The stupid explodes: obesity now a disability

bit_pattern said:
We don't offer to meet the needs of people who are disabled because they failed to achieve an objective, we do it because they are disabled. Do you think denying the means for survival to someone who can otherwise not function as an able bodied person in society would aid them in meeting a given objective?
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You've finally made me see the light!

I get it - I totally get it. I am so frigging dumb not to have seen it before. It's a disability, so it is really society's responsibility to help them survive.

So, once a person has eaten him/herself into inability to walk, they will need to be looked after, fed, cleaned, toileted and kept alive. Since they're going to weigh 7 or 800 lbs, it's going to need a few people to do all this, and as you say, it's society's responsibility to get it done.

You've solved the obesity crisis and unemployment forever!

I'm off to change my sig.
 
The Atheist said:
Then, there's this guy: http://www.stuff.co.nz/life-style/w...27/taylor-swifts-biggest-fan-shakes-off-190kg

A simple decision to change.
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jimbob said:
It is simple, it is not easy.
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theprestige said:
QFT. I found it an incredibly simple decision, once I made it myself. But it was not easy getting to the point where I actually made it.
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This guy did something similar - he was on a cycling forum and I briefly chatted when passing him on a charity ride when he'd lost just about 20-stone (starting weight 39st).

However that doesn't make it easy for many people. Gaz had quite a few other personal problems that he mentions in his blog which probably helped get him to a weight of 540lbs.

I have never bothered with looking at my weight - as I do a a fair amount of exercise for a modern western lifestyle* (although not by historical standards) and have a resting pulse rate somewhere between 45 and 55 and a 31" waist. However, given how hunger affects me, I would not want to try dieting, where I imagine feeling hungry would be a large part.

*cycle-commute 125-miles/5000ft a week at a speed sufficient to break out a sweat but not become breathless.
 
bit_pattern said:
The obesity part. The etc. is pretty broad too.
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It does change the conversation if obesity is an illness. I would support paying for treatments.

Have we talked about the ramifications of obesity as a defined disability under the Americans with Disabilities Act? I am thinking of what "reasonable accommodations" might mean for the obese.
 
marplots said:
It does change the conversation if obesity is an illness. I would support paying for treatments.

Have we talked about the ramifications of obesity as a defined disability under the Americans with Disabilities Act? I am thinking of what "reasonable accommodations" might mean for the obese.
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Is it that obesity is a disability, or that it disables people, so that they have difficulty walking, for example?
 
I am seeing recent speculation that obesity might be caused by changes in the microbiome caused by antibiotics taken as a child...

Also another study where they show that not all obese people lose weight at the same rate even given identical food inputs per pound of body weight...

It really does seem to be a disease process at least in some people.
 
jimbob said:
However that doesn't make it easy for many people.
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Nor is it easy for an alcoholic, compulsive gambler or drug addict to give up their addiction.

Some do, some don't...

jimbob said:
Is it that obesity is a disability, or that it disables people, so that they have difficulty walking, for example?
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Obviously the latter, but the end result is the same - once they have a disability, they are disabled.

But it's ok, because Bit Pattern has shown us the way forward - if people disable themselves through food, drugs or booze, it is society's responsibility to help them survive.

It's so darned obvious.

Paying for all these disabled obese people is going to cost a lot of extra tax, so I will just cut the wages of our employees to pay for it. Problem solved.

That is the perfect answer and fully reflects the intent that it is society's responsibility to help those unable lift themselves off their beds to even go to the toilet, let alone buy food or work.
 
The Atheist said:
You've finally made me see the light!

I get it - I totally get it. I am so frigging dumb not to have seen it before. It's a disability, so it is really society's responsibility to help them survive.

So, once a person has eaten him/herself into inability to walk, they will need to be looked after, fed, cleaned, toileted and kept alive. Since they're going to weigh 7 or 800 lbs, it's going to need a few people to do all this, and as you say, it's society's responsibility to get it done.

You've solved the obesity crisis and unemployment forever!

I'm off to change my sig.
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Well that sure was a mature and level headed response. Well done.

The Atheist said:
Nor is it easy for an alcoholic, compulsive gambler or drug addict to give up their addiction.

Some do, some don't...



Obviously the latter, but the end result is the same - once they have a disability, they are disabled.

But it's ok, because Bit Pattern has shown us the way forward - if people disable themselves through food, drugs or booze, it is society's responsibility to help them survive.

It's so darned obvious.

Paying for all these disabled obese people is going to cost a lot of extra tax, so I will just cut the wages of our employees to pay for it. Problem solved.

