The stupid explodes: obesity now a disability

[blutoski]

Guns don't kill, people do...


( I hear what you are saying..... )

You quoted one of my earlier statments

I don't think that's important, because it's proven not to be true, and the research shows that this misinformation increases the chance the person will be obese. This is my point.

And said:

This flies in the face of your earlier statement:

We don't exercise enough, and we should exercise more, there are many long term health benefits. Weight management just isn't one of them, we should not be trying to 'fight obesity' with exercise, it is a strategy that is objectively proven will fail.

I don't think my two statements contradict. My first one was responding to this:

I think it is important for anyone who wants to lose weight to accept the idea that increasing their physical activity will be an important part of that endeavor..

The key being that the endeavour in question is 'losing weight'. Research shows that no, physical activity is not an important part of that endeavour.

I'm not saying to tell people to exercise to lose weight, I'm saying exercise is part of a healthy lifestyle, whether the goal is to lose weight or not.

I completely agree with this, so I think we're on the same page and somehow got our wires crossed.

 

[Skeptical Greg]

I think we are on the same page also..

I need to revisit the study you referenced because it sounds misleading, regardless of the results..

What I hear is " For most people who successfully lost weight, exercise was not a factor "...

When what they may be saying is " People are unlikely to try to lose weight if told that exercise was necessary ... "

As for the latter, it doesn't sound like a group of people who would be motivated under any circumstances to lose weight, and therefore a lost cause.

If the study is saying most obese people fall under this category, then what is really the point?

 

[blutoski]

I think we are on the same page also..

I need to revisit the study you referenced because it sounds misleading, regardless of the results..

What I hear is " For most people who successfully lost weight, exercise was not a factor "...

When what they may be saying is " People are unlikely to try to lose weight if told that exercise was necessary ... "

As for the latter, it doesn't sound like a group of people who would be motivated under any circumstances to lose weight, and therefore a lost cause.

If the study is saying most obese people fall under this category, then what is really the point?

I posted about a dozen studies, actually. They would include things like "Does introducing an exercise program in the school curriculum result in improved obesity outcomes," or: "Does introducing and maintaining an exercise program reduce body fat percentage in adults." In those cases the answer turns out to be no, for example.

I discussed some mechanisms in previous posts. (children seem to have a maximum hours of exercise innately, so doing more exercise in school means doing less unstructured exercise outside of school / for adults, increasing exercise increases appetite to the point of overcompensation and is just as likely to result in weight gain rather than loss, &c)

 

[rustypouch]

I think the principle is that people know to diet, but can't seem to do it. So, if we're going to design an approach, just repeating the same advice "eat less and exercise more" doesn't seem to work, we shouldn't keep banging our heads against the wall.

I'd like to know why people don't stick to the plan, maybe there are solutions in that space. And there are: we have interesting knowledge about obesogenic environment features. Mitigation is just difficult to implement because it challenges commercial interests, and to some extent, political preferences vis a vis our sense of autonomy.

Which brings me to casebro's prior post where he assigns some blame to psychology. I actually half agree. The solutions we find in environmental management are psychological. The problem is in implementation, unfortunately, as the environment is partially (or largely) out of the subject's control.

Indeed. It's one of those things that's simple in principle, but hard to execute.

Consistent over consumption leads to weight gain.

But why do many people feel the need to consistently over consume, especially knowing the myriad of negatives associated with being overweight?

I really don't know.

 

[blutoski]

I think we are on the same page also..

I need to revisit the study you referenced because it sounds misleading, regardless of the results..

What I hear is " For most people who successfully lost weight, exercise was not a factor "...

When what they may be saying is " People are unlikely to try to lose weight if told that exercise was necessary ... "

Both are true. (different studies)

It's important to jump back a bit and reiterate my terminology. I'm not looking at weight loss, so much as weight management. This would be, say, a 5+ year timeframe where a subject achieves their weight target and maintains it. Obesity management would be more epidemilological, describing a population which is succesfullly maintaining lower body fat percentage on average.

This is important, because if we're just looking at weight loss (and don't care if everybody gains it back in 5 years plus some), then sure, intense exercise and starvation diets have drilled many of us into losing a few pounds. If the goal is to lose 5lb this week, then starvation and exercise will obviously work. But if the goal is to be healthy for the rest of your life, it's not sustainable, and this is the real world we live in: so what now, is the question these researchers are investigating.

