The stupid explodes: obesity now a disability

[bit_pattern]

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.

Telling a friend that you're concerned about their health is a world away from stigmatisation and shaming. This anecdote sounds like a very positive interaction. Whereas saying: "Hey, lardarse, you're fat because you're lazy and stupid" would be a very negative interaction.

 

[bit_pattern]

http://www.theage.com.au/victoria/h...onash-childrens-hospital-20141228-12c9et.html

Public health experts are calling for the new Monash Children's Hospital to exclude fast food outlets and say the Royal Children's Hospital should dump its contract with McDonald's because it is creating a "healthy halo effect" that sends the wrong message to families.

With one in four children overweight or obese, Melbourne University public health professor Rob Moodie said Australia's leading paediatric hospitals should not be supporting multinational fast food chains like McDonald's that targeted children.

"It's like Peter MacCallum [Cancer Centre] supporting the tobacco industry," he said.

"It's hard enough to encourage people to eat healthy foods at the moment. We don't need the branding of some of Australia's most prestigious hospitals lending their support to something that is fundamentally promoting a poor diet. There's a real clash of purpose there."

 

[Tatyana]

And evolution is survival of the fittest. Not who breeds best and dies young.

Unless your a fly

Fitness means reproductive fitness.

You are falling into the common misinterpretation of the definition of evolution that wasn't even a statement from Charles Darwin, but his cousin, who was an economist.


As well, evolution is not about any one individual, so it doesn't matter if any one individual lives or dies, it is about the change in gene frequency across a population.


http://evolution.berkeley.edu/evolibrary/misconceptions_faq.php#b5

MISCONCEPTION: The fittest organisms in a population are those that are strongest, healthiest, fastest, and/or largest.

CORRECTION: In evolutionary terms, fitness has a very different meaning than the everyday meaning of the word. An organism's evolutionary fitness does not indicate its health, but rather its ability to get its genes into the next generation. The more fertile offspring an organism leaves in the next generation, the fitter it is. This doesn't always correlate with strength, speed, or size. For example, a puny male bird with bright tail feathers might leave behind more offspring than a stronger, duller male, and a spindly plant with big seed pods may leave behind more offspring than a larger specimen — meaning that the puny bird and the spindly plant have higher evolutionary fitness than their stronger, larger counterparts. To learn more about evolutionary fitness, visit Evolution 101.

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

Herbert Spencer first used the phrase – after reading Charles Darwin's On the Origin of Species – in his Principles of Biology (1864), in which he drew parallels between his own economic theories and Darwin's biological ones, writing,

The phrase "survival of the fittest" is not generally used by modern biologists as the term does not accurately describe the mechanism of natural selection as biologists conceive it. Natural selection is differential reproduction (not just survival) and the object of scientific study is usually differential reproduction resulting from traits that have a genetic basis under the circumstances in which the organism finds itself, which is called fitness, but in a technical sense which is quite different from the common meaning of the word.[6]

 

[blutoski]

So I'm imagining carrying around one of those 50 lb bags all day, every day, and suddenly the reluctance of a fat person who doesn't want to walk across the parking lot becomes a bit easier to understand. It can't be easy being fat.

I brought a 300lb friend on a hike over the summer, and watched him struggle with ground features I hadn't even noticed were there. To his credit, he did the whole hike without complaint.

I weigh in the 150lb range. The following week I put some barbell weights in my pack to bring my total mass up to 300lb and did the same hike - it almost killed me.

 

[blutoski]

Fair enough. Thanks for the correction.

This is also a good example of one new element that contributes to obesity: science vs popular media claiming to be science.
The consumer is totally confused and either can't devise a plan, or worse: rotates among contradictory plans.

Taubes has done an enormous amount of damage to obesity management, in my opinion.

 

[blutoski]

There has been a lot of research into what is more effective in losing weight, diet, exercise or diet and exercise.

The most effective is diet and exercise, then diet, then exercise.

As long as a calorie deficit is created, it doesn't really matter what combination people use.

