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Sunday, November 12, 2023

Software rot

From Wikipedia, the free encyclopedia

Software rot (bit rot, code rot, software erosion, software decay, or software entropy) is either a slow deterioration of software quality over time or its diminishing responsiveness that will eventually lead to software becoming faulty, unusable, or in need of upgrade. This is not a physical phenomenon; the software does not actually decay, but rather suffers from a lack of being responsive and updated with respect to the changing environment in which it resides.

The Jargon File, a compendium of hacker lore, defines "bit rot" as a jocular explanation for the degradation of a software program over time even if "nothing has changed"; the idea behind this is almost as if the bits that make up the program were subject to radioactive decay.

Causes

Several factors are responsible for software rot, including changes to the environment in which the software operates, degradation of compatibility between parts of the software itself, and the appearance of bugs in unused or rarely used code.

Environment change

When changes occur in the program's environment, particularly changes which the designer of the program did not anticipate, the software may no longer operate as originally intended. For example, many early computer game designers used the CPU clock speed as a timer in their games. However, newer CPU clocks were faster, so the gameplay speed increased accordingly, making the games less usable over time.

Onceability

There are changes in the environment not related to the program's designer, but its users. Initially, a user could bring the system into working order, and have it working flawlessly for a certain amount of time. But, when the system stops working correctly, or the users want to access the configuration controls, they cannot repeat that initial step because of the different context and the unavailable information (password lost, missing instructions, or simply a hard-to-manage user interface that was first configured by trial and error). Information Architect Jonas Söderström has named this concept Onceability, and defines it as "the quality in a technical system that prevents a user from restoring the system, once it has failed".

Unused code

Infrequently used portions of code, such as document filters or interfaces designed to be used by other programs, may contain bugs that go unnoticed. With changes in user requirements and other external factors, this code may be executed later, thereby exposing the bugs and making the software appear less functional.

Rarely updated code

Normal maintenance of software and systems may also cause software rot. In particular, when a program contains multiple parts which function at arm's length from one another, failing to consider how changes to one part that affect the others may introduce bugs.

In some cases, this may take the form of libraries that the software uses being changed in a way which adversely affects the software. If the old version of a library that previously worked with the software can no longer be used due to conflicts with other software or security flaws that were found in the old version, there may no longer be a viable version of a needed library for the program to use.

Online connectivity

Modern commercial software often connects to an online server for license verification and accessing information. If the online service powering the software is shut down, it may stop working.

Since the late 2010s most websites use secure HTTPS connections. However this requires encryption keys called root certificates which have expiration dates. After the certificates expire the device loses connectivity to most websites unless the keys are continuously updated.

Another issue is that in March 2021 old encyption standards TLS 1.0 and TLS 1.1 were deprecated. This means that operating systems, browsers and other online software that do not support at least TLS 1.2 cannot connect to most websites, even to download patches or update the browser, if these are available. This is occasionally called the "TLS apocalypse".

Products that cannot connect to most websites include PowerMacs, old Unix boxes and Microsoft Windows versions older than Server 2008/Windows 7. The Internet Explorer 8 browser in Server 2008/Windows 7 does support TLS 1.2 but it is disabled by default.

Classification

Software rot is usually classified as being either dormant rot or active rot.

Dormant rot

Software that is not currently being used gradually becomes unusable as the remainder of the application changes. Changes in user requirements and the software environment also contribute to the deterioration.

Active rot

Software that is being continuously modified may lose its integrity over time if proper mitigating processes are not consistently applied. However, much software requires continuous changes to meet new requirements and correct bugs, and re-engineering software each time a change is made is rarely practical. This creates what is essentially an evolution process for the program, causing it to depart from the original engineered design. As a consequence of this and a changing environment, assumptions made by the original designers may be invalidated, thereby introducing bugs.

In practice, adding new features may be prioritized over updating documentation; without documentation, however, it is possible for specific knowledge pertaining to parts of the program to be lost. To some extent, this can be mitigated by following best current practices for coding conventions.

Active software rot slows once an application is near the end of its commercial life and further development ceases. Users often learn to work around any remaining software bugs, and the behaviour of the software becomes consistent as nothing is changing.

Examples

AI program example

Many seminal programs from the early days of AI research have suffered from irreparable software rot. For example, the original SHRDLU program (an early natural language understanding program) cannot be run on any modern day computer or computer simulator, as it was developed during the days when LISP and PLANNER were still in development stage, and thus uses non-standard macros and software libraries which do not exist anymore.

Online forum example

Suppose an administrator creates a forum using open source forum software, and then heavily modifies it by adding new features and options. This process requires extensive modifications to existing code and deviation from the original functionality of that software.

