The stupid explodes: obesity now a disability

[The Atheist]

None of that data actually supports the idea that obesity is not disabling.

Try reading for context - I was answering a specific question about sport, as blutoski obviously saw.

 

[The Atheist]

This is actually an old ethics debate, not limited to obesity. The most common example I have come across in ethics textbooks is: does the guy who drank himself into cirrhosis of the liver deserve a liver transplant?

Others: Does the smoker who got lung cancer deserve a lung transplant? Does the patient who got HIV via IV drug use deserve the same protection from discrimination as a mother of three who got HIV from tainted blood during surgery after getting hit by a car?

Excellent - this is exactly the point.

I'd vote no on all of those cases - self-inflicted harm cannot be treated as equivalent to harm caused by misadventure or random disease.

 

[Minoosh]

Scientific research has nothing to do with the manufacturing of food products ...

No, it was consumer demand and manufacturer's using science to make their products more appealing.

Sorry, I have snipped, but doesn't the second part I quoted indicate that science has been involved? Seducing us with ever-more-enticing tidbits?

 

[Minoosh]

Does the patient who got HIV via IV drug use deserve the same protection from discrimination as a mother of three who got HIV from tainted blood during surgery after getting hit by a car?

How did she manage to get herself hit by a car ?

I've had serious junk-food cravings the past week or so - I might be more sympathetic than usual to the siren song of fat-salt-carbs.

 

[qayak]

Excellent - this is exactly the point.

I'd vote no on all of those cases - self-inflicted harm cannot be treated as equivalent to harm caused by misadventure or random disease.

Random disease? If it runs in your family is that still random? What's the difference if an overweight person gets heart disease while a normal weight person gets it from poor eating habits?

What difference does it make if a drug addict got HIV from a contaminated needle or a patient got it from a contaminated batch of blood? Neither was intentional.

Other than the fact you are trying to split hairs to justify your discriminatory beliefs, that is.

 

[bit_pattern]

This is another reason I try to clarify what a person means when they say they're 'dieting' or 'on a diet'. Often, what they mean is they have changed their food palette, not that they are reducing their eating.

I have seen quite a few people go full vegetarian and develop worse health outcomes, I suspect entirely because of the subsequent weight gain. One friend was going through a cup of peanut butter a day. She felt that since it was home-made in a food processor from organic peanuts, she could just eat as much as she wanted.

The Mediterranean Diet is another one where I had clients baffled by their weight gain. But I can completely understand how it happened: I could eat olives or nuts all day.

This is me.

I'm a good ten kilos heavier than I am comfortable with and probably 20 kilos heavier than what is healthy.

I've never been much concerned with weight and saw the obsession with weight as the only indicator of health as a bit misleading. One thing that caught my attention around half way through last year was the relationship between microbiota and health and the notion that a high fibre diet was good for maintaining a healthy microbiome. So I cut right back on meat and dairy and started eating a lot of whole legumes, beans and vegetables (which still makes up the bulk of my diet). But my body fat trajectory, which was already trending upwards (I'd quit smoking in this period too so that was probably a factor), continued to grow unabated.

Realising that my abdominal fat was really not healthy and a likely indicator for no end of future health problems I decided I needed to be more active and joined a gym. After only four or five days of cardio I noticed a change in my chest area (I was jokingly telling people I'd dropped 3 cup sizes) so, feeling motivated, I eventually got the gym to draw up a programme (one day on, one day off of intensive cardio and weight training) that I've been pretty good at following. Since reading Tatyana's posts in this thread I've also started calorie counting using an app, so will be interested to see what results it yields.

The big thing I've noticed is just how badly alcohol busts the calorie budget completely - it's easy to convince yourself that smashing half a dozen to a dozen beers a night is no big thing but it eats up a HUGE amount of the daily limit. I'm mildly dependent on alcohol, a couple of days without a drink is no big thing but usually by the third day I'm gagging for a taste. So that's going to be the biggest struggle.

 

[bit_pattern]

I think The Atheist was trying to support the claim that exercise is 'positive' behavior. This would be a premise to support the argument that if a person is disabled due to exercise, they should be treated differently than a person who is disabled from becoming morbidly obese, even if they meet every other criteria for disabled status.

This is actually an old ethics debate, not limited to obesity. The most common example I have come across in ethics textbooks is: does the guy who drank himself into cirrhosis of the liver deserve a liver transplant?

Others: Does the smoker who got lung cancer deserve a lung transplant? Does the patient who got HIV via IV drug use deserve the same protection from discrimination as a mother of three who got HIV from tainted blood during surgery after getting hit by a car?

