The Global Obesity Epidemic

[Distracted1]

I don't know how you could do that without the data being swamped by larger effects like different available food and different physical activity levels associated with work/transportation. There are so many potentially confounding variables that I doubt you could separate out something like fat shaming.

Perhaps.
Perhaps different cultures within the same time period could be compared instead.

 

[Ziggurat]

Perhaps.
Perhaps different cultures within the same time period could be compared instead.

Different cultures within the same time period had different availability of food. And the data on something like obesity rates for anything other than very recent times isn't going to be very accurate to begin with.

 

[Distracted1]

Different cultures within the same time period had different availability of food. And the data on something like obesity rates for anything other than very recent times isn't going to be very accurate to begin with.

How much does that matter?
The idea is to determine what role fat shaming might have played in individuals who are not obese in a culture where becoming obese is easy to do.

 

[dann]

What does "involuntary Obesity" mean?, and What percentage of obese individuals would you describe as being "involuntarily" obese?

It means that the vast majority of fat people don't choose to be fat and don't enjoy being fat.

Is fat shaming similar to "smoke shaming"?

Only to the extent that it doesn't work at all. Banning smoking in most public rooms, however, affected smokers and made many of them stop. So does the alternative, vaping, apparently.

It seems we have no compunction as a society with "shaming" smokers, and attempting to make it more and more difficult to engage in that lifestyle even though we recognize that stopping that behavior is particularly difficult.

We used to have no problems with the tobacco industry's obfuscation about the dangers of smoking or with its attempts to make smoking look cool, i.e. the opposite of shameful.
I don't think that "stopping that behavior is particularly difficult." Stopping any addiction is difficult. That's an important part of the definition, I think. I also don't think that 'we' are doing much to make the 'lifestyle' of smoking difficult. It has just been banned from places where smoking irritates and sometimes even harm other people. Photos of cancerous lungs on cigarettes don't make it difficult to smoke. They just remind smokers of the consequences to themselves.

Are smokers "involuntary smokers"?

Not at first. But when they become addicted, you could argue that it's no longer entirely voluntary.

 

[Ziggurat]

How much does that matter?
The idea is to determine what role fat shaming might have played in individuals who are not obese in a culture where becoming obese is easy to do.

I get the idea, and like I said, it's an interesting question. But I don't think you can get good enough data to test it. There are too many potentially confounding variables you can't control for with a purely observational study, and it's not ethical to do a controlled experiment.

 

[Orphia Nay]

UNICEF released a report this week, and most of the recent posts are people in here asking about things it's saying:

https://features.unicef.org/state-of-the-worlds-children-2019-nutrition/

"Most forms of malnutrition across all parts of the world – from rural plots to city blocks – are rooted in poverty and inequity.
"Globally at least half of all children under five suffer from hidden hunger: a lack of essential nutrients that often goes unnoticed until it’s too late."

"Malnutrition e.g. from obesity, diet, hunger are why children's needs should be central to planetary food management.
"Women are 40% of the world’s formal labour force. Yet mothers remain responsible for most child feeding and care and often receive little support from families, employers or society at large, facing the impossible choice of feeding children well or earning a steady income. [...]
"even within households, these three forms of malnutrition – undernutrition, hidden hunger and overweight – co-exist."

"In the United States, childhood obesity is more common in families with lower education and income levels. In England, rates of childhood overweight and obesity are more than twice as high in the poorest areas. These areas also have five times more fast food restaurants than the most affluent areas. In many cases, healthy foods are more expensive than unhealthy options.

"But good nutrition can break the vicious cycle of poverty and malnutrition – in just one generation. With proper care and nutrition, children of malnourished parents can still grow to a healthy height. In order for that to happen, women and girls, especially adolescent mothers, need support and guidance on nutrition before pregnancy, both for their own well-being and to make sure their children get the nutrition they need in the crucial first 1,000 days of life.

"By contrast, there are numerous examples of how better nutrition is associated with improvements in children’s school performance. From China to Tanzania, from Guatemala to the United States, multiple studies have shown how better nutrition improved rates of school enrolment, attendance, and performance in areas like mathematics and reading.

"Good food and nutrition are not only the foundation of children’s health and the development of society at large, they are also a child’s basic human right."

- The State of the World's Children 2019

 

[Orphia Nay]

I lost quite a lot of weight about 4 years ago and have kept it off.

