The stupid explodes: obesity now a disability

[The Atheist]

So yeah, we have biological drives and we pick our poisons based on whatever makes us feel "fixed." Which is probably in itself a caution against shaming behavior. IMO, people who are self-medicating because they think they're crap don't actually need to feel any crappier.

Yet it appears the "food fix" is a myth.

We don't actually have comfort foods, we just think we do.

1 2 3 4 They may include repeats, but there's a point of obviousness beyond which I don't get too excited.
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Seems to me we're losing sight of the big picture, which is that we are setting up an entire generation of health problems and premature death, simply because we don't feel comfortable doing something about it.

The stupid part is, it doesn't even need to be shaming. I have no compunction saying to a friend who has packed on the fat: "Mate! Have you piled on a few kgs lately?"

I will also tell them I'd like to help, when they feel the need to do something about it.

 

[casebro]

The BMI concept was supposed to be a formulaic conversion of the Metropolitan Life height/weight tables, circa 1920s. I have never seen any data backing those tables, but my own formula for them is: At five feet tall, women should weigh 100 pounds, men 125. Add five pounds per inch to either sex. Simple. Too simple? Seems waaay toooo pat, especially without seeing data to back it up.

And lately, 3-4 years ago, Kaiser of Canada did a study of 8,000 patients. Real science re: BMI. Results were that any where from 17-34 is PERFECT. 17,25,34, all the same minimal relative risk.

Other studies show that the preconceived BMI 34= Obese, have shown that to be plain wrong at tall/bigger stats. IIRC, they showed that at the tall end, BMI has a negative correlation.

So much for BMI science and the lack there of.

Now, the best indicator is soooo simple. Waist/hip ratio. Your waist ought to be smaller than your hips. Done. Because it is not your weight, it is you metabolism, and if you stock your fat in the middle, watch out. It means fatty liver and internal fat storage- it gets in the way of organ function. If your ass is so wide it needs side marker lights, no problem.

 

[casebro]

Definition of obese please? Any descriptive term ought to be scientific, not "looks really sloppy fat at that point".

Hmm, maybe two bell curves overlaid- one of whatever chosen metric for weight, the other for health care outcomes? Maybe the two lines intersect at umm, 80th percentile of weight?

 

[FromBelgiumWithLove]

The BMI concept was supposed to be a formulaic conversion of the Metropolitan Life height/weight tables, circa 1920s.

Where did you get that from? The BMI was devised somewhere between 1830 and 1850 by the Belgian astronomer, statistician and sociologist Adolphe Quetelet, the founder of the Royal Observatory of Belgium. Hence, it was always known as the Quetelet index. Until some American slapped the term Body Mass Index onto it in 1972.

 

[rustypouch]

The BMI concept was supposed to be a formulaic conversion of the Metropolitan Life height/weight tables, circa 1920s. I have never seen any data backing those tables, but my own formula for them is: At five feet tall, women should weigh 100 pounds, men 125. Add five pounds per inch to either sex. Simple. Too simple? Seems waaay toooo pat, especially without seeing data to back it up.

And lately, 3-4 years ago, Kaiser of Canada did a study of 8,000 patients. Real science re: BMI. Results were that any where from 17-34 is PERFECT. 17,25,34, all the same minimal relative risk.

Other studies show that the preconceived BMI 34= Obese, have shown that to be plain wrong at tall/bigger stats. IIRC, they showed that at the tall end, BMI has a negative correlation.

So much for BMI science and the lack there of.

Now, the best indicator is soooo simple. Waist/hip ratio. Your waist ought to be smaller than your hips. Done. Because it is not your weight, it is you metabolism, and if you stock your fat in the middle, watch out. It means fatty liver and internal fat storage- it gets in the way of organ function. If your ass is so wide it needs side marker lights, no problem.

Sources?

BMI does have its faults. It breaks down a bit with tall, heavily muscled men. Besides that, it tends to give false negatives in regards to obesity, compared to using body fat percentage. Here's the summary:



From: http://www.plosone.org/article/info:doi/10.1371/journal.pone.0033308

 

[Minoosh]

Yet it appears the "food fix" is a myth.

We don't actually have comfort foods, we just think we do.

Don't really see the news here. What we think helps us cope actually doesn't help us cope. Addictions are to some extent cognitive errors and there's nothing wrong with educating people about cognitive errors. But there are also biological compulsions. In fact everything might be biologically compelled. Your thin-ness might be completely dictated by biochemical events over which you have no control at all.

Seems to me we're losing sight of the big picture, which is that we are setting up an entire generation of health problems and premature death, simply because we don't feel comfortable doing something about it.

Who is "we"?

I work in schools and see that kids are getting low-fat milk and being encouraged to move more. Fast-food outlets seem less likely to push "supersize" options and some convenience stores now offer oranges, bananas and apples in addition to the dominant fat-salt-carbs trinity. People are, as far as I can tell, willing to "do something about" trends toward obesity. Tell me what doing something about it would look like to you.

The stupid part is, it doesn't even need to be shaming. I have no compunction saying to a friend who has packed on the fat: "Mate! Have you piled on a few kgs lately?"