Some are easier to resolve than others, and the critical element is that we need to be able to estimate agency. There is no scientific unit of agency, so some ethicists argue that we shouldn't arbitrarily assign agency estimates, that we should assume no agency for things that research shows are very difficult to overcome through willpower. Other ethicists disagree.

In terms of historical context, it's got more than a hint of the old Victorian moralism of the deserving/undeserving poor and the Protestant work ethic about it as well.

 

[Tatyana]

Sorry, I have snipped, but doesn't the second part I quoted indicate that science has been involved? Seducing us with ever-more-enticing tidbits?

It really is hard to say, for the time period, but if scientific journalism and the media is anything like the current situation, then I would say no.

Not pure academic research. I am certain that research done by food manufacturers may have used the ever more enticing tidbits.

Most current research is seriously complicated, scientists do not talk to reporters, or if they do, they are not great at explaining things as they forget what lay people actually know, it gets dumbed down, it gets changed into fantastic sound bites that are often not really that related to the original research.

 

[Minoosh]

Not pure academic research. I am certain that research done by food manufacturers may have used the ever more enticing tidbits.

Maybe we can reverse-engineer junk food to make it all taste awful.

There's a lot of research done to make food producers' brands more appealing. A whole theory of eating, having to do with branding the eating experience - having it engage all of your senses and prolonging the sensuality to be highly reinforcing.

The Reese's Peanut Butter cup is such an evolved treat. The trouble is that they are so satisfying I'm content with a 2-pack. Or even one. This is good for portion control if you do not want to give up dessert all together.

I've also noticed fast-food places routinely offering ranch dressing to accompany french fries - replacing sugary ketchup with a condiment made of fat *and* sugar. One place pushing ranch also has crinkle-cut fries, which greatly expands the surface area of the morsel and makes salt (and ketchup and ranch) stick better. You get an expanded crunch experience, priming your palate for the flour-y insides, which have the virtuous aridity of a perfectly baked potato. Like an ancient ad for Lays potato chips - "betcha you can't eat just one."

 

[bit_pattern]

Hey Tatyana - a question.

My calories counting app sets a goal of around 2100 calories a day, but on days where I've worked and have recorded the calories supposedly burned it adds them to the goal meaning I can eat more calories. Am I better off following that method or still keep my intake to 2100 on workout days.

Hope that makes sense...

 

[phiwum]

Mea culpa. I didn't think I'd need to be so pedantic as to point out what I meant, but here goes:

British Journal of Sports Medicine:



Web MD:



Otago University:



American Academy of Pediatrics:



Let me know if you need more, there's plenty out there.

None of those links were relevant to my point. I'm not asking whether overeating is a positive pursuit. I'll take that for granted.

I'm asking why the fact that overeating is not a positive pursuit is relevant to whether obesity is a disability.

 

[phiwum]

Try reading for context - I was answering a specific question about sport, as blutoski obviously saw.

You weren't answering my question. I'll repeat it for you.

So, whether someone is disabled or not depends on whether their condition is caused by a positive pursuit?

You can't answer that question by pointing to evidence of bad health effects of overeating.

 

[phiwum]

I think The Atheist was trying to support the claim that exercise is 'positive' behavior. This would be a premise to support the argument that if a person is disabled due to exercise, they should be treated differently than a person who is disabled from becoming morbidly obese, even if they meet every other criteria for disabled status.

This is actually an old ethics debate, not limited to obesity. The most common example I have come across in ethics textbooks is: does the guy who drank himself into cirrhosis of the liver deserve a liver transplant?

Others: Does the smoker who got lung cancer deserve a lung transplant? Does the patient who got HIV via IV drug use deserve the same protection from discrimination as a mother of three who got HIV from tainted blood during surgery after getting hit by a car?

Some are easier to resolve than others, and the critical element is that we need to be able to estimate agency. There is no scientific unit of agency, so some ethicists argue that we shouldn't arbitrarily assign agency estimates, that we should assume no agency for things that research shows are very difficult to overcome through willpower. Other ethicists disagree.

There is another critical element, namely whether there is a great cost to society or the use of limited resources. Transplants require the exclusive use of scarce resources. Treating someone as disabled isn't free, but it doesn't put one in competition for scarce resources needed by others with the same medical condition.

Even if we may grant that how one came to need an organ transplant is morally relevant to whether they receive it, we are not committed to treating disabilities due to self-destructive behaviour as not "real" disabilities at all.

 

[Tatyana]

Hey Tatyana - a question.

My calories counting app sets a goal of around 2100 calories a day, but on days where I've worked and have recorded the calories supposedly burned it adds them to the goal meaning I can eat more calories. Am I better off following that method or still keep my intake to 2100 on workout days.

Hope that makes sense...

I don't add in the calories from exercise when I am trying to lose weight.