From here, there are several ways software rot can affect the system:

  • The administrator can accidentally make changes which conflict with each other or the original software, causing the forum to behave unexpectedly or break down altogether. This leaves them in a very bad position: as they have deviated so greatly from the original code, technical support and assistance in reviving the forum will be difficult to obtain.
  • A security hole may be discovered in the original forum source code, requiring a security patch. However, because the administrator has modified the code so extensively, the patch may not be directly applicable to their code, requiring the administrator to effectively rewrite the update.
  • The administrator who made the modifications could vacate their position, leaving the new administrator with a convoluted and heavily modified forum that lacks full documentation. Without fully understanding the modifications, it is difficult for the new administrator to make changes without introducing conflicts and bugs. Furthermore, documentation of the original system may no longer be available, or worse yet, misleading due to subtle differences in functional requirements.

Refactoring

Refactoring is a means of addressing the problem of software rot. It is described as the process of rewriting existing code to improve its structure without affecting its external behaviour. This includes removing dead code and rewriting sections that have been modified extensively and no longer work efficiently. Care must be taken not to change the software's external behaviour, as this could introduce incompatibilities and thereby itself contribute to software rot.

 

Rheumatism

From Wikipedia, the free encyclopedia
 
Rheumatism
Other namesRheumatic disease
SpecialtyRheumatology
ComplicationsAmplified musculoskeletal pain syndrome

Rheumatism or rheumatic disorders are conditions causing chronic, often intermittent pain affecting the joints or connective tissue. Rheumatism does not designate any specific disorder, but covers at least 200 different conditions, including arthritis and "non-articular rheumatism", also known as "regional pain syndrome" or "soft tissue rheumatism". There is a close overlap between the term soft tissue disorder and rheumatism. Sometimes the term "soft tissue rheumatic disorders" is used to describe these conditions.

The term "Rheumatic Diseases" is used in MeSH to refer to connective tissue disorders. The branch of medicine devoted to the diagnosis and therapy of rheumatism is called rheumatology.

Types

Many rheumatic disorders of chronic, intermittent pain (including joint pain, neck pain or back pain) have historically been caused by infectious diseases. Their etiology was unknown until the 20th century and not treatable. Postinfectious arthritis, also known as reactive arthritis, and rheumatic fever are other examples.

In the United States, major rheumatic disorders are divided into 10 major categories based on the nomenclature and classification proposed by the American College of Rheumatology (ACR) in 1983.

Diagnosis

Blood and urine tests will measure levels of creatinine and uric acid to determine kidney function, an elevation of the ESR and CRP is possible. After a purine-restricted diet, another urine test will help determine whether the body is producing too much uric acid or the body isn't excreting enough uric acid. Rheumatoid factor may be present, especially in the group that is likely to develop rheumatoid arthritis. A fine needle is used to draw fluid from a joint to determine if there is any build up of fluid. The presence of uric acid crystals in the fluid would indicate gout. In many cases there may be no specific test, and it is often a case of eliminating other conditions before getting a correct diagnosis.

Management

Initial therapy of the major rheumatological diseases is with analgesics, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Steroids, especially glucocorticoids, and stronger analgesics are often required for more severe cases.

Etymology

The term rheumatism stems from the Late Latin rheumatismus, ultimately from Greek ῥευματίζομαι "to suffer from a flux", with rheum meaning bodily fluids, i.e., any discharge of blood or bodily fluid.

Before the 17th century, the joint pain which was thought to be caused by viscous humours seeping into the joints was always referred to as gout, a word adopted in Middle English from Old French gote "a drop; the gout, rheumatism".

The English term rheumatism in the current sense has been in use since the late 17th century, as it was believed that chronic joint pain was caused by excessive flow of rheum which means bodily fluids into a joint.

Rheumatology

From Wikipedia, the free encyclopedia
Rheumatology
SystemMusculoskeletal, Immune
Significant diseasesAutoimmune disease Inflammation, Rheumatoid arthritis, Lupus, Osteoarthritis, Psoriatic arthritis, Ankylosing spondylitis, Gout, Osteoporosis
Significant testsJoint aspirate, Musculoskeletal exam, X-ray
SpecialistRheumatologist

Rheumatology (Greek ῥεῦμα, rheûma, flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatology covers more than 100 different complex diseases, collectively known as rheumatic diseases, which includes many forms of arthritis as well as lupus and Sjögren's syndrome. Doctors who have undergone formal training in rheumatology are called rheumatologists.

Many of these diseases are now known to be disorders of the immune system, and rheumatology has significant overlap with immunology, the branch of medicine that studies the immune system.

Rheumatologist

Rheumatologist
Occupation
NamesDoctor, Medical Specialist
Occupation type
Specialty
Activity sectors
Medicine
Description
Education required
Fields of
employment
Hospitals, Clinics

A rheumatologist is a physician who specializes in the field of medical sub-specialty called rheumatology. A rheumatologist holds a board certification after specialized training. In the United States, training in this field requires four years undergraduate school, four years of medical school, and then three years of residency, followed by two or three years additional Fellowship training. The requirements may vary in other countries. Rheumatologists are internists who are qualified by additional postgraduate training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists also conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases. Treatment modalities are based on scientific research, currently, practice of rheumatology is largely evidence based.

