The Fat Doctor Podcast

World Ob*sity Day: Selling Solutions to Problems We Invented

• Dr Asher Larmie • Season 5 • Episode 9

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CW for the o-word 

In this rather passionate episode of The Fat Doctor Podcast, I take on World Obsity Day and use this farce to challenge the very foundation of weight-centric healthcare. We take a look at how organizations like the World Obsity Federation medicalize and pathologize fatness while claiming to fight weight stigma, exposing the contradictions and financial interests behind these narratives. 

Key moments:

  • Why ob*sity is not a disease but a descriptor (fat) that has been unnecessarily and intentionally medicalized
  • How weight stigma and weight cycling, as opposed to fatness itself, contributes to negative health outcomes
  • A critical analysis of the UK medical guidelines for fatty liver disease that recommend weight loss despite zero supporting evidence
  • Research showing that preoperative weight loss before joint replacement surgery provides no benefits, yet is still routinely required

My revolutionary approach to medicine: simply not mentioning patients' weight and instead focusing on providing evidence-based care. Find out more at noweigh.org. 

Want to learn more about Fatty Liver Disease or Osteoarthritis, then check out my free resources. 

For a deep dive, you’ll find both masterclasses in the masterclass membership. 

Make sure you’re subscribed to my mailing list for daily moments of awesomeness delivered straight to your innbox. 

The journal article I referenced is: Laperche, Jacob et al. “Obesity and total joint arthroplasty: Does weight loss in the preoperative period improve perioperative outcomes?.” Arthroplasty (London, England) vol. 4,1 47. 4 Nov. 2022 

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It is Wednesday the 5th of March. This is episode nine of season five of the Fat Doctor podcast. I am your host, Dr. Asher Larmie. Welcome.
Come on in, settle down. Grab yourself a cup of coffee or pop in your headphones or whatever it is you're doing or you might be watching on YouTube, you might be listening in wherever you listen to your podcast.
And wherever you are, whatever you're doing, welcome. I'm going to offer a content warning before we start today. I've also realized that I haven't turned my phone off before recording. That would have been a mistake, but that's why I've done it now.
Content warning, please, dear listeners, I'm going to be using the O word repeatedly today.
Intentionally. Those of you who know me have been around for more than a few days know I hate this word. I do not believe in this word. I do not believe it's a real thing. It's a very problematic word and I'll be getting into that later.
But in order to do this podcast episode that I had planned, which I think is very important to talk about, I need to use this word repeatedly. And I'm sorry if that's going to cause you too much distress, then you need to just skip this episode.
But as you listen along and you hear me using the word, remember that I am on your side, and I hate this word as much as you do. So today we're going to be talking about World Obesity Day. And that was yesterday, the Tuesday, the 4th of March.
As Dr. Monica Peralta said last week in our episode, it is a day to celebrate the eradication of fat people.
What a wonderful day. So I wanted to talk a little bit about it today, please. If you will.
Humor me for a moment. Because World Obesity Day paints fatness as a health crisis.
And I have a counter-argument.
To that argument, which is the real health crisis isn't fat bodies.
The real health crisis is weight stigma and weight cycling. And the World Obesity Federation who are the creators of World Obesity Day, they are responsible not fully responsible, but definitely partly responsible for this health crisis.
The very health crisis they claim to be trying to solve is the very health crisis that they have created or certainly played a part in creating.
And I'm going to be spending the next however many minutes, talking about why obesity is not a disease.
In spite of all the claims that people make, it's not, it's just not. It's just another fancy way of saying fat. In fact, let's put that card on the table right now. Let's lay that out there. Obesity simply means to eat so much as to become fat. That's all it means.
Fat. You can use the terms interchangeably. But when we use the term obesity, we're using a very medicalized, very pathologized term.
Fat is a descriptor. Hey, that person's fat. But when we say that person is obese, all of a sudden we're saying they're fat and unhealthy. And that is very problematic.
So let's get into it, shall we? Let's begin with World Obesity Day.
2025, if you check out the website, please don't. I won't be linking to it in the show notes. But if you check it out.
First of all, you'll see the World Obesity Federation and I just want to point out I'm a big Star Trek fan, the fact they use the term federation really does not sit right in my body. But anyway, they are a quote unquote global organization that includes members from national and regional obesity associations, which are funded by the weight loss industry, that's not in their thing. They are researchers, also funded by the weight loss industry.
