The stupid explodes: obesity now a disability

[The Atheist]

I'm not Blutoski, but I'll give you my $0-02c on it.

Nothing unreasonable or new in it.

None of it escapes the point that fewer calories results in less weight.

 

[The Atheist]

She's not selling a book right now or anything?

 

[bit_pattern]

I'm not Blutoski, but I'll give you my $0-02c on it.

Nothing unreasonable or new in it.

None of it escapes the point that fewer calories results in less weight.

Yes but that's not the only point you've been making.

 

[The Atheist]

It's at the base of it, though.

If people need to change habits to do it, then they have a choice: do it or not. Either is perfectly fine as long as they don't want someone else to pay for it.

 

[bit_pattern]

It's at the base of it, though.

If people need to change habits to do it, then they have a choice: do it or not. Either is perfectly fine as long as they don't want someone else to pay for it.

The idea that it is simply a matter of will-power is exactly the kind of fallacious reasoning I was referring to. It leads to some pretty ****** logical consequences: obesity is a choice, people who don't make the choice do so because they lack willpower, this lack of willpower is a moral failure of character, therefore we can call people "human balloons" and other derogatory remarks to shame them for their moral failings. I think this thread is one long demonstrations of that line of reasoning. It's not effective, it's not helpful, it's damaging, and it's based entirely on flawed reductionist notions around the nature of human psychology and physiology.

 

[bit_pattern]

It's at the base of it, though.

If people need to change habits to do it, then they have a choice: do it or not. Either is perfectly fine as long as they don't want someone else to pay for it.

The idea that it is simply a matter of will-power is exactly the kind of fallacious reasoning I was referring to. It leads to some pretty ****** logical consequences: obesity is a choice, people who don't make the choice do so because they lack willpower, this lack of willpower is a moral failure of character, therefore we can call people "human balloons" and other derogatory remarks to shame them for their moral failings. I think this thread is one long demonstrations of that line of reasoning. It's not effective, it's not helpful, it's damaging, and it's based entirely on flawed reductionist notions around the nature of human psychology and physiology.

 

[marplots]

The idea that it is simply a matter of will-power is exactly the kind of fallacious reasoning I was referring to. It leads to some pretty ****** logical consequences: obesity is a choice, people who don't make the choice do so because they lack willpower, this lack of willpower is a moral failure of character, therefore we can call people "human balloons" and other derogatory remarks to shame them for their moral failings.

What would you offer as an alternative?
The data we are trying to explain is why obesity rates have more than doubled in the last 35 years. An account based on genetics wouldn't explain this. One based on psychological factors (not genetically driven) would bring in an element of choice, wouldn't it?

Unless we are prepared to say that sociological/cultural factors are irresistible drivers - perhaps through advertizing or available foods - it still falls back on choice. However, it may be that the ability to choose wisely under some set of conditions, is itself not chosen and hardwired.

That "mixed-hypothesis" marries the two ideas without abandoning either. So we'd then say, "Those who are capable of choosing wisely have already been filtered out of the sample - they aren't obese because they are able to control their eating. Leaving us with the sub-set who are not able to choose under prevailing pressures to consume."

To make that fly, we'd have to show some difference in the past 35 years in whatever we are going to claim is the psychological pressuring mechanism pushing people to become fat.

 

[The Atheist]

The idea that it is simply a matter of will-power is exactly the kind of fallacious reasoning I was referring to.

Oh god, are we all the way back to this nonsense?

Of course it has to do with willpower. There is no other agency involved. Someone else doesn't stand there handing them food - they need to go and get it.

The cause is biological; the cure is willpower.
The cause is mental; the cure is willpower.

I'm not saying it's simple, but any action requiring a change of mental attitude requires willpower - the will to give something a go; the will to stick to it; the will to succeed.

... obesity is a choice, people who don't make the choice do so because they lack willpower,...

The sad part is, that is absolutely correct.

Pity the next bit is pure straw:

... this lack of willpower is a moral failure of character, therefore we can call people "human balloons" and other derogatory remarks to shame them for their moral failings.

