The stupid explodes: obesity now a disability

[Skeptical Greg]

......A few are, but not in proportion to obesity. Obesity is more correlated with low education than it is low income.

Then, why would obesity be on a sharp rise in the last 50 years, when education has improved dramatically also?

 

[casebro]

Then, why would obesity be on a sharp rise in the last 50 years, when education has improved dramatically also?

Because the low ed people are eating even more.

 

[casebro]

It doesn't take me any longer to pick up the makings of a decent variety of home-cooked meals than it does to pick up calorie-laden ready-meals. I use a lot of frozen vegetables which saves on preparation and eliminates waste. I don't have to use up veggies that are going soft. And it takes me about 20 minutes to cook the food - but I'm doing other things in the kitchen while it cooks.

I find fast food from takeaways very expensive compared to cooking for myself too, so it can't be that. I genuinely don't understand how people on low incomes can afford to be buying takeaways all the time.

I home cook 95% of my meals. Less than $10/day. My problem is prtion control, not quality of food.

Smart & Final has 50# bags of HUGE excellent baking potatoes, $10. How many potato pancakes can I make? One spud, shredded, fried in home rendered beef shortening, slathered in sour cream. Dinner cost, $1? Vs $8 for a fast food meal?

 

[Skeptical Greg]

Because the low ed people are eating even more.

Then that would equate to 66% of people in the US..

The educational system is worse than I thought..

 

[The Norseman]

Then, why would obesity be on a sharp rise in the last 50 years, when education has improved dramatically also?

Then that would equate to 66% of people in the US..

The educational system is worse than I thought..

Grade inflation? No Child Left Behind?

I home cook 95% of my meals. Less than $10/day. My problem is prtion control, not quality of food.

Smart & Final has 50# bags of HUGE excellent baking potatoes, $10. How many potato pancakes can I make? One spud, shredded, fried in home rendered beef shortening, slathered in sour cream. Dinner cost, $1? Vs $8 for a fast food meal?

Could you please start a new thread elsewhere about your personal anecdote? This thread is more evidence- and population-based than single self-professed outliers.

 

[Minoosh]

How casually Donald Trump dropped that line that the DNC hacker "could weigh 400 pounds." As if that means anything whatsoever. In his mind, 400 pounds = loser. I'm not at all sure 400 pounds is a healthy weight for anybody. I know a few people packing that kind of weight.

My uncle went on disability because (I've heard) he could no longer work as a city electrician due to being overweight for the cherry-picker used in fixing traffic lights. Morbid obesity may not be a disability in itself, but then again maybe it is.

Obesity is a medical condition, not a moral failing. Yet I still have a judgmental outlook when I examine the groceries of a very obese person in the checkout lane. I remind myself, the problem of too much food and too little activity is a fairly recent phenomenon. Emphysema is a disability even though it's the person's "own fault" for smoking cigarettes. Both afflictions stem from biological issues involving the brain's reward system. I very much believe Americans need to be more active and drink water instead of half-gallon cups of sugared soda. But it doesn't come naturally for a lot of people. Yesterday I plowed through a bag of potato chips specifically designed to meet the craving for fat, salt and carbs. The motto used to be, "Bet you can't eat just one." Snack foods are engineered this way.

I see a behavioral health issue with extremely high monetary and quality-of-life costs. This mostly-U.S. problem should be tackled with science, not shame. Obesity can in fact be a disability. It can also be treated.

 

[Rolfe]

As the cook in my household, I'm not sure that's true. I've challenged myself to do the different levels of 'from scratch'. Do you grind your own flour, for example? We all pay extra for 'convenience' - we just judge those who choose more convenience on the continuum as morally inferior and resent those further along the 'prep' chain who judge us as judgy mcjudgerton.

What is this "flour" of which you speak? (OK, there is a small bag festering somewhere. I don't bake.)

I use frozen vegetables and would like to canonise the guy who invented frozen chips. The meat part of my meal may be a piece of haddock, or salmon, or a lamb chop, but it could be sausages or a burger or I might have some sort of pie. All these last are prepared by someone else.

The point is that doing it that way I can make a meal with around 350 to 400 calories on the plate. The ready-meals I see in the Co-op are far higher than that, even for one person. Unless you buy an actual Weight Watcher's product.