Rheumatologists treat arthritis, autoimmune diseases, pain disorders affecting joints, and osteoporosis. There are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, and tendinitis. Some of these are very serious diseases that can be difficult to diagnose and treat. They treat soft tissue problems related to the musculoskeletal system, and sports related soft tissue disorders.

Diseases

Diseases diagnosed or managed by rheumatologists include:

Degenerative arthropathies

Inflammatory arthropathies

Systemic conditions and connective tissue diseases

Medical laser for the treatment of rheumatism.

Soft tissue rheumatism

Local diseases and lesions affecting the joints and structures around the joints including tendons, ligaments capsules, bursae, stress fractures, muscles, nerve entrapment, vascular lesions, and ganglia. For example:

Diagnosis

Synovial fluid examination
Type WBC (per mm3) % neutrophils Viscosity Appearance
Normal <200 0 High Transparent
Osteoarthritis <5000 <25 High Clear yellow
Trauma <10,000 <50 Variable Bloody
Inflammatory 2,000–50,000 50–80 Low Cloudy yellow
Septic arthritis >50,000 >75 Low Cloudy yellow
Gonorrhea ~10,000 60 Low Cloudy yellow
Tuberculosis ~20,000 70 Low Cloudy yellow
Inflammatory: Arthritis, gout, rheumatoid arthritis, rheumatic fever

Physical examination

Following are examples of methods of diagnosis able to be performed in a normal physical examination.

  • Schober's test tests the flexion of the lower back.
  • Multiple joint inspection
  • Musculoskeletal Examination
    • Screening Musculoskeletal Exam (SMSE) - a rapid assessment of structure and function
    • General Musculoskeletal Exam (GMSE) - a comprehensive assessment of joint inflammation
    • Regional Musculoskeletal Exam (RMSE) - focused assessments of structure, function and inflammation combined with special testing

Specialized

Treatment

Most rheumatic diseases are treated with analgesics, NSAIDs (nonsteroidal anti-inflammatory drug), steroids (in serious cases), DMARDs (disease-modifying antirheumatic drugs), monoclonal antibodies, such as infliximab and adalimumab, the TNF inhibitor etanercept, and methotrexate for moderate to severe rheumatoid arthritis. The biologic agent rituximab (anti-B cell therapy) is now licensed for use in refractory rheumatoid arthritis. Physiotherapy is vital in the treatment of many rheumatological disorders. Occupational therapy can help patients find alternative ways for common movements that would otherwise be restricted by their disease. Patients with rheumatoid arthritis often need a long term, coordinated and a multidisciplinary team approach towards management of individual patients. Treatment is often tailored according to the individual needs of each patient which is also dependent on the response and the tolerability of medications.

Beginning in the 2000s, the incorporation of biopharmaceuticals (which include inhibitors of TNF-alpha, certain interleukins, and the JAK-STAT signaling pathway) into standards of care is one of the paramount developments in modern rheumatology.

Rheumasurgery

Rheumasurgery (or rheumatoid surgery) is a subfield of orthopedics occupied with the surgical treatment of patients with rheumatic diseases. The purpose of the interventions is to limit disease activity, soothe pain and improve function.

Rheumasurgical interventions can be divided in two groups. The one is early synovectomies, that is the removal of the inflamed synovia in order to prevent spreading and stop destruction. The other group is the so-called corrective intervention, i.e. an intervention done after destruction has taken place. Among the corrective interventions are joint replacements, removal of loose bone or cartilage fragments, and a variety of interventions aimed at repositioning and/or stabilizing joints, such as arthrodesis.

Research directions

Recently, a large body of scientific research deals with the background of autoimmune disease, the cause of many rheumatic disorders. Also, the field of osteoimmunology has emerged to further examine the interactions between the immune system, joints, and bones. Epidemiological studies and medication trials are also being conducted. The Rheumatology Research Foundation is the largest private funding source of rheumatology research and training in the United States.

History

Rheumasurgery emerged in the cooperation of rheumatologists and orthopedic surgeons in Heinola, Finland, during the 1950s.

In 1970 a Norwegian investigation estimated that at least 50% of patients with rheumatic symptoms needed rheumasurgery as an integrated part of their treatment.

The European Rheumatoid Arthritis Surgical Society (ERASS) was founded in 1979.

Around the turn of the 21st century, focus for treatment of patients with rheumatic disease shifted, and pharmacological treatment became dominant, while surgical interventions became rarer.