If that view has been aired in this thread, it has been done sarcastically, or if genuine, by a very tiny percentage of posts and posters.

Go and count them - tell me what numbers of people in this thread have said it's cool to abuse people for being fat? Go on - don't make stuff up, prove your point or retract it.

I think this thread is one long demonstrations of that line of reasoning.

Finishing with a completely false statement, ignoring the excellent and insightful posts of several of the participants and much worse, ignoring the actual content to come up with a description that fits your agenda.

Poor effort.

It's not effective, it's not helpful, it's damaging, and it's based entirely on flawed reductionist notions around the nature of human psychology and physiology.

Yes, we all understand what isn't good, and it's very notable that among your criticisms and statements you haven't once tried to propose a mechanism for stopping the obesity epidemic. Have you ever seen the movie Wall-E? It seems to describe the kind of world you want to build - everyone's too fat to walk and they use mobility scooters while robots do all the work.

Like I keep saying, people can be as fat as they choose to be and I couldn't give a damn.

Until they expect me to pay for it.

 

[blutoski]

Framing obesity as a failing of moral character certainly provides a sense of moral superiority, which I'm sure certain people find very comforting.

Specifically, I think it's a fallacy called Attribute substitution^WP - it's really hard to measure willpower, gluttony, laziness. I'm not sure what the units of willpower even are.

But imagine there are units of willpower that a person demonstrates by being below their biologically predisposed set percentage body fat... and let's say that it's one unit of willpower demonstrated per percentage...

A person whose predisposed percentage is 5% body fat, but is carrying 10% body fat - minus ten willpower units.

A person whose predisposed percentage is 45% body fat, but is carrying 30% body fat - plus fiften willpower units.

The point is that body fat percentage is not telling us anything about a person's willpower. It is an inappropriately substituted attribute.

 

[blutoski]

Would be interested in hearing Blutoski's thoughts on this

http://www.salon.com/2015/04/12/you_should_never_diet_again_the_science_and_genetics_of_weight_loss/

In particular the prison experiment and the conclusions the author draws from it.

I'm looking forward to reading the book.

Regarding the prison studies: I'd have to read the actual papers. I expect there are citations in the book. They're saying they fed subjects 10,000 calories per day for months and prohibited exercise, but saw no change in body fat percentage. Sounds improbable at face value, and I'd like to read the material. I'd be curious about wastage, for a start. Meaning: they could have been offered 10,000 calories per day, of which they ate as much (or as little) as they chose, and may have maintained body fat percentage that way. We're talking prison food here, I probably wouldn't eat more than I absolutely had to. And it could be a demonstration of environment's effects that way as well, rather than genetics per se.

Other experiments have been conducted that have similar goals and structures, volunteers who are not prisoners, and the results were different. So it'd be interesting to identify whether there was a systematic confounder with these.

The author does work with the Minnesota Twin Study database, and I've noticed those guys have a bias toward genetics and tend to gloss over the database's primary weaknesses. Specifically selection bias - the less similiar twins are, the less they get along. The ones that don't get along don't join or continue with the study and don't have much impact in the database. There is an uncorrected selection bias toward similarity.

However: the percentage the author reports (70% genetic predictability) is consistent with other analyses.

So for the most part, I'm in pretty good agreement. We have biological predispositions that at in an environment. (not the least of which is that we are drawn to eat sugar, fats, salt) The environment has changed over the last X years to become more obesogenic. Ergo we have become more obese. No argument there.

The author also advises against 'dieting' and off-limits foods &c, and that's my stance as well, although it becomes semantics a bit. Lifestyle changes with an eye to sustainability seem to be the recipe for weight management success.

Here's where I think I diverge a bit: my compromise regarding 'dieting' is that since fullness is not entirely dependent on calories, there are opportunities to eat 'less' and not go into the starvation-obsession mode she describes in the conclusion. As mentioned above, finding recipes that goose up the grams of fiber/water at the expense of fat, sugar/starch, and ethanol does seem to reduce the incidence. As is creating realistic rates of fat loss. No lentil soup recipe will salvage a 1000 calorie day. Secondly, I think the author's article is probably skimming what must be a richer discussion of environmental management.

