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diets cw, follow ozymandias271 for more sad gays, neurodivergence, polyamory, science side of tumblr, sex positivity
Game Changer: A Memoir of Disruptive Love: A memoir by Franklin Veaux, author of More than Two, about his marriage to an obligate monogamous person while being obligate poly. If you are like “wow, that seems like an incredibly horrible idea,” you are far more sensible than anyone in this book, who universally seem to be under the impression that this situation can be managed by coming up with a bunch of rules about Franklin’s dates with other people. (No “I love you”s! No sleeping in their bed! His wife for years gives him, a grown man, a curfew.) Naturally this entire situation is very painful for Franklin, his wife, and all of Franklin’s other partners. Somehow this relationship, which in any sensible world would have ended after the third date, managed to stay together for eighteen years. Eighteen years! That is definitely an impressive feat of endurance if nothing else.
Trauma Stewardship: An Everyday Guide To Caring for Self While Caring for Others: I really wanted to like this book. I think the concept of “trauma stewardship” is really interesting and important: the author reframes trauma exposure responses (the mental health consequences often faced by people who help others– whether people or animals– cope with highly traumatic situations) as trauma stewardship, the entire conversation about how we come to do the work, how we’re affected by it, and how we make sense of it. I think it’s a really interesting move to understand helpers’ relationship to trauma as stewardship, as taking a valuable thing which has been entrusted to us and which we have responsibility for but which ultimately does not belong to us. Unfortunately, I have a limited tolerance for woo, and after the sixth or seventh comment about the wisdom of Native Americans I checked out. So it did not really live up to its potential from my perspective.
The Myth of Sex Addiction: I really, really wanted to like this book. And to be fair some of its arguments are effective. Probably the most effective argument in the book is a case study of a college student and evangelical Christian who identified as a sex addict because he felt like he couldn’t control his masturbation no matter what he did and it was causing him serious distress. He masturbated twice a month. That, I think, is the best argument I’ve ever heard that some cases of sex addiction are best treated with sex positivity and destigmatization, not attempting to get the patient to reduce their masturbation to zero times a month.
I also find it plausible that the diagnosis of sex addiction is, as it were, gynecentric. That is, “sex addiction” doesn’t just pathologize unusual but harmless behavior such as BDSM; it pathologizes behavior that, for whatever cultural or biological reason, is far more common in men than in women (a desire for anonymous sex, enjoying sex outside of a relationship context, seeing sex workers, daily masturbation to pornography).
Unfortunately, The Myth of Sex Addiction itself has an addiction to gee-whiz clickbait-headline thirty-undergraduates-from-an-Intro-Psych-class this-is-never-going-to-replicate psychology studies. It tells us that these studies are Just How Men Are, because of Biology and Evolution, without ever doing any sort of cross-cultural analysis or acknowledging that its sample is WEIRD. It repeatedly cites the SurveyFail guy, who years later has still not managed to work out that women don’t jerk off to fade-to-black romance novels.
The Myth of Sex Addiction very confidently claims that women don’t have fetishes. I think this is a bizarrely confident claim to make after you’ve spent five pages mustering the evidence that women are less likely to masturbate and to approve of porn and non-PIV sex. Maybe they do have fetishes and they just have no idea? Also, the definition of fetish is actually androcentric. My research suggests that men don’t have fetishes, because while it is very common for women to dream of being ravished by a cowboy, almost no men dream of being ravished by a cowgirl. In fact, the entire genre of cowgirl-ravishment books appears to be aimed at lesbians.
As always when I read books about mental illness that don’t come from a social-model perspective, I think the social model would make this guy’s life so much easier. Yes, it is possible for the same mental trait to be an illness if it causes you distress or difficulty functioning, and a quirk if it doesn’t. The fact that I don’t experience any negative consequences from my hypersexuality doesn’t mean anything one way or the other about whether it’s a mental illness; it just means that my environment accommodates me.