As for the latter, it doesn't sound like a group of people who would be motivated under any circumstances to lose weight, and therefore a lost cause.

If the study is saying most obese people fall under this category, then what is really the point?

This specific study is asking random subjects whether they thought it is realistic to expect to exercise off excess calories as part of a weight management lifestyle, versus is it unrealistic to expect to exercise off excess calories and therefore important to focus on reduced consumption. Those who were keen on exercise carried a higher fat percentage than those who did not think exercise could be effective.

I'm not sure it said anything specifically about their motivation. If anything, the people who were not keen on exercise could arguably be less motivated.

 

[Marcus]

Correct, but the research shows that people who diet are more likely to succeed than those who choose exercise. Let's go with the odds.

Better to choose both. However, weight loss is a poor motivation to start exercising, if you succeed at the weight loss, you are likely to drop the exercise. Better to habitually exercise regardless of what your weight is.

 

[casebro]

To each his own, which is psychology.

When I was working carving carousel horses and furniture making, I ate 7,000 calories per day, weight was stable at 264. When muscle disease acted up and I went disabled, I slowly rose to 325. Dieted some of it off, to 305. Muscle got better, meantime loss to 295. busted my pasty white ass restoring the power wagon in my avatar, dropped to 235. In 3 months. Eating about 2500 per day.

So don't tell me exercise never works. But it takes motivation, for me a project. Psychology.

Kept the weight off for a year or more, then slowly put it all back on. 5 years. 280. Recently very sedentary due to an arthtiric knee that needs replacement. Weight crept up to 305, drifts down to 290, back to 300... Psychology. And appetite control, more psychology.

Psychology trumps all else.

When psychologist figure out how to flick that mental switch, I'l believe in that as science.

 

[blutoski]

Better to choose both.

Not necessarily, which is what the research suggests. The orders of magnitude difference between the approaches (and in some situations, paradoxical negative benefits eg: exercise leading to weight gain in certain demographics) directs where limited resources should be applied. So, as a specific example, I'm talking about school physed programs, where we observe that there is zero impact to obesity management and possibly even an increase in obesity in these pilot studies. If we were allocating dollars that are earmarked for obesity management, we should not include exercise in the list of weight managment strategies or we would be wasting resources.

However, weight loss is a poor motivation to start exercising, if you succeed at the weight loss, you are likely to drop the exercise. Better to habitually exercise regardless of what your weight is.

I don't think I've seen any research showing that's true - I think this is speculation on your part. In fact, the opposite seems to be true - people abandon exercise programs mostly because they do not see results.

 

[blutoski]

To each his own, which is psychology.

When I was working carving carousel horses and furniture making, I ate 7,000 calories per day, weight was stable at 264. When muscle disease acted up and I went disabled, I slowly rose to 325. Dieted some of it off, to 305. Muscle got better, meantime loss to 295. busted my pasty white ass restoring the power wagon in my avatar, dropped to 235. In 3 months. Eating about 2500 per day.

So don't tell me exercise never works. But it takes motivation, for me a project. Psychology.

Kept the weight off for a year or more, then slowly put it all back on. 5 years. 280. Recently very sedentary due to an arthtiric knee that needs replacement. Weight crept up to 305, drifts down to 290, back to 300... Psychology. And appetite control, more psychology.

Psychology trumps all else.

When psychologist figure out how to flick that mental switch, I'l believe in that as science.

I'm not saying it 'never' works - what i'm saying is that it works for so few people, and has negative gains for just as many, so it's a wash in the population.

We're used to seeing this in other health claims. Yes, Scientology worked for you. You're not the general population. Thanks for the anecdote. Now, onto the actual question: what's good advice for everybody else? What does the science show?

 

[casebro]

I'm not saying it 'never' works - what i'm saying is that it works for so few people, and has negative gains for just as many, so it's a wash in the population.

We're used to seeing this in other health claims. Yes, Scientology worked for you. You're not the general population. Thanks for the anecdote. Now, onto the actual question: what's good advice for everybody else? What does the science show?

Proof? There isn't any that shows any system actually works. That is why there is so much woo in the weight loss industry. Overall, only about 10% of people can lose umm 20 pounds, and keep it off for umm 2 years.

