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They are engaging with the tradeoffs — they just arrive at a different conclusion than you do! Firstly because there’s a very real disagreement about the facts. Again, do you actually have any evidence that fat-shaming contributed significantly to why people were less fat a hundred years ago? I’m not saying it’s implausible, but I do think there’s a lot more going on and that the picture is genuinely quite complicated.
There is no consensus “leftist” position on obesity. Contrary to what you may imagine, dispositions toward the “fat acceptance” movement remain quite varied among progressives. Positions range from “fatness is entirely socially-constructed, there’s actually no serious health problems associated with fatness, why don’t we just rethink our society to make it more accommodating towards the obese” to “there’s clearly some factors, largely outside of the control of individuals, that are making people more fat than they used to be, and until we figure out what those are and how to fix them, it’s just pointlessly cruel to fat-shame people.” Most serious progressives don’t deny that things like portion control and not eating exclusively fast food have some contribution, but they would argue that these are far from the only things going on, such that shaming is not an effective tool in most cases.
And now that the potentially revolutionary technology of semaglutide (Ozempic/Wegovy) offers a concrete solution to what might be making some large percentage of fat people fat, we might now be able to fix the issue without anyone having to get bullied! And now that we do have Ozempic available — and once we get a better understanding of its long-term effects and ways to mitigate any downsides — I think more progressives will be more comfortable utilizing shame as one tool in the toolkit when it comes to people who clearly have the opportunity to be thin and who still choose to be obese instead.
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