Utopia for Realists: I am honestly pretty surprised by this book, because I didn’t expect anyone to be so slavish in following Silicon Valley political orthodoxy. Guaranteed basic income, shorter work weeks, randomistas in foreign aid, open borders… it honestly surprised me that there wasn’t a chapter on fixing the housing crisis by building more houses. Anyway, it was all pretty boring for me, because I live here and am already familiar with the arguments for and against a guaranteed basic income and open borders, but if you are curious what Your New Tech Overlords think about things there are really far worse books you can read.
The Joy of Gay Sex: A evocation of gay male life circa 2009 cleverly disguised as a sex advice book. The sex advice itself is mostly not very interesting, assuming you have some idea of the mechanics of anal sex. The little essays about HIV, chosen families, monogamy, and all the other details of gay life build up a rich tapestry that really helps you intuitively understand what it’s like to be a (certain kind of) gay man. The sections on the Internet were particularly interesting to me, because they were written pre-Grindr; the gay Internet as described in the book is both recognizable and distinctly less convenient than the present Internet. My one complaint is the underrepresentation of the gay and bisexual men of my acquaintance (where are the furries? where are the anime nerds?) but I suppose that they don’t really hang out at gay bars so perhaps the author never had a chance to meet them.
Crazy Like Us: The Globalization of the American Psyche: I am leery of giving a positive review of this book, because it is written by a journalist, and it is very possible the author is misunderstanding all the research because he doesn’t have a background in the field. Perhaps Scott Alexander or Sarah Constantin or someone could fact-check it for me.
Until it is fact-checked by someone I trust on psychiatry, my tentative opinion is that this book is very plausible. Essentially, the thesis is that certain things (trauma, mental distress, psychosis) are universal, but we tend to express symptoms of those things depending on what’s floating in the cultural “symptom pool.” A psychotic person who grows up in America will think the CIA is mind-controlling them; a psychotic person who grows up in a developing country will think demons are talking to them. A person in severe emotional distress in the United States may be anorexic or self-harm; a person in severe emotional distress in Indonesia may commit a mass assault. (Caveats: it does occasionally happen that people pick up symptoms that aren’t usual for their culture; anorexia is probably not caused by the “thin ideal”, and in fact one of the strongest pieces of evidence for anorexia as a culture-bound syndrome is the existence of societies with a thin ideal and very very low rate of anorexia.) When a syndrome only exists in another culture, it is called a “culture-bound syndrome.” When a syndrome only exists in the Anglosphere, it is called “how people work.” Because the DSM is seen as authoritative, we export our local symptom pool around the world.
I am personally interested in the prospect of cultivating the symptom pool to reduce distress in mentally ill people. Through careful messaging, could we remove harmful symptoms like anorexia, somatization which results in chronic pain, and running amok and replace them with less harmful expressions of distress like snapping a rubber band against your wrist or cutting off your hair? I imagine how much future schizophrenics could be helped by a hundred million dollars directed towards PSAs about people who have a positive relationship with their voices and representation of people with nice voices in popular culture. Sadly, the book does not explore this concept.
The last chapter was annoying. While it established that pharmaceutical companies increased the rate of antidepressant prescription in Japan by raising awareness of depression, it did not provide any evidence that this actually increased the rate of emotional distress in Japan. Would one assume from the Viagra marketing campaign that before Viagra no one had ever had erectile dysfunction?
Evolution’s Rainbow: Diversity, Gender, and Sexuality in Nature and People: I agree with the main thesis of this book: I think that sexism, homophobia, and other oppression-related cognitive biases affect how we interpret biological data and lead to inaccurate conclusions. I appreciated Joan Roughgarden pointing out that commonly used terms like “female mimic” and “cuckoldry” can lead scientists to assume one explanation has to be true (that the animal is pretending to be female, that the female is passing off offspring from an extra-pair copulation as the male’s) when they haven’t collected the data to justify the assumption.
