The stupid explodes: obesity now a disability

[Skeptical Greg]

Keep in mind that the thrust of the OP is not that obesity is not disabling, but that it is an " official " disability that warrants pension type benefits..

 

[Rolfe]

People get there gradually though.

Once someone has got to the stage where their obesity means they genuinely can't work, what do you do? You can be as judgmental as you like, but people have to live. If only it were as simple as "letting them starve" which under the circumstances might actually be a good thing, but it's not. The positive correlation between poverty and obesity has been highlighted many times, counter-intuitive though it is.

Is someone whose disability is self-inflicted to be denied support? Back to the smokers and the mountaineers and the show jumpers. We've been round all that.

More fruitful for discussion, and what much of the discussion in the thread has been about, is how you tackle the problem, and even if it's possible to tackle the problem. Otherwise it's only going to be a wrangle about whether obese people should be awarded disability pensions and I think we did that.

 

[blutoski]

Keep in mind that the thrust of the OP is not that obesity is not disabling, but that it is an " official " disability that warrants pension type benefits..

Yep. And this is why I brought up the 'two discussions' problem. Is it a disability? Yes, that's obviously true. OK, but does it qualify for support from the community? That's a moral question.

So, those who emphasize Care and Fairness - Opportunity lean toward including this as a community assisted condition, but those who emphasize Fairness - Proportionality don't want to be on the hook for other peoples' bad choices.

For many medical conditions, there's a mix of inputs that include both genetics, environment, and choices. So, debate is more about personal values than objective facts, unfortunately. I find close analogy to vaccination as a medical example (antivaxxers have a Liberty angle on top of this) and another one is household finances.

 

[blutoski]

Googling " benefits of fiber " brings up a lot of references to the fact that
fiber interferes with the digestion of dietary fat.

I don't think the USDA calorie counts take that into account.. i.e. The calorie count for a tablespoon of butter doesn't take into account that you ate it with a cup of oatmeal..

One example:

Nutritional implications of dietary fiber

The above example has references to several other papers..

Yes, this is something I lump into the category of "rearranging the deck chairs on the titanic" - the effect appears trivial, and in my opinion, at the moment, there is no reason to account for it.

From the abstract you cite above: "The significance of the changes in fat, nitrogen, and energy output remains to be evaluated," which sounds premature to translate into any dietary advice.

However, I found some studies with estimates, and here's one that has some ranges: [Dietary Fiber Decreases the Metabolizable Energy Content and Nutrient Digestibility of Mixed Diets Fed to Humans]. It looks like less than 1%.

In particular, since the problem we're dealing with is too much of everything, the observation that we may be getting one percent less of a micronutrient we're already getting 200% daily requirements of is not a public health concern. If anything, it's reducing the risk of vitaminosis, for example. This may contribute as a mechanism for why high fibre diets are associated with better health outcomes. ie: a feature, not a bug.

 

[blutoski]

More fruitful for discussion, and what much of the discussion in the thread has been about, is how you tackle the problem, and even if it's possible to tackle the problem. Otherwise it's only going to be a wrangle about whether obese people should be awarded disability pensions and I think we did that.

I think part of the thread's drift into causes/solutions is that identifying causes leads to identifying responsibility, and that contributes to the morality discussion.

For a condition that is the interaction of genetics, environment and choice, there's plenty of blame to go around, and people weigh accountability in accordance to our worldview.

 

[The Atheist]

Takeaway food outlets did exist, principally the chip shop, but when I was a child there wasn't one in the village and it was a treat for seaside holidays.

I was driving around one of the poorer areas of Auckland on Thursday morning and had to pass through their shopping centre. Traffic was slow and I stopped outside a takeaway, watching a hugely obese Pasifika woman alternate bites of one of those revolting battered sausage on a stick things with her ~1 year old child.

Wish I'd taken photos.

 

[jimbob]

I was driving around one of the poorer areas of Auckland on Thursday morning and had to pass through their shopping centre. Traffic was slow and I stopped outside a takeaway, watching a hugely obese Pasifika woman alternate bites of one of those revolting battered sausage on a stick things with her ~1 year old child.

