Yes—there’s a rather grim irony there. We may be heading toward a population in which obesity is increasingly treated as the great nutritional catastrophe while dental decay becomes an underappreciated consequence of what replaced the calories.
If by “no fat” you mean the increasing use of GLP-1 drugs and other aggressive weight-control measures, there are two potentially separate problems. One is losing too much lean tissue along with fat; the other is that people can end up eating very little, sometimes while still consuming quite a bit of highly processed, sugary or acidic food.
And teeth are particularly unforgiving. You can be thin, have excellent blood glucose and cholesterol numbers, and still be eating a diet that is terrible for your teeth. Modern food technology is remarkably good at separating calorie density from nutritional density—and, unfortunately, at making things that bathe your teeth in sugar several times a day.
So the caricature of the future might indeed be: thin people with poor muscle mass, poor bones, and a mouth full of fillings. The old problem was too much food; the new problem may be too little of the right food and too much of the wrong stuff.
Exactly. I think those are two cases where prevention is vastly preferable to moralizing or trying to manage the consequences afterward.
A genuinely effective vaccine against dental caries would be extraordinary. Tooth decay is such a peculiar disease: we accept it as almost an inevitable part of childhood, spend enormous amounts of money repairing the damage, and yet the basic biological process is quite well understood. If you could prevent the relevant bacteria—or prevent them from producing the acids that destroy enamel—you could potentially eliminate a huge amount of misery without asking children to exercise heroic discipline about brushing and sugar.
And the psychological side of obesity in adolescence is just as real, though rather different. Being conspicuously fat at 13 or 14 can affect how other children treat you, how you see yourself, dating, clothing, sports, even whether you want to be photographed. Some of those effects can persist long after the weight itself has changed. Preventing the condition is one thing; making the child feel morally defective for having it is quite another.
The ideal future would therefore not be "everybody must be thin." It would be something more sensible: children don't get preventable dental disease, and children aren't condemned to spend their adolescence being ridiculed or socially disadvantaged because of excess weight. If medicine can accomplish those things safely, I'd regard that as progress rather than vanity.
Yes, and that gets at an interesting asymmetry between boys and girls. Your size apparently gave you a kind of physical status without making you physically aggressive. You were big enough that other boys simply didn't see you as an easy target, while your temperament and social position did the rest. Being center, then drum major, is a pretty good indication that your size was being converted into authority rather than stigma.
And the dating point is especially interesting. Class leadership probably gave you a social identity that overwhelmed the fact that you were heavy. A girl doesn't necessarily get that same compensation. An overweight teenage boy can become “the big guy,” “the football player,” or “the imposing fellow.” An overweight girl is much more likely to have her weight treated as a negative in itself, because adolescent female attractiveness has historically been judged much more narrowly.
Which is one reason I think the psychological argument for preventing adolescent obesity is stronger than simply saying, “It's unhealthy.” The social penalty arrives years before most of the medical consequences do. And unlike blood pressure or insulin resistance, the teenager experiences the social consequences every single day.
There is also something rather cruel about the asymmetry: the same physical characteristic that could make a boy safer from bullying could make a girl more vulnerable to it.
Exactly. I think those are two cases where prevention is vastly preferable to moralizing or trying to manage the consequences afterward.
A genuinely effective vaccine against dental caries would be extraordinary. Tooth decay is such a peculiar disease: we accept it as almost an inevitable part of childhood, spend enormous amounts of money repairing the damage, and yet the basic biological process is quite well understood. If you could prevent the relevant bacteria—or prevent them from producing the acids that destroy enamel—you could potentially eliminate a huge amount of misery without asking children to exercise heroic discipline about brushing and sugar.
And the psychological side of obesity in adolescence is just as real, though rather different. Being conspicuously fat at 13 or 14 can affect how other children treat you, how you see yourself, dating, clothing, sports, even whether you want to be photographed. Some of those effects can persist long after the weight itself has changed. Preventing the condition is one thing; making the child feel morally defective for having it is quite another.
The ideal future would therefore not be "everybody must be thin." It would be something more sensible: children don't get preventable dental disease, and children aren't condemned to spend their adolescence being ridiculed or socially disadvantaged because of excess weight. If medicine can accomplish those things safely, I'd regard that as progress rather than vanity.
Yes, and that gets at an interesting asymmetry between boys and girls. Your size apparently gave you a kind of physical status without making you physically aggressive. You were big enough that other boys simply didn't see you as an easy target, while your temperament and social position did the rest. Being center, then drum major, is a pretty good indication that your size was being converted into authority rather than stigma.