Some of her criticisms seem quite valid to me. For example, it does seem implausible that if humans can tell apart with the naked eye females and female mimic males of a species with sharp eyesight, then the male (who has an evolutionary reason to be good at telling these things apart) does not. Perhaps the female mimic male assists the male somehow: helping him defend his territory or allowing him to signal that he won’t attack the female. It also seems implausible that male seabirds never notice extra-pair copulations occurring in public, and thus we should look for alternate explanations in which the female having extra-pair copulations improves the male’s reproductive success somehow. Maybe extra-pair copulations reduce the risk of another male committing infanticide if the female’s partner dies.
However, I think Roughgarden has a bad habit of presenting her interpretations as settled science, when in reality they’re just interpretations. We would have to do a lot more detailed ecological work to decide whether her conclusions are accurate. And every time she says “this interpretation has an unfortunate oppressive implication” as an argument against a particular interpretation of the data, I want to cringe. That is not what science is supposed to do. You can’t decide the truth by saying what’s most convenient to your ideology.
Roughgarden writes mostly about the potential adaptive benefits of genetic diversity in humans, which makes me really curious about her opinions about the adaptive benefits of neurodiversity in humans. I agree with her hypothesis that many genetic impairments would not be as common as they are if the genes didn’t pose some fitness benefit, the way that people who are heterozygous for sickle-cell anemia genes are protected against malaria. However, she once again fails to consider alternate hypotheses. Many genetic impairments, for example, are very common in Ashkenazi Jews, who have a relatively small effective population size and thus are particularly susceptible to genetic drift. There is no reason to suppose that those impairments have an adaptive benefit.
[this review talks about rape]
Unscrewed: Women, Sex, Power, and How to Stop Letting the System Screw Us All: Probably my least favorite of Jaclyn Friedman’s books so far. I mean, anticapitalism aside, she’s right about everything. Reproductive justice does need to include not just the right to contraception and abortion but the right to start a family, have adequate perinatal care, and not be shackled to the bed while giving birth. Sex work stigma does harm women who aren’t sex workers and combating it is a vital part of sex-positive activism. The de facto legalization of rape of Native American women on reservations is horrifying. While level of vaginal arousal is completely uncorrelated with level of self-reported arousal, reporting this as “women don’t know what they want, are all secretly bisexuals who like fucking bonobos” both is sexist and misrepresents the science. While there are personal decisions that affect sex-negative cisheteropatriarcy, like volunteering for a rape crisis center or choosing not to be an asshole to people whose sex lives you disapprove of, whether or not you flash their boobs and say “wooooo!” is not one of them, either on a “this is empowering!” or a “this is objectifying!” level.
I continue to highly recommend Yes Means Yes, and maybe if any of those statements is surprising to you consider checking out Unscrewed.
I was very annoyed at the chapter on masculinity. Jaclyn Friedman is, in fact, a decent person who comes to the correct conclusion that male gender norms both hurt men and cause men to hurt others and that both aspects should be recognized. But goddamn does she feel like she needs to signal that she is still a Woke Feminist who engages in Fashionable Misandry. Is it really necessary to make fun of men who internalize oppositionally sexist norms to the point that they can’t buy female-branded products? Do you have to put in that paragraph about how the harm male gender roles cause to women ought to be enough to get men to be feminists, but okay if we have to we can talk about the harm it causes to men? Notably, Friedman does not do that in the chapter on how sex work stigma hurts non-sex-workers, which I can’t help but figure is related to the fact that Friedman is a woman and is not a sex worker.
[the next book is about dieting]
Health at Every Size: The Surprising Truth About Your Weight: I realize that no one knows why weight set points are going up, but I wish there had been more discussion of various hypotheses. Instead, the author basically goes with “dieting causes weight set points to rise!”, which is one plausible hypothesis but also seems really convenient for the book about how you should stop dieting.