Healthcare professionals, funded by the weight loss industry. And people with lived experience of obesity, lived experience of obesity.
We'll say funded by the weight loss industry. Now, I'm not going to criticize the FAT members of this organization. I'm not going to. I'm not going to come after my own, as it were. I am not going to attack the very people who are causing pain and suffering for the rest of us fat people because they don't know any better. They are not responsible. The people who are responsible are the national and regional obesity associations.
Evil, evil, evil associations. So their goals, their lofty goals, are to reduce, prevent and treat obesity. In other words, as Dr. Peralta said.
To eradicate us, get rid of us, to reduce us, to prevent us.
And to cure us. That's essentially what they're trying to do.
To advocate for evidence-based obesity policy. Oh, dear. Okay. If you say so, evidence-based meaning the evidence you like, not actual evidence, to improve food systems. That's a very lofty goal. Are you going to be feeding people more? I don't think so. Are you putting any of your money into feeding people?
Into sorting out food apartheids or food deserts? No, no, you're not doing that. You're just lobbying the food industry. To improve health systems. Again.
Billions, maybe not billions, but millions of dollars a year, this charity. Is this a charitable organisation.
Just put it out there. So do you put any of that money into improving health systems? No, you just spend the money on obesity campaigns. And my favourite, to tackle childhood obesity because children are getting fat and that is absolutely outrageous.
So if you go, again, don't go onto the page. Don't go onto the webpage for World Obesity Day 2025. But if you were to do that, you will see large infographics very obviously spend a lot of money on these infographics. I'm just joking. I think they did it on Canva, but whatever.
Somebody put them up there and there's a lot of scaremongering. A lot of scaremongering in this messaging. 1.9 billion people around the world will be, and my favorite term, living with obesity in 2035. As I said, obesity fat can be interchangeable words. And so living with fat, I'm living with fat. Did you know I'm living with fat?
I'm also living with trans. I'm living with queer and I'm living with fat, yes. I don't know where that accent came from, but whatever.
It kind of felt a bit Trump-like, but not quite. Anyway.
4.32 trillion dollars estimated, oh, my favorite, global economic impact of overweight and obesity in 2035. How did they get to this number? That's what I want to understand where they got to 4.32 trillion.
What is, just how are fat people costing the economy 4.3 trillion?
It's just, anyway, 100% expected increase in childhood obesity, 100% between 2020 and 2035, 100%.
More fat children in the next 15 years. That sounds delightful.
One in four people expected to be living with obesity by 2035. You know what that tells me?
Do you know what that tells me? That this is just normal.
To be fat is to be normal. 25% of the population that counts as normal, right? You know, it's like, I don't know what percentage of the population have blonde hair.
But we don't turn around and go, oh, this is only 5% of the population are blonde. No, just they are, right? What percentage of the population have blue eyes? I don't know. But we just, it's just nonsense to me but anyway.
There's going to be a double, double the amount of adults now living with overweight and obesity.
Between 2010 and 2035. Double the amount. The world's getting fatter, folks. They've told us.
And again, that sounds delightful to me, but whatever. Now. We have these infographics and then they go, let's put a spotlight on the systems. Because we're fighting the systems, people. We're all in this together.
I think I want to say stupid things like the systems are failing us. We must work together to call for changes to these systems. And people living with obesity must lead this call, except for this organization is run by other obesity organizations, healthcare professionals and researchers.
With a smattering of people who are fat. You can tell there aren't that many because most of us know they're talking nonsense.
But they say, in the next sentence, it's just amazing. We must also recognize obesity as a complex and chronic disease.
One that is a driver of other diseases. And then we have to reduce the global burden.
Isn't that amazing? They're so like hot nowadays on weight stigma. Like weight stigma is bad. We've all agreed even the people who are trying to eradicate us agree that weight stigma is bad, which is great. I'm glad we can all agree on that. And then they go on to stigmatise us every moment. They're literally calling us a global burden.
Terrible stuff. I am not a burden. I am a delight, not a burden. I make this world a better place. You are very welcome that I exist in this world.