I used to eat more highly-palatable, low-nutrient, high-calorie, foods which did not keep me satiated for long. Not fast food every meal, but a bit much dessert, larger portions, and usually meat with lunch and dinner, so I was taking in more kilojoules per day than I needed.

I've been learning daily about nutrition, kilojoule intake and expenditure, and much more, and have noticed that over time, the body transitioned to stop wanting those sorts of food.

I learned what foods were worth using those amounts of calories for.

Sometimes, cake is worth it. But mostly, it's just "empty calories" that don't fill your stomach up and you want more.

Sometimes, steak is a nice treat and a good source of nutrients you might need. But for many, it's a cut of red meat that you have used weekly when mince would be more egalitarian.

I learned to bulk up my plate with more veggies, which, as well as having essential nutrients, contain fibre to keep you full, keep your digestive tract in good condition, and create volume to increase satiation even more. And frozen veg can be cheap and just as good and more "fresh" than "fresh".

Online, and when dieting, some people act as if "healthy" means to punish yourself.

They can avoid "healthy" food altogether.

Or they can go on a "healthy" diet of kale and half a steamed chicken breast a day.

Then they both wonder why they don't like dieting.

When I was bigger, I used to wake up thinking, I'm going to try and lose weight today. Miss breakfast, tiny lunch, be starving by dinner and want all the tasty foods, alcohol, and dessert.

Wake up, feel crap, repeat.

I lost the weight during 2015-2016 by cutting back on overall energy intake, but not changing what I felt like having, including alcohol.

The alcohol use stopped in Feb 2018 when I wanted to try a new challenge, Feb Fast, and I found it was wonderful being able to eat those calories instead and feel super-good all day.

People want one quick solution, one quick diet trick.

Bodies and diets are all different and personal, and change over time. We all have to choose what we work on.

Keeping the weight off is just the same. Some days you eat more, some days less. Keeping an eye on overall weekly intake and/or the scale keeps you from having to make radical changes for a long time. Holidays and regular “diet breaks” are now recommended by leading dieticians and nutrition scientists, due to the need to maintain an optimal metabolism and mindset.

 

[Skeptical Greg]

You make a lot of great points Orphia..

I lost ~ 40 ponds over a period of 18 months about two years ago.

I quit eating processed foods and most of the ingredients that go into them, particularly refined grains and sugar.

I eat mostly single ingredient foods, with a bias toward meat, fish and eggs. I don't avoid fat that I consider healthy.

I don't count calories or macros. If 'meal time' rolls around, and I'm not hungry, I don't eat. I don't get a lot of exercise, and I think that curbs my appetite, along with having lost any craving for the calorie dense, nutritionally deficient foods I used to eat.

I think a lot of people, particularly adolescents, stay hungry and over eat because they eat a lot of those foods, and they are still nutritionally malnourished.


At 70, I feel better than I have in 30 years and have no health concerns.

 

[The Atheist]

Child obesity has increased worldwide from 10% to 18% already this century.

https://www.npr.org/sections/goatsa...rising-shockingly-fast-even-in-poor-countries

Obviously, whatever we've been doing to date isn't working.

 

[dann]

I don't think that's something we have been doing.
They have been trying to make kids eat and drink all kinds of unhealthy ****, and it appears to be working so well that they are getting rich by killing them. (Or making them kill themselves, if you will.)
Fast-food advertising has replaced the old Come-to-Marlboro-County ads:

Jennifer Harris, director of marketing initiatives at the University of Connecticut’s Rudd Center for Food Policy & Obesity, and her team constantly publish papers on the correlation between fast food marketing and childhood obesity. Like Gearhardt, she thinks teenagers are especially vulnerable to junk food ads, more so than children 12 and under.
“Teenagers don’t have well-developed cognitive control mechanisms,” Harris told HuffPost. “Their frontal cortex doesn’t develop until the early 20s, so they’re very impulsive.”
How Fast Food Advertisements Get Under Your Skin, Whether You Realize It Or Not (HuffPost, March 3, 2019)

I was a teenager in the late '60s and early '70s, but in spite of hardly ever having a coke, their cinema advertising (in particular the sound of the bottle being opened and the fizz when it's poured into the glass) makes me positively crave one (but not enough to get me out of my seat ). When it has that effect on me, I'm not surprised by the effect that it has on teenage brains.