The advice for practicing Health at Every Size is as follows:
- Stop hating yourself and your body. Find supportive people who won’t talk about how you need to lose weight. Practice reframing your negative thoughts about your body, food, and exercise.
- Eat delicious food. Pay attention when you eat. Eat when hungry; stop when full. If you find yourself eating to manage an emotion, use a different self-care technique while practicing self-compassion (it is perfectly natural to use food to manage your emotions if you don’t have another way to do so).
- Integrate movement into your daily life. Eat a variety of food, mostly plants, almost all unprocessed food, 100% food you enjoy. Get enough sleep. Manage your stress.
- If you have a hard time with the food advice in #3: learn to cook, check out community-supported agriculture programs, eat in a peaceful and loving environment, slow down, and pay attention to presentation.
Thing of Things 
When I end up dreaming of being ravished by a cowgirl I’m going to blame you, Ozy.
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Your story of the man who thought he had sex addiction because he was masturbating twice a month reminds me of reading about a woman who thought she had food addiction/bingeing and went to OA– she found that taking seconds sometimes wasn’t an eating disorder.
In re fat acceptance: you might be interested in Taking Up Space, which recommends strength training in addition to the usual advice about fat acceptance.
What are the societies with a thin idea but little or no anorexia? This is interesting because it wouldn’t surprise me if the amount of shaming/blaming for not being idea matters at least as much as what the ideals are.
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The case study in the book was Korea, which shamed people for not being thin but had very low rates of anorexia until there was a high-profile case of a woman dying from anorexia.
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A possibility is that it’s not so much culture, but Western technology that reduces how many calories people burn and/or Western food causing people to ingest more calories. It’s probably much easier to stay thin if you have to walk/cycle places, have to wash clothes by hand, don’t have a TV/PC/smartphone to sit in front off, etc. Furthermore, Western levels of meat consumption and Western junk food may cause over-consumption of calories compared to a diet of kimchi and such.
The obesity rates seem to have increased dramatically in Asia and it seems logical to assume that increased body weight drives people to adopt eating disorders as a solution. I don’t consider it credible that (only) dieting causes people to become overweight, because the correlation doesn’t seem to exist. For example, white girls are more likely to diet, but black women are obese more often.
I also don’t really find it plausible that it requires exposure to Western culture for people to figure out the possibility and/or methods of eating disorders.
PS. Chinese levels of eating disorders seem to rival Western levels by now.
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The premise of the book is that we’re exporting Western medical science and, by extension, Western culture-bound syndromes. That is perfectly compatible with a successful export of anorexia to China; indeed, the case study in the book is about a successful export of anorexia to Korea.
Americans are fully capable of having conversion disorder, and yet we generally don’t. Koreans before the export of anorexia were fully capable of being anorexic, and yet they generally didn’t. It’s not that people can’t think of expressions of mental disorders that aren’t in their symptom pool; it’s that in general the symptom pool shapes how people express distress.
My understanding is that experts in the field believe that dieting and the thin ideal do not cause eating disorders, and that these are mostly equated for political reasons.
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(WordPress confuses me, there’s no reply button under Aapje’s response to the same comment I’m responding to)
I read Crazy Like Us five or six years ago when I was a teenager growing up in Korea, and the writer’s account of how anorexia got exported to East Asia seemed plausible, and none of the factual stuff seemed obviously wrong. I grew up an environment where people have phones, TVs, and lifestyles were if anything more sedentary for young people, especially girls – workout culture wasn’t a thing. (I was really surprised when I came to the US for college and saw how prevalent ‘hiking’ and ‘going to the gym’ was among young people.) And yet (1) most of my classmates were thinner than the average American on my (pretty fit!) college campus, (2) I never encountered anyone with anorexia, or even mention of it, while growing up.
It’s not tech, it’s probably not exercise-related-lifestyle. It might be food (lower protein and fat, higher carb, more vegetables), it might be genetics, it might be other culture stuff, I don’t know what’s up. But your hypothesis about Western tech and the ensuing lifestyle changes being responsible is almost certainly wrong.