Obesity-associated morbidity

From Wikipedia, the free encyclopedia
 
Obesity-associated morbidity
Obesity may cause a number of medical complications which negatively impact peoples' quality of life.
Death rate from obesity, 2019

Obesity is a risk factor for many chronic physical and mental illnesses.

The health effects of being overweight but not obese are controversial, with some studies showing that the mortality rate for individuals who are classified as overweight (BMI 25.0 to 29.9) may actually be lower than for those with an ideal weight (BMI 18.5 to 24.9). Health risks for those who are overweight may be decreasing over time as a result of improvements in medical care. Some obesity-associated medical conditions may be the result of stress caused by medical discrimination against people who are obese, rather than the direct effects of obesity, and some may be exacerbated by the relatively poor healthcare received by people who are obese.

Medical discrimination

Because of the social stigma of obesity, people who are obese may receive poorer healthcare than people within the normal BMI weight range, potentially contributing to the relationship between obesity and poor health outcomes. People who experience weight-related discrimination, irrespective of their actual weight status, similarly have poorer health outcomes than those who do not experience weight-related discrimination. People who are obese are also less likely to seek medical care than people who are not obese, even if the weight gain is caused by medical problems. Peter Muennig, a professor in the Department of Health Policy and Management at Columbia University, has proposed that obesity-associated medical conditions may be caused "not from adiposity alone, but also from the psychological stress induced by the social stigma associated with being obese".

Cardiological risks

Heart attack (myocardial infarction)

Body weight is not considered to be an independently predictive risk factor for cardiovascular disease by current (as of 2014) risk assessment tools. Mortality from cardiovascular disease has decreased despite increases in obesity, and at least one clinical trial was stopped early because the weight loss intervention being tested did not reduce cardiovascular disease.

Ischemic heart disease

Abdominal obesity is associated with cardiovascular diseases including angina and myocardial infarction. However, overall obesity (as measured by BMI) may lead to false diagnoses of myocardial infarction and may decrease mortality after acute myocardial infarction.

In 2008, European guidelines concluded that 35% of ischemic heart disease among adults in Europe is due to obesity.

Congestive heart failure

Having obesity is associated to about 11% of heart failure cases in males and 14% in females.

High blood pressure

More than 85% of those with hypertension have a BMI greater than 25, although diet is probably a more important factor than body weight. Risk estimates indicate that at least two-thirds of people with hypertension can be directly attributed to obesity. The association between obesity and hypertension has been found in animal and clinical studies, which have suggested that there are multiple potential mechanisms for obesity-induced hypertension. These mechanisms include the activation of the sympathetic nervous system as well as the activation of the renin–angiotensin–aldosterone system. As of 2007, it was unclear whether there is an association between hypertension and obesity in children, but there is little direct evidence that blood pressure has increased despite increases in pediatric overweight.

Abnormal cholesterol levels

Obesity is associated with increased levels of LDL cholesterol and lower levels of HDL cholesterol in the blood.

Deep vein thrombosis and pulmonary embolism

Obesity increases one's risk of venous thromboembolism by approximately 2.3 fold.

Dermatological risks

Obesity is associated with the incidence of stretch marks, acanthosis nigricans, lymphedema, cellulitis, hirsutism, and intertrigo.

Endocrine risks

Gynecomastia in an obese male

Diabetes mellitus

The link between obesity and type 2 diabetes is so strong that researchers in the 1970s started calling it "diabesity". Excess weight is behind 64% of cases of diabetes in males and 77% of cases in females.

Gynecomastia

In some individuals, obesity can be associated with elevated peripheral conversion of androgens into estrogens.

Gastrointestinal risks

Gastroesophageal reflux disease

Several studies have shown that the frequency and severity of GERD symptoms increase with BMI, such that people who are underweight have the fewest GERD symptoms, and people who are severely obese have the most GERD symptoms. However, most studies find that GERD symptoms are not improved by nonsurgical weight loss.

Cholelithiasis (gallstones)

Obesity causes the amount of cholesterol in bile to rise, in turn the formation of stone can occur.

Reproductive system (or genital system)

Polycystic ovarian syndrome (PCOS)

Due to its association with insulin resistance, the risk of obesity increases with polycystic ovarian syndrome (PCOS). In the US approximately 60% of patients with PCOS have a BMI greater than 30. It remains uncertain whether PCOS contributes to obesity, or the reverse.

Infertility

Obesity can lead to infertility in both males and females. This is primarily due to excess estrogen interfering with normal ovulation in females and altering spermatogenesis in males. It is believed to cause 6% of primary infertility. A review in 2013 came to the result that obesity increases the risk of oligospermia and azoospermia in males, with an of odds ratio 1.3. Being morbidly obese increases the odds ratio to 2.0.

Complications of pregnancy

Obesity is related to many complications in pregnancy including: haemorrhage, infection, increased hospital stays for the mother, and increased NICU requirements for the infant. Obese females also have increased risk of preterm births and low birth weight infants.