Or are you saying there is proof that diet without exercise actually works? Link?

Nah. The only thing that sort of works is called "lifestyle changes". Eat less, exercise more.

The study in question is not cause/effect. It's finding a division in overweight people- some think one way, some the other. And one side weighs more. Note that even the ones who think diet is the key are/were overweight. And when was the study done? Is there a two year follow-up?

 

[blutoski]

Proof?

Posted upthread... in the same post as this study... ([907]) I have a feeling you may have come into the thread late and have not read my other citations.

There isn't any that shows any system actually works. That is why there is so much woo in the weight loss industry. Overall, only about 10% of people can lose umm 20 pounds, and keep it off for umm 2 years.

Or are you saying there is proof that diet without exercise actually works? Link?

I'm saying that exercise does not seem to be important for weight loss, when the question is about what works for a population.

There's no best system, but some don't work. As skeptics we need to remove them from the list. Macronutrients is the other urban legend I'm trying to get phased out.

Nah. The only thing that sort of works is called "lifestyle changes". Eat less, exercise more.

Eat less, for sure, exercise more, not so much. This is the study results I'm trying to convey.

The study in question is not cause/effect. It's finding a division in overweight people- some think one way, some the other. And one side weighs more. Note that even the ones who think diet is the key are/were overweight. And when was the study done? Is there a two year follow-up?

Correct, it's a cross sectional study, not a longitudinal study. I'm not sure this is a significant criticism, as the connection between modelling a weight loss strategy is, through common sense, probably causally related to how a person builds and executes their strategy.

However, I've posted another half dozen above, this was just adding to the list. And worked with MDs and physiology grads to review 1,000 over my career. I can repost the ones that I reviewed recently that specifically address the question of the benefits of exercise, if you can't locate them upthread.

 

[Marcus]

Not necessarily, which is what the research suggests. The orders of magnitude difference between the approaches (and in some situations, paradoxical negative benefits eg: exercise leading to weight gain in certain demographics) directs where limited resources should be applied. So, as a specific example, I'm talking about school physed programs, where we observe that there is zero impact to obesity management and possibly even an increase in obesity in these pilot studies. If we were allocating dollars that are earmarked for obesity management, we should not include exercise in the list of weight managment strategies or we would be wasting resources.




I don't think I've seen any research showing that's true - I think this is speculation on your part. In fact, the opposite seems to be true - people abandon exercise programs mostly because they do not see results.

If you abandon your exercise program because you do, or don't lose weight, than losing weight is a poor motivation for exercise. You should exercise for it's own sake, without respect to what your weight is doing.

 

[Archie Gemmill Goal]

We can talk about anything ... but your contention was TIME was the factor

It wasnt my contention I was just laughing at your idea that it takes over an hour to get some mcds and that time could be used to exercise instead.

Thats a fantasyland.

 

[jimbob]

If you abandon your exercise program because you do, or don't lose weight, than losing weight is a poor motivation for exercise. You should exercise for it's own sake, without respect to what your weight is doing.

Why?

If you are obese, losing weight alone will tend to improve your health. Being less sedentary also trnds to improve health, but it's probably harder to increase activity if you are more overweight due to increased risk of injury and joint strain as well as sheer discouragement. I know what it's like to carry a rucksac all day and how it reduces my mobility and even a stone adds significantly to the effort required. At that weight I'm still lighter than many people.

 

[blutoski]

If you abandon your exercise program because you do, or don't lose weight, than losing weight is a poor motivation for exercise. You should exercise for it's own sake, without respect to what your weight is doing.

I have said exactly the same, above.

Exercise has many demonstrated health benefits, and I am a strong advocate of increased participation levels.

 

[Marcus]

Why?

If you are obese, losing weight alone will tend to improve your health. Being less sedentary also trnds to improve health, but it's probably harder to increase activity if you are more overweight due to increased risk of injury and joint strain as well as sheer discouragement. I know what it's like to carry a rucksac all day and how it reduces my mobility and even a stone adds significantly to the effort required. At that weight I'm still lighter than many people.

Where to start? The big thing is, you are stronger, you feel great, you have more energy if you exercise. It's trickier if you are obese. You can't really run because your joints will protest. Biking is good, things in the water, swimming and water aerobics, even better.