I'm also on record as somebody who believes many store bought frozen meals can be healthier than those cooked at home, and easier to monitor calorie counts for those who are using that strategy. What I'm saying is: I don't think there's a strong correlation with convenience vs home prepared and obesity, BUT that those cooking from fresh ingredients probably are self-selected as higher educated, which is itself correlated with better eating habits. I think it's a common cause connection rather than directly causal.

You are seeing a different range of frozen meals from me then. 650, 700 calories in a serving. I've had to cut these out completely while I've been on my calorie-controlled diet because I can't fit that into my daily calorie limit. I do buy the Weight Watchers ones which clock in about 300 to 350 calories per serving, but there isn't much variety so I don't use them a lot. (When my mother was alive we often bought one of the biggies, 700 calories or so, and split it between us. She only weighed about 7 stones - she was 5 ft 1 in tall - and I actually got the larger share!)

It's all about calorie control and if you really look at the calorie counts on a lot of these things you have to leave them right there on the shelf. Or at least I do.

Even grocery shopping can be a challenge for somebody with a long commute. I was at my sister's place, and the IR is about a 2 and a half hour bus ride from the nearest grocery store. So: frozen veggies are going to thaw, as an example, and pretty much off the shopping list for that community. Juice crystals, on the other hand, are immortal, so a logical choice for beverages. If your shopping is a 5 hour bus ride out and back, you're not buying a lot of spoilables or frozen food, as it's something you want to do infrequently (monthly). Not surprisingly, IRs have a very high obesity incidence.

To me, "IR" is "Inland Revenue", the tax man. So I don't have a reference point for what you're talking about. I don't think anyone in Scotland is as far as 2½ hours in the bus from a basic grocery shop. Not even these days when shops in the smaller villages have closed. People in remote communities have freezers, and they either have cars or a neighbour who wil shop for them or give them a lift. A car can carry a freezer-load of stuff and you just use freezer bags or boxes to get it home. (Or in winter just don't turn the car heating on and wrap up warm!)

So the situation you describe isn't in my own experience in my community at all. But I do wonder about one thing. People living in remote communities tend to be significantly more active than those in cities. That usually counters overeating quite a bit. Does this not apply in America? They also grow a lot more of their own vegetables, at the very least, and some keep hens. That's activity and fresh food for you. I mean, one thing about a remote community is that you're not living in a block of flats with nothing but a window-box.

So the situation you describe is simply alien to me. Does it preclude calorie-counting though?

In any case, the reactions are not surprising - as in predictable. There's just a chasm that I'm not sure how to bridge between people who very highly value personal accountability versus those who think it interacts with our environment enough to advocate for enforced restrictions in the name of public health. This topic is identical to vaccination, in my list of skeptical topics.

There's actually a science of morality (descriptive - not normative) with a model called "Moral Foundations Theory" that has identified what they believe are biologically predisposed 'moral dimensions' that people value, and how they cluster into different high level moral positions. The proposal to address a problem by environmental shaping is championed by those who strongly value Care and Fairness=opportunity, and opposed by those who strongly value Liberty and Fairness=proportionality. These are generally the same clusters as pro and anti vaccination cohorts.

Yes, I totally see where you're coming from. It's a behavioural issue, and to some extent the question is, can we influence peope's behavioural choices so that they don't harm themselves and don't become a burden on the community. Should we? It's a big subject.

 

[Rolfe]

I home cook 95% of my meals. Less than $10/day. My problem is prtion control, not quality of food.

Smart & Final has 50# bags of HUGE excellent baking potatoes, $10. How many potato pancakes can I make? One spud, shredded, fried in home rendered beef shortening, slathered in sour cream. Dinner cost, $1? Vs $8 for a fast food meal?

I totally identify with that. Your "potato pancakes" aren't in my repertoire but they sound delicious.

You know what the most important purchase was for me at the beginning of my weight loss plan? This.

http://www.ikea.com/gb/en/products/.../ordning-scales-stainless-steel-art-90100057/

I looked up the calorie content of the things I wanted to eat and made a note of it. I have a page on my computer headed "common things to eat" and just added to it every time I checked something else out. I weighed everything religiously, even weighing a slice of bread before and after putting spread on it, then again with marmalade, to get an estimate of how much was in my usual serving. (I only did that once, I'm not a complete obsessive.) I put my salad plate on the scales before adding the salad dressing so I could compute that accurately too.

