Sometimes life is beautifully ironic.
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It's not size. It's composition. Although in this case it's both. Basically everyone is insulin resistant. Too much sugar. Too much carbs in general (the USDA recommendation is about 3 times higher than it should). Not enough fat. Wrong type of fat (did you know that a cow has 60% of its calories in visceral and subcutaneous fat and the vast majority of that doesn't get used for food purposes because vegetable oils are supposedly healthier). Fix the insulin resistance and you generally won't have to worry about portion size because it fixes itself.
And the worst part is no one (who isn't already non-normie right wing) believes me. "That's not what doctor's say. Do you think you know more than my doctor? My sister-in-law is a nutritionist and she says to stuff carbs down your gullet until you choke." Everyone is so unhealthy and they know they are unhealthy and they know everyone is unhealthy but then why is it so hard to convince people that maybe the experts are wrong. People who are into heterodox nutrition can argue the finer points but I don't know why anyone trusts any orthodox nutrition.
Low carb is winning overall though (i.e. becoming more and more accepted over time). The reason is that it works and people who try it then see the results for themselves.
I'm, unfortunately, gonna have to die on my hill made of fruits and pastas.
Thing is, I don't think carbs are a problem if we fucking weren't so sedintary. Americans have always eaten carbs. Early colonial diets were fucking outrageous with carbs... but then they worked manual labor for 12 hours a day.
If there's anything that's wildly obvious within fields of medicine or health, it's that the entire field of nutrition was so badly propagandized that there's almost no good data on what actually is good to eat from a scientific standard. I'd say that the field is actually more pseudo-science than "social psychology" at this point.