You are welcome. And so, yes, governments, health professionals, advocates, it's supposed to be fat people who are leading this charge, but it's not. It's governments, health professionals, advocates and the public can transform our systems and build a healthier future for people all over the world.
Hmm. So they claim to be concerned about systems and stigma while simultaneously pathologizing fat bodies and calling us diseased and calling us a burden and using words like crisis and economic impact and stuff like that, massively stigmatising.
And then also they do this very clever thing where they're like, oh, no, we're not stigmatizing you. It's not your fault. You have a disease.
It's a disease, they say. It's not a disease. Being fat is not a disease.
How is being fat a disease? That's like saying being tall is a disease or being bald is a disease or having a big nose is a disease or, you know.
Being rather flatulent is a disease. It's not just sometimes we just are. We just are. I am short, flatulent, and have a big nose. That's just who I am.
Sure, there might be reasons why I'm sure genetics, but it doesn't matter. That's just who I am.
There's no need to pathologize any of that stuff. Although my husband probably would like to pathologize the fact that I'm flatulent.
He claims that's a problem. He claims that is a crisis that needs to be dealt with on a global scale, but whatever.
Prone to hyperbole. So I just want to highlight how dangerous these organizations are.
They use words that make it almost seem like they make sense. If you read Go on the website and you read it. To begin with, you'll be like, oh, that actually makes a lot of sense. I can't see what's wrong with it. You have to pick it apart. You have to realize you have to sort of dig deep into what they're saying before you can begin to see the sort of the nastiness of it. But you don't have to do that much. In fact, you can just scroll down on the webpage and then you get to our partners because you see, as I said, this is a charitable organization that is funded by the weight loss industry. And if you don't believe me, check out our partners. You know who features in there?
Eli Lilly, Nova Nordisk, Pfizer, Boehringer, Johnson & Johnson, or people who are either currently or planning to be invested in weight loss medication. So that's interesting.
Medicalizing fatness, pathologizing fatness. Is the real issue here, folks.
And let me explain why. When you call fatness or obesity a disease. When you pathologize it, when you say this is something that needs to be treated, prevented, cured.
The only solution, right, is weight loss. Obviously, there is no other way to cure the disease of fatness rather than making people not fat.
And so it's pushing weight loss by pathologizing fatness, we are pushing, driving, forcing people to lose weight.
And we know that weight loss is unsustainable. Right? We've talked about this many, many times. The evidence is overwhelming. Weight loss is unsustainable. The vast majority of people, up to 98%, depending on what study you look at, the vast majority of people will weight cycle. They will lose weight. They will hit the peak.
And then they will regain weight. And up to two thirds of people will end up heavier than when they first started.
So weight cycling is responsible for a lot of poor health outcomes.
And again, plenty of evidence to support this. Recently, I think it was this month, a study came out saying there's nothing wrong with weight cycling. It doesn't harm anybody.
And I just love the fact that Reagan Chastain, you must, I'll link to the weight and healthcare letter. But on her sub-step, I really love the way that Reagan just goes.
Yeah, this is a bad study and let me tell you why. And then she rips it apart. She shreds it into little pieces and it's like.
The study is nonsense. Weight cycling is harmful.
And there is overwhelming evidence to support this. But even if we put that to one side and we stop talking about like the sort of outcomes of weight cycling.
They're claiming to want to cure fat by forcing people to become more fat.
Do you get that? If the vast majority of people, up to two thirds of people end up fatter after each diet and they're promoting dieting then they're literally making people fatter. And you know why this serves them?
Because the people who fund them are selling weight loss. And so if they can drive obesity up, if they can make how many, what was it? I forget now. I have to go back to my statistics. If they can actually convince 1.9 billion of us to be fat by 2035,
They're making even more money. And by they, I mean the funders of this organisation, the people who basically are behind the organization. The organization is just a front. What is it that like, you know, whenever I watched police dramas.
And they talk about like the mob, the mafia, there's always like, you know, it's a front. It's a money laundering, you know, like it's not a real business. It's just a front for what's actually going on underneath. I don't think I've got the correct word there, but never mind.
And I watched so many crime dramas. Anyway, I've now lost my train of thought. But so they are driving, they are driving the quote-unquote obesity pandemic. They are responsible what is going on.
And this is really problematic. There is absolutely no evidence that we should be encouraging people to lose weight.