I kept a running total of everything I ate during the day, with a plan of what I was going to eat for the rest of the day, and aimed for 1300 calories. If I came in under 1200 calories I could have a small glass of wine in the evening. Of course once I got into the swing of it I was repeating meals so I didn't have to work everything out from scratch every time.

This has recalibrated my perceptions of portion size. I posted a couple of pictures above of evening meals prepared like this, 350 and 435 calories respectively, and these now seem like a good feed to me.

Yes, this does take time and I can see why people in a hurry don't fiddle with these little details. But if you have the time to do it and you're determined to lose weight, it works. Obviously the actual calorie limit for the day will be higher for a larger person (I'm 5 ft 7 in) but the principle works for anyone with the time and the determination to do it. (I was also doing two or three days a week with very few calories at all - about 250 - which speeded up the process a lot. But I'd still have lost weight healthily if I'd just stuck to 1300 calories a day.)

It is a mindset thing though. I psyched myself into wanting to be able to wear the nice clothes I had in my wardrobe that I hadn't worn in maybe 10 to 15 years, more than I actually wanted to eat something. I also took periodic breaks from the diet, usually coinciding with actual holidays, and these were something to look forward to on a longer term basis. It was about delayed gratification. Don't stress about not eating today, you get 1300 calories tomorrow. Don't stress about holding down to 1300 calories for now, you have a week away when you can do what you like. And principally, think about how good you'll feel when you can get into that Laura Ashley dress you like.

For me it was totally worth it. I lost 4 stones. Almost 60 lb. I'm actually coming to the end of it now and I will have lost 60 lb when I get there. I'm swanning round in clothes I once thought I could never wear again, and people are paying me compliments that are making me quite conceited. But I really wanted to do it. I don't know how you encourage people to want to do it.

Except, although for me it was largely about vanity - I have a naturally good figure and smothering it in adipose tissue was self-destructive - it turned out not just to be about that. The list of niggling health problems that have simply gone away is absolutely astounding. Not just things I thought might be weight-related, like a tendency to swollen ankles in the evening, but things it never occurred to me for a moment had anything to do with my weight. My persistent cough has gone, the occasional stress incontinence has gone, my acid reflux has gone, a really troublesome problem where food I was swallowing would get stuck in my gullet half way down has gone. I'm moving around far more easily. I can duck under a barrier and out the other side without touching anything or going down on one knee in the mud. I'm riding my bike to the shops in a far higher gear than before, and going that much faster. I feel light on my feet, and quite frankly 20 years younger.

And the biggest contributor to all this has been that wee set of kitchen scales from Ikea.

 

[Rolfe]

Could you please start a new thread elsewhere about your personal anecdote? This thread is more evidence- and population-based than single self-professed outliers.

The population is composed of individuals though, and the utter inapplicability of one-size-fits-all solutions is part of the problem. So individual anecdotes about how one person has successfully tackled it, or the particular reasons why someone else feels they can't tackle it, are actually quite illuminating.

In particular there is the split between those who advocate increasing exercise and those who go for straight calorie restriction. Calorie restriction gets results more easily because you need to exercise a lot to trim off a relatively small number of calories. But then not exercising isn't so healthy. We have the people in MikeG's anecdote who successfully lost weight without cutting down their food intake, simply by taking up serious cycling. The best course is undoubtedly a combination approach, but what's the best split for each individual? It's an individual thing.

The thing I find puzzling about Casebro is that I don't know whether he thinks he's actually absolutely fine just because he doesn't have overt diabetes and sleep apnoea, or whether he realises he's in a bad place but doesn't intend to do anything about it, or whether he realises he's in a bad place and feels powerless to do anything about it because his orthopaedic condition has confined him to his chair.

So it's interesting from that point of view.

 

[Rolfe]

Obesity is a medical condition, not a moral failing.

We could debate this for weeks and not come up with an answer. It could be both.

Smoking wasn't a moral failing before the reports about the health damage and the start of the societal pressure not to smoke. People who became addicted before the 1960s genuinely didn't know what they were doing to themselves. After that? Well we could debate that too.

Then people raise the question of dangerous sports and the costs of caring for people injured in these sports. Should we discourage riding horses because of what happened to Christopher Reeve, for example? We could debate that one as well.

But the fact is we all have to eat. There is no "just say no" strategy. And there is nothing at all that nobody should ever eat, and there is no subset of food items you can tell people not to eat and if they follow that rule they'll be fine. So it's a completely different problem from smoking or climbing sheer rock faces or galloping flat-out over jumps.