That is the perfect answer and fully reflects the intent that it is society's responsibility to help those unable lift themselves off their beds to even go to the toilet, let alone buy food or work.
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You realise that alcoholics can and do receive support if and when their condition disables them, right?

You might have a kind of conceptual libertarian fantasy world in your head, but in the real world (in Australia at least, and I'd imagine NZ too but really don't know, I'd be amazed if they didn't) society acts to provide support for people who have disabling conditions - even those you think are examples of moral deficiencies.
 
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marplots said:
It does change the conversation if obesity is an illness. I would support paying for treatments.

Have we talked about the ramifications of obesity as a defined disability under the Americans with Disabilities Act? I am thinking of what "reasonable accommodations" might mean for the obese.
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Can't say I'm familiar with the American landscape. In Australia, if someone can demonstrate through medical opinion (under very tight restrictions, including getting independent verification medical practitioners appointed by Human Services) that they are incapable of working for two years or longer, then they qualify for a disability support pension - whether it be the result of obesity, or alcoholism, or any other condition that disables them and prevents them from working.
 
bit_pattern said:
Can't say I'm familiar with the American landscape. In Australia, if someone can demonstrate through medical opinion (under very tight restrictions, including getting independent verification medical practitioners appointed by Human Services) that they are incapable of working for two years or longer, then they qualify for a disability support pension - whether it be the result of obesity, or alcoholism, or any other condition that disables them and prevents them from working.
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The Americans with Disabilities Act governs a bunch of work-related and public accommodation issues. So, for example, I might have to provide wheelchair access in my place of business if it is open to the public, whether or not I have an employee in a wheelchair.

An example related to obesity might be the provision of wider chairs in a restaurant or special seats on an airplane.
 
bit_pattern said:
You realise that alcoholics can and do receive support if and when their condition disables them, right?
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Sure, they receive minimum sickness benefits if they get to the disabled stage, and I'm fine with obese people having that option as well.

The big difference is, druggies and alkies don't expect the employer to pay for them to do less work for the same pay.

Good strawman on the moral deficiency, though.
 
BenBurch said:
I am seeing recent speculation that obesity might be caused by changes in the microbiome caused by antibiotics taken as a child...

Also another study where they show that not all obese people lose weight at the same rate even given identical food inputs per pound of body weight...

It really does seem to be a disease process at least in some people.
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If it was the same study I saw, they still lost weight. Is not like anyone gained weight on a calorie negative diet.

“In general, as things currently stand, weight loss strategies should be the same for all: make smart food choices, practice portion control and increase movement and exercise,” Votruba said. She pointed out that every volunteer in the study lost a significant amount of weight, suggesting that “regardless of biological differences, weight loss is plausible with sustained effort.”
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http://www.forbes.com/sites/tarahae...ht-but-your-best-friend-can-on-the-same-diet/
 
Tsukasa Buddha said:
If it was the same study I saw, they still lost weight. Is not like anyone gained weight on a calorie negative diet.
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Do you know which study that was? I was trying to make sense out of BenBurch's post. It has been an established fact that different people of the same weight will not spend the same number of calories per day. It's the reason the BMR estimates ask you if you're very male or female, athletic, somewhat active, or inactive, and your age. A pound of muscle burns more calories than a pound of fat, and infinitely more than a pound of water. Older people burn fewer calories than a younger person with the same morphology.

This is all known and accounted for in weight management models for three generations, so I'm not sure what the study BenBurch described is trying to investigate. I was assuming it was just BenBurch incorrectly describing the study's purpose.



Tsukasa Buddha said:
http://www.forbes.com/sites/tarahae...ht-but-your-best-friend-can-on-the-same-diet/
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The article is discussing [A Human Thrifty Phenotype Associated With Less Weight Loss During Caloric Restriction]

It's reasonably good from what I can tell, but there's some limitations to extrapolating it to general dieting advice: the study had 12 people, the variation was all over the map (the effect was not consistent for any of the subjects, which means it may 'average out' to zero), and the conditions were semi-starvation, which is not consistent with any sustainable diet anyway.

It's very interesting, but I would slide this on the 'academic interest' shelf for now. It is not refuting the consensus weight management model of lifestyle change to facilitate a small calorie deficit to lose weight slowly until target is achieved.
 
The Atheist said:
Nor is it easy for an alcoholic, compulsive gambler or drug addict to give up their addiction.

Some do, some don't...



Obviously the latter, but the end result is the same - once they have a disability, they are disabled.

But it's ok, because Bit Pattern has shown us the way forward - if people disable themselves through food, drugs or booze, it is society's responsibility to help them survive.
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It's easy to get to 250 or 300 lbs just by losing the genetic lottery. 800 lbs is different, you really have to engage in some extreme overeating to get there, as far as I know.