And this is where I was pretty unpopular when I worked in the fitness industry. Exercise is part of a weight loss plan, but not a vital part. For some people, possibly most people, it's best to start with a focus on portion control if they're hitting the gym with the goal of weight loss.

And the season is just around the corner - I get a few dozen phonecalls every January from old colleagues who know I'm retired, but desperately need the temp help to manage the explosion of "NYRs". They don't need a permanent hire - 97% of these clients will disappear in 3 months.

Why? Because they don't see results. They dedicate themselves to exercise alone, and it just doesn't have a big impact. Some even gain weight if they're the type who are vulnerable to post-workout compensatory overeating.

 

[Silly Green Monkey]

I'm going to need to exercise specifically to maintain bone mass, ad all I can think of is carrying weights up and down the stairs. Is there anything else you can think of?

 

[The Atheist]

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.

Not equivalent at all. Sport is at least a positive pursuit. Sitting on your fanny eating isn't.

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.

I'm sure it is, but if they've lost 20 kg, that should be a hell of an incentive to keep going.

 

[The Atheist]

And this is where I was pretty unpopular when I worked in the fitness industry. Exercise is part of a weight loss plan, but not a vital part. For some people, possibly most people, it's best to start with a focus on portion control if they're hitting the gym with the goal of weight loss.

And the season is just around the corner - I get a few dozen phonecalls every January from old colleagues who know I'm retired, but desperately need the temp help to manage the explosion of "NYRs". They don't need a permanent hire - 97% of these clients will disappear in 3 months.

Why? Because they don't see results. They dedicate themselves to exercise alone, and it just doesn't have a big impact. Some even gain weight if they're the type who are vulnerable to post-workout compensatory overeating.

Excellent post and very important advice, because I do know a lot of overweight people think exercise alone will fix it and they end up very disappointed.

 

[Elaedith]

How much of obesity do you think is genetic? There's a 75/0/25 model that works surprisingly well for psychological variables (iq, personality), and I wonder if it applies to medical stuff.

Of the variance in obesity:

75% is caused by genes
0% by shared family environment (e.g., parenting philosophy)
25% by non-shared family environment (e.g., your sister but not you works for Hostess).

Anyone know?

This seems to be correct for obesity and related adiposity measures such as BMI, body fat or waist circumference. Most well controlled recent studies estimate heritability at around .7. The remaining variance is almost entirely attributed to non-shared environment. Effects of shared environment (e.g. early parenting) on variance in BMI are present in early childhood in some studies but are typically zero or negligible from adolescence onwards.

MZ twins are more similar in BMI than DZ twins. MZ twins reared apart are more similar in BMI than DZ twins, and only slightly less similar than MZ twins raised together. Children adopted from birth end up with BMIs more correlated with those of their biological parents and siblings than with their adoptive parents and siblings.

In other words obesity is highly heritable, and non-genetic variance in BMI is entirely or almost entirely attributable to adult environment rather than early childhood environment. There is little evidence that parenting makes any substantial contribution to variance in BMI in adulthood.

In comparative terms BMI has about the same heritability as height, and obesity has greater heritability than most medical conditions that have been subjected to epidemiological study. This is now so well established it is no longer even seriously disputed apart from a hypothesis concerning the possible effects of pre-natal environment. Recent research is focusing more on which genes are involved and how they interact with environment, as well as the implications for intervention.

For examples, a couple of recent reviews:

http://diabetes.diabetesjournals.org/content/57/11/2905.full

https://www.scienceopen.com/documen...tral/fa17f476-3886-40cd-a713-1a55d8a18c61.pdf

 

[cullennz]

Pattern. Kids hospitals there macdonalds.

Flippn heck

 

[marplots]

On the naming and shaming front, it occurred to me that a selection bias would explain the results.

Everyone who would be fat, but isn't because blaming worked, wouldn't get asked any "fat" questions - they aren't fat. Only those who have "survived" the insult and ridicule and remained fat would be selected. And, of course, the ridicule didn't work for them.

In a situation where fat gets shamed, there is no subset available who can serve as a control - everyone who was ever fat has already been tainted by the process. So you can't delineate a group that is "fat and shame free" to use as part of your test population.

