Unlikely that there is one single reason and it might be also different from country to country but there seems to be factors like genetic differences towards insulin production levels in East Asians vs western etc. The risk to get diabetes at a much lower BMI (or other metrics) in easter asian is significantly higher than in other parts of the world. There seems to be differences in white vs brown fat ratios etc
Same research in the article linked here “Ethnic Differences in BMI and Disease Risk”, perhaps easier to read, but not as much detail about the research.
It states
" One possible explanation is body fat. When compared to white Europeans of the same BMI, Asians have 3 to 5 percent higher total body fat. (5) South Asians, in particular, have especially high levels of body fat and are more prone to developing abdominal obesity, which may account for their very high risk of type 2 diabetes and cardiovascular disease. (6,7) In contrast, some studies have found that blacks have lower body fat and higher lean muscle mass than whites at the same BMI, and therefore, at the same BMI, may be at lower risk of obesity-related diseases"
Of course the references in the article, and the Pubmed link are better in terms of the actual science, but maybe harder to read.
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Funny.
Some of the thinnest people I know are diabetic.
Funny
It’s a riot.
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Can you explain why you think it’s poorly written and researched?
Do you think it was poorly written from a grammatical perspective (as in “he have fat stomach”) or poorly written as in not coherent (as in one sentence is about food and the very next sentence is about the weather)?
As to research, how was it poorly researched, if at all? I don’t think the Time Magazine piece was a scientific article, or a peer-reviewed meta-analysis, but merely an anecdotical look at the differences in cultural perspectives vis-a-vis food from one person’s on-the-ground reporting. I don’t think it was pretending or trying to be anything more than that.
I am genuinely curious, and not trolling.
I thought this was the most intriguing bit;
“So I was surprised to learn that most of Japan’s food culture was invented very recently—in living memory, in fact. Barak Kushner, who is professor of East Asian History at the University of Cambridge, told the writer Bee Wilson, for her book First Bite , that until the 1920s, Japanese cooking was just “not very good.” Fresh fish was eaten only once a week, the diet was dangerously low in protein, and stewing or stir-frying were not much of a thing. Life expectancy was a mere 43.”
Now I’m left wondering it it “worked”.
Granted there is less “obesity”, however that is defined for this article ( according to the linked article I linked "…China and Japan define overweight as a BMI of 24 or higher and obesity a BMI of 28 or higher; in India, overweight is defined as a BMI of 23 or higher, and obesity, a BMI of 27 or higher), and some of the longest living people live there, but I feel like I still need to figure out if most folks, and especially soldiers, live longer, healthier ( and happier?) lives.
Maybe Type 1 people?
No, these are type 2 diabetics.
They are still producing insulin, but they’re just insulin resistant.
The diabetics I know are definitely not slim.
I know many skinny diabetics
Not sure what made you take it as a “lecture”
Your comment was about the prevalence of diabetes in Japan and the related need for Ozempic
The article is almost entirely about obesity and the author’s conjectures on why there is so much less obesity in Japan than in the US, not about diabetes in the two countries
The only reason to use Ozempic in the title and not Wegovy is it’s more effective clickbait
Without spending a lot more time on something that has already occupied more time than it warranted, they mention the sugary drinks tax in Mexico and ban from schools in Amsterdam. Would not have taken much effort to use the NYC example instead or in addition, and why it ultimately failed.
That’s also a generalization. Perhaps portion-sizes are experiencing an Americanization the world over, but I’ve had PLENTY of meals in Germany - at German or Italian restaurants, where the main dish is comically large. And traditional Wirtshäuser and their Schlachtplatten have always been more than generous, long before doggie bags were even a thing.
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I grew up in Europe as well, and therefore (? 
correlation? causation?) am also a YUGE fan of science.
Fatness is neither the sole nor a reliable indicator of any person’s health. I don’t know ‘many skinny folks with diabetes,’ but I know a meditating, dry vegan* who’s never smoked & who has diabetes along with several other health issues, high cholesterol, high blood pressure, heart problems, etc. - presumably shitty genetics, none of which any of us can do much about besides trying hard to combat or work with what we were given.
I also have a friend roughly my age who, for some reason or another, has started sliding into anorectic disordered eating, and certainly not due to any weight or health issues. Now there’s a far more dangerous illness to talk about.
Lastly, I figured eventually insurance premiums would be mentioned, since we live in a society where we have decided to carry the weight for those less fortunate than us - SWIDT? - by contributing our share, and AFAIK, smokers already pay a higher premium for health insurance (do correct me if I’m wrong - I’m confident someone will).