Wish I'd taken photos.

As an aside, when we were in Auckland we visited my cousins and they suggested a meal at their favourite... "restaurant"(?), which was called Genghis Khan, and an all you can eat supposedly* Mongolian restaurant. I suppose it was reasonable value for money if you were only considering calories per dollar, but was a waste in a country where good quality eating out is fairly cheap. My kids particularly liked the fact that the children got the food for their morbidly obese mother... and that in a couple of weeks they'd seen more of the country - having been south of Rotoroua.

We went there with Dad's girlfriend, with whom we had spent the day, and on the way back she called them "Jaffas" (and explained the acronym, which has been the only time in about a decade that I have heard her swear).


*From what I have read, authentic Mongolian cuisine would be unlikely to be much of a hit outside its heartland.

 

[Minoosh]

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?

A lot. Gaining 7 pounds over the holidays is more or less normal. The problem is never losing it then gaining 7 again next season. Etc.

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?

I would say yes, pretty much by definition. Plus, once you get overweight, you don't need to eat an abnormal amount to stay heavy. You have to do the abnormal thing by capping the calorie count.

It's adaptive to overeat if you're a hunter-gatherer whose food supply waxes and wanes. We're hardwired to want calorie-dense foods. Putting the brakes on does not come naturally. I think another big culprit is convenience. Remote controls, elevators and even electric typewriters shave off a few calories burned each day. Sometimes I do the inconvenient thing to make up for that, parking farther away from the store, taking the stairs when possible. On holiday I love to explore by foot and bike and actually usually end up a bit trimmer after a week or two away.

Leaving aside people suffering from Prader-Willi, how uneven is the genetic playing field? I don't think anybody knows.

Well it's not exactly even, obviously, but there are many factors beyond the simplistic "willpower" formulation. Our bodies have appetites, our brains, or minds, are part of our bodies. I'm not sure there's a single ingredient labeled "willpower" or "brain over body" control. Eating is more pleasurable for some people than others; some people are naturally fidgety and burn calories, some are tall and can carry more weight.

Compulsive overeating is probably unhealthy by definition and there's not one answer to that. The compulsion is biologically based; how could it not be? Same with any other addiction. It can be very hard work to change habits over time, with many issues to address. The motivation to do that work is probably more important than "willpower." There could be a lot of reasons for the calorie imbalance, a suite of unhealthy behaviors that require differing interventions.

 

[Skeptical Greg]

The compulsion is biologically based; how could it not be?

Was it biologically based 50 years ago when obesity was much more rare? Does evolution happen that dramatically, that quickly?


All addictions could be said to be biologically based, but the availability of your ' drug ' of choice, along with commercial advertising pressure goes a long way to feed the need..

 

[P.J. Denyer]

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

I don't think that anyone else has given you a serious answer on this so I'll try.

Because it only correlates in countries with sufficient availability of cheap calories, in a famine struck country the rich will be better fed and better educated. The post WWII years have brought an abundance of food to the Western world without historical precedent. Also education may have improved but the correlation is across across the range not with a particular level of attainment.

 

[P.J. Denyer]

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.

I think you've perfectly articulated the way that so many of us slip slowly out of our healthy zones. Thank you for putting it so well.

 

[P.J. Denyer]

I'm following this thread with interest and really enjoy your contributions. You seem to have a very in depth knowledge of nutrition.

Church calendars not so much. Pancake day is before lent. You use up the good stuff before starving.

Then pig out on chocolate eggs at Easter

Ramadan can involve two large calorie heavy meals a day.

 

[Minoosh]

Was it biologically based 50 years ago when obesity was much more rare? Does evolution happen that dramatically, that quickly?

Not evolution, economics. As mentioned above an abundance of cheap calories and less physical activity. It adds up. Evolution favors those who stay alive long enough to breed. Living into a healthy old age isn't such a big factor.

 

[Rolfe]

It must have been a fairly big thing at one time, or we wouldn't have evolved to live as long as we do. Society benefited from retaining the knowledge and wisdom of older people.