ETA: We all know the photos they put on packets of cigarettes nowadays. I have some suggestions for the photos that should be placed on boxes of junk food: Death by Morbid Obesity

 

[Skeptical Greg]

Along with your coke, don't forget the fresh popped popcorn with the buttery flavored/colored oil slathered all over it..
The buttery flavored industrial oil wouldn't have a clue about what a real butter molecule looks like if it tripped over one..

Yes, I can believe it's not butter..

 

[dann]

We don't add anything to popcorn around here. Even movie-theater popcorn appears to be nothing but corn and a bit of cooking oil. (Remember that we don't have artificial trans fats.) The last time I asked about the ingredients at a movie theatre, they claimed that they used peanut oil. No buttery sauces or similar stuff is added to the two basic ingredients - except salt, of course. So I guess that popcorn in Denmark is a pretty healthy snack - if you don't combine it with sugary soft drinks:

Q: Popcorn is presented as both a healthy and unhealthy snack, depending on who you ask. Is it good for me?
A: You’re so right. Is popcorn healthy? The short answer is yes.
Popcorn is a whole-grain, fiber-rich food, so you digest the carbs slowly and steadily. It’s also very low in calories (especially for a snack food). More benefits: It contains free radical-fighting antioxidants and tryptophan, an amino acid important for sleep. (If you’re noshing while watching Netflix before bed, that’s a good thing.)
Is Popcorn Healthy? A Nutritionist Explains (Nutritious Life)

(I don't know if this website is a reliable source of information. All the sources I could find in Danish describe popcorn as a healthy snack: Eat Popcorn with a Good Conscience (TV2, March 26, 2012))

 

[Orphia Nay]

We don't add anything to popcorn around here. Even movie-theater popcorn appears to be nothing but corn and a bit of cooking oil. (Remember that we don't have artificial trans fats.) The last time I asked about the ingredients at a movie theatre, they claimed that they used peanut oil. No buttery sauces or similar stuff is added to the two basic ingredients - except salt, of course. So I guess that popcorn in Denmark is a pretty healthy snack - if you don't combine it with sugary soft drinks:



(I don't know if this website is a reliable source of information. All the sources I could find in Danish describe popcorn as a healthy snack: Eat Popcorn with a Good Conscience (TV2, March 26, 2012))

https://en.wikipedia.org/wiki/Bronchiolitis_obliterans

Around 2012 there were stories hitting the media of "popcorn lung" in the USA.

"Bronchiolitis obliterans may be caused by inhalation of airborne diacetyl, a chemical used to produce the artificial butter flavoring[24] in many foods such as candy and microwave popcorn and occurring naturally in wines.

"This first came to public attention when eight former employees of the Gilster-Mary Lee popcorn plant in Jasper, Missouri developed bronchiolitis obliterans.

"On 16 January 2008, it was announced that Wayne Watson, a Denver man who developed "popcorn lung" after inhaling fumes from microwaved popcorn, was suing the Kroger grocery store chain and its affiliates. In the lawsuit, filed in U.S. District Court, Watson's attorney claimed that the companies "failed to warn that preparing microwave popcorn in a microwave oven as intended and smelling the buttery aroma could expose the consumer to an inhalation hazard and a risk of lung injury."[31] On 19 September 2012 a jury in U.S. District Court in Denver awarded $2.3 million in actual damages and $5 million in punitive damages to Watson."

 

[blutoski]

It's an interesting question, but I don't know how you study it. You could only ever do observational studies, you could never do a controlled study because that would never get past an Institutional Review Board. And I don't know if you could separate out fat shaming from other factors in a purely observational study.

There's *lots* of studies that do exactly this, to the point where it's even broken down by demography (adult males, male vs female K-12 age, [LGBTQ]... )

It's a very studied subject, for obvious reasons - policymakers want to do something about obesity. Fat shaming is a national pastime. Is it working? Can we make it work better? &c.

We also have credible proxies such as public weighings, which are part of many K-12 school health programs, which have been introduced to random students in a single class, as an attempt to control for as many variables as possible.

The results show that public humiliation of the overweight has negative motivational results, and negative weight loss effects (specifically: causes more weight gain, reduces participation in physical activities, and increases depression and suicide rates).

The conflict, as pointed out by many posters, is that fat shaming is something some people want to do for their own reasons, but the data show's it causes the situation to worsen. The complication is that while advocates say it's about reducing weight, when confronted with the data, they persist anyway, and that reveals to me that it's not about the patients, it seems to be more about the shamer's personal entertainment/gratification.