And I've said these over and over again. Weight loss is unsustainable. Weight loss has never been proven to benefit your health in the long term. Weight loss causes an immense amount of harm.
Both in the short term and the long term. And so there is no evidence for promoting weight loss ever really that we should never be doing it. Ever, ever, ever, ever for health reasons.
And yeah, we do. And this is driving the problem. Let me give you an example, right? We're going to look at fatty liver disease, a very common thing. We love to fat shame livers as much as we love to fat shame people.
Ooh, you've got a fatty liver. And all fatty liver means is that when we've been scanning you, whatever, we've found more than 5% fat in your liver, which is kind of like we found more than 5% fat on your body you know it's just the same thing. It's Start shaming the liver. And in almost all cases, this is just a thing that we've noticed, like it's not causing any harm or it's a completely benign thing. We just observed it.
And so fatty liver disease in the UK, the National Institute for Clinical Excellence is our National Institute for Health in the US, the equivalent.
And it is basically the organization that creates all the guidelines for healthcare professionals.
So they published its guidelines for fatty liver in July 2016.
And I've read the guidelines. Several hundred pages long. And section 10 of the guidelines focuses on weight reduction.
And it starts with a very simple statement that basically says it is generally assumed but not proven that weight loss may help to reverse fatty liver disease.
All right. Simple enough statement. That's what we all assume. It's certainly what we've all been told.
So let's look through this, shall we? I mean, that piqued my interest.
So what happens when they're making guidelines is the first thing they do is a literature search, an exhaustive literature search where they look for, in this case, any Randomized controlled trials or prospective cohort studies, for those of you who like the science, these are the most reliable, least biased studies out there. So they were looking for either of the two that studied the impact of calorie restriction on fatty liver disease. Pretty simple, right? They had a very wide net. They didn't care how you measured fatty liver. They didn't care how you measured the improvement. They didn't care what kind of calorie was just any calorie restriction whatsoever.
That's what they do. They cast a wide net and then they check to see whether the guidelines meet their inclusion criteria.
And so there's a huge search. And they found a grand total of zero studies that met their inclusion criteria. Zero. In all of our, you know, in Medline and all of the other search databases, basically in all of the world.
Put it that way. The studies don't exist. They literally don't exist.
So they said, we can't make a recommendation, which is correct. If you don't have any evidence, you can't make a recommendation.
And do you know what they did straight after? They made the recommendation.
We can't make a recommendation for you to lose weight, to help with your fatty liver because there literally is zero evidence to support it.
And yet we're making the recommendation. Isn't that amazing? How that worked. And the mental gymnastics and they claimed that the reason that they did this was because the absence of relevant clinical evidence should not be misinterpreted as evidence that weight reduction interventions in themselves are of no clinical effectiveness in the management of fatty liver disease. In other words.
Just because the evidence doesn't exist doesn't mean it doesn't work.
Sure, but you could say that for everything. You could literally say that for anything.
I could be like, well, I personally think, well, I mean, you could be RFK spouting nonsense about worms in the brain.
And then saying, just because the evidence doesn't exist doesn't mean it's not true.
And that would be a factual statement. Just because you have evidence like this doesn't mean it's not true. That is true. We all agree. However if you're a guidelines committee.
You cannot make recommendations without evidence. You just can't because that's not okay. Otherwise, we're going to start making recommendations about worms in the head which okay that is actually much more likely than we think. But anyway.
And then they went on to explain the lack of evidence. This is even better. They explained the lack of evidence because weight reduction advice is now widely viewed by clinicians as part of routine care for people with fatty liver disease, which is why we don't bother to study it. Why would we? Because it is routine. So somewhere along the line, somebody went.
Fatty liver, you should lose weight. And then everybody agreed, I wonder why. And now we don't need evidence because it's just what we do.
This is what we do, guys. It's what we do. My voice is very squeaky because I have a cold and also because I'm very angry. But yeah, that's nonsense, isn't it? But fatty liver disease is very common.
There's a very common condition. By the way, up to 40% of people with fatty liver disease are not fat, but whatever. It's overly diagnosed in fat people. And if a fat person has a report, you know, I've had an ultrasound scan looking for some pelvic pathology or was looking at something else, but it happened to note. So they will note it. First, they'll note that you're a fat person.