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I believe that dieting has contributed to obesity, but it isn’t the only cause.
It doesn’t seem to be uncommon for people to regain all the weight lost on a diet plus 25 pounds, and some people go through the cycle three or four times.
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@ozymandias
My belief is that culture can cause people to have issues and can make people deal with their issues in a certain way, but that these are generally separate.
As you said, (some of) Asia already had a thin ideal for women, so that didn’t get exported to them. It seems logical to assume that a desire for methods to stay/become thin requires both a thin ideal and women having trouble staying thin.
If Asian women already had trouble staying thin and simply were not aware of eating disorders as a potential solution or those disorders were not seen as a legitimate ‘solution’ before, we would have expected them to have used other methods before switching over to eating disorders (similar to how horny women who didn’t have enough sex switched from ‘hysteria’ aka having doctors stimulate them, to using ‘neck massagers’). I see no evidence of eating disorders having displaced other methods.
Furthermore, if Asian women in the past had trouble staying thin, we’d expect quite a few women to fail. Yet the evidence shows Asians getting much more overweight in recent years. Key evidence is that this is also true for Asian men, who don’t have so much of a thin ideal.
My explanation explains two major changes that happened at the same time (increased obesity and increased eating disorders), which IMO makes it more plausible than assuming two separate mechanisms that happened at the exact same time.
@etirabys
Genetics seems extremely implausible, given the rapid increase in obesity in China. They didn’t suddenly get non-Asian genes.
Food tastiness & ubiquity may be the main reason.
@nancylebovitz
We have strong evidence that dieting doesn’t work very well to make people lose weight, but that isn’t evidence that it is is a major contributor to people getting overweight.
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Aapje, All I’ve got is anecdotes about weight gain from dieting.
I did a little casual research about whether there are population studies about what people do to lose weight and what the results have been, and couldn’t find anything.
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I assume that the evangelical student was not married and masturbating twice a month was the only sex he had. If so, I’d think that many people would see that as evidence of a low libido, if anything.
I respect the honesty, actually. Many others also seem to only present explanations are consistent with their dogma. Sometimes the data even completely contradicts the interpretation. I almost never see people admit to it (presumably most don’t realize they are doing it).
Of course, it’s still bad science, but bad science with a warning label is better than bad science without one.
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I had never ever heard of PTSD, tirggers, flashbacks, or anything even remotely related to emotional trauma before experiencing the textbook example thereof – which I didn’t recognize as such, because again, my knowledge was insufficient to even recognize this as pathology rather than “huh, this is an odd feeling”.
I’m not sure if it’s the case? Russia definitely uses section F of ICD with some local additions, and doesn’t care about DSM.
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Does Healthy At Any Size explain why you should eat delicious food, contra The Hungry Brain which says you should eat bland food?
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The claim of Healthy At Every Size is that if you eat food you like, you are satisfied and content and can stop when you feel full, whereas if you eat food you don’t like you will often end up eating more on a quest for satisfaction.
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Perhaps both methods work, but for different people. If something is very tasty, I certainly have a craving to eat even if I’m already full.
For some people, neither method may work, as well. For some, easy availability may be the issue. There is a company that sells time locks which markets then explicitly as being useful to lock up a cabinet, pantry or fridge.
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In my experience, when eating delicious food when feeling hungry and paying attention, the first bite is GLORIOUS. The second bite is pretty damn good. The third bite is good. The fourth is OK, and so on. It’s a diminishing returns thing, which definitely invites me to stop eating when I’m no longer hungry – because why keep eating if you no longer need to when the taste has gone out of it?
The ‘paying attention’ thing is key, though. Food is never delicious unless I’m paying attention, but it can be ‘good’, ‘palatable’ or even just ‘moreish’ (especially low-quality food like potato chips or boring chocolate) and invite you to keep eating. If paying attention isn’t easy for you, or just too much work, then perhaps precommitting to eating only bland foods is the way to go. If I eat potato chips or boring chocolate when paying attention, I find they’re not even good. When I’m distracted, multitasking or bored though, it’s way too easy to eat a lot of them without even noticing.
