that you feel you may have to end yourself just to stop it.

It's truly horrible to endure. That alone is worth getting rid of, before getting to whether weight can be reversed or not.  The erasure of hunger to reposition it as some kind of emotion or thought leaves it to go where it wants.

If that's normal great, if not, tough shit, if you hurt you hurt, if you die, you die.

How this can happen during a supposedly feverish global crusade that's supposed to be against weight, is evidence that the 'obesity' crusade is not about solutions or medical advance.

It still hasn't even penetrated the minds of many activists that it's not simply that those who are healthy are being attacked, their well being and health undermined, it's also that those who do actually have something wrong, are being shafted.

They're being denied the proper means of assessment, treatment and relief. Diet 'n' exercise pens everyone into the same. Solutions for the Nandwana children and others like them leads to progress for anyone and that's a big spanner in the works. So the Nandwana family have to pay the price for leveraging the threat of ill health to drive social engineering and the politicization of fatness.  

There's something bitter-sweet and telling about how those who still feel hunger as near foe can't bring themselves to starve those they love, even in this case borrowing money at times.

This is something nations whose memory is perhaps more dim actively clamour for. The further away from hunger you are, the more you discount the toll it takes. The more romance it acquires.

All those invested in 'obesity' should crowd fund this man, the least they can do for their indulgence is spare this devoted loving dad his kidney.

Wednesday, 15 April 2015

Sporting People

Something rarely if ever mentioned, but achingly obvious is;
There seems to be a world of difference between moderately overweight couch potatoes, who would sportingly accept their own culpability, as most do....
[My emphasis] Where this thought goes awry is Barbara Ellen's attempt to split fat people into 'morbid' i.e bmi 40+ and under that. [At last the much touted FA dichotomy of good/bad fatty finally makes some sense to me.]

She's wrong though.

ALL fat people are and have always been very sporting about mea culpa(bility). We've been on a continuous loop of, "We are fat because we eat too much and do too little." Or should I say, lazy 'n' greedy, as long as the crusade and before. That is all any fat person I've ever know has ever said about "why" they/we are fat.

I can't speak to interactions fat people may have with those who aren't fat though. Don't forget how much we pander to slimz, instead of setting them right or ignoring them, we respond to their rote interrogations, as if we're on trial. Which we are, due to being defined as guilty.

We can learn to say no to this though.  

One of the unintentionally comical things about the mainstream fat phobic mindset is its so psyched up to meet a resistance that rarely if ever comes. The sheer momentum of expecting resistance carries them on as if they are;
Despite my best efforts, Betty denied any personal contribution to her unhappy life situation. Oh yes, she could, on an intellectual level, agree that, if she stopped eating and lost weight, the world might treat her differently.....Besides she marshaled other responsibility-absolving arguments... 
She could agree that if she stopped eating and lost weight, the world would treat her differently, in what way is that "responsibility-absolving"? It's as if the frequency of our "confessional" has moved the idea of 'responsibility versus denial' onwards. Onto our bodies. Our words and actions mean nothing. Weight loss is everything.

Weight is deemed the sum total of actions ergo fat people must be "in denial" merely by being. Fat people must be refuting culpability due to our size.

The central reason we're in the dog house is because, ALL PEOPLE LOVE BASTARDY.

Permit me to explain.

Bear in mind, women are human beings. Yes, you're saying, you know. What I mean is, women are fully human. Meaning when you can perceive qualities in women, you are likely perceiving a quality of the human character, not some lesser category of.

M'kay?

Usually a form of that particular complaint, "Women love bastards" is issued by hetero-guys having erm.... less luck pursuing intimacies with women than they would like to explain their situation.

Their general thesis is that they're nice, i.e. helpful, respectful and responsive to women's needs, but are overlooked continually for what they call bastards. That's men who don't appear to give a damn about making nice.

I will not sally forth into the mire that is friendzone, nice guy syndrome et al. All I need to say is that any truth there is in that sentiment is that we all have ideas of qualities we desire from each other that when we meet those qualities in others, we absolutely loathe those who display them.

I remember a golden age Hollywood actress liked to give some snap about the more she saw of dogs the more she preferred them to men. I remembered thinking, if any man behaved like a dog, you'd despise him.

One of my pet hates [lol] used to be animal loving types who project noble savage/innocent onto other animals and then seek to surround themselves with them as if to say, they are transmitting the glory of their noble savagery/innocence onto moi. Which makes me better than you.

You could say fat people have been the ultimate nice guys when it comes to people's attitudes to their weight. We listened, avoided confrontation, put the demands of others first and that's exactly why we're loathed.