Or maybe actual researchers have already considered this point, and I'm making stuff up, again.

 

[cullennz]

Just out of intetest do doctors there not point a fat person needs do lose weight or die early

 

[bit_pattern]

On the naming and shaming front, it occurred to me that a selection bias would explain the results.

Everyone who would be fat, but isn't because blaming worked, wouldn't get asked any "fat" questions - they aren't fat. Only those who have "survived" the insult and ridicule and remained fat would be selected. And, of course, the ridicule didn't work for them.

In a situation where fat gets shamed, there is no subset available who can serve as a control - everyone who was ever fat has already been tainted by the process. So you can't delineate a group that is "fat and shame free" to use as part of your test population.

Or maybe actual researchers have already considered this point, and I'm making stuff up, again.

Lol

 

[The Atheist]

TWhereas saying: "Hey, lardarse, you're fat because you're lazy and stupid" would be a very negative interaction.

I missed this earlier. I wouldn't even do that, no matter how tempted I was.

Pattern. Kids hospitals there macdonalds.

Flippn heck

Starship not only had a Macdonald's in it for 8 years, they harbour a very strong relationship with Auckland Hospital through the Ronald Macdonald House program.

Irony in fast food: Man of the People, Michael Jones. Was Key's first pick for Race Relations Conciliator, but turned it down, which is why Devoy got it.

I sat three feet from the Iceman about 20 years ago, not long after he'd finished his degree and his AB career was coming to a close.

He was expounding how he was going to do so much good for the Samoan and Pasifika people. He was even awarded the New Zealand Medal for service to the Pacific Island community - pretty much on reputation, because he hadn't done much at that time, but promised to.

His achievement? He owns half-a-dozen Carl's Jr burger joints in Pasifika-dominated neighbourhoods around Auckland.

 

[cullennz]

Atheist. Really. Auckland is a funny place.

In welly they get to pay for a family stay place for aome ad time and thats about it

 

[The Atheist]

In welly they get to pay for a family stay place for aome ad time and thats about it

I wish I had some idea what that means.

 

[cullennz]

Place to stay for sick kids families when being treated. they get to call it macdonalds house and have the stupid clown on the sign.

 

[The Don]

Not equivalent at all. Sport is at least a positive pursuit. Sitting on your fanny eating isn't.

Well that's your arbitrary judgement. It's unlikely but it's possible that I've done more damage to my body than if I had just sat down and eaten bonbons. At the minimum I suspect that there are more body-kind sporting choices I have made over the years and yet you're willing to give me a free pass because it happens to align with your view that fat = greedy and lazy and not worth accommodating.

I'm sure it is, but if they've lost 20 kg, that should be a hell of an incentive to keep going.

People's relationship with food seems to run counter to that. Often substantial amounts of weight are lost - and subsequently regained.

In any case your complaint isn't about weight management or the ease/difficulty of it but rather that if someone is disabled as a result of their weight then you don't feel that their employer ought to accommodate them.

 

[Tatyana]

Just out of intetest do doctors there not point a fat person needs do lose weight or die early

Doctors tell people all the time they need to lose weight, stop smoking, stop drinking.

Just last week I phoned a GP because one of her patients had a high amylase.

He had alcoholic pancreatitis, and he was very reluctant to communicate with his GP. He had presented in AE in the previous month, but he discharged himself before AE could fully investigate him.

The GP sounded sad, however, she said either he would stop drinking and try and get well, otherwise he would probably start bleed internally, vomit blood and die.

This patient was 32 years of age.

I see people who just don't take care of themselves every single day, diabetics who, since diagnosis, have not had a single glucose of HbA1c in control, and this has been the case for ten years.

The doctors are obviously contacting them to have tests, but if the patient is non-compliant, what can they do?

I have had doctors tell me 'I will give them some drugs, but it won't make any difference until they lose weight, and I have told the patient this'.

I am not sure why people think that doctors are not recommending things like exercise, weight loss, not smoking and minimal drinking, but they do all the time.

People don't listen to good advice.