I'm not sure how the medical establishment ignores this, from my understanding (and please correct me if I'm wrong as I'm not fact checking myself in this moment) - the association between the two is largely linked to vascular dementia (obesity, hypertension, yadda yadda).

I think it's hard to argue "The medical establishment" ignores diet as an important factor.

I think the reality a lot of the time is doctors prescribe something to help. They can't force a diet change on a patient, and they're not mutually exclusive interventions.

It's easy to say "just diet ez" and it's hard to "just diet".

If you can administer a treatment as a simple one and done thing, that's alright. If it's a pill you got to take every day, that's pretty bad. More than once a day? Horrible. Why? Because a lot of patients just don't have it in them to take a pill 3 times a day consistently.

If it's purely an "exercise willpower" thing or a "change your lifestyle" thing? You might as well give up.

The medical establishment wants to do things that work. Telling people "go diet" doesn't work. Semaglutide, evidently, does.

You underestimate what people Will do to lose weight without putting in any effort or changing their lifestyle

bro the problem is not eating burgers every time you see them. if eating a pill once a day will prevent somebody from having these urges people will easily make this a routine. fat people don't like being fat (body positive is the world biggest cope). if you give them something they gotta take once a day, takes 10 seconds, they will throw their money at you.

You say force a diet change on a patient. OP certainly meant forcing a diet change in the input of American factories. Sugar can be found in fruits. That's the right place. If you need some, use fruits, maybe alcohol. Everything else can be slashed. No sugar in prepared meals anymore. No sugar in pasta anymore. And most of all, no sugar in water. Sugar input makes more damage than cocaine today.

We can call it the Prohibition II. There will be underground bars with sick people binging on sugar. We can change the shape of sugar to prevent restaurants from adding it to food. We can make it bitter. Absolutely need sugar? Eat that lemon-tasting block. We can call it The War On Sugar.

people are so addicted to sugar that you are getting downvoted and maybe even flagged.

I like "The War on Sugar" idea (even tho I went out 1 hour ago to buy lots of chocolates and candies, as I'm an addict).

I think it’s more because it’s kind of a strange rambling rant? He didn’t make any good points, he just made an analogy between it and alcohol prohibition like 7 times. He didn’t even bother to bring the idea home in the end, he just left it free-floating there. It’s just not a great comment.

Closed the gyms during COVID not the McDonald's

The medical establishment that I have familiarity with (in the US) pretty much only ever treats symptoms, not causes.

Don't believe me? Next time you go to see your primary care physician, ask them what you should be doing to lower your risk of whatever malady tends to run in your family. (Diabetes, cancer, dementia, etc.) They're going to stare at you in blank confusion for a few seconds before making some vague suggestion about a better diet and more exercise. Guaranteed.

The reasons are many, and detailed enough to write MANY books about, but the low hanging fruit is: we don't have a culture of monitoring and improving our own individual health, physicians are trained almost exclusively to solve problems not prevent them, modern nutrition science is a joke, omnipresent health insurance distorts incentives for everyone, doctors are too overworked to get to know their patients, private equity has captured a large chunk of health care, drugs are positioned as the first line of treatment for almost everything, etc.

In my experience that’s wildly inaccurate. Dietary choices, weight loss, exercise, etc are often given as an effective means of avoiding and or controlling a wide range of conditions.

People are instead blowing off such advice because they don’t want to hear it.

I never knew Kaiser Permanente was so "anti-establishment" but I get pages of recommendations for healthy eating and exercise every time I go and also randomly as part of my "Personal Action Plan".

Everyone pretty much knows how to be healthy- good diet (leafy greens, abstain frand exercise. Diets, fads, etc are all just ways people sidestep being slightly uncomfortable rather than limit what they eat and do. Lots of societal things male it harder, eg hyper-palatable foods/ads/overworked/food availability, but that’s the long and short of the root cause.