The stupid explodes: obesity now a disability

[casebro]

.....

Hey Skeptical Greg- How much weight would you have to lose to become Skeletal Greg?

I can't help,., I've been misreading your name in association with this thread.

 

[casebro]

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..

Exactly. 50 calories is a ten minute walk at 3 mph.

 

[blutoski]

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

Right, and this is the 'gradient of moralizing' that I'm talking about. I don't think I've bought baked goods in 30 years. But that's because I exchange time doing other things (less hiking) for time doing home preparation of foods (more baking). But that's my choice, and I can make the choice because I can find 3 hours at a stretch a couple nights a week. I don't think those people out there who pay more to buy bread at the bakery are lazy and spendy.

We all feel our balance of convenience to cost is the definition of 'appropriate', and we vilify those who shift toward convenience as 'lazy', and those who shift toward less convenience who regard us as lazy as 'judgemental'. (or even 'snobby' - how do skeptics regard the Slow Food Movement?)

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.

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.

Weight Watchers is a good example. There are other brands that are designed around calorie management systems, such as the diabetes diamond charting system.

A shopper can choose to buy a higher calorie prepackaged meal, but the same shopper can choose to cook a higher calorie home-prepared meal. Both are eating poorly. There's no magic to home cooking. If it was up to my kids, I'd home-make cheeseburgers, deep fried french fries and milkshakes every night. I can do that practically from scratch (and do, usually every Canada Day) - it doesn't make it healthier than McDonald's.

The distinctions I emphasize are that buying the prepackaged meal requires less overhead time investment in learning how to prepare food. Some people don't know how to organize their shopping around meal plans, don't know how to prepare food &c... If you're calorie counting, there's an overhead investment in calculating the nutrient values in the home made meal, you have to weigh everything and record it and look it up in a tool. So there's an efficiency in buying prepackaged foods for people in this situation. This is why I think education is a big part of the solution.

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?

It doesn't preclude calorie-counting, but the problem is the environment does restrict options for 'home cooking' and calorie counting has to take a back seat to meal planning around logistical complications, and the point being that this is extra time involved in cooking that middle class snobs like us don't take into account when we talk about 'how easy it is' to prepare a variety of healthy and nutritious home cooked meals every day. IR = Indian Reservation. In my province (BC), that's 10% of the population. I think about half of them don't have running water, either, which increases the overhead time for food preparation enormously.

Yes, I totally see where you're coming from. It's a behavioural issue, and to some extent the question is, can we influence people'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.

Yep. And it's a reason that I fell out with skepticism. The local skeptics group I worked with more or less concluded that any important issue facing us (climate change, obesity, vaccination refusniks, commercial fraud), skeptics could contribute nothing of value. The proven solutions required community action, and they were Libertarians and opposed in principle, so we could not advocate anything beyond humiliating the victims for their ignorance, hoping it would inspire change. I refuse to be part of such a dark project.

 

[Skeptical Greg]

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.

I think it's important to get moving.. My daily walk is always refreshing, and at least earns me a beer..

 

[blutoski]

In my province (BC), that's 10% of the population. I think about half of them don't have running water, either, which increases the overhead time for food preparation enormously.

Just in case it wasn't clear: the author of the op/ed I referenced is also Canadian.

And we have to use a bit of imagination. Even in an urban area, public transportation is not conducive to frozen groceries. It doesn't have to be 2-1/2 hours, even an hour commute is enough to make frozen chicken risky. This also eliminates the economical bulk purchases at big box stores, which tend to be in suburbs. Not to mention, people who are transient and in small spaces don't have the storage space for bulk items. There's a lot of research on this, with the principle that "the poor pay more for everything."

 

[blutoski]

Exactly. 50 calories is a ten minute walk at 3 mph.

My calculator says 42 calories, and that is total burn (ie: not net burn from the walking versus not walking).

Recall that just sleeping for that same 10 minutes burns 26 calories for the same weight, so the action of walking versus not walking is burning 24 calories in the same period, or about 144 per hour - less than a 12oz beer.

If my calculator is more accurate, the net burn is 96calories/hour, less than a small lite beer.

 

[Skeptical Greg]

I think if I had a choice to sleep or walk for ten minutes, I'd definitely go with sleep...

 

[jimbob]

I think if I had a choice to sleep or walk for ten minutes, I'd definitely go with sleep...

Why not combine the two in sleepwalking?

 

[blutoski]

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

Good question, worth investigating.

My opinion from reading the research is that I think it's the conflation of two factors: as commercial messaging has inflated exponentially, the importance of education as a defense has grown. eg: in my grandmother's era, her lack of education (she dropped out in grade 5 in 1915) didn't disadvantage her in an advertising environment, because there was no mass media at the time. She didn't see her first TV commercial until she was into her 50s.