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Some thoughts on HAES and science…
First, that famous claim that “95% of diets fail” was based on a badly-designed study:
If I recall correctly, the patients were provided with a very small amount of education and left to their own devices. And of course, these were not randomly selected patients, but ones who likely had worse weight problems then average.
The reality is more complex. The National Weight Control Registry tracks people who have lost substantial amounts of weight and kept it off for many years. In general, long-term weight maintenance seems to require permanent lifestyle changes—many of the people in the NWCR are fairly dedicated walkers, for example. A “diet” is not a one-time thing. It’s a permanent, life-long commitment to new behaviors. Obviously, this is a non-trivial problem! Even if we know how to control weight, we need to ask what percentage of the population will comply with long-term lifestyle changes!
“Metabolic damage” is probably exaggerated. I knew a professional bodybuilding coach with an MD, who has worked with dozens of bodybuilders (male and female). These are people who have done years worth of bulk and cut cycles, and who force their bodies to unnaturally low body-fat levels. So if anybody would show “metabolic damage”, it would probably be these people. And it should be possible to measure any effect, because the people in question use food scales and track their intake! But according to the coach in question, he’s rarely seen an athlete whose TDEE is more than 200 calories on the low side. And research backs this up: Individual variation in TDEEs is apparently about ±200 calories. Yes, substantial weight loss will depress TDEE for a while. I believe that current studies suggest that the mechanism may be a reduction in non-exercise activity thermogenesis (NEAT), that is, you fidget less. But there’s also evidence that people’s TDEEs will normalize after a year or so of weight maintenance.
But it’s really hard to be sure of any of this, because nutrition is full of garbage science.
So, let’s put the research aside for a minute and talk about QALYs. I’ve lost about 30% of my bodyweight and kept it off for years, with a 5lb regain. My goal here was to improve my expected QALYs. And according to actuarial tables, I’ve added an expected 7 years to my life. It’s harder to calculate the increase in QALYs, but I guess I’ve added more than 7. But this comes at a price: I need to track what I eat, and I’ve committed to doing so for the rest of my life. It also seems to help if I remain in shape. So in total, calorie counting requires about 10 minutes a day, and the gym requires about 4 hours a week. On the other hand, managing my weight appears to be a lot easier than managing diabetes, which is my most likely alternative.
But it’s important to remember that anorexia has a catastrophic effect on QALYs. And on a lesser scale, a lifetime of misery and guilt about food also reduces quality of life, particularly if the weight loss isn’t going to be maintained anyway.
So for those people who can maintain a long-term lifestyle intervention without being miserable or risking anorexia, it’s probably a net gain in QALYs. And in theory, it’s a solved problem—just ask your local natty bodybuilder how they remain strong and lean, and only do 20% of what they do, because you don’t need to have giant biceps and <10% body fat. But it demands a degree of compliance that won't scale to general population.
So why has the general population gained so much weight in the last 50 years, and can it be fixed? Personally, as a calorie counter, I lean towards the theory that modern food is a hyper-stimulus. My "evidence" for this is when I count calories, I'm constantly saying no to delicious processed foods that are unfilling and high in calories. This effect goes away, however, if I look at whole, unprocessed foods. I'm not sure there's any fix, other than "destroy global capitalism", which has undesirable side effects! So personally, I've decided to settle for another strategy, which is: "When asked, try to correct common myths about weight loss and to be accurate about the costs and benefits."
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It’s conceivable that the people who have trouble with the weight gain and loss pattern for body-building drop out of the hobby, or at least the more extreme forms, but I’m just guessing.
Thank you very much for bringing up the QWALY cost of eating disorders.
I don’t think I’ve seen anything about derailing an eating disorder when it’s just getting started.