Some say something about your body habitus making the scan a little bit more complicated than normal. And then the second thing or third thing they'll note is, look, fatty liver. That's not why we requested the scan, but they need to note it.
And then the report goes back to your doctor and your doctor goes, oh, fatty liver, you better lose weight because that's what we do.
And so the person goes and loses weight because their doctor tells them to lose weight. So they're going to listen, loses weight.
Regains the weight later because that's going to happen. And guess what? The fatty liver gets worse. Why? Because fatty liver disease is caused by in part insulin resistance and weight cycling worsens insulin resistance.
Do you see how that works? Do you see how messed up that is?
When we pathologize fat and we say it's a condition that needs to be cured. We find all sorts of ways.
To promote weight loss. We take conditions, you know, observations, I should say.
Got a fatty liver. There are a few, a handful of people who will have fatty liver disease that progresses into NASH, which is non-alcoholic steatohepatitis, which then progresses into fibrosis, which progresses into cirrhosis. That does happen.
Very, very rarely. The vast majority of people who have cirrhosis of the liver have it through drinking excess of alcohol.
It is very, very unlikely that you are going to get cirrhosis of the liver.
From fatty liver. Or from just non-alcoholic fatty liver disease or whatever you want to call it. Actually, what they found is that people with fatty livers tend to die of strokes and heart attacks and cancer, which is not surprising because we've pathologized fatness.
And as a result, we have weight stigma and weight stigma causes an increase in the number of deaths heart attacks and strokes.
And cancer. I'm not sure if I made my point, but it makes me so mad.
I'm going to be getting into it more and more, but if you were interested in fatty liver disease, head to my website, noweigh.org.
There is a section on fatty liver disease there. It's all completely free. You can read all about it. If you want to know more, I've done a masterclass.
And if you're part of the masterclass membership, then you can just go and access that masterclass anytime. Also wrote a lot about it in chapter four of my book.
And if you're part of the no way membership then you get access to my book, chapters of my book as I write them. So chapter four is out. You can read it anytime and you can go to all the studies.
And you can work your way through them if you want to do that. I don't know why you would.
There you go. So folks, weight stigma is the true health crisis, weight cycling as a result of weight stigma, the true health crisis. And we know that weight stigma contributes to poor health outcomes.
First, because doctors delay or miss diagnoses. Right? Doctors do not treat their fat patients correctly. I understand that there was a TV program recently, I don't think it's out in the UK, but people in the States and Canada were talking about it where there was a moment where a doctor was berated for weight stigma, first time in medical in like any medical drama ever apparently it's very exciting. That might not be true. It might have happened before, but this is what people are telling me.
And I'm like, hmm, nice. We're finally talking about it, are we? Millions of people around the world. Soon to be 1.9 billion people around the world are experiencing weight stigma every time they go and see their doctor.
Every single time. Delayed and misdiagnosis, less time spent with the patient, less time, less likely to examine a patient, less likely to investigate a patient, to do bloods or blood tests or scans or whatever. Less likely to do cancer screening, less likely to take serious concerns like fatigue and weight changes.
And other red flags, seriously, because what you're off your food.
That's a good thing. You could stand to lose a few pounds.
That could be a sign of a very serious underlying condition, but doctors will miss it because of their weight stigma. So yeah.
Weight stigma is causing poor health outcomes for that reason. It also means that we, the fat people, do not trust our doctors.
We do not want to spend time with our doctors. In fact, we actively avoid our doctors.
And when they do tell us to lose weight and we do have a go.
Because we don't know any better. Then it doesn't work.
And that causes even more harm. So why would you trust your doctor if instead of saying, hey, you're in pain, let me give you a painkiller. Or hey, your blood pressure's high.
Let me give you something to treat your blood pressure. Instead, we say, go lose some weight and it doesn't work.
And then we're like, oh, my life is crap. You know, my health is never going to get better. Because your doctor is wrong. It's nothing to do with you.
So, I guess I, as a doctor, have a very different way of treating people. It's very simple. It's rather revolutionary though. I just don't mention people's weight.
And everything else. But all the other bits. I just don't mention people's way ever. It's incredible.
When they bring it up, I go, oh, weight's got nothing to do with it. And then I just move on.
That's literally all I do. Completely changes everything. Because I'm not stigmatizing my patients.
I am spending the time with them. I am examining them. I am ordering the tests. I am taking their symptoms seriously.