This is frequently missed, especially by fat people many of whom flat out state that our attitude upon awakening from this stupour of "niceness" is responsible for the aggression of others. And that we need to be courteous at all times, explain to the disingenuous and hostile, who will change their minds on presentation of compelling evidence.

They have some kind of Stockholm amnesia complex,  plus a mathematical fault-where they've forgot that we've been just as nice as its possible to be and if that has brought us here, it stands to reason that the answer does not lay there.

In a way you could say its heartening that people aren't so shallow that all you have to do is play like a pup and you'll win them over. They actually prefer you to be real, to inhabit yourself. To be there in person, rather than acting a part.

Things like this made me realize just how much human relations are ruined by our expectations of each other. And how the things we think we want from others, we actually detest when we get them.

"Everybody wants" [thinks they want] other people not to deny any [seemingly] obvious culpability or possibility of it. That kind of knee jerk defensiveness and avoidance of responsibility can be so wearying to the soul. It makes approaching people with their possible or otherwise wrong-doing ever more daunting. This tension has created many a misanthrope.

Yet....here's fat people fronting up, no defense, no fuss, "We did it gov'nur 'twas us, we're guilty as heck" etc., Instead of relief, cheers all round and like Barbara, "How sporting of you." We are utterly despised. And no, it's not for our so called "gluttony".

When individuals have more wealth than some sovereign nations, when the earth is being bled try then torn up to find every resource garnered by nature over thousands of years. Or if you prefer personal consumption, when what people snort up their nose so they can babble shite faster, causes people all over the world to get shot to hell, trying to go about their business.

When in some countries, booze is almost religion and getting drunk virtually a sacrament. I'd venture to suggest greed is hardly unspeakable.

Fat people are effortlessly loathed for doing what we all yearn for. So much so that people weary themselves making an effort to contain any of it.The truly nicest, generous most tender hearted souls manage to dredge up a fiery hatred of fat people, out of nowhere. It can be quite curious. 

To me this sportingness is one of the things that's great about being fat. I'm unmoved by the endless search for innocence that I see reflected in the construction of slimness as the signal of an unblemished character.

Trying to erase what is or is deemed negative about the human character is an understandable way to raise self-esteem, reduce stress and enhance well-being. But it is, dehumanizing in its way, positively so. We are not free of blemish and often a fault is the other side of a blessing and vice versa.

Tuesday, 14 April 2015

Orthorexia Nervosa

I heard about Orthorexia Nervosa and swatted it away as some kind of excessive affectation. I couldn't get to the bottom of what it meant. And anyway, how many narrow declensions of eating/hunger disorders do you need? It seemed infinitely self-absorbed.

This feeling went on for years until I happened to land on Steven Bratman's own site [the guy who coined the term]. I couldn't believe it, such a precise reading of what I'd experienced. I'm sure you've had quite wide ranging/long lasting experience that you notice, but somehow don't see clearly. The WHAM, you land on it.

I didn't think of myself as a dieter. My focus was sticking with the idea of what a healthy diet was then. Thinking what would make me healthy would make me slim and vice versa- many fat phobes don't appear to realise that we've thought all their main thoughts because we received the same mental conditioning about eating and weight as everyone else. 

Not only that, orthorexia for me became an atypical trigger that led to hyperphagia.

Okay, so what's Orthorexia Nervosa [ON]?

Basically, its when a conscious ideology of eating, in this case healthy/healthist unbalances the hunger/appetite mechanisms function. Basically healthy eating tips into compulsion.

People still have problems grasping the point about eating or hunger disorders. We seem to assume, they follow a behaviour. That someone has gone to an extreme. On the whole NO. What happens is- Same behaviour differing response.

A person is anorexic, bulimic, orthorexic because their system yields to behaviours others perform with nothing more than the demands of said acts. The reason why desisting from those behaviours may cure the problem totally, is that it removes pressure, not because those behaviours can cause that unbalancing in anyone.

Note I didn't say hyperphagic because I don't understand binge eating and I only know my own type of hyperphagia, which I know was a physiological imbalance, probably brought on by stressed nervous system.

The idea of a habit of "comfort eating" doesn't fit.

Looking through an i-net search the consensus description is-an obsession with healthy eating. This is typically facile and un-illuminating. 

With anorexia, the pressure is on hunger signalling. With orthorexia, the pressure on your hunger comes THROUGH the pressure you are putting on your APPETITE to conform to what you want it to be. Which ends up obscuring and distancing you from your body needs. Ironically, you do this because you believe your body needs your idea of "healthy foods."