I do like the calories from exercise listed as it is a record of what days I have trained.

As well, I prefer to use either the Katch-McArdle formula for TDEE (total daily energy expenditure) or Harris-Benedict to set my calories on apps like myfitnesspal as I think they set it far too low (at least for me).

Harris-Benedict is easier as it doesn't require a body fat percentage.

link to Harris-Benedict to calculate TDEE:

http://manytools.org/handy/bmr-calculator/

Then, depending on what you want to do, you either take 20% off the calories to lose weight, eat those calories to maintain weight, or add 20% to gain weight.

Of course, you need to track some sort of parameter to see how it is working, waist measurement, weight, body fat percentage.

 

[bit_pattern]

Holy crap, that calculator says I need 2782 calories just lying around/sitting all day, lol!

ETA: Oh, I missed the 'subtract 20%' bit

2225 calories a day - so only 55 more than the limit set by My Fitness Pal, I'll keep that in mind as a bit of a buffer.

Thanks for the response!

 

[dirtywick]

You weren't answering my question. I'll repeat it for you.

So, whether someone is disabled or not depends on whether their condition is caused by a positive pursuit?

You can't answer that question by pointing to evidence of bad health effects of overeating.

Of course not.

But the discussion isn't really about that, it's about whether or not obesity should be considered a disability in terms of receiving government benefits.

Given the potentially transient nature of obesity, the control an individual has over their own obesity, and the long, easily observable, and preventable period between no obesity and obesity so extreme one would be considered disabled it's a fair point to consider. It's interesting.

 

[The Atheist]

You weren't answering my question. I'll repeat it for you.

So, whether someone is disabled or not depends on whether their condition is caused by a positive pursuit?

You can't answer that question by pointing to evidence of bad health effects of overeating.

No, you're asking something not related to what I said.

I was talking about sport being positive and posted many organisations in the health field that agree with that, showing exactly where it's positive in the fight against obesity.

Maybe you should go back and read it.

 

[phiwum]

No, you're asking something not related to what I said.

I was talking about sport being positive and posted many organisations in the health field that agree with that, showing exactly where it's positive in the fight against obesity.

Maybe you should go back and read it.

I did. Here's the relevant bit.

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.

Seems to me that you're saying obesity doesn't count as a disability because it's self-induced, but sports related injuries count as a disability because, although they are self-induced, they are a positive pursuit.

No one asked you for evidence that exercise has a positive effect. I'm just trying to figure out what you think makes the difference between "real" and "laughably stupid"[1] disabilities.

[1] "Laughably stupid" is not a quote. Until just now, of course.

 

[The Don]

For my money, you could gladly take the sporting injuries and call them self-inflicted and ignore them, but it you certainly cannot equate sport with eating.

So you're saying that an employer doesn't have to accommodate an employee whose disabilities are sports related ?

What criteria would you apply to determine whether someone's disability needs to be accommodated by their employer ?

Your argument against the obese being accommodated is that it is self inflicted so therefore the employer isn't required to accommodate that disability. Is it down to where the blame lies ? If I'm disabled because I crashed my own car then should I not be entitled to accommodation but if someone crashed into me I'm OK ? Or is it to do with reversibilty/treatability ? Some of the disabling effects of obesity (such as amputation due to type 2 diabetes) aren't reversible.

Or is there a somewhat complex set of criteria where blame, reversibility and other factors come into play ?

 

[The Atheist]

So you're saying that an employer doesn't have to accommodate an employee whose disabilities are sports related ?

They're treated the same as any other injuries. Fine by me.

What criteria would you apply to determine whether someone's disability needs to be accommodated by their employer ?

When it's something 100% avoidable.

Your argument against the obese being accommodated is that it is self inflicted so therefore the employer isn't required to accommodate that disability. Is it down to where the blame lies ? If I'm disabled because I crashed my own car then should I not be entitled to accommodation but if someone crashed into me I'm OK ? Or is it to do with reversibilty/treatability ? Some of the disabling effects of obesity (such as amputation due to type 2 diabetes) aren't reversible.

Or is there a somewhat complex set of criteria where blame, reversibility and other factors come into play ?

Reversibility is irrelevant.

There are lots of shades of blame in most injuries, and lots of them are avoidable as well.

Trouble is, how would you know with certainty? Accidents and sports injuries are incredibly bad analogies. Pity, because a perfect one exists: cigarette smoking.

In the case of obesity and cigarette smoking, there is no agency to blame other than the eater or smoker. Nobody makes them eat crap, and nobody forces them to smoke.

You're not talking about a momentary lapse of concentration or a brain fart that causes an an accident and disability. Overeating, like smoking, is a lifestyle choice and 100% self-inflicted.