I'm not missing diagnosis. I mean, I'm not saying you'll never miss a diagnosis, but I'm not intentionally missing a diagnosis or missing a diagnosis just because of my own bias that I haven't bothered to investigate or to reflect upon.
It's really that simple, isn't it? But the World Obesity Federation does not like people like me.
I'm a threat to their very wellbeing because they are pushing the notion that being fat is a disease that needs to be cured.
And in order to do that, you've got to sell drugs, you have to sell weight loss surgery, et cetera, et cetera.
And so if doctors were to all turn around and go, no, we're not going to do that anymore. That's more than 1.9 billion. That's 500 billion, that's 450 billion on Wegovy and Ozempic alone. Okay, so they cannot afford for us to do this. And I don't care because I stopped giving a care about capitalism a long time ago so they can just deal with it.
So let's move on to everything you've been told about weight loss as a lie.
That is the tagline to my website, noweigh.org. If you go to noweigh.org, the tagline for the website is everything you've been told about weight loss is a lie. It's also going to be the title of my book. No way.
Colon. Everything you've been told about weight loss is a lie because everything you've been told about weight loss is a lie. And today we are going to be looking at Lapesh, I believe Jacob Lapesh et al.
Jacob Lapesh and buddies. A study that was published in November 2022 in the journal Arthroplasty.
Never heard of it before. And the article is obesity and total joint arthroplasty. It makes sense that they would publish it. I mean, that makes sense, right? Obesity and total joint arthroplasty. Does weight loss in the preoperative period improve perioperative outcomes?
For those who need a bit of a translation, does losing weight prior to a hip replacement or a knee replacement improve your short-term outcomes within 30 days of the surgery. That's what this study was looking at.
And what it found, it was very simple. Too long, did not read TLDR.
Preoperative weight loss is a complete waste of time. And let me tell you for why. It took 302 participants who lost at least 10% of their body weight prior to either a hip or a knee replacement.
And they matched them to 567 controls. Participants who didn't lose weight prior to surgery.
And they found no difference in operative time.
Length of stay in hospital. Discharge destination or 30-day adverse events.
Now, 30-day adverse events include any complications like bleeding. Clots, anything like that, having to re-operate. They also include readmissions. So you leave hospital and they have to come back. And they also include obviously mortality because some people unfortunately do die after surgery.
So all of these are counted as 30-day adverse events. There was no difference whether you lost 10% of your body weight or not.
Prior to surgery. Everyone had the same outcomes. Which is odd, right? Because the reason that all orthopedic surgeons give for why they don't want to perform surgery on you if you're a certain weight.
Because, the operation will take longer and you'll have to stay in hospital for longer and you'll have complications. You're more likely to have complications. You're more likely to be readmitted and we might have to operate on you a second time around and you're more likely to die in surgery. And so we can't possibly operate on you unless you lose weight.
Is that right? Will losing weight improve any of these things? No.
So why are you making me do it? Wouldn't it not just be easier to say, I don't want to operate on you?
Because that's the truth. I don't want to operate on you because I don't like operating on fat people.
That's it. Weight loss isn't going to improve things. Now, that doesn't mean that fat people don't have a higher risk of certain complications. They do.
No one's denying that. No one's denying that an operation on fat people will take longer than an operation on thin people. I'm not saying it doesn't.
What I'm saying is that weight loss isn't going to make a damn bit of difference.
And so if weight loss isn't going to make a big difference, why are you telling me I have to lose weight?
Why not just say, I don't want to do the operation because I'll have to spend longer in surgery and because I'll have to engage my brain a little bit more and I might have to manage your complications, which requires more effort and energy and resources and I don't want to do that.
Maybe it's the individual surgeon. Maybe it's the practice that they're working in that has a policy.
You know, but let's just call a spade a spade. Is that an okay thing to say? I'm not sure if that's an okay thing to say but anyway.
Let's just be honest, shall we? Doctors are not telling patients to lose weight prior to their hip replacement and knee replacement.
Because it's going to benefit them. They're doing it because they know that you won't achieve it.
And then they have a legitimate reason to deny your surgery.
It's that simple. If I tell you you have to lose 10% of your weight.
The only way to do that, realistically speaking, is to starve yourself for several months, which is really not a good idea.
