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naraburns  nihil supernum  1yr ago (text post)   3084 thread views

Small-Scale Question Sunday for February 19, 2023

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once [an obesity cure] exists adoption will be near-instant and universal

How can you think that to the case when we have existing obesity cures that don't see broad adoption? Nicotine works. Cocaine works. Stimulants in general reduce BMI. You can claim that an obesity cure would be near-instantly and universally adopted, but public policy reveals a preference for things other than thinness. I think that's a shame, personally.

I sometimes wonder what would be different if Nicotine had been separated from the tobacco plant early in its use (if there were nicotine patches or infusions or some other delivery system that isn't smoking). Is Nicotine harmful by itself? Would it be low status or would it be more like caffeine (in a socially accepted beverage, and also added to all sorts of other products for the addictive properties).

Maybe instead of excise tax, we should rather make cigarette producers also supply patches in same box as cigarettes.

Is Nicotine harmful by itself?

Kind of, yes, albeit is it very minor to total harm of smoking.

Nicotine also about 300x more toxic than caffeine.

Nicotine works. Cocaine works.

It's pretty disingenuous to say "we have existing obesity cures that people don't use" and then bring those two up as your examples. You know damn well why people aren't using those things to fix obesity, and it isn't because they prefer things other than thinness.

You know damn well why people aren't using those things to fix obesity

Why not? "Smoke yourself thin" was an idea with real currency for a long time. And how many fat coke users do you know?

You know damn well why people aren't using those things to fix obesity

It's mostly because everything that cures obesity is either illegal or low status. Do you really think the harms of cigarette smoking outweighed the problems of widespread obesity? We made a terrible mistake by ostracizing smokers. I'm also not convinced that stimulant drugs are bad and that government bans on their sale and use are justified on utilitarian or public policy grounds. These drugs are ruinous to individuals only to the extent that state meddling increases prices and decreases safety.

Why not? "Smoke yourself thin" was an idea with real currency for a long time.

Lots of people have done lots of things in the past. That doesn't make them a good idea. It was a stupid idea, and remains so.

Do you really think the harms of cigarette smoking outweighed the problems of widespread obesity?

Yes, easily.

Again, I refuse to believe you don't know that nicotine and cocaine are horribly addictive, and that using those things will ruin your life far more than being fat ever will. This is common knowledge. So pretending like "oh we have these obesity cures and people don't use them because they prefer being fat" is completely disingenuous. You know damn well why people aren't using the "cures" you propose.

nicotine and cocaine are horribly addictive

So what if they're addictive? Caffeine is addictive too, and there's zero stigma associated with drinking coffee. Why is addiction to a plentiful and salutary substance a bad thing?

You know damn well why people aren't using the "cures" you propose.

I do: state meddling. The government should stop trying to regulate what people do with their own bodies. Various amphetamines and other stimulants ought to be 100% legal.

No, it's because people believe the "cures" you are proposing are addictive and more destructive than being fat. It has fuck all to do with state meddling.

I actually disagree on this one, depending on scale. I'd sooner smoke a pack a day with a normal BMI than be obese. And I think "objectively" the latter will reduce your quality of life more than the former. I'd sooner not smoke at all and have a small belly than smoke two packs a day and have defined abs or whatever.

I've never tried cocaine so I won't speak to it, but there are vastly more occasional users than addicts, historically, and the failure to realize this blinds our policy.

I honestly don't think I know enough about Cocaine to speak to it, I've never used it and anyone I know who told me they used it my response was something "Really? No shit!" so it's not even like I have strong secondhand experience. Where I've used nicotine products on a mega casual basis and known many people who used it often.

Especially if you isolate nicotine from smoking specifically, I'm not sure how it reduces your quality of life much more than, say, a caffeine addiction.

Ok, so you disagree with the common consensus on smoking (and recognize that it may be wrong on cocaine use). Fair enough, that's your prerogative. But surely you would not disagree that the common consensus exists, no? And that it's because of that, not because they think obesity is tolerable, that people are not using these substances to "cure" themselves?

Like you could make the argument that we have effective cures for obesity but we don't use them because people are misinformed about the risks. But that isn't what was being claimed, rather it was that people apparently prefer to be fat. Which is totally disingenuous and ignores the actual reason people aren't flocking to those "cures".

https://www.ox.ac.uk/news/2009-03-18-moderate-obesity-takes-years-life-expectancy

It appears that between a BMI of 30 and 45 obesity moves from a third to exactly as fatal as smoking. It seems intuitive to me that the non-fatal health risks probably scale with the fatal health risks. And it seems obvious to me from looking around that I'd rather be a smoker than obese in terms of social and physical downsides that are not health related (or smokers can wear normal clothes and fit into airline seats and get anesthetics).

So I don't know where you're seeing a separable consensus that nicotine will ruin your life "much" faster than obesity. It seems like, depending were you weight fatal vs non fatal tradeoffs, nicotine offers a better solution. So from a harm reduction perspective, we are as a society, ignoring nicotine as a weight loss drug.

Granting all of that is true...

So from a harm reduction perspective, we are as a society, ignoring nicotine as a weight loss drug.

That still isn't what Imaginary_Knowledge was claiming and what I was pushing back on. What you've said is basically summed up as "society is incorrectly valuing the costs of obesity and nicotine". Fine. But what Imaginary_Knowledge said was that people prefer to be fat. That's not what is going on here, at all. They think that nicotine (and cocaine) are going to hurt them more, but that's not the same thing as some glib take of "well I guess people prefer to be fat" and it was disingenuous for him to act like they are the same.

I don't find it disingenuous, just a different interpretation of people vs society/establishment/cathedral/whatever. If you want to say that people themselves have been misinformed or otherwise lack sufficient agency to make that choice individually, it still reflects a society that chooses to value smoking and obesity in the ways it does. We, as a society from media to government to medical orgs, could choose to value things differently.

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