It's about moderation. It's about not eating more calories than you expend over a period of time. People who did that without realising what they were doing have a difficult job to fix it. But hey, how many people is that, really?

There comes a point where it is actually true that nobody is forcing you to open your mouth and put that food in it. It is also true that substantial numbers of people can manage to curb that impulse and not put the excess food in there. So what about the people who can't, or won't? How much is "can't" and how much is "won't"?

Is it really the case that some people are born with less will-power than others? That some have food cravings that are really, genuinely, irresistible while others can resist them? Leaving aside people suffering from Prader-Willi, how uneven is the genetic playing field? I don't think anybody knows.

I've seen threads like this degenerate into huffy slanging matches when it's suggested that a lack of will-power is the problem, but in a non-judgmental sense, could that be true? Could some people simply be blessed with the mental and psychological ability to say no when some aren't?

 

[fagin]

... And there is nothing at all that nobody should ever eat,...

You should never eat anything bigger than your head.

Come to think of it you shouldn't really eat someone's head neither.

 

[casebro]

Obesity is a medical condition, not a moral failing. Yet I still have a judgmental outlook when I examine the groceries of a very obese person in the checkout lane. I remind myself, the problem of too much food and too little activity is a fairly recent phenomenon. Emphysema is a disability even though it's the person's "own fault" for smoking cigarettes. Both afflictions stem from biological issues involving the brain's reward system. I very much believe Americans need to be more active and drink water instead of half-gallon cups of sugared soda. But it doesn't come naturally for a lot of people. Yesterday I plowed through a bag of potato chips specifically designed to meet the craving for fat, salt and carbs. The motto used to be, "Bet you can't eat just one." Snack foods are engineered this way.

I see a behavioral health issue with extremely high monetary and quality-of-life costs. This mostly-U.S. problem should be tackled with science, not shame. Obesity can in fact be a disability. It can also be treated.

It parallels sexual activity don't it? Behavioral, but hard to control. No known genetic cause, not much science behind it, probably psychological. There are even porn sites of fatties, a combination.

If we can find a chemical/organic problem to these psychological variations, and we can fix them, should we? They are why you're you, I'm me.

 

[casebro]

Lssee, I put on 60 lbs in five years. Since weight gain/loss is half water, that is 30lbs of fat @3,500 cal/lb. About 100,000 calories gained in 1800 days. 55 calories per day. That is within 3% of calories in/calories out. Pretty good homeostasis, eh?

How about yourself?

 

[Rolfe]

Lssee, I put on 60 lbs in five years. Since weight gain/loss is half water, that is 30lbs of fat @3,500 cal/lb. About 100,000 calories gained in 1800 days. 55 calories per day. That is within 3% of calories in/calories out. Pretty good homeostasis, eh?

How about yourself?

If you're talking to me, I put on 60 lb in 15 years. I'm not proud of this. I knew I was letting it get away from me but didn't seriously tackle it. When I did, I took it off in 15 months. This is not a recommendation.

That's kind of the whole point. It doesn't need a huge excess over one's actual energy requirement to rack up a significant weight gain if it's sustained every day for years. One needs to be in the habit of balancing the excess days with days when one eats under maintenance.

Turning this from the particular to the general, if people are under the impression that it's absolutely peachy if all you're doing is exceeding your maintenance requirements by less than 100 calories a day, they're doing it wrong. Of course it's fine to exceed your maintenance requirements by 100 calories a day. So long as you balance that with another day when you eat 100 calories less than your maintenance. And of course it can vary by a lot more than 100 calories either way.

That was my mistake. I don't think I was overeating in the normal day-to-day course of events at all. I was overeating at Christmas/New Year, and when I was on holiday, and I didn't cut down to compensate. If I had, I wouldn't have put on the 60 lb I had to lose. (Or rather, I would have put it on a few pounds at a time and taken it off again soon afterwards instead of all in one fell swoop over more than a year.)

I've learned my lesson now. I genuinely think this is an observation of more than individual relevance.

 

[casebro]

If you're talking to me, I put on 60 lb in 15 years. I'm not proud of this. I knew I was letting it get away from me but didn't seriously tackle it. When I did, I took it off in 15 months. This is not a recommendation.

That's kind of the whole point. It doesn't need a huge excess over one's actual energy requirement to rack up a significant weight gain if it's sustained every day for years. One needs to be in the habit of balancing the excess days with days when one eats under maintenance.