Prior to surgery because prior to surgery, you do not want to lose muscle mass. You do not want to deplete your nutrient stores. The last thing you want to do prior to surgery, you don't want to increase your cortisol levels. All of these things are consequences of any form of dieting. So last thing you want to do, you want to be in optimal health prior to surgery.
But you either have to starve yourself literally because no sort of, it's not just a few calories and a bit more exercise. No, that won't work.
That only is an average of about 2.5% weight loss. If you want to get to 10%, it's either absolute starvation or weight loss drugs or bariatric surgery. That is the only effective way to lose 10% of your body weight.
And so they are forcing their patients to either do that or not have surgery.
Win-win. It's a win-win. It's a win for the weight loss industry. It's a win for the surgeon. The only person who is losing is the fat person with joint pain.
I'm mad today. So we got to the Ask Me Anything part.
Portion of this section and none of you have asked me anything. Which is pretty disappointing. How can I answer your questions? If you don't ask them, please ask me some questions.
Stick them at the bottom of this YouTube video. Message me contact at fatdoctor.co.uk. I will put a link in the show notes. You can just go it.
Ask me on Instagram. Ask me anywhere. Just ask me a question.
And I'll answer it. So I guess I have to think about questions that I want you to ask me.
And the question today, I think, in keeping with this episode is why, Asher, do you put an asterisk and censor the word obesity.
I just want you to ask that. Really, I just want to tell you the answer.
And the answer is because, as I said, it's a very pathologizing term. I don't mind you calling me fat.
As a descriptor, I am fat. That is correct. Some people don't like being called fat. I understand that. Preference and preference.
You prefer chubby? Plus size. I don't care. Use whatever term you want to describe yourself.
But I will not accept the pathologization of your fatness. That I will not tolerate.
Because it is not true. It is not a disease. Being fat is not a disease.
Stop calling me, this person, this human being, a disease. It's like saying being trans is a disease.
Or being queer is a disease. Oh, and don't think that that's weird because a lot of people argue that it is.
There are people all over the world right now arguing that my transness is a disease that needs to be cured.
And the WHO until 1993, the WHO considered homosexuality a disease.
It was in the ICD, the International Classification of Diseases, until 1993 when it was removed.
Centuries we believed that it was a disease that needed to be cured.
People consider autism to be a disease. Is it really a disease? I don't think so.
Stop pathologizing things that do not need to be pathologized. By pathologising them, you are driving stigma. You are driving shame and you are driving the entire you're driving, what's the word I'm looking at? You're causing the harm. You're creating a problem and then claiming to fix it. That is what you're doing. That is what they're doing.
We made up a disease so that we could give you a treatment for that disease and sell you a treatment for that disease, I should say.
And more importantly, the more we treat it, the worse it gets. And then we can just keep treating it over and over and over again and the money will never run out.
The weight loss industry did not lose any money during the COVID pandemic.
None whatsoever. This is a recession-proof industry. That's how solid a wall we are facing right now, folks. That's why people think I'm Britain's most outrageous doctor and why weight inclusive medicine is not a thing.
Because if we pathologize fatness. We create a condition.
And then you pay us to treat the condition. And every time you do that condition gets worse and then you pay us again.
And you pay us again. And you pay us again and you pay us again and it keeps going on until you die.
Hope you enjoyed this episode. I'll be back next week with a slightly different take on the same problem. Ask me something.
For next time. I'd really appreciate that. I love to hear from you. So please get in touch.
Take care of yourselves. Try not to spend any time listening to the news because it's horrible and you should stay well away well clear of that. I've been your host, Dr. Asher Larmie. Don't forget that I have two websites. One of them is noweigh.org. And if you go to noweigh.org, you will find a whole bunch of free information.
Including condition-specific information so Arthritis, fatty liver disease, it's all covered.
Symptom specific information like pain and fatigue and blood sugars management.
You'll find lots of information about why weight loss is unsustainable, why weight loss has not been proven to be beneficial to our health, why weight loss causes harm.
Why weight stigma is dangerous? Why weight inclusive medicine is the only correct form of medicine?
So please check out the website. It's pretty basic, but nothing wrong with being a basic.
And what else was I going to tell you? Oh, don't forget to sign up to my newsletter.
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Hope you're not too mad and I'll see you next week.