Now we have books the internet.

 

[jimbob]

It must have been a fairly big thing at one time, or we wouldn't have evolved to live as long as we do. Society benefited from retaining the knowledge and wisdom of older people.

Now we have books the internet.

Yes, and grandmothers (especially maternal grandmothers) can help with childcare (there is a 100% guarantee that their daughter's child is their grandchild). Indeed, that is probably one reason for the menopause in the first place.

For retaining knowledge about rare events, you only need a handful of elders (I think there is also evidence that elderly Elephants have a similar role in remembering resources or behaviours that worked in rare situations.

 

[Rolfe]

I tend to think that childcare is only a small part of it. Homo sapiens is a societal species, and longevity of the individual is heavily influenced by the functioning of the society he is born into. If societies with a significant complement of older people were more conducive to individual survival, then that selection would prevail. Unfortunately we didn't cop the break that only the intellectually gifted deveoped the long life-span. (And as you say, there are useful roles for older people who aren't in the "sage" category.)

My own view is that the menopause (which is almost unique in mammals) is a function of us having evolved from a shorter-lived ancestor species and the ovum capacity of the ovaries didn't extend with the lifespan. And of course this was a feature not a bug, as you point out, so there was no pressure to change that.

But we're getting a bit off topic.

 

[jimbob]

I tend to think that childcare is only a small part of it. Homo sapiens is a societal species, and longevity of the individual is heavily influenced by the functioning of the society he is born into. If societies with a significant complement of older people were more conducive to individual survival, then that selection would prevail. Unfortunately we didn't cop the break that only the intellectually gifted deveoped the long life-span. (And as you say, there are useful roles for older people who aren't in the "sage" category.)

My own view is that the menopause (which is almost unique in mammals) is a function of us having evolved from a shorter-lived ancestor species and the ovum capacity of the ovaries didn't extend with the lifespan. And of course this was a feature not a bug, as you point out, so there was no pressure to change that.

But we're getting a bit off topic.

It is relevant to a discussion of hypothetical evolutionary pressures for longevity without obesity when most of the time the population would be limited by one of the four horsemen (war being a subset of predation) and gluts of food would be short-lived. ETA: Childcare really makes the most sense for maternal grandmothers.

One wouldn't need to be particularly bright to tell stories about the old times and how the problems were dealt with in the past, nor would there need to be many old people. Of course, humans have oral cultures, so stories can survive a long time - the Australian Aborigines have Dreamtime stories that seem to accurately describe the coast before the Great Barrier Reef was formed 10k years ago. Other long-lived social animals, for example whales and elephants don't have that advantage, but still do seem to transmit knowledge from elders to their young - for example leading to the best waterholes that tend to survive even in exceptional droughts.

 

[Rolfe]

Interesting.

http://www.independent.co.uk/news/w...sitting-next-to-obese-passenger-a7326081.html

A man is suing the Emirates airline after having to sit next to an overweight passenger during a nine-hour flight.

Giorgio Destro, from Padua in northern Italy, said that after he settled into his seat next to the window, he was “amazed” when the overweight man took the seat next to him.

He said he asked to be moved, but could not be re-seated as the aircraft was fully booked.

Mr Destro claims he suffered for the duration of the flight from Cape Town to Dubai, and was so uncomfortable he could not even use his seat for most of the journey.

 

[blutoski]

I don't think that anyone else has given you a serious answer on this so I'll try.

Because it only correlates in countries with sufficient availability of cheap calories, in a famine struck country the rich will be better fed and better educated. The post WWII years have brought an abundance of food to the Western world without historical precedent. Also education may have improved but the correlation is across across the range not with a particular level of attainment.

Another factor that gets little attention (I personally think marketing of food explains the lion's share BUT there is a batch of other inputs worth mentioning) is that there wasn't much of an increase until 1984ish. This coincides with the success of antismoking campaigns. We may have exchanged one unhealthy habit for another.

 

[jimbob]

On the personal weight-loss thread, it struck me how much fizzy soda some of the Americans say that they drink or drank.

I might have about half a dozen glasses a year - mostly in the summer.