Weird though it might seem, our idea that our bodies need  only food classed as "healthy", isn't backed up by experience.

An anorexic, reduces overall energy intake. This can be of any particular kind of diet-though that demand may skew the proportions and types of foods they will eat. Orthorexics get into trouble due to seeking to eat certain foods and exclude others, i.e. high protein, high intake of low calorie veg and fruit, low carb, low sugar, low-fat.

The body is threatened by this as it is energy reduction, just less so.  Whereas lack of energy threatens life, restriction of types of food threatens inadequate nutrition or balance of [for your requirements]. It could go as far to poisoning if one takes in too much of foods that have toxic substances. Like some leafy greens for example- caution; we're talking a probably unpalatably high amount.

The reason we don't tend to get to that level of intake is we have such an effective disgust reflex for certain foods because they contain small amounts of toxic substances. This, not greed or self destructiveness or "food addiction is why we don't tend to crave low density veg, like we do calorie dense foods.

Terms like that and "hyperpalatability" are mis-direction, calorie dense foods are just of more use to our bodies. We can sometimes feel we can eat any amount of so called "junk" calorie dense foods, because they do not contain such.

One of the ways ON slips beneath awareness, leading up to an anorexic or other conclusion is your focus is on eating, not starving yourself. Where it gets you is your focus becomes progressively narrower without you realising it. Again, you aren't "obsessed," you are seeking to eat totally healthily, which is what you're supposed to do. In my case, it was that I wasn't getting slim, so I kept trying harder. Isn't that supposed to be why we fat people fail to slim?

All this just happens to be enough to activate an unforeseen tendency.

You too may retain skeptism, I wouldn't blame you. Others have become incredibly anguished over the mere idea of ON, taking it as some kind of personal affront against healthist eating.

In order to grasp it and probably other ED's/neuroses, its best to consider more of the context for them.

Starting with our still crude notions of free will...............

Sunday, 12 April 2015

Disappointed Researchers suggest Findings are Underweight

It's instructive to see weight research from another angle. Far more cautious, detailed and careful in  reporting. Its pronouncements, conclusions, assessments and speculations are a cut above bariatrics *ouch*.

It's refreshing. The study in question features 2 million people and uses GP's patient records of dementia diagnosis matched with BMI.

It found those with a bmi of under 20 [underweight is usually under 18.5] in middle age, have the greatest number of dementia diagnosis of all weight categories. That progressively lowers as you go up in size, the lowest have a bmi of 40 +.

Looking at the headline, "Underweight people face significantly higher risk of dementia, study suggests." Most if not all the familiar things occur, this time with an unusual distance. Comparative or relative rather than absolute risk, for each individual. 

You can't help noticing again what a blunt tool weight is as a way of assessing individual risk. Epidemiology is the start of science, not that itself, telling you what can look for, not necessarily what you're looking at.

What may be on your mind is the much touted previous insistence that fat people have the higher risk. That should tell you about the abuse of that term in this crusade. It continually uses theoretical risk collated from other theoretically heightened risk factors to produce its hypetastic endgame.

The use of research as thinspiration puts intolerable pressure on plain fact.

Authors responses should be noted by those usually snowed by @besity;
Prof Stuart Pocock, one of the authors, said: “Our results suggest that doctors, public health scientists, and policymakers need to rethink how to best identify who is at high risk of dementia. We also need to pay attention to the causes and public health consequences of the link between underweight and increased dementia risk which our research has established. 
The latter highlighted is especially telling, why not causes and treatments/cures? Public health consequences are fine, but that particular omission smacks of a pre-text to interfere in other people's lives. I hope that isn't the case. It does say this is an avenue for research, but what kind though?

When a frame is established, others can be framed by it. Precedent is used to legitimize.

On a lighter note, hur, hur, we're helpfully told this doesn't mean being fat is okay-we may not live long enough to avoid dementia given other risks. In addition, we're given an anti-dote to the logical fallacies we're usually expected to pretend aren't.

Some things you never hear- From lead author Dr Nawab Qizilbash;
We haven’t been able to find an explanation......We are left with this finding which overshadows all the previous studies put together. The question is whether there is another explanation for it. In epidemiology, you are always left with the question of whether there is another factor.
*Sob*

Usually that spot's filled with eat less, do more, healthy lifestyles blah, blah, blah.  Can you notice how stupid that makes them sound? In this they actually sound like they're thinking.
Dr Simon Ridley, from Alzheimer’s Research UK, said further work is needed. “This study doesn’t tell us that being underweight causes dementia, or that being overweight will prevent the condition,” he said.
The comments too are worth reading for the number of critiques of the same faulty logic usually advanced when the subject is fat. You'll see those same criticisms dismissed when we resume normal programming......