Obese females have more than twice the rate of C-sections compared to females of "normal" weight. Some have suggested that this may be due in part to the social stigma of obesity.

Birth defects

Those who are obese during pregnancy have a greater risk of have a child with a number of congenital malformations including: neural tube defects such as anencephaly and spina bifida, cardiovascular anomalies, including septal anomalies, cleft lip and palate, anorectal malformation, limb reduction anomalies, and hydrocephaly.

Intrauterine fetal death

Maternal obesity is associated with an increased risk of intrauterine fetal death.

Buried penis

Excess body fat in morbid obesity can, in some cases, completely obscure or "bury" the penis.

Neurological risks

MCA territory infarct (stroke)

Stroke

Ischemic stroke is increased in both men and women who are obese.

Meralgia paresthetica

Meralgia paresthetica is a neuropathic pain or numbness of the thighs, sometimes associated with obesity.

Migraines

Migraine (and headaches in general) is comorbid with obesity. The risk of migraine rises 50% by BMI of 30 kg/m2 and 100% by BMI of 35 kg/m2. The causal connection remains unclear.

Carpal tunnel syndrome

The risk of carpal tunnel syndrome is estimated to rise 7.4% for each 1 kg/m2 increase of body mass index.

Dementia

One review found that those who are obese do not have a significantly higher rate of dementia than those with "normal" weight.

Idiopathic intracranial hypertension

Idiopathic intracranial hypertension, or unexplained high pressure in the cranium, is a rare condition that can cause visual impairment, frequent severe headache, and tinnitus. It is most commonly seen in obese women, and the incidence of idiopathic intracranial hypertension is increasing along with increases in the number of people who are obese.

Multiple sclerosis

Obese female individuals at 18 years of age have a greater than twofold increased risk of multiple sclerosis compared to females with a BMI between 18.5 and 20.9. Female individuals who are underweight at age 18 have the lowest risk of multiple sclerosis. However, body weight as an adult was not associated with risk of multiple sclerosis.

Cancer

Hepatocellular carcinoma 1

Many cancers occur at increased frequency in those who are overweight or obese. A study from the United Kingdom found that approximately 5% of cancer is due to excess weight. These cancers include:

A high body mass index (BMI) is associated with a higher risk of developing ten common cancers including 41% of uterine cancers and at least 10% of gallbladder, kidney, liver and colon cancers in the UK. For those undergoing surgery for cancer, obesity is also associated with an increased risk of major postoperative complications compared with those of "normal" weight.

Psychiatric risks

Risk of death from suicide decreases with increased body mass index in the United States.

Depression

Obesity has been associated with depression, likely due to social factors rather than physical effects of obesity. However, it is possible that obesity is caused by depression (due to reduced physical activity or, in some people, increases in appetite). Obesity-related disabilities may also lead to depression in some people. Repeated failed attempts at weight loss might also lead to depression.

The association between obesity and depression is strongest in those who are more severely obese, those who are younger, and in women. Suicide rate however decreases with increased BMI. Similarly, weight loss through bariatric surgery is associated with increased risk of suicide.

Social stigmatization

Obese people draw negative reactions from others, and people are less willing to help obese individuals in any situation due to social stigmatization. People who are obese also experience fewer educational and career opportunities, on average earn a lesser income, and generally receive poorer health care and treatment than individuals of "normal" weight.

Respiratory system

Obstructive sleep apnea

Obesity is a risk factor for obstructive sleep apnea.

Obesity hypoventilation syndrome

CPAP machine commonly used in OHS

Obesity hypoventilation syndrome is defined as the combination of obesity, hypoxia during sleep, and hypercapnia during the day, resulting from hypoventilation.

Chronic lung disease

Obesity is associated with a number of chronic lung diseases, including asthma and COPD. It is believed that a systemic pro-inflammatory state induced by some causes of obesity may contribute to airway inflammation, leading to asthma.

Complications during general anaesthesia

Obesity significantly reduces and stiffens the functional lung volume, requiring specific strategies for respiratory management under general anesthesia.

Obesity and asthma

The low grade systemic inflammation of obesity has been shown to worsen lung function in asthma and increase the risk of developing an asthma exacerbation.

COVID-19

A study in England found a linear increase in severe COVID-19 resulting in hospitalisation and death for those whose BMI is above 23, and a linear increase in admission to an intensive care unit across the whole BMI spectrum. The difference in COVID-19 risk from having a high BMI was most pronounced in people aged under 40, or who were black. A study from Mexico found that obesity alone was responsible for a 2.7 times increased risk of death from COVID-19, while comorbidities with diabetes, immunosuppression or high blood pressure increased the risk further. A study from the United States found that there was an inverse correlation between age and BMI of COVID patients; the younger the age group, the higher its BMI.

