My ex-boss, the one who threatened to disown his fat sister if she didn't get a gastric bypass, was (and is) married to a woman who was obsessed with nutrition and fitness. She was a very nice person, and she was very smart (a microbiologist at a hospital), but she was a little overboard with the whole diet thing. She made home-cooked meals every day, setting aside a specific amount for her husband's lunch the next day. Meals were planned to be low-fat, low-sodium, and the conventional idea of "healthy". She also made sure the store was well-stocked with plenty of fruit for him, and kept some fat-free organic yogurt there. The surgeon general would have an orgasm over this guy's diet. The wife also exercised the man like a dog, making him go on long walks every day, regardless of the weather, and making him do other things like sit-ups and biking as well. He wasn't skinny, but he was about average weight for a fiftyish man.
So imagine his reaction when his doctor called to tell him that his "bad" cholesterol levels were through the roof! Talk about a total freak out! He ranted and raved about how he does EVERYTHING RIGHT, and it's just not fair, and he couldn't imagine what went wrong.
Now, I never learned to keep my mouth shut around the guy, because I'm just not capable. So I thought it would make him feel better if I said that there was a strong genetic component to cholesterol levels, and that it wasn't necessarily anything he was doing wrong.
Well, you'd have thought I'd suggested he copulate with a two-headed goat or something, he was so mad. "What, you mean I don't have any control over this?! That all the dieting and exercise has been for nothing?!"
Control. The magic word--it became immediately clear to me that people want more than anything to have control over their own fates, and he was a huge control freak to begin with. He'd rather have been responsible for having bad health than have good health based on simple luck. He was also annoyed that he'd had to diet and exercise all this time, only to feel like it was for naught over one surrogate endpoint. I didn't continue talking to him about it, but I could have pointed out that cholesterol isn't an absolute indicator of health, and that it could be managed (at that time, I didn't know that statins were pretty much useless).
No matter what you eat, no matter how many crunches you do, no matter how many pounds you lose, the biggest risk factor for death is being alive. Treat it badly, treat it well, whatever you do, your body will eventually wear out, have a part go bad, or get crushed by a falling piano. And now that we're learning that conventional wisdom about weight loss, dieting, and exercise prolonging our lives is not necessarily true, people are starting to question whether they'd rather spend the time they DO have running on a hamster wheel and weighing portions, or doing things that are more enjoyable. The cool thing about Fat Acceptance is that it frees us to think more carefully about how we want to live our lives. Once you realize that you get what anybody gets--a lifetime--you can consider what would make that life well-spent.