Today, the same person would be vulnerable from the day she's born, the value of education is probably the ability to have a broader base of knowledge with which to evaluate the credibility of marketing efforts, ranging from massmedia to package claims.

 

[blutoski]

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.

This was where my head was at when I was working at those recreation centers... we had a mixed mandate, but one of the recreation board's objectives was to increase participation levels. In other words: not just building facilities for the jocks who were already into exercise, but establishing operations to get nonathletes to become more active.

At the time, we all bought into the "this will reduce obesity" argument - which I no longer accept - but in addition, there's the psychological and political benefits of getting people to participate in a group activity, and the overall health benefits of increasing exercise.

I don't specifically recommend walking, but that's an easy entry level activity if there ever was one, and unless the patron has health contraindicators (extreme obesity - risk of injury falling / advanced osteoporosis / dementia / vulnerable to current weather). Very low cost equipment requirements, although in Vancouver, there's the weather issue that adds expense in the form of weatherproofing clothing. It mostly rains here.

 

[blutoski]

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?

And I disagree with Rolfe on the claim that there's not much science on this... if anything, we have a good picture of causality, but the challenge is forming a mitigation plan.

Obese people are doing pretty much the same thing as non-obese: eat when we're hungry, stop when we feel full.

We have different biological predispositions that create different weight levels for hungry/satiated, which marketing has learned to stimulate as a mechanism for increasing sales. There is an arc of growth because they're getting better at it over time, and we're more exposed to it due to the explosion of media access. There is evidence it's levelling off, which is the industry reaching its limits of human biology. Also, they don't want the public to understand this (lest it confound their marketing), so there's an investment in doubtcasting.

With that as the baseline, there's a debate about how to manage it, with two almost independent conversations: "What works, whether it's morally justified or not?" (the scientific discussion) versus "What is morally justified, whether it works or not?" (the political discussion).

 

[Pterodactyl]

Good question, worth investigating.

My opinion from reading the research is that I think it's the conflation of two factors: as commercial messaging has inflated exponentially, the importance of education as a defense has grown. eg: in my grandmother's era, her lack of education (she dropped out in grade 5 in 1915) didn't disadvantage her in an advertising environment, because there was no mass media at the time. She didn't see her first TV commercial until she was into her 50s.

Today, the same person would be vulnerable from the day she's born, the value of education is probably the ability to have a broader base of knowledge with which to evaluate the credibility of marketing efforts, ranging from massmedia to package claims.

I dont think it takes a master's degree to know that eating a banana is better for you than eating a whole goddam bag of Doritos though.

As evidenced by posters in this very thread, people either don't think science applies to them (magical thinking) or they are not worried about the long term effects as much as the instant gratification.

 

[blutoski]

Just in case it wasn't clear: the author of the op/ed I referenced is also Canadian.

And we have to use a bit of imagination. Even in an urban area, public transportation is not conducive to frozen groceries. It doesn't have to be 2-1/2 hours, even an hour commute is enough to make frozen chicken risky. This also eliminates the economical bulk purchases at big box stores, which tend to be in suburbs. Not to mention, people who are transient and in small spaces don't have the storage space for bulk items. There's a lot of research on this, with the principle that "the poor pay more for everything."

Link to Caplovitz' The Poor Pay More, in the Open Library: [The Poor Pay More]

 

[blutoski]

I dont think it takes a master's degree to know that eating a banana is better for you than eating a whole goddam bag of Doritos though.

Right, but I admit I'd have to research where the breakeven point is. A "small" bag of Doritos is probably as healthy as a banana, if the intention is calorie management. And Doritos are a sometimes food, so both have a place in healthy family meal planning. Education helps people find the balance point.

As evidenced by posters in this very thread, people either don't think science applies to them (magical thinking) or they are not worried about the long term effects as much as the instant gratification.

Yeah, but they're outliers. The typical obese person did not gorge on Doritos. They probably had two tough years in 1995-1996 and have never lost the weight ("maintaining" just like a thin person does, for 21 years since).

Most eating decisions are not conscious, is the problem. So educating people about how to manage their environment in advance to shape their own behavior would be the direction.

 

[Pterodactyl]

Right, but I admit I'd have to research where the breakeven point is. A "small" bag of Doritos is probably as healthy as a banana, if the intention is calorie management. And Doritos are a sometimes food, so both have a place in healthy family meal planning. Education helps people find the balance point.

