> I feel like I've seen and heard more of the opposite: The trend is to avoiding anything that might make someone feel blame for arriving in their situation.

> I've heard countless people explain to me that dieting doesn't work for them.

I think you're being a tad reductive – "dieting right now doesn't work for me for reasons I can't control" and "reducing calorie intake will help me reduce weight" aren't necessary contradictory, and don't imply "I'm going to attribute it all to biology/blame it on something general".

Anyway, let me assert the opposite: as a partner of a nutritionist who's talked (with anonymity) about her clients, the majority of the people she's worked with, who struggle with sustainably reducing calorie intake over the course of years, come to dieting with that logic, and _then_ struggle against specific barriers, and _then_ blame themselves. (A recent example: "because of my work schedule I don't get enough sleep, which leads to weight gain and time only for frozen food – on top of my predispositions".)

In that case, GLP-1 inhibitors as an intervention _complements_ the way her clients think about dieting.

> and _then_ blame themselves.

I was responding to a comment about Americans blaming others, not dieters blaming themselves.

The concept of "blame" isn't really helpful anyway. The problem I frequently see is that blame becomes something to be avoided, which turns into a game of externalizing the source of the problem, which makes people think the problem is out of their hands.

A similar pattern happens in addiction and addiction counseling, where well-meaning friends and family try to soften the blow by telling the person that the addiction was not their fault, it was the result of their circumstances or bad influences. Addiction counselors have to undo this thinking and find a way to gently get the person to take some ownership of their role in arriving at the problem, which is the first step to having some control over correcting it.

For nutrition, when people convince themselves that they have a hidden metabolic disadvantage that makes caloric restriction not work for them, they're more likely to give up than anything.

If anything it vindicates those people's beliefs. If you've seen the way someone can take Ozempic and survive on a few mouthfuls of food each day, while exercising 30 minutes each day, and become much less fat, but still be fat, then you'd understand. When your endocrine system is that dysfunctional, you need to exercise about 4 hours a day to look normal, and for most people that simply isn't a realistic lifestyle change, especially when every cell in your body is telling you that you must hibernate to survive. This is something that rightfully should be treated as medical issue.

Why is it that the people who hate fat people, are the ones most opposed to the treatment that will give them the choice to not be fat? If you hate the obese so much, then do you really want to live in a world where the majority of people are obese? It's like burning down a city to be king of the ashes. Some people can only feel superior if others are suffering for it.

> Even Eliezer Yudkowsky, a figurehead of the "rationalist" movement, has written about "metabolic disprivilege" and claimed that his genetics do not allow him to lose weight through dieting. This thinking runs deep.

I thought EY's point was different. Am I misremembering? I thought it was about not being able to do mental work productively when dieting enough to loose weight(maybe maintain a low weight too, though I do not remember that being mentioned explicitly).

It's a long story. His description of "dieting" was extreme calorie restriction. He was eating something like 800 calories per day (don't quote me on the exact number) and then was complaining that he didn't feel well when doing that (to the surprise of absolutely nobody).

Then it turned into a false dichotomy between the 800 calorie severe calorie restriction or no dieting at all. Then he just started declaring he'd delete any comments that suggested dieting.

I agree with you, but it's important to remember that "dieting down" is way harder for a lot of people. I am and always was skinny through my life. Whenever I need to eat less, I can do it without much effort. However, I have friends who would faint if they tried to diet down the way that I do. I don't know why that happens, but I've seen happening and it changed my perspective about this subject. If Ozempic can help with that, I will never criticize someone who uses it.

Genetics do factor. It's not just a question of genetics affecting metabolism. People literally don't feel hunger with the same intensity as one another. It's like sex drive. There are both very horny people and asexuals out there. There are also people who routinely forget to eat. For many people though, the notion of "forgetting to eat" seems completely alien, because those signals are much stronger for them.

It's clearly both. Someone with stronger motivation to stay healthy can survive in adverse conditions, but a society that pushes unhealthy lifestyle harder is going to catch more people out. It's obvious that Americans aren't just all individually lazier than the rest of the world. Their cities and food are unhealthy.

Primary source on Yud's weight-loss efforts: https://www.lesswrong.com/posts/udFuYqqNdpdo5ym3f/?commentId...