Still, once you have reached the point that you are so obese that you cant work, society has a responsibility to support you, even if it's your own fault.
 
Marcus said:
It's easy to get to 250 or 300 lbs just by losing the genetic lottery. 800 lbs is different, you really have to engage in some extreme overeating to get there, as far as I know.
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I don't think it's extreme in the sense that it probably takes awhile to get there. Certainly maintaining the weight means a large volume of calories per day, but the point is that it's the same decisions a person makes to gain less weight: eating when the body should be saying you've had enough.



Marcus said:
Still, once you have reached the point that you are so obese that you cant work, society has a responsibility to support you, even if it's your own fault.
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This certainly where I stand, but I do appreciate there never going to be agreement. It's a moral and political topic. Look at China's one child policy: "You chose to have a second child, why should the nation support her just because she's a person? Her medical and education costs are coming out of your pocket jack." Pretty cruel, and I can't help but notice their national policy is Atheism, which probably lends itself to a utilitarian moral view that chooses to see people as merely assets or liabilities. Hint-hint.
 
Thought this was interesting in light of some of the strands of debate inspired by this thread

http://www.theguardian.com/science/...es-obesity-heart-disease-microbes-microbiomes

Scientists have created bespoke diets using a computer algorithm that learns how individual bodies respond to different foods.

Researchers believe the tailored diets could help stem the rising tide of diabetes, heart disease and obesity, by personalising people’s daily meals and so helping them to adopt healthy eating habits.

The first results from the Personalised Nutrition Project, run by leading researchers in Israel, are due to be unveiled on Friday at the Human Microbiome conference in Heidelberg, Germany.
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This bit in particular caught my eye

To test the algorithm, Segal and Elinav used it to draw up bespoke diets for 20 pre-diabetic people. In the small trial each patient was given two very different diets. In the first week, their diet was tailored to minimise spikes in their blood glucose levels. In the second week, their diet was designed to have the same calorie content, but not to control their blood sugar.

“In all these cases, there was a big difference between the good diet and the bad diet, even though they contained the same calories,” said Segal. “By personalising these diets, on the good week, in some people, blood glucose fell to healthy levels, whereas in the bad diet week, they had glucose spikes that would be considered as glucose intolerant.”

The study highlights how traditional thinking around diets is flawed in the assumption that people put on weight purely because their meals contain more calories than they burn off. “Calories are definitely an important player, but we’ve been led to think that it’s the only player, and that is absolutely not true,” said Segal.

In many cases, he said, the tailored diets included foods that some might find surprising. For example, many people had low glucose responses to ice cream, and bread and butter tended to trigger less of a glucose response than unbuttered bread. “There are many more such surprises, including foods considered to be good which on average are not,” he added. “Our entire approach is data driven, not based on hypotheses or preconceptions, which in our view makes it powerful and science based.”
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bit_pattern said:
Thought this was interesting in light of some of the strands of debate inspired by this thread

http://www.theguardian.com/science/...es-obesity-heart-disease-microbes-microbiomes



This bit in particular caught my eye
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I'd have to read the paper to make sense out of that. I assume by 'bespoke diets' they mean 'microbiome diets' for example?

Additionally... it sounds like they're saying they didn't show an actual effect on weight, but are projecting it based on presence or absence of 'glucose spikes'.

I think we'd like to see them show their diets' effects on weight by showing effects on... weight. Their announcement feels pretty speculative. I don't think all the claims actually follow from the results, in particular because the applicability of GI in weight management is controversial and unresolved, we're mostly looking at positive rat studies and mixed results in human studies. They're assuming the causal connection is proven.

They also seem to be mixing up what they're testing. They seem surprised that people have different glucose responses to a particular food. Is this what they were investigating? Not sure why that would surprise them, there's a body of literature showing not only wide variation in responses between subjects, but that there's a wide variation within a single subject. In any case, when I see a press release that seems like the experiment was a jumble of investigations, I suspect [Texas Sharpshooter].

In particular, I am not sure why they found butter by itself to have a higher response than butter mixed with bread. This is [Glycemic Index] (GI) 101, and one of the reasons we can't use a GI reliably for anything than pure foods. Once you start mixing ingredients, the additional complexity changes the response, usually reducing the GI.

Weight loss aside, reducing insulin response is a good goal, so if their customized diets can accomplish this, it's still potentially beneficial. They'd have to show how much improvement they achieve to estimate the benefit. The second problem is practicality: are these diets nutritionally complete, do they have enough variety to be sustainable, &c.
 
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