So, not sure what to make of it without really reading the book, but worried that the author may unintentionally fall into the trap that a lot of geneticists do: accidentally give readers the impression that genetics have power outside our environment.

 

[blutoski]

I'm starting to get better access to my old site's sql database. Here are more on the same topic:

• Church, T., Thomas, D., Tudor-Locke, C., Katzmarzyk, P., Earnest, C., Rodarte, R., Martin, C., Blair, S., & Bouchard, C. (2011). [Trends over 5 Decades in U.S. Occupation-Related Physical Activity and Their Associations with Obesity] PLoS ONE, 6 (5) DOI: 10.1371/journal.pone.0019657
  
  blutoskitorial: the above study is well done; just ignore their fallacious conclusion. 100 calories per day cannot explain 'the majority' of weight gain. maybe 17%, though.
  
  
  
  
• Wilkin, T., Mallam, K., Metcalf, B., Jeffery, A., & Voss, L. (2006). [Variation in physical activity lies with the child, not his environment: evidence for an ‘activitystat’ in young children (EarlyBird 16)] International Journal of Obesity, 30 (7), 1050-1055 DOI: 10.1038/sj.ijo.0803331
  
  blutoskitorial: the phenomenon called 'activitystat' is not completely proven, but very well supported by evidence - it is why registered dieticians are not concerned about the impacts of eliminating physed from K-12 public education... kids seem to just have a fixed amount of daily exercise they can perform, and they will accommodate
  
  
  
  
• Luke, A., Dugas, L., Ebersole, K., Durazo-Arvizu, R., Cao, G., Schoeller, D., Adeyemo, A., Brieger, W., & Cooper, R. (2008). [Energy expenditure does not predict weight change in either Nigerian or African American women American] Journal of Clinical Nutrition, 89 (1), 169-176 DOI: 10.3945/ajcn.2008.26630
  
  blutoskitorial: the goal with this one was to control for both genetics and exercise - the dominant difference between these cohorts was clear... nether genetics nor exercise are as important as the 'environment' as a contributor to obesity levels; the best explanation is that we have absorbed marketing messages to eat more into our cultural values
  
  
  
  
• Lara R Dugas, Regina Harders, Sarah Merrill, Kara Ebersole, David A Shoham, Elaine C Rush, Felix K Assah, Terrence Forrester, Ramon A Durazo-Arvizu, & Amy Luke (2011). [Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies The American Journal of Clinical Nutrition], 93 (2), 427-441 : 10.3945/​ajcn.110.007278
  
  blutoskitorial: conclusion does follow from the data analysis... this is consistent with other findings that we are about as 'active' as previous generations, just different activities (ie: less on-the-job activity, but considerably more sports)
  
  
  
  
• Westerterp, K., & Speakman, J. (2008). [Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals] International Journal of Obesity, 32 (8), 1256-1263 DOI: 10.1038/ijo.2008.74
  
  blutoskitorial: there's more than one thing going on here... two key conclusions, both independently replicated over and over... firstly, the more overweight a person is, the worse they are at estimating their caloric intake, and the direction of causality seems to flow that way (first obesity, followed by poor estimation of caloric intake); secondly, that there may have been a slight increase in average energy expenditure since 1982 (this is consistent with Church et al above, in that Church was only examining occupational energy expenditure, not taking any account for non-occupational exercise), but our caloric intake has increased much faster;
  
  
  
  
• Swinburn, B., Sacks, G., & Ravussin, E. (2009). [Increased food energy supply is more than sufficient to explain the US epidemic of obesity] American Journal of Clinical Nutrition, 90 (6), 1453-1456 DOI: 10.3945/ajcn.2009.28595
  
  blutoskitorial: this is calories in calories out, and attempting to see if independent approaches to estimates match up... they do. in this study, they worked backwards by calculating the food produced, destroyed, imported, exported, and therefore how much Americans must have eaten, year over year, subtracted the total energy in BMR and exercise, and the increase each year it is almost exactly the amount of energy in Americans' adipose tissue that has accumulated in that period.
  