Do you really think it has escaped their notice?

 

[casebro]

Sources?

BMI does have its faults. It breaks down a bit with tall, heavily muscled men. Besides that, it tends to give false negatives in regards to obesity, compared to using body fat percentage. Here's the summary:

[qimg]http://www.internationalskeptics.com/forums/imagehosting/thum_96754a08bad96fbb.png[/qimg]

From: http://www.plosone.org/article/info:doi/10.1371/journal.pone.0033308

Okay, guys, my history is off. But my overall point is that neither BMI, nor ht/wt, not the definition of Obesity are risk based. Well, except for Kaiser's study that showed no negative effects of a BMI up to 34.

But why is there even the word "Obese"? It obviously does NOT mean "at higher risk for disease states".

 

[bit_pattern]

I wonder if people here would support the tough measures required to deal with the structural causes of obesity - things like banning certain types of advertising, restrictive food labelling, fat taxes on calorific foods etc? The sort of public health measures that have been shown to be so successful in curbing tobacco use, which obesity has since taken over from as the leading cause of a lot of the same diseases that tobacco use resulted in. I'm guessing not because there seems to be an attitude that it's ALL down to the agency of the individual, but I'd be interested all the same.

 

[rustypouch]

Okay, guys, my history is off. But my overall point is that neither BMI, nor ht/wt, not the definition of Obesity are risk based. Well, except for Kaiser's study that showed no negative effects of a BMI up to 34.

But why is there even the word "Obese"? It obviously does NOT mean "at higher risk for disease states".

I normally like this forum because most people who post here are smart and well-informed, and that's reflected in the quality of discussion.

Then there's posts like this.

Sorry, but I'll trust the CDC on this one.

http://www.cdc.gov/healthyweight/effects/index.html

 

[The Atheist]

Definition of obese please? Any descriptive term ought to be scientific, not "looks really sloppy fat at that point".

Nothing wrong with the clinical description right now of BMI 30+.

While BMI isn't necessarily accurate, it can be adjusted. If your BMI is 32 and you have rock-hard abs and biceps like Hulk Hogan, you're not obese, while if your BMI's 32 and you look like you have a truck tyre under your shirt, you are.

I'd be very wary of any concern about specifics, because it is clinically and visibly obvious when someone has too much body fat.
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The point of it got driven home to me again this morning.

We'd taken a family trip to the supermarket to stock up on things to cook over the next week, filling our trolley with salads, steaks, fruit & amazingly tasty goods.

Down one aisle we passed a couple with a daughter aged about 12. A trolley full of soft drinks, potato crisps and junk food.

The girl would have been 163 cm tall.

And minimum 80 kg. She looked like a boated parody.

If you did that to a dog I reckon the RSPCA would have you, but feel free to stuff your kid. Sick.

 

[The Atheist]

Who is "we"?

We are the world.

I work in schools and see that kids are getting low-fat milk and being encouraged to move more.

Well, I go to a primary school 10 times a week and have two kids there, so I know exactly what you mean - the education system does try. I temper that, however, with the knowledge that every single party day/fundraising day/school dance/special occasion at the school is faithfully attended by fast food, soft drinks and hot chips.

Do you really think it has escaped their notice?

Quite possibly. Slow changes aren't easy to notice.

 

[Tatyana]

I love BMI

Richie McCaw just rang to say his is dodgey

Is this some sort of new knowledge for you?

Wiki is your friend.

http://en.wikipedia.org/wiki/Body_mass_index


Athletes, who tend to have an atypical muscle/fat ratio (atypical body fat percentage), may have a BMI that is misleading at first sight.[6]

"Defining obesity". NHS. Retrieved 19 December 2014.


The medical establishment[27] and statistical community[28] have both highlighted the limitations of BMI.


BMI is particularly inaccurate for people who are very fit or athletic, as their high muscle mass can classify them in the overweight category by BMI, even though their body fat percentages frequently fall in the 10–15% category, which is below that of a more sedentary person of average build who has a normal BMI number.

 

[The Atheist]

I wonder if people here would support the tough measures required to deal with the structural causes of obesity - things like banning certain types of advertising, restrictive food labelling, fat taxes on calorific foods etc? The sort of public health measures that have been shown to be so successful in curbing tobacco use, which obesity has since taken over from as the leading cause of a lot of the same diseases that tobacco use resulted in. I'm guessing not because there seems to be an attitude that it's ALL down to the agency of the individual, but I'd be interested all the same.

Now you're talking - and I did say exactly that much earlier in the piece.

Yes, we should be taxing the hell out of fast food, soft drinks and unhealthy foods.

 

[rustypouch]

Nothing wrong with the clinical description right now of BMI 30+.

While BMI isn't necessarily accurate, it can be adjusted. If your BMI is 32 and you have rock-hard abs and biceps like Hulk Hogan, you're not obese, while if your BMI's 32 and you look like you have a truck tyre under your shirt, you are.

I'd be very wary of any concern about specifics, because it is clinically and visibly obvious when someone has too much body fat.
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I think body fat percentage would be the thing to use.

The report I linked a few posts using the cutoff for obesity at 25% for men, and 30% for women.