*Since the OG article was "just an anecdotal collection of nonsense I mean evidence, I thought I could contribute one of my own 
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Some of the skinniest people I know have also had elevated cholestorol (necessiting medication and monitoring) and others I have known with heart disease.
It’s exhausting how many people decide they can diagnose with a mere glance at body-type. (It also reminds me of a time when I was very heavy and experiencing health issues. I sppoke to my doctor, who said “yes, you have health issues, but nothing weight-related”.) Meanwhile, those concern trolling me at the time had little interest in providing support I needed, but instead kept merely suggesting I lose weight to manage X and Y risk. When I gave them my numbers-- all putting me in a place of no risk at all for X and Y-- they suddenly lost all interest.)
I eventually lost weight intentionally, but more so I could finally get diagnoses, which I did. How interesting, though, that so many interested in my health vis a vis my weight in fact had no interest. It was my body size, not my actual conditions that have been the subject of these ostensibly well-meaning gazes. And it’s hardly surprising: It’s much easier to find fault with someone than reflect on the systemic barriers to participation faced by disabled and chronically ill people.
Meanwhile, those with smaller bodies benefit from social approval but also slip past crucial diagnoses (because only fat people, and people who eat X are at risk for heart disease, diabetes, etc.). Don’t even get me started on the fat people with anorexia who go untreated because people assume that no one can be starving themselves and still be fat.
Seriously, fat is a health issue only as far as anti-fat bias is. And usually as an instrument for austerity (as well as racism). I can list my sources, but why? No one will read or is necessary able to access them because of academic paywalls.
I should really not engage, but this topic just gets me riled.
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Btw it’s an excerpt from the author’s new book, not an article
Adapted from MAGIC PILL: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs by Johann Hari. Copyright © 2024 by Johann Hari.
So you are saying there is no scientific correlation between obesity and elevated risk factors for diabetes, CVD and overall life expectancy. I would be interested to see your papers as there are plenty of papers pointing towards these correlations
Type 1 & Type 2 have to be viewed completely differently, but very often get conflated in these types of discussions. That’s also where your comment about whether diabetics are thin or not relates – many of the T1 diabetics I know are thin, many of the T2 are not. T2 used to be called “adult onset” until so many children started getting diagnosed with it.
For Type 1, there’s genetics (including insulin production and resistance, and fat ratios and locations) first. For Type 2, behavioral and environmental factors.
You mentioned rice and other carbs as a possible cause. Given your familiarity with Indian food, you know that South India is a heavy rice consumer. However much of the rice eaten there is par-boiled. Much other carb consumption is after fermentation (idlis, dosa, etc).
Science is only recently catching up with how those things impact insulin response — for eg par-boiling converts some of the starch to resistant starch, which dampens insulin response. (See this other thread about sequencing, combinations, etc as well.)
Causality is very complicated, and often not what it appears on the surface.
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You might be interested to look up some of the work by the endocrine / weight management / metabolism experts I mentioned on the other thread.
There is a growing body of research over the past several decades as to obesity being a symptom and not a cause. Here is one such article. Here is a discussion of the same by Ludwig (who has talked extensively about why the weight set point in the brain sabotages long-term weight loss).
The body isn’t a passive energy-storage depot, it’s a dynamic organism that fights back against calorie restrictions. So we know that when you cut back calories or you try to burn off more calories with exercise, typically we get hungrier and hungrier. It isn’t just a fleeting feeling. It’s a primal biological signal that your body wants more fuel,” he shared.
And even if someone does have the willpower to ignore their hunger for months or even years, the body will continue to fight back by slowing down its metabolism.
So as we continue to lose weight and metabolism slows down, we need fewer and fewer calories to keep the weight off, even as our hunger and desire for those calories increase,” Dr. Ludwig said. “And unless we understand this alternative view of cause and effect, treatment approaches will be at best symptomatic and not effective over the long term.
But it is an uphill battle to fight ingrained societal bias, even with science.
Much easier to blame people and to buy into a simplistic causal relationship even if it is wrong.
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You are writing it as the CIM is a well established model and accepted by the scientific community as the only/leading model. There is a lot of ongoing debate around CIM vs EBM and I don’t think the science is in anyway “settled” there. There is also a lot of criticism of Ludwig, who is one of the low carb gurus (including low carb diet books) - so your conclusion of “ingrained societal bias” is a bit early and just takes those science into account which fits your argument and ignores everything else. It might turn out that CIM will get more established but at this point that is still up for debate and more required data