Admittedly Im painting with a broad brush here, but In my experience relatively few people are actively interested in physical fitness or health maintenance, particularly at lower income levels. In other words, they're not looking for a "balance point" they're looking to hammer as many goddam boneless wyngz as they can choke down while watching TV.
This kind of relates to the point I made earlier in the thread about correlation between obesity and poverty going deeper than the low quality food the poor can afford or that is available to them. I would argue that poor personal finance, unwed motherhood, criminal history, are all highly correlated with obesity, not because of low intelligence or education, but because people just dont give a crap enough to worry about the future. Got room on the credit card? New flatscreen.
Bag of Doritos? Destroy it. A little too drunk to drive? I'll be fine...

Yeah, but they're outliers. The typical obese person did not gorge on Doritos. They probably had two tough years in 1995-1996 and have never lost the weight ("maintaining" just like a thin person does, for 21 years since).

Most eating decisions are not conscious, is the problem. So educating people about how to manage their environment in advance to shape their own behavior would be the direction.

Im all for education, I just dont think it is particularly relevant in this context.

 

[Rolfe]

Right, and this is the 'gradient of moralizing' that I'm talking about. I don't think I've bought baked goods in 30 years. But that's because I exchange time doing other things (less hiking) for time doing home preparation of foods (more baking). But that's my choice, and I can make the choice because I can find 3 hours at a stretch a couple nights a week. I don't think those people out there who pay more to buy bread at the bakery are lazy and spendy.

We all feel our balance of convenience to cost is the definition of 'appropriate', and we vilify those who shift toward convenience as 'lazy', and those who shift toward less convenience who regard us as lazy as 'judgemental'. (or even 'snobby' - how do skeptics regard the Slow Food Movement?)

I'm not intending to be judgmental about it, but really to understand people's choices. To me, the ready-meals I see all have way more calories than I want in a regular meal, unless I choose the ones specifically marketed at people trying to lose weight. In that situation, constantly choosing the ordinary ready-meal is going to predispose to weight gain.

It's not about being lazy, or spendy. I have cousins who make all their own bread, I wouldn't do it on a bet, life's too short. I don't think either choice is wrong in any way. I don't bake cakes because I'd only have to give away 80% of the batch.

I was mostly trying to explore what the easiest way to keep to a calorie restriction is, and it seems to me that unless you do some actual cooking your choices are going to be quite limited.

Weight Watchers is a good example. There are other brands that are designed around calorie management systems, such as the diabetes diamond charting system.

A shopper can choose to buy a higher calorie prepackaged meal, but the same shopper can choose to cook a higher calorie home-prepared meal. Both are eating poorly. There's no magic to home cooking. If it was up to my kids, I'd home-make cheeseburgers, deep fried french fries and milkshakes every night. I can do that practically from scratch (and do, usually every Canada Day) - it doesn't make it healthier than McDonald's.

The distinctions I emphasize are that buying the prepackaged meal requires less overhead time investment in learning how to prepare food. Some people don't know how to organize their shopping around meal plans, don't know how to prepare food &c... If you're calorie counting, there's an overhead investment in calculating the nutrient values in the home made meal, you have to weigh everything and record it and look it up in a tool. So there's an efficiency in buying prepackaged foods for people in this situation. This is why I think education is a big part of the solution.

It may be you have a better variety of ready-meals available where you are. I'm fed up picking something up that looks nice then putting it back on the shelf once I've seen the calorie count. Our local Co-op used to have a couple of lines that were OK, but now they don't stock anything reasonable.

I agree in principle, that it's the calories that matter and you can do it well enough using ready-meals, if you can source the right products.

It doesn't preclude calorie-counting, but the problem is the environment does restrict options for 'home cooking' and calorie counting has to take a back seat to meal planning around logistical complications, and the point being that this is extra time involved in cooking that middle class snobs like us don't take into account when we talk about 'how easy it is' to prepare a variety of healthy and nutritious home cooked meals every day. IR = Indian Reservation. In my province (BC), that's 10% of the population. I think about half of them don't have running water, either, which increases the overhead time for food preparation enormously.

It's obviously a different world. I doubt if there's anyone in Scotland who isn't living on the streets who doesn't have access to running water. (Some houses, including some quite big fancy houses, aren't on mains water, but they have a watercourse piped in from the hill above them and unless there is a really dry summer the whole thing is indistinguishable from normal mains water.)

I also can't quite get my head round people having to travel so far to shop - and by public transport too, which much seriously restrict the amount they can carry home on any one trip. We have lost a lot of small village shops but there are very few homes so remote that that sort of travel time is required to get any groceries, and where it does happen the people have cars. (In fact it's people choosing to drive to the cheaper supermarkets that has caused the village shops to close.)

Why is it not a huge business opportunity to open a basic grocery and staple needs shop right there in the middle of a community like that?