Friday, 10 April 2015

A Doctor/Patient Model Could Have Been

It has always been my contention that though doctors increasingly wax on about "personal responsibility" they simply don't want the reality that entails. One of those titles sums up, "It's difficult being a doctor in the age of the empowered patient."

Why if you wish patients to take more responsibility for themselves? That phrase "empowered patient" is somewhat redundant. Why should patient equal dis-empowered? Why should a patient be any less than the equal of any doctor they bring their body to? Who else but a patient has the potential to have a uniquely comprehensive insider view of the experience of being themselves? And how can this even be a thing when there are open assertions about sometimes, extreme lack of patient initiative?

Like all humans, medics wish to have their cake and eat it to. They want the abject docility, they've come to base their power on, without the burden that increasingly imposes on them, in an era of chronic health problems. As a profession overall, they've grown accustomed to used to the kind of passivity that serveed the contagion/magic bullet mode of disease.

Their power has to a large extent come from patient dis-empowerment, to put it bluntly.That exchange requires reformation.

They could have had this already, if they'd truly desired to. Fat people took it up themselves to follow their general prescription, to diet, diet and diet again-no matter what, and press repeat. Until our nervous systems burned out from that-because that's what happens if you keep at it long enough. Or simply wised up that these findings were consistent and repeatable. In other words, they were scientific, despite mainly going unacknowledged at best, or denied at worst by those charging themselves with that.

If instead the truth had been full recognized, our extensive co-operation and goodwill could have promoted a respectful mutual dialogue and illuminating interaction. A truly progressive exchange. As we were so committed to the experiment, it could have changed in nature being informed by our experience. That usually happens with research, progress.

Those of us that wanted to could have signed on-unofficially-for the shifts in focus that would have had to have been the product of greater intelligence collated from practice. Practice that illuminated physiological function e.g. the first thing that happens when you merely intend to start a restricting energy is hyperphagia-hunger and appetite activity goes right up.

This can be a trigger for hyperphagia nervosa [heightened appetite not knowingly related to hypothalamic compromise]. This could have been warned against, to this day, most people don't realise having restriction hanging over you long-term can have this effect. It would have acted as a break on the always be trying to lose weight culture. It would have meant switching off between attempts and that could have stopped some hunger/disordered/eating disorders from developing.

Not only reducing the number and extent of hyperphagia/cs, reducing the psychological harm that can occur when the nervous system gets repeatedly then becomes chronically overtaxed. That's simply one aspect. True acknowledgement of facts and reality, monitoring through genuine and meaningful study would have reduced stress immeasurably, giving people a sense of their own power, even if it didn't bring the desired results.

Not all of this is for medics obviously, but this would have informed communication between doctor and lay people-if not patient. All would have been ample evidence of the extent of people's efforts, that could then not be denied. It could also reassure doctors, reducing their weird sense of being victimized by their patients' weight.

When you find out that a person struggling to deny their body for years, finally somehow corners their body into reduction and finds their body loses weight from everywhere but their mountainous belly/their big arms, legs etc.,-me!!

You'll find it hard to shout, "Non-complaint" into a void made from ignorance. Indeed, there would be no void, instead a pool of facts and figures. There would be potential for progress and hope of more.

This filtering of on-going experience into an on-going real life experiment with human metabolic function would have altered the expectation of patient engagement without little duress, for either.

But of course, the medical profession as a whole didn't want that. Many still don't. Though I can grasp that, I'm still struggling with the depth of their desire to martyr themselves at the alter of fat people's supposedly refusnik will. I cannot fathom what they hoped or hope to achieve from penning us into a place where we cannot move forward, only press repeat ad infinitum often going backwards. Nor do I get how they are able to behave as if this hasn't happened.

Though I guess that's a feature of the denial of reality. 

They'll take some challenge from their social peers though as long as it's tightly within the conventional frame of boning up on acceptable available research;
Often our patients were well-informed scientists, teachers or university lecturers. They did extensive research on the unusual ailment or the latest groundbreaking medication. As a trainee GP with little experience, it was often daunting to manage these intense patient-led encounters. Whether prescribing a statin for high cholesterol or referring for investigations, everything involved negotiation with the patient. It was immaterial that there were 10-15 minutes allocated to each encounter: the consultation finished when a plan was reached.
This for me doesn't really come close to what might have been. That's about social position, not the future of medicine. We could have been part of moving the research process forward of directing it to more fruitful and useful grounds.

What a bloody waste.