The other one that policymakers keep trying - but is proven not to work - is activity. '[Normal]' increased activity levels (eg: [giving kids ten times as much physed]) just don't seem to have any effect on obesity rates. We are more active than our previous three or four generations of ancestors; obesity is a product of gradual calorie intake increases over that timeframe, which has various causes that need to be addressed in their own ways.


(My background
25 years as a personal fitness trainer.
I was unusual in my personal fitness training career in that I was very scientifically predisposed (my masters is research medicine). Most of my peers were highschool grads with the minimum biology required for provincial certification, and good lord the quackery and healthfraud was rampant. I also had the advantage of a psychology degree and license as a therapist at the time (disclosure - I'm no longer a licensed therapist). I spent 25 years with people who were trying to modify their bodies through willpower and effort, be it muscle mass gain or adipose tissue loss or endurance improvement, &c. I've kept current as part of skepticism/healthfraud, and I maintain some adjacent skills as an open water swim coach for adults and children. I am *considering* returning to the profession when I take a package at my current workplace in a few years, but it will depend on how my writing is going.

A valuable skeptical concept here is something called Attribution Bias^WP. We congratulate ourselves on making complex decisions, while attributing the decisions of others to them being mindless sheep. I see this in practice with fat shaming. [I have seen a lot of fat shamers gain wait and either never speak of it again] or double down and emphasize that for them it's *different*. But the truth is, most of us were never demonstrating better willpower or knowledge... just wrapping a story around the fact that we were dealt a different hand of cards.

 

[dann]

[I have seen a lot of fat shamers gain weight and either never speak of it again] or double down and emphasize that for them it's *different*. But the truth is, most of us were never demonstrating better willpower or knowledge... just wrapping a story around the fact that we were dealt a different hand of cards.

I couldn't agree more. I've never been fat, but I always stress that willpower has nothing to do with it. I have no need to fat shame or to think of myself as a better person because I'm not fat, so if I ever get fat for some reason, I also won't have to feel ashamed or be in denial about it. The fat shamers who get fat remind me of the people who blame others for being unemployed and then end up on the dole themselves. Or the white supremacists who get DNA tested and discover that their great-grandmother was black ...
Interesting Reddit story!

 

[blutoski]

I couldn't agree more. I've never been fat, but I always stress that willpower has nothing to do with it. I have no need to fat shame or to think of myself as a better person because I'm not fat, so if I ever get fat for some reason, I also won't have to feel ashamed or be in denial about it. The fat shamers who get fat remind me of the people who blame others for being unemployed and then end up on the dole themselves.

Or the white supremacists who get DNA tested and discover that their great-grandmother was black ...

The 1929 Great Depression was a big part of what killed off American and British (including here in my home town of Vancouver, Canadian) eugenics movements. All those men and women who assumed they were employed and wealthy because they had better 'character' than the unemployed and poor, found themselves in bread lines and had time to do a little thinking.

Interesting Reddit story!

I try not to pin a scientific claim on anecdote, but there's value in extracting an example for illustration purposes. This contributor had an injury, but most of the fat shamers I know who gained weight simply aged into it over time. Hormones are a bitch.

 

[dann]

There are also incorrigible fat shamers who don't stop fat shaming even after they've grown fat themselves:

 

[Distracted1]

There's *lots* of studies that do exactly this, to the point where it's even broken down by demography (adult males, male vs female K-12 age, [LGBTQ]... )

It's a very studied subject, for obvious reasons - policymakers want to do something about obesity. Fat shaming is a national pastime. Is it working? Can we make it work better? &c.

We also have credible proxies such as public weighings, which are part of many K-12 school health programs, which have been introduced to random students in a single class, as an attempt to control for as many variables as possible.

The results show that public humiliation of the overweight has negative motivational results, and negative weight loss effects (specifically: causes more weight gain, reduces participation in physical activities, and increases depression and suicide rates).

The conflict, as pointed out by many posters, is that fat shaming is something some people want to do for their own reasons, but the data show's it causes the situation to worsen. The complication is that while advocates say it's about reducing weight, when confronted with the data, they persist anyway, and that reveals to me that it's not about the patients, it seems to be more about the shamer's personal entertainment/gratification.



The other one that policymakers keep trying - but is proven not to work - is activity. '[Normal]' increased activity levels (eg: [giving kids ten times as much physed]) just don't seem to have any effect on obesity rates. We are more active than our previous three or four generations of ancestors; obesity is a product of gradual calorie intake increases over that timeframe, which has various causes that need to be addressed in their own ways.


