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Links of Interest for March 26, 2023: Should we think of obesity as a disease?

An overweight woman exercises on either an elliptical machine or an assault bike, and looks miserable while doing it. Her trainer tries to be encouraging.

Exercise because it makes you feel good, improves your cardio health, and lowers your risk of diabetes. It won't help you lose much weight. Photo by Andres Ayrton from Pexels.

I've always been overweight. Age, marriage, and a decade of weight lifting have tipped me into obesity. I don't care enough about being thin to do much about trying to get there. My weight also hasn't presented any health challenges that didn't also exist when I was 50 pounds lighter. I might even be healthier at this weight because now I exercise.

Now that I think about it, my opening paragraph reflects something about how we discuss weight gain and weight loss. We blame ourselves and our lack of self-control — or other people for their lack of self control. We discuss weight gain and weight loss in moral terms. It's about our failure or ability to show restraint at the buffet or the bar.

There's some emerging research that suggests fat behaves more like an organ. It creates hormones that can be controlled by a new class of pharmaceutical products. Miraculously, these drugs seem to work without the nasty side effects of previous weight-loss drugs such as Belviq and the disastrous 1990s combo of Fen/Phen.

The drugs — Ozempic, Wegovy, and Mounjaro — are designed, approved, and intended for use by diabetics, pre-diabetics, and those with high A1C levels. People who take them also tend to lose weight. As a result, these drugs are being prescribed for off-label usage as a weight loss drug to people who are neither diabetic, pre-diabetic, nor, in some cases, overweight or obese.

Their popularity as weight loss drugs are leading to shortages for people who need them for health. Their popularity also asks us to consider the morality and fairness of weight gain and easy weight loss. Below are some of the best reads, watches, and listens I've encountered on the subject.

Mounjaro and Me
Samhita Mukhopadhyay, part of my legendary 2007 South by Southwest crew, writes this beautiful essay about what it means to lose weight with pharmaceutical assistance after finally learning to accept her curvy body. (New York Magazine/The Cut)
Life After Food
A look at the popularity of GLP-1 mimicking drugs among the fashion and entertainment crowds where being thin is part of the job description. If anyone can become thinner with weekly injections, are we still embracing body positivity? (New York Magazine/The Cut)
Will the Ozempic Era Change How We Think About Being Fat and Being Thin?
A piece from The New Yorker (which is a different magazine than New York), asks a similar question: Are semaglutide and tirzepatides shifting how we think about obesity, or reinforcing our cultural preference for thinness, and what does that mean for people with fat bodies?
The Truth About Fat
The PBS series, Nova looks at current research about obesity, its treatments, and the relationship between physical activity, weight, and health. Note that you can also watch it for free on Amazon Prime.
Examining energy and evolution with Herman Pontzer
Pontzer was featured in the above-linked Nova episode. This episode of Chris Hayes’ Why Is This Happening? podcast takes a deeper dive into Pontzer’s research and what it teaches us about the relationship between caloric intake, caloric output, and weight.
The Trouble With Calories
Aubrey Gordon and Michael Hobbes host Maintenance Phase, a podcast devoted to debunking myths about diets, weight loss, obesity and wellness. In this episode, the pair discuss the history of the calorie as a unit, and upend the calories in, calories out canard.
Is Being Fat Bad For You?
In this episode, also of Maintenance Phase, Gordon and Hobbes review the literature in an attempt to answer a question about whether being fat is truly bad for you.