Yep. And it's a reason that I fell out with skepticism. The local skeptics group I worked with more or less concluded that any important issue facing us (climate change, obesity, vaccination refusniks, commercial fraud), skeptics could contribute nothing of value. The proven solutions required community action, and they were Libertarians and opposed in principle, so we could not advocate anything beyond humiliating the victims for their ignorance, hoping it would inspire change. I refuse to be part of such a dark project.

Well, that's a whole other argument.

 

[Rolfe]

This was where my head was at when I was working at those recreation centers... we had a mixed mandate, but one of the recreation board's objectives was to increase participation levels. In other words: not just building facilities for the jocks who were already into exercise, but establishing operations to get nonathletes to become more active.

At the time, we all bought into the "this will reduce obesity" argument - which I no longer accept - but in addition, there's the psychological and political benefits of getting people to participate in a group activity, and the overall health benefits of increasing exercise.

That is so true. Providing an exercise facility is probably not going to reduce obesity at a population level though it might help for a few people. People have to want to take part, and the ones who will keep at it are the ones who are doing it for reasons other than weight loss.

I don't specifically recommend walking, but that's an easy entry level activity if there ever was one, and unless the patron has health contraindicators (extreme obesity - risk of injury falling / advanced osteoporosis / dementia / vulnerable to current weather). Very low cost equipment requirements, although in Vancouver, there's the weather issue that adds expense in the form of weatherproofing clothing. It mostly rains here.

And here. But did you see in the weight control thread what Archie Gemmill Goal was doing? He was walking quite substantial distances and has managed to lose over 60 lb so far by combining that with calorie control (principally giving up booze). It shows how varied the stratagems that work really are, because the idea of doing that is to me vastly less attractive than just sitting here consuming only 250 calories the entire day.

 

[Rolfe]

And I disagree with Rolfe on the claim that there's not much science on this... if anything, we have a good picture of causality, but the challenge is forming a mitigation plan.

I don't think I said there wasn't much science in this, and if I did say something like that, it wasn't what I meant. Of course we know what's happening, but we don't seem to know how to prevent it.

Obese people are doing pretty much the same thing as non-obese: eat when we're hungry, stop when we feel full.

We have different biological predispositions that create different weight levels for hungry/satiated, which marketing has learned to stimulate as a mechanism for increasing sales. There is an arc of growth because they're getting better at it over time, and we're more exposed to it due to the explosion of media access. There is evidence it's levelling off, which is the industry reaching its limits of human biology. Also, they don't want the public to understand this (lest it confound their marketing), so there's an investment in doubtcasting.

With that as the baseline, there's a debate about how to manage it, with two almost independent conversations: "What works, whether it's morally justified or not?" (the scientific discussion) versus "What is morally justified, whether it works or not?" (the political discussion).

My point is that "what works" seems to vary a lot between individuals, and finding a general approach that will deliver results across the board might not be possible.

 

[blutoski]

Right, but I admit I'd have to research where the breakeven point is. A "small" bag of Doritos is probably as healthy as a banana, if the intention is calorie management. And Doritos are a sometimes food, so both have a place in healthy family meal planning. Education helps people find the balance point.

And it's also about portions... I have an obese colleague who is a vegan and very hands-on about her food preparation. Grows a lot of her own vegetables. The problem is that as healthy in principle as this food is, she eats a little bit more than she should is all.

And why wouldn't she? She's out there busting her ass doing all that weeding, which is hungry work. Exercise stimulates the appetite, and one of the demonstrated problems with introducing an exercise routine in an effort to lose weight is that a lot of people report it gives them more cravings, and that they need to eat more before achieving satiety, often out of proportion to the actual calories burned by exercise. She's a good example of this effect.

 

[blutoski]

My point is that "what works" seems to vary a lot between individuals, and finding a general approach that will deliver results across the board might not be possible.

What I'm interested in is not micromanaging, but rather, what are the broad strokes that produce net benefits for millions of people. Again, like vaccination. Vaccination doesn't work at the individual level - it works on a population. That doesn't make "get vaccinated" bad advice.

I don't think there's "one" solution for any single person - it is a war of a thousand battles. Some of the battles need to be fought from outsiders.

For example, soft drink taxes reduce obesity over a population. I wouldn't sell it as a 'solution' but it's 'part of the solution' in my opinion.

Another demonstrated effective change is prohibiting fast food advertising directed at children. This establishes a better parental negotiating position due to reduced demand. Again, not 'the' solution, but it's a brick in the solution wall a community might want to build.

And there are some people who see net benefit from exercise, even though there are possibly an equal number of people who don't... the city where I worked had a policy of subsidizing their community center participation (full access to the pools, fitness classes, and a masters swim team with 12 workouts a week with an Olympic quality coach was $25/mo for a student or senior, $40/mo for an adult). We have been the healthiest city in Canada for two generations, and I attribute this to public policy in action.