Anyone can lose weight, the trick is keeping it off. For obese people, yes, calorie restriction is essential, but in the long run you will need to increase your activity level in whatever manner you can find.

 

[casebro]

Posted upthread... in the same post as this study... ([907]) I have a feeling you may have come into the thread late and have not read my other citations.

...
Correct, it's a cross sectional study, not a longitudinal study. I'm not sure this is a significant criticism, as the connection between modelling a weight loss strategy is, through common sense, probably causally related to how a person builds and executes their strategy.

.

From ypu link, an abstract, "Moreover, laypeople who indicted a lack of exercise were more likely to actually be overweight than were those who implicated a poor diet."

Hmmm, "more likely", and "implicated"? I couldn't get to the whole study, but "more likely", and "implicated" may mean 51% to 49%. I guess I'l keep to my own plan- hold steady for now, work off the weight after I get the knee replaced.

I do know that I can make a 3,000 calory oer day deficit from exercising, but can not cut intake by that much. Calories in - calories out.

 

[casebro]

........

However, I've posted another half dozen above, this was just adding to the list. And worked with MDs and physiology grads to review 1,000 over my career. I can repost the ones that I reviewed recently that specifically address the question of the benefits of exercise, if you can't locate them upthread.

You do realize that thousands of studies that show an improvement for 2/3 of people are WRONG for the other 1/3?

Medicine really needs to look a bit closer at the differences between those 2/3 vs 1/3. Find out why something works for some, and not others.

Though specifically pertaining to weight loss, NOTHING WORKS for long time loss.

Perhaps they are working on the wrong end of the spectrum? Study anorexics?

 

[blutoski]

You do realize that thousands of studies that show an improvement for 2/3 of people are WRONG for the other 1/3?

Sure, but the ones i'm interested in are population based. What works for more people? What works for zero? What has negative net benefits? I find that a valid basis for comparison.

All medicine is like this: which drug works for more people with fewer experiencing side effects? This is a way to compare modalities, when the goal is to recommend one over the others, and possibly even identify some which are universally contraindicated.

Medicine really needs to look a bit closer at the differences between those 2/3 vs 1/3. Find out why something works for some, and not others.

The short answer is: adherence. The medical specialty that explores that is epidemiology, and their conclusion is that people have different environmental factors. This is the principle of the obesogenic environment.

The other specialty that addresses that is psychology, particularly the subspecialties that explore interaction between environmental conditions and behaviors.

Though specifically pertaining to weight loss, NOTHING WORKS for long time loss.

I hesitate to agree, as many strategies work for a portion of the population, and environmental shaping also has been proven to work long term. The problem with environmental shaping is that there is resistance from commercial and political interests.

Perhaps they are working on the wrong end of the spectrum? Study anorexics?

This is condition is well studied, but doesn't really shed light on healthy weight loss. Anorexics are very unhealthy. Additionally, it's a mental illness where subjects have a distorted self image, so can't be extrapolated to a population that does not have that perceptual distortion.

 

[blutoski]

From ypu link, an abstract, "Moreover, laypeople who indicted a lack of exercise were more likely to actually be overweight than were those who implicated a poor diet."

Hmmm, "more likely", and "implicated"? I couldn't get to the whole study, but "more likely", and "implicated" may mean 51% to 49%. I guess I'l keep to my own plan- hold steady for now, work off the weight after I get the knee replaced.

I'll see if I can scan and upload the charts, but there were actually 3 cohorts compared: those whose lay theory of weight management was that exercise was key to weight loss, those whose lay theory was that reducing calories was key to weight loss, and those who whose lay theory was a combination of the two.

There were several surveys and experiements conducted on these 3 cohorts, in addition to comparing their BMIs. So, 'more likely' in this context means an average BMI of 28 for the 'exercise' cohort, versus average BMI of 25 for the 'calorie reduction' cohort.

Just as an example of their inquiry strategies for 'implicated': an inferential experiment was conducted where subjects could eat chocolate in a monitored setting, and the exercise lay theory cohort ate almost twice as many chocolates (4.1) as the calorie reduction theorists (2.1).

Both results were well beyond error bars, it is both medically significant differences and statistically significant confidence intervals.