Rheumatological and orthopedic risks

Gout

Gout

Compared to men with a BMI of 21–22.9, men with a BMI of 30–34.9 have 2.33 times more gout, and men with a BMI ≥ 35 have 2.97 times more gout. Weight loss decreases these risks.

Poor mobility

There is a strong association between obesity and musculoskeletal pain and disability.

Osteoarthritis

Increased rates of arthritis are seen in both weight-bearing and non-weight-bearing joints. Weight loss and exercise act to reduce the risk of osteoarthritis.

Low back pain

Obese individuals are twice to four times more likely to have lower back pain than their "normal" weight peers.

Traumatic injury

In females, low BMI is a risk factor for osteoporotic fractures in general. In contrast, obesity is a protective factor for most osteoporotic fractures.

Urological and nephrological risks

Urinary system

Urinary incontinence

Urge, stress, and mixed incontinence all occur at higher rates in obese people. The rates of urinary incontinence are about double that found in the "normal" weight population. Urinary incontinence improves with weight loss.

Chronic kidney disease

Obesity increases one's risk of chronic kidney disease by three to four times.

Hypogonadism

In males, obesity and metabolic syndrome both increase estrogen and adipokine production. This reduces gonadotropin-releasing hormone, in turn reducing both luteinizing hormone and follicle stimulating hormone. The result is reduction of the testis' production of testosterone and a further increase in adipokine levels. This then feeds back to cause further weight gain.

Erectile dysfunction

Obese male individuals can experience erectile dysfunction, and weight loss can improve their sexual functioning.

Body positivity

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Body_positivity
The sculpture of two women in bronze, Jag tänker på mig själv - Växjö ( 'I am thinking of myself - Växjö') by Marianne Lindberg De Geer, 2005, outside of the art museum of Växjö, Sweden. It depicts one thin woman and one fat woman and demonstrates society's infatuation with outward appearances. The sculpture has been a source of controversy in town, with both statues being vandalized and repaired during 2006.

Body positivity is a social movement focused on the acceptance of all bodies, regardless of size, shape, skin tone, gender, and physical abilities, while challenging present-day beauty standards as an undesirable social construct. Proponents focus on the appreciation of the functionality and health of the human body, instead of its physiological appearance.

This is similar to the concept of body neutrality, that focuses on a similar concept.

Viewpoints

Elizabeth Smith Miller, best known for being the first woman to wear the costume of Turkish pantaloons and knee-length skirts. She contributed to the Victorian Dress Reform, a specific event that shaped the modern body positivity movement.

Body-positive advocates believe that size, like race, gender, sexuality, and physical capability, is one of the many ways that our bodies are placed in a power and desirability hierarchy. In other words, judgments about one's physical appearance inherently place one on a certain rung of a ladder that rates and values one's desirability, effectively increasing or reducing one's power in society. The movement aims to challenge unrealistic ideals of physical attractiveness, build positive body image, and improve self-confidence. A central belief advocated is that beauty is a construct of society and that this construct should not determine one's confidence or self-worth. Individuals are encouraged to love themselves to the fullest while not only accepting but even embracing their physical traits.

Body positivity has roots in the fat acceptance movement as well as the National Association to Advance Fat Acceptance. Body positivity differs from fat acceptance in that it is all encompassing and inclusive of all body types, whereas fat acceptance only advocates for individuals considered to be obese or overweight. The movement argues that neither fat-shaming nor skinny-shaming is acceptable, and that all body types can and should be celebrated.

Although body positivity is perceived as the celebration of one's physical appearance as it is, women are highly motivated to advocate the normalization of body hair, bodily fluids, menstruation, and to challenge preconceived ideas regarding a woman's appearance.

History

Victorian Dress Reform Movement (1850s–1890s)

As part of the first wave of feminism from the 1850s-1890s, the Victorian Dress Reform Movement aimed to put an end to the trend of women having to modify their bodies through use of corsets and tightlacing in order to fit the societal standard of tiny waistlines. A minority of women participated in this tradition of conformity, but often ended up facing ridicule whether or not they were successful at shrinking their waistline. The practice of tight-lacing proved to have many negative health risks, and was also extremely uncomfortable for women who partook. Women were mocked for their egotism if they were not able to shrink their waistline, and they were criticized for too small a waistline if they were successful. This instilled a feeling of defeat in women during these times, as nothing they did seemed to satisfy their male counterparts. As part of the Victorian Dress Reform Movement, women also fought for their right to dress in pants. Acceptance of all body types – regardless of waist measurements – was the major theme of the Victorian Dress Reform Movement, and this was the first movement of its kind.

First wave (1960s)

The origins of the body positivity movement date back to the Fat Acceptance movement of the 1960s. The idea of ending fat-shaming served as the seed of a larger project of accepting and celebrating all bodies and body types.