This would have the downside of more people being considered obese.

 

[bit_pattern]

Now you're talking - and I did say exactly that much earlier in the piece.

Yes, we should be taxing the hell out of fast food, soft drinks and unhealthy foods.

I'm glad we found some common ground.

To add to that, in the spirit of the principle that government should tax things that are bad and not things that are good, the extra revenue could go into any number of programmes to encourage healthy eating. For instance, removing any existing taxes of fresh foods - or even some kind of negative tax to subsidise fresh food purchases to make them even cheaper, or subsidising classes that encourage physical activity for low income parents (e.g karate lessons, gym memberships etc), or nutritional cooking classes. Really the possibilities are endless when you start thinking about it.

 

[Tatyana]

Personally (and I may be wrong) obesity in most cases is habitual rather than addictive. Which is why you need to educate the kids

There is evidence for addiction:

http://www.nature.com/ijo/journal/v35/n12/abs/ijo201156a.html

Altered hypothalamic function in diet-induced obesity

http://www.ncbi.nlm.nih.gov/pubmed/23408738

Abdominal fat is associated with a greater brain reward response to high-calorie food cues in Hispanic women.

There is a old, but decent article from the New Scientist that has been reposted after the first few paragraphs on this page. This is a crap woo site, but it is one of the few places you will find the whole article that isn't behind a paywall.

http://www.organicconsumers.org/old_articles/foodsafety/fastfood032103.php#burgers

Burgers on the brain
Article from New Scientist vol 177 issue 2380. Date: 1 February 2003
Diane Martindale

 

[Tatyana]

I think your last part is the most likely, because all of the others cost money, and I would certainly object to my tax dollars paying.

Taxing fast food, soft drinks etc the way cigarettes are taxed would be the smart option.

This is the really difficult part of health economics, most of the time the money that is saved in prevention or from having some health service not used when you have an initial 'more expensive' outlay of cash is not really that popular with people.

Even though it is evidence based and will save money in the long run, people always have these 'moral' objections.

PS. I often have an entire bar of Lindt Lindor chocolate (100 g). This is typically around 500-600 kcal.

This summer I would have two Magnum ice creams for desert every night. Again, this is around 400 - 500 kcals

I still was eating something like 1700-1900 kcal per day and I still lost weight.

You can eat a lot more food if you eat things like vegetables and lean meat, but you can still eat 'junk food' and lose weight.

 

[Minoosh]

We are the world.

For a lot of people all over the planet, life is inconvenient, which means they burn more calories.

Quite possibly. Slow changes aren't easy to notice.

Maybe they'll see the light due to your timely intervention. I doubt it, but follow your conscience.

 

[The Atheist]

I'm glad we found some common ground.

To add to that, in the spirit of the principle that government should tax things that are bad and not things that are good, the extra revenue could go into any number of programmes to encourage healthy eating. For instance, removing any existing taxes of fresh foods - or even some kind of negative tax to subsidise fresh food purchases to make them even cheaper, or subsidising classes that encourage physical activity for low income parents (e.g karate lessons, gym memberships etc), or nutritional cooking classes. Really the possibilities are endless when you start thinking about it.

I don't know about other countries, but that's what we do here with cigarette taxes.

They pay for cessation advertising and program costs: nicotine replacement, etc, which are provided free.

This is the really difficult part of health economics, most of the time the money that is saved in prevention or from having some health service not used when you have an initial 'more expensive' outlay of cash is not really that popular with people.

Which is why governments shy away from intervention that way. No doubt the increasing pressure on health budgets will force action at some stage.

For a lot of people all over the planet, life is inconvenient, which means they burn more calories.

Maybe they'll see the light due to your timely intervention. I doubt it, but follow your conscience.

Sure, everyone's needs are different, but at least I have had one success. A very good mate of mine was packing on the lard and I started suggesting he was setting himself up for an early grave. That got him thinking - eventually - about leaving his kids without a dad and he pulled the plug on the crappy food and started walking.

Looks great now and happiest and healthiest he's been in a couple of decades.

It won't always (or maybe even often) work, but it has to be worth trying.

 

[The Don]

Christ mate, you're not playing the game at all!

How dare you allow pressures like that to dictate whether you lose weight? You could have just had knee reconstruction surgery and a disabled sticker for your car while you waited.

I am waiting for knee reconstruction surgery as it happens. If I qualified for a disabled sticker as a consequence of my knee injuries, should I be disqualified because they were the result of sporting accidents ? After all I didn't have to run all those miles or go skiing.

I was able to lose the weight but then again that coincided with a range of lifestyle changes which made the weight loss less difficult. It wasn't just a matter of willpower otherwise my ongoing smoking/not smoking giving up issues wouldn't be happening.

I get the feeling of righteous indignation towards people so fat that it is disabling, I just don't happen to agree with it. Maybe because I've lost a modest amount of weight (and kept almost all of it off for nearly 20 years) that I can appreciate how disabling weight can be, how easy it is to get heavy and how daunting losing weight is. I can imagine that if you've lost, say, 20kg but still have 100kg to lose that it is quite easy to become despondent.