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(Avatar changed because I used the wrong account before. CN: Discussion of eating disorders and weight management. Epistemic status: Mostly personal experience.)
Anorexia nervosa has a mortality rate between 5% and 20%, according to various unreliable sources. And young people can be at very high risk, so you’re not just talking about people dying at 65 instead of 72, or something like that. So anorexia is going to cost a big pile of QALYs, just in raw life expectancy, even before we count quality of life.
Whereas somebody who dropped from, say, BMI 35 to BMI 25 and maintained that weight permanently might only gain 5 more years of life. That’s not bad! But it suggests that it’s probably a lot better to carry an extra 50 pounds than to risk an anorexia relapse.
For me personally, weight maintenance feels a lot like managing a minor medical condition, or like managing household expenses. I need to live within a “calorie budget.” I can splurge on an enormous slice of buffalo chicken pizza for dinner, but it still has to fit into a plan. In some ways, it’s not bad: my personal budget isn’t too restrictive. And managing my “food budget” appears to be a lot easier than managing insulin levels. And after all, I do get to enjoy my yummy treats, just not all of them in the same week.
But, I have two important caveats (besides the aforementioned “anorexia relapses have a huge negative effect on QALYs”):
The idea of “living within a food budget” may not be equally easy for everybody. In my case, going to the gym actually helps—if I stop going for a month, I eventually get a lot hungrier. I don’t know if I could actually maintain my weight at my “non-gym” hunger levels.
Even the easier form of “food budgeting” that I do may require a level of long-term compliance that’s unrealistic for many people.
So I guess I try to be realistic. More people could manage their weight and muscle mass. And for some people, this is absolutely an empowering message. But it’s one of those things that’s “simple but not easy,” and there are tradeoffs. And some people might very rationally choose a different set of tradeoffs. So we probably need spaces which say, “Don’t let food make you miserable, it’s not worth it,” and other spaces which say, “You can be lean and strong and athletic if you want!”
And as for the prevalence of anorexia in the US, sometimes I wonder if there isn’t some link between anorexia and the popularity of do-it-yourself very low calorie diets? There are reasons to suspect that slow starvation is a trigger for all sorts of mental issues. (Google “Minnesota Starvation Experiment”, for example.) And so a culture which maintained low weights naturally—because their food environment was full of nutritious and filling foods—might have very few problems with anorexia. But a different culture, one where young girls were encouraged to crash diet, might trigger various issues in the brain. But this is just a hypothesis.
Since nutrition and exercise science are much less rigorous than experimental psychology, and since experimental psychology is currently undergoing a massive replication crisis, I’m not expecting to get trustworthy answers for any of this.
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You may have already figured this into your eating disorder loss of QWALYs, but anorexia doesn’t just cause misery and death when it’s active– people can cause themselves permanent physical damage which persists even if they get back to eating normally.
Weird notion: traditional adulthood ordeals have been evolved to cause few deaths and not much physical damage. If anorexia and bulimia are DIY attempts to prove oneself tough enough, then part of the problem is that there’s no tradition.
It might be better to carry an extra 50 pounds than to risk getting anorexia at all.
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CN: More discussion of anorexia, weight management and exercise.
Yeah, it’s important to constantly underline that fact that anorexia is horrible. If somebody finds that they’re having miserable and obsessive thoughts about food, then I would strongly recommend consulting a professional immediately, and certainly before losing any more weight.
I think we could probably estimate the QALY cost of anorexia, and I have every reason to believe the numbers would be horrible, possibly in the same general range as “jumping off of cliffs wearing a wingsuit.”
But if we really want to be accurate, we should also weigh several other numbers: (1) the fact that anorexia affects roughly 0.3% of young, white females in the US, (2) the prevalence and QALY costs of metabolic syndrome and Type II diabetes (which can also get pretty high), and (3) the portion of the population that will actually benefit from weight management, and at what cost in happiness.