In 1967, New York radio host Steve Post held a "fat-in" in Central Park. This event involved a group of people who were partaking while holding posters of a famous thin woman and setting diet books on fire. He described the purpose of the event "was to protest discrimination against the fat." This moment is often cited as the beginning of the Fat Acceptance movement. Five months after the "fat-in", Lew Louderback composed an essay entitled "More People Should be Fat!" as a result of him witnessing the discrimination his wife experienced for her size. The essay shed light on the discrimination fat people experience in America and the culture surrounding fat-shaming. Louderback's contribution inspired the creation of the National Association to Advance Fat Acceptance (NAAFA) in 1969 by Bill Fabrey, with the mission of ending discrimination based on body weight.

Second wave (1990s)

The second wave of the body positivity movement prioritized providing people of all sizes a place where they could comfortably come together and exercise. There were programs being made specifically for overweight people, such as Making Waves. Home exercise programs like Genia Pauli Haddon and Linda DeMarco's home exercise video series Yoga For Round Bodies were also made for those who were not comfortable joining a wellness community. During the 90's, dangers in dieting were found, mostly saying that it was ineffective and caused more physical and psychological problems, and did not actually solve anything. Therefore, people sought help from dieting. They wanted to learn how to eat again. Chronic dieting had not proven to be effective. Dieting had been used as a ploy to get people's money and proven to not actually work, especially in the long term.

Third wave (2010s)

The third wave of the body positivity movement arose around 2012 largely as a response to the increase in social media culture and advertisements. The rise of Instagram inspired a debate about cultural beauty standards, and the body positivity movement arose as a response and argument in favor of embracing all body types, loving, and feeling confident about one's own body even with any flaws. Since 2012, there has been a heightened presence of the movement, although corporations have capitalized on the sentiments in order to sell products.

The movement challenged ideals including unblemished skin and slim "beach bodies". Model and feminist Tess Holliday founded '@EffYourBeautyStandards', which brought an outpour of support to the body positivity movement. After founding the movement, the size-26 Holliday was signed to Milk Management, a large model agency in Europe, as their first model over size 20. Instagram has been utilized as an advertising platform for the movement since. Pioneers connect with brands and advertisers to promote the movement. In 2016, Mattel released a new line of Barbie dolls under the name Fashionistas with three different body shapes, seven skin colors, twenty-two eye colors and twenty-four hairstyles to be more inclusive. Additionally, in the spring 2019 New York Fashion Week, a total of 49 models that were considered plus-size made an appearance in 12 shows. These plus-size models were also hired to be featured on fashion campaigns as well as magazine covers.

Psychology

The body positivity movement aims to change societal and individual perceptions of weight, size, and appearance to be more accepting of all bodies regardless of their diverse characteristics. An individual's perception of their body can greatly influence their mental health and overall well-being, particularly in teenagers. Poor body image, also known as body dissatisfaction, has been linked to a range of physical and mental health problems including anorexia, bulimia, depression, body image disturbance, and body dysmorphic disorder. Partakers are encouraged to view self-acceptance and self-love as traits that dignify the person.

The movement advocates against determining self-worth based on physical appearance or perceptions of one's own beauty. In the field of psychology, this is referred to as appearance-contingent self-worth, and can be highly detrimental to an individual's mental health. The degree to which one feels proud of their physical appearance is referred to as appearance self-esteem. People who fall under the appearance-contingent self-worth umbrella put great effort into looking their best so that they feel their best. This is can be beneficial when an individual feels that they look good, but is extremely negative and anxiety-inducing when they do not.

Inclusion

The body positivity movement focuses largely on women, recognizing that women face more societal pressure to conform to beauty standards than men. Eating disorders are more common in women due to this social phenomenon. Nevertheless, men may face societal pressures to fit into a masculine physical ideal. Qualities that fit that mold are height, rectus abdominis muscle or "six pack abs", a broad upper body, muscular arms, shoulders, pectoral muscles, genital shape and size, etc. Men may face anxiety and pressure to shape their bodies to fit this mold and may struggle with body image disorders, including body dysmorphia, anorexia nervosa and bulimia nervosa. Eating disorders in men are less commonly diagnosed and therefore less publicized. Although there is an underdiagnosis of body dysmorphic disorder, the clinical symptoms can affect people of any gender. While body positivity has largely been discussed with regard to women, the body positivity movement may uplift people of all genders and sexes - as well as ages, races, ethnicities, sexual preferences, and religions.

Brand influence and social media

Due to social media the notion "every body is beautiful" came into being. The movement for body positivity has played a role in influencing marketing campaigns for major corporations. In 2004, Dove launched their "Real Beauty" campaign, in which advertisements depicted women of varying body types and skin tones in a manner that portrayed acceptance and positivity towards their bodies. On their website, Dove presents its Dove Self-Esteem Project as a mission for "helping young people reach their full potential by delivering quality body confidence and self-esteem education". The company also partners with and raises money for eating disorder organizations.