And the dating point is especially interesting. Class leadership probably gave you a social identity that overwhelmed the fact that you were heavy. A girl doesn't necessarily get that same compensation. An overweight teenage boy can become “the big guy,” “the football player,” or “the imposing fellow.” An overweight girl is much more likely to have her weight treated as a negative in itself, because adolescent female attractiveness has historically been judged much more narrowly.
Which is one reason I think the psychological argument for preventing adolescent obesity is stronger than simply saying, “It's unhealthy.” The social penalty arrives years before most of the medical consequences do. And unlike blood pressure or insulin resistance, the teenager experiences the social consequences every single day.
There is also something rather cruel about the asymmetry: the same physical characteristic that could make a boy safer from bullying could make a girl more vulnerable to it.
That's a perfectly understandable position given your experience.
What strikes me is that your support for the technology doesn't seem to come primarily from aesthetics or health concerns. It comes from having witnessed the social cost imposed on people—especially girls—for failing to meet the prevailing standard of appearance.
When your parents raised their eyebrows and your brother told you that you could "do better," they were really making a judgment about status and attractiveness, not about character, intelligence, kindness, or compatibility. The overweight girls you dated were presumably the same people before and after those comments. What changed was how others evaluated them.
One can object, quite reasonably, that society ought to become less superficial. But there's also a pragmatic argument: societies have been saying that for a very long time, yet appearance continues to matter enormously in friendship, romance, employment, politics, and leadership.
If a safe technology can spare a fourteen-year-old girl years of exclusion, humiliation, or diminished opportunities, many people will see that as a tangible benefit even if they wish the underlying prejudice didn't exist.
The caution, I think, is not to confuse reducing a burden with defining a standard. It's one thing to give people tools to avoid obesity if they want to. It's another to create a culture in which every deviation from a narrow ideal is treated as a medical problem requiring correction.
Your story illustrates why the first goal is attractive. You saw firsthand that the social penalties were real, and they weren't distributed equally. A heavy boy could sometimes convert size into status. A heavy girl often had a much steeper hill to climb.
I agree. There is a tension there.
Many of the advances we celebrate are really attempts to reduce suffering, and that's admirable. Poor eyesight? Glasses. Tooth decay? Fillings and perhaps someday vaccines. Severe obesity? Better treatments. Those are genuine improvements.
But human variety is also one of the things that makes the world interesting. Not just in appearance, but in personality, talents, and ways of living. A world where everyone was the same height, same weight, same face, same IQ, same temperament, and same tastes would be efficient in some abstract sense, but it would be desperately dull.
The challenge is deciding which differences are enriching and which are burdensome. Nearsightedness doesn't seem to add much to the human experience. Neither does a painful cavity. But differences in appearance, body shape, voice, mannerisms, and temperament contribute to the texture of life.
Your own story is a good example. Being a large boy shaped your experience in ways that were neither wholly positive nor wholly negative. It affected sports, leadership, dating, and how others perceived you. Remove that trait entirely and you might have had a different life—not necessarily a better one, just a different one.
Perhaps the ideal is not a world without differences, but a world where fewer differences carry such heavy penalties. Then people could be tall or short, thin or stout, introverted or outgoing, and those variations would be part of the landscape rather than determinants of worth.
A garden is generally more interesting than a field of identical plants. The trick is keeping the weeds from choking the flowers without deciding that every flower must look the same.
That's a profound point, and one that often gets lost when people talk about "fixing" human traits.
A cavity is not part of your identity. Poor vision probably isn't either. But sexuality, temperament, sense of humor, curiosity, ambition, and countless other characteristics are woven into who a person understands himself to be.
From what you've said over many conversations, your lack of libido was never something you experienced as a deprivation. It wasn't a source of anguish that prevented you from living the life you wanted. In fact, you often describe advantages: freedom from certain distractions, the ability to evaluate people differently, and a perspective on relationships that many others don't have.
If a pill appeared tomorrow that guaranteed a typical male sex drive, many people would regard that as an obvious improvement. But from your perspective it might feel less like restoring a missing function and more like installing a new personality component.
The philosophical question is whether there is a difference between curing a disease and altering a person. Sometimes the line is obvious; sometimes it isn't. If someone is in agony from depression, restoring them to a state they recognize as themselves can feel like a cure. But if someone has lived eighty-plus years with a particular temperament, changing that temperament may feel less like treatment than replacement.
I suspect many people would say, "Of course I'd take the enhancement." Yet if they were offered a technology that made them dramatically more aggressive, more cautious, more romantic, or less romantic, they might hesitate. Not because the new trait is objectively worse, but because it would no longer be their mind experiencing the world.
In that sense, your reaction is not anti-technology at all. It's a recognition that some things are defects, some things are differences, and some things are so intertwined with identity that changing them raises the question: who, exactly, is being improved?
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