And the answer to those questions may vary a lot from one person to another. For example, I personally only need to live within a realistic “food budget” that still allows me indulgences. Most of the time, this no harder for me than, say, living within a reasonable monetary budget. But for maybe 2 weeks out of a typical year (so far), I have pretty miserable feelings about food, typically when I’m lifting hard during a cut and I need to figure out how to fix my macros. In exchange, I get to be strong, I love what my body can do, my body feels “right”, etc. The benefits are worth the cost to me, personally.
But I could easily believe that somebody else might see the biggest happiness gains from saying, “Screw it, I’m happy with my weight, I’m going to enjoy food.” Or, “Every time I try to lose weight, my brain starts acting strange, and anorexia is not worth the risk.”
There are also some areas where I probably agree with HAES (based on personal experience, not science): A moderate amount of exercise has wonderful health benefits even without weight loss. The diet industry is an abomination, and teenagers should not be designing DIY weight-loss plans. Thinspo is absolutely horrifying, and plenty of fitspo encourages unhealthy exercise habits. Most young women would probably be happier trying to lift bigger weights (or doing bodyweight exercises!) than worrying about getting a “thigh gap.” And spending 5+ hours a week on cardio is a surprisingly inefficient weight loss plan.
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Why the heck would you get married to someone who is expecting fidelity when you know you are not cut out to be a one-person spouse? Why would you do that and expect it to work out? See, this is the kind of thing that has my aromantic self going “Love is insanity” because in no other instance would anyone ever think this was a good idea. “Hey, I know – I’ll empty out my bank account the day before the rent is due and give every last penny to that person emigrating to New Guinea – I’m sure my landlord will understand!” No, you would not consider it.
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I think the answer is “when the relationship started there was less awareness of polyamory and he thought the best he could get was someone who would tolerate his polyamory.”
I remain puzzled why a monogamous person would marry a poly person and why he didn’t end his relationship immediately upon realizing his mistake.
(Eighteen years!)
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Yeah, whatever about a poly person thinking “this is the best I can get given the situation and the times”, I have never understood the monogamous person going into this.
Maybe they have a rose-tinted view of the matter (e.g. “It doesn’t matter because it’s only sex with these others, he loves only me!”) or they think they can handle it better than they end up doing or they don’t quite get the idea that if their spouse finds someone they consider suitable to be a partner, they will pursue that (and not squash the impulse out of loyalty to their spouse).
Maybe they treat it as the traditional “marriage is one thing, but it’s acceptable to have discreet affairs and keep a mistress on the side, as long as it’s all discreet and handled in the appropriate way” method.
The most extreme example of this I can think of is the late Tory politician Alan Clarke, who I don’t think ever considered poly relationships as such but was infamous for having a string of affairs (possibly the most notorious when he was sleeping with a woman and both her daughters at the same time, or at least in rapid succession, whom he charmingly referred to as “the coven”), and his wife Jane who knew about these and seemed to accept them.
But her acceptance seems to have been based on (a) ‘my husband can’t help himself’ and (b) excoriating scorn for the women with whom he had affairs, and that does not seem to be a healthy state of affairs.
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Seems to me that your intolerance for woo is a little misplaced there. Social instincts semi-involuntarily taking on the trauma from others is a problem that cultures of all stripes have probably dealt with since well before we were even homo sapiens. If the traditional received wisdom of nomadic hunter-gatherer groups* is gonna be good for anything, it’ll be good for “managing networks of intimate relationships and restoring traumatized members of those networks into full functionality.”
* it is not at all true that Native Americans were predominantly hunter-gatherers, small-scale horticulture agriculture was really the most common, but for various reasons when people talk about “~Native American wisdom~” they’re often talking about the groups that were
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To be clear, if I had any faith that the author was actually reporting the behavior of nomadic hunter gatherer groups, I would be interested and listen, but I don’t actually trust white people to do this, especially when they talk about Native Americans as if they are a single group.
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Yeah that’s fair
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