(My background
25 years as a personal fitness trainer.
I was unusual in my personal fitness training career in that I was very scientifically predisposed (my masters is research medicine). Most of my peers were highschool grads with the minimum biology required for provincial certification, and good lord the quackery and healthfraud was rampant. I also had the advantage of a psychology degree and license as a therapist at the time (disclosure - I'm no longer a licensed therapist). I spent 25 years with people who were trying to modify their bodies through willpower and effort, be it muscle mass gain or adipose tissue loss or endurance improvement, &c. I've kept current as part of skepticism/healthfraud, and I maintain some adjacent skills as an open water swim coach for adults and children. I am *considering* returning to the profession when I take a package at my current workplace in a few years, but it will depend on how my writing is going.

A valuable skeptical concept here is something called Attribution Bias^WP. We congratulate ourselves on making complex decisions, while attributing the decisions of others to them being mindless sheep. I see this in practice with fat shaming. [I have seen a lot of fat shamers gain wait and either never speak of it again] or double down and emphasize that for them it's *different*. But the truth is, most of us were never demonstrating better willpower or knowledge... just wrapping a story around the fact that we were dealt a different hand of cards.

I understand your response, but not how it might apply to the question of the role "fat shaming" plays in the non obese population.
The studies seem to be looking at how fat shaming fails to help currently obese individuals to become healthier, and how it actually has negative health effects in that population. They do not seem to be attempting to ascertain what role it play (if any) in preventing obesity in the first place.

Analogous to making a study as to how laws against murder do not prevent murders by studying people who have committed the act, without considering the reasons people in a similar situation did not kill.
I wonder if anyone has tried to determine how much higher or lower obesity rates would be without negative societal pressures against being obese.
Might one consider that we older people tend to let ourselves become fat, not only because of biological changes- but perhaps in part because our susceptibility to the peer pressure of fat shaming (among other social pressures) is either diminished, or simply becomes too difficult to acquiesce to.

 

[blutoski]

I understand your response, but not how it might apply to the question of the role "fat shaming" plays in the non obese population.
The studies seem to be looking at how fat shaming fails to help currently obese individuals to become healthier, and how it actually has negative health effects in that population. They do not seem to be attempting to ascertain what role it play (if any) in preventing obesity in the first place.

Analogous to making a study as to how laws against murder do not prevent murders by studying people who have committed the act, without considering the reasons people in a similar situation did not kill.
I wonder if anyone has tried to determine how much higher or lower obesity rates would be without negative societal pressures against being obese.
Might one consider that we older people tend to let ourselves become fat, not only because of biological changes- but perhaps in part because our susceptibility to the peer pressure of fat shaming (among other social pressures) is either diminished, or simply becomes too difficult to acquiesce to.

So firstly, the claim that's being tested is that the fat shamers are brave heroes taking action for the greater good, because the more they shame the fatties the more likely they'll change their ways and turn back to being a good skinny. I'm willing to examine the claim that's being made, and it turns out to be crap.


Secondly, not all studies are as you describe. Some are longitudinal, and take place over many years. Publishing weights and fitness results, for example. The populations with public weight and fitness displays develop more obese, less active kids over time than the segment without the policy. The causal relationship seems supported.

*** having said that ***
There are many causes to obesity, and public denigration is just one of them. The contribution is minor. But all of the factors' contributions are minor, and combine into what's referred to as an obesogenic environment. There need to be many solutions, there is no quick fix.

 

[Distracted1]

So firstly, the claim that's being tested is that the fat shamers are brave heroes taking action for the greater good, because the more they shame the fatties the more likely they'll change their ways and turn back to being a good skinny. I'm willing to examine the claim that's being made, and it turns out to be crap.


Secondly, not all studies are as you describe. Some are longitudinal, and take place over many years. Publishing weights and fitness results, for example. The populations with public weight and fitness displays develop more obese, less active kids over time than the segment without the policy. The causal relationship seems supported.

*** having said that ***
There are many causes to obesity, and public denigration is just one of them. The contribution is minor. But all of the factors' contributions are minor, and combine into what's referred to as an obesogenic environment. There need to be many solutions, there is no quick fix.

Without the hyperbole, still no.
The question that might be tested would be what extent the role of "fat shaming" plays in motivating the non obese to remain (or become) so.
Or, as a corollary, does greater social tolerance for obesity produce more obese individuals?