Turning this from the particular to the general, if people are under the impression that it's absolutely peachy if all you're doing is exceeding your maintenance requirements by less than 100 calories a day, they're doing it wrong. Of course it's fine to exceed your maintenance requirements by 100 calories a day. So long as you balance that with another day when you eat 100 calories less than your maintenance. And of course it can vary by a lot more than 100 calories either way.

That was my mistake. I don't think I was overeating in the normal day-to-day course of events at all. I was overeating at Christmas/New Year, and when I was on holiday, and I didn't cut down to compensate. If I had, I wouldn't have put on the 60 lb I had to lose. (Or rather, I would have put it on a few pounds at a time and taken it off again soon afterwards instead of all in one fell swoop over more than a year.)

I've learned my lesson now. I genuinely think this is an observation of more than individual relevance.

It's not always about you.

I lost 60# in three months by working it off. THEN regained it over five years, at 50 calories per day.

That is about 15 minutes of walking for an average sized individual. Not hard to control weight via exercise, eh?

 

[Rolfe]

It parallels sexual activity don't it? Behavioral, but hard to control. No known genetic cause, not much science behind it, probably psychological. There are even porn sites of fatties, a combination.

There are always going to be a number of people who are so far off the wall they're not going to come under any normal programme. People who believe obesity is sexually attractive are probably among that number.

The point is that whereas 50 years ago only a relatively small percentage of the population was obese, now it's an astounding number. They're not all fat-fetishists or Prader-Willi sufferers. They're people who would have been a normal healthy weight if they'd been part of society in the 1950s. These are the people who need to be addressed, not the weirdos.

They're no different in themselves from their 1950s compatriots. It's society that has changed. Can society be changed again so this doesn't happen?

 

[Skeptical Greg]

...
My uncle went on disability because (I've heard) he could no longer work as a city electrician due to being overweight for the cherry-picker used in fixing traffic lights. Morbid obesity may not be a disability in itself, but then again maybe it is.

It certainly is a disability, but a self induced one.

Obesity is a medical condition, not a moral failing.

Again, a self induced medical condition; like lung cancer from smoking..

It is a moral failing in that you become a burden on the community, your family and most of all yourself..

 

[Rolfe]

It's not always about you.

I lost 60# in three months by working it off. THEN regained it over five years, at 50 calories per day.

That is about 15 minutes of walking for an average sized individual. Not hard to control weight via exercise, eh?

No, it seems to be all about you.

I think you're a fair bit out with the idea that you use up 50 calories above BMR simply by walking for 15 minutes. I'll let someone who has the numbers at their fingertips address that one though.

Obviously the whole thing is about the balance between calories in and calories out. If people were taking that bit extra exercise over and above what they were eating, regularly, we wouldn't be seeing this obesity epidemic. But dammit we are.

Now maybe the amount of exercise needed per day to maintain weight when eating 50 or 100 calories per day over maintenance isn't all that much, but people aren't doing it. Is it easier to take 75 calories worth of extra exercise or simply not to eat that chocolate biscuit? For some people it's one way, for some it's the other.

But that's maintenance. When we get into weight reduction, it's a more difficult matter. Some people have the time and the ability to start burning a lot more calories than they were. MikeG's cycling club recruits for a start. But many don't. Again it varies, but on average it's a lot easier simply not to eat the food than to sweat out say 500 calories a day.

Probably most people do best with a mix. A bit extra exercise and a bit less food. But some people will do it entirely on reduced consumption (such as me) and some will do it entirely on increased expenditure (such as MikeG's cycling mates). The trick is to find out the best approach that will suit each individual, not pontificate that one or the other is the "right" or "best" way to do it.

 

[Skeptical Greg]

I'm sure you are aware, it really depends on how far you travel and how much you weigh..
Speed has some effect as it relates to raising your pulse rate. Most of the charts I've consulted give me about 100 calories per mile at my weight of 175..

Here is a rough chart..

Here is a calculator that gives me 105, for a 20 minute mile on a level surface..

 

[Rolfe]

Mmm, so that wasn't that far out actually. I still don't see the vast majority of obese people suddenly taking up walking even half a mile, or indeed the vast majority of OK people doing that just to avoid having to turn down a chocolate biscuit.

Unless you're Archie Gemmill Goal that is. And even he was cutting down a lot on calories in at the same time.