In 2017, the American women's underwear company Aerie launched a campaign called "AerieReal", in which the company promised to not retouch or edit their models, encouraging body positivity and body-acceptance despite features such as cellulite, stretch marks, or fat rolls. Aerie has begun featuring body positive influencers in their photo shoots and advertising campaigns, as well as plus sized models. To accommodate the last, the brand has launched a plus size clothing line.

In 2019, Decathlon joined the efforts of other companies with their #LeggingsForEverybody campaign, stating their mission as "to boost body confidence and support you in your fitness journey".

Recently, paradigms on social media have been changing from pushing feminine beauty ideals to challenging those ideals through image related empowerment and inspiration. Several influencers such as AerieReal model Iskra Lawrence have been preaching body positivity, creating hashtags such as #IWokeUpLikeThis, #EffYourBeautyStandards, #HonorMyCurves, #CelebrateMySize, #GoldenConfidence, and #ImNoModelEither.

Social media plays a pivotal role in the body positivity movement, in part by providing education and exposure on different body types. Instagram and Facebook are some social platforms that, as of 2019, have body positive policies that cause advertisements for cosmetic surgery, weight loss supplements, and detox products, to be hidden from underaged demographics. In addition to promoting positive body image, these policies aim to curb the advertisement of supplements unregulated by the Food and Drug Administration (FDA). Social media platforms such as Instagram are frequently used to post body positivity content and fuel related discussion.

Although studies about social media and body image are still in their early stages, there seems to be a correlation between social media use and body image concerns. Body image tends to be positively or negatively affected by the content to which people are exposed on social media. The action of people uploading pictures of themselves appears to effectuate a negative body image.

Criticism

The body positivity movement has been criticized for encouraging lifestyle habits that negatively affect one's health. A central complaint is that excessive approval of overweight and obese individuals could dissuade them from desiring to improve their health, leading to lifestyle disease. Among health professionals, agreement with the movement is very low. A 2012 study found that among a sample of 1,130 trainee dietitians, nutritionists, nurses and medical doctors, only 1.4% had "positive or neutral attitudes" regarding excess body fat.

The movement has also faced criticism from feminists. Gender scholar Amber E. Kinser wrote that posting an unedited photo of your body to a social media website, which is an example of an action associated with the movement, does little to prevent women's worth from being directly correlated to their physical appearance.

With the majority of the body positivity movement recently occurring on Instagram, a recent study found that 40 percent of body positivity posts were centered around appearance. With Instagram being a photo-sharing social media site, the effort to place the focus less on appearance has been criticized to be contradictory.

Another criticism is that the movement puts too much emphasis on the role of the individual to improve their own body image, and not enough attention on identifying and eliminating the cultural forces, messages, beliefs, and advertising campaigns accountable for causing widespread body dissatisfaction.

The criticism has also been leveled that the movement can impair one's agency and authenticity. Researcher Lisa Legault argues that an undue emphasis on body positivity can "stifle and diminish important negative feelings." She explains that negative feelings are a natural part of the human experience and that such feelings can be important and informational. She says "ignoring negative feelings and experiences exerts a cost to authenticity and self-integration." The movement, Legault argues, cannot make it seem like a person should only feel positive emotions. This expectation to have only positive feelings is sometimes called "toxic body positivity."

Positive effects of body positivity

Understanding the positive impacts of body positivity has allowed society to embrace new ways of thinking about the self and individual bodies. According to Chef Sky Hanka, there are different ways to love your body but also ditch negativity. The idea of body positivity can result in individuals feeling more optimistic about their bodies, which can lead to improved self-esteem and overall self-confidence. Embracing body positivity starts with thoughts, words, and actions. Individuals spend the most time with themself, so they must not break their relationship with themselves.  When embracing body positivity, a person should not beat themself up if there are moments when they are struggling with their body image. Working with body positivity, step by step – will eventually improve one’s self-esteem. 

A healthy person often has a relationship with their body. Because they are motivated by self-care rather than shame or guilt, people who are body positive engage in healthy habits like exercise and balanced eating. Positive emotions can enhance physical health.  Body positivity requires one to practice positive thinking towards their body. Some of the physical health benefits of this way of thinking are “Increased lifespan,” Lower levels of distress and pain,” Greater resistance to illnesses,” reduced risk of death from respiratory conditions,” and “reduced risk of death from infections.” Practicing body positivity will help increase an individual’s desire for self-care, leading to better habit-building and helping them define what wellness means to them. 

It also improves mental health. One can reduce anxiety and depression by being body positive. Having a positive approach to life and accepting uncomfortable situations has proven to help keep one's mind healthy and resilient.  Body positivity is, "the mindset that everyone is worthy of love and a positive body image, regardless of how the media and society tries to define beauty or the ideal body type." When individuals have a positive body image, they reduce the development of Anxiety and depression.

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