yup many times, sock puppets exist in abundance on dedicated instances or derelict instances. We have gone through many rounds of spam/vote manipulation cleaning at the admin level. This can be done through pinging the admins incase they missed it, or defederating from instances that are not behaving well.

The reason it doesn't seem so bad now is due to the attention the admins are paying to the blatant methods. (i.e. 300 votes from a instance in a minute from randomized user names)

Think of the most basic spam:

Advertising something, then give it a bunch of upvotes.

Ohh weird manifestation of a monopoly

Freetube does this really well

What is the minimum intervention required to give people a healthier life:

• cut fructose
• cut sugar
• cut industrial oil
• cut processed food

Take your pick, all improve lives. Nobody is trying for perfection, just better

it can be truly stressful when discussing this from my position both online and in real life. Hearing that I am “killing myself” or that I am “killing people” is really hurtful.

Yeah, people are typically not open to having real discussions, especially online. Hyperbole and attacks are common. It's just the nature of human discourse, anything different is met with much contempt.

he latter still focusing on general healthly living without attempts to point it to size and proper active debunking and corrections since without doing so it would increase stigma even more (where in schools can very easily lead to bullying, and it already happens for the same reason).

96% of westerners do not have optimal metabolic health. That includes all the Thin on the Outside Fat on the Inside (TOFI) people. It's a massive problem, obese people are just the easy ones to see. Thin people get heart attacks too! Metabolic health is at a all time low! This is a problem for everyone not just the obese.

want more widespread knowledge on what to do to have an healthy life

I tried to spread this knowledge, but I was met with some resistance :)

medical assistance due to the very heavy focus on weight as a metric for health

The core problem is that most doctors do not get nutritional training, so they are stuck in the CICO / Eat Less - Move More world, because thats all they have heard.

I feel comfortable in my own skin, and I want to live my life in the body I like while doing what I can to mitigate the known risks.

Great, I'm glad you found happiness!

I want to reconcile and want to have a proper discussion without anyone being attacked.

Great, let's start there.

Going to the topic of this post - I do agree Eat Less - Move More - isn't helpful. Though my rational (as I outlined in another comment here) isn't the same as the articles.

I fear the article is getting stuck in overwhelming "associations" with obesity, and "associations" with weight-loss. Part of the problem with the existing messaging, advice, and obesity programs is this type of "associative" advice can bit a bit confusing because associations don't speak the mechanistic cause.

Things I have seen documented as being directly causal to obesity in the literature

• elevated insulin
• elevated industrial oil consumption
• adrenal tumors
• chronic stress

The last two are interesting in that they basically are a sneaky way to have persistently elevated insulin.

What would you like to see as a better form of obesity care?

I'm a fan of the multi-touch telehealth models as demonstrated by virta health and others. Consultation with doctor for medicine, nutritional plan, daily bio-feedback, coaching sessions, social community for peer pressure and approval. Perhaps one person can just read a book and fix their problem, or another person just needs to see bio-feedback data, having the holistic approach can meet people at many levels encouraging success, and forgiving mistakes.

Obesity-associated improvements in metabolic profile through expansion of adipose tissue

Hypertrophic vs hyperplasic genetic phenotypes result results in better insulin sensitivity into obesity. This paper does not say obesity isn't harmful to health, just that in one dimension hyperplasic people have a better outcome and higher levels of obesity

It's Not How Fat You Are, It's What You Do with It That Counts

If someone was morbidly obese but was insulin sensitive, i.e. no visceral fat, yes they wouldn't be exposed to most of the co-morbidities - just the structural problems (joints, knees, arthritis), and hormonal dysregulation (via adipose aromatase interactions). This paper even speaks to this itself.

The Benefits of Physical Activity for People with Obesity, Independent of Weight Loss: A Systematic Review

This is a non-sequitur and while physical activity is beneficial for obesity people it doesn't remove the morbid dangers.

None of the papers speak to a safe way to be obese, just that it can be mitigated in some circumstances. If someone is obese and metabolically healthy, by virtue of their better hormonal situation their hunger regulation and satisfaction will work well and they will trend down to their homeostatic healthy weight (and no longer be obese).

I'm firmly in the camp of fat acceptance, we have to meet people where they are, but we should also educate and encourage our rotund friends to be the best version of themselves. Acceptance, Encouragement, Demonstration, Enablement, Success.

On a personal note - thank you for making your vote manipulation accounts the same name - the fact your double voting your own posts and downvoting others isn't a good look.

Did I miss something in the article? Some underlying unifying thesis? I'm looking at it again, and its not saying much specific.

Framing it as a personal failure not only ignores decades of evidence – it actively harms the very people who need support.

I thought I was agreeing with this.

pushing your preexisting agenda.

Yeah, when I know the solution to obesity and addiction, and I see people suffering from those exact things, I'm going to my best to ensure people are informed of their options and the underlying mechanisms. My life would have been very different if I had know this at a younger age.

The conversation should not be about eat less move more, it should be about the [Paper] The Carbohydrate-Insulin Model of Obesity - Beyond “Calories In, Calories Out” - 2018

TLDR: Carbohydrates drive insulin, insulin drives obesity. This is far more clinically relevant to obese patients then the current form of CICO shaming (if the current advice doesn't work for you, its a moral failing on your part)

Carbohydrates/sugars are very addictive, breaking the habits does take a holistic approach, but education is a good first step.

We now understand that obesity is multifactorial. Genetics, childhood experiences, cultural norms, economic disadvantage, psychological health, mental illness and even the kind of job you have all play a role.

These are associations not causation, it's being kind of used as a excuse for why nobody has done anything yet.

This “obesogenic environment” refers to the world we live in. Its one where high-calorie, low-nutrient foods are cheap and everywhere, and where physical activity has been engineered out of everyday life, from car-centric cities to screen-dominated leisure time.

Not a mention of carbohydrates?

higher rates of obesity and deprivation

Overfed and undernourished - This is a problem with processed foods to be sure, but people are eating to satisfy their carbohydrate addictions and not whole food nutritional needs.

normal human things like consuming things in excess.

Excess and normal are contradicting each other in this sentence.

Yes cellular metabolism can use glucose, but that glucose in humans does not need to be eaten in the form of carbohydrates, the body is perfectly able to make its own glucose via gluconeogenesis

Fats need to be balanced.

What does this mean?

Vitamin C is also lacking in an all meat diet devoid of organ meats.

Vitamin C is in meat in small amounts, but if one is eating only meat then there is not glut4 competition and that vitamin c is very effective.

Addictions are real things in both my experience and reading - can you explain how they are not real?

Carbohydrates are not necessary for human nutrition, so there is no such thing as a carbohydrate imbalance.

Eating saturated fat does not become bad at any level of consumption.

Meat has everything we need in it, its the perfect food.