I'm doing a sort of pincer movement on my reading: I'm trying to read the current literature as it is published, and also catch up on missed content chronologically.

This one is quite recent: Gioia Mura et al, [Physical Activity Interventions in Schools for Improving Lifestyle in European Countries] / Clin Pract Epidemiol Ment Health. 2015; 11(Suppl 1 M5): 77–101.

blutoskitorial: the conclusion is too long-winded and vague to paste here, but the findings were that evidence for PE classes having an impact on childhood obesity is mixed, and when positive, it's weak. My experience across the board is that when we see this type of result from a large volume of investigations over decades, the positive results are pretty much background noise.

This is not to say that I think we should cancel PE... just that we shouldn't hang our hat on it as the solution to childhood obesity. We need to invest resources somewhere else, and I'm pretty sure it's diet. "childhood obesity is caused by sedentary lifestyle" is a plausible falsehood that the soda and fast food industry have spent millions of dollars promoting in order to deflect attention from their products - we need to start pushing back.

 

[The Atheist]

Dr Sarah Burnett:

'It's wrong to tell fat women they look fabulous'

 

[The Atheist]

This could be the first time in all history that I have agreed with a bunch of Admirals and Generals.

Too fat to fight: America's youth.

Who knew such good come from obesity?

http://www.startribune.com/lifestyle/health/301829151.html

 

[jimbob]

I'm doing a sort of pincer movement on my reading: I'm trying to read the current literature as it is published, and also catch up on missed content chronologically.

This one is quite recent: Gioia Mura et al, [Physical Activity Interventions in Schools for Improving Lifestyle in European Countries] / Clin Pract Epidemiol Ment Health. 2015; 11(Suppl 1 M5): 77–101.

blutoskitorial: the conclusion is too long-winded and vague to paste here, but the findings were that evidence for PE classes having an impact on childhood obesity is mixed, and when positive, it's weak. My experience across the board is that when we see this type of result from a large volume of investigations over decades, the positive results are pretty much background noise.

This is not to say that I think we should cancel PE... just that we shouldn't hang our hat on it as the solution to childhood obesity. We need to invest resources somewhere else, and I'm pretty sure it's diet. "childhood obesity is caused by sedentary lifestyle" is a plausible falsehood that the soda and fast food industry have spent millions of dollars promoting in order to deflect attention from their products - we need to start pushing back.

On the "it's simple" front here is a rather confusing diagram that seems to try mapping a lot of influences on obesity.

I am not sure it is entirely clear - TBH,, it is too complex for me to bother with, but it might be easier to read if you are working in the field anyway.

http://www.shiftn.com/obesity/Full-Map.html


I don't think any concept in there is particularly complex, it is just that there are a lot of them

 

[blutoski]

On the "it's simple" front here is a rather confusing diagram that seems to try mapping a lot of influences on obesity.

I am not sure it is entirely clear - TBH,, it is too complex for me to bother with, but it might be easier to read if you are working in the field anyway.

http://www.shiftn.com/obesity/Full-Map.html


I don't think any concept in there is particularly complex, it is just that there are a lot of them

That's a gorgeous map, thanks for posting the link.

It's the 'a lot of them' that qualifies the system as 'complex' in my book.

What it doesn't show is proportionality. We see this with genetics maps as well. Some traits have, say, 300 genes that interact. But actually, 1 gene has overwhelming 99.9% influence, so yes it's complex, but no, not really. Diet is similar: there's a lot of discussion about minor influences that distract from the fact that we mostly know what the big problems are already.

So: my context about what I describe as simple versus complex is more about how we provide effective advice by going for that low hanging fruit of big influencers. That isn't very complex.

But it's layered, because high level advice ("get more sleep") needs a more detailed and localized/customized execution plan. Some people sincerely don't know what "get more sleep" means, and this detailed level of advice doesn't scale for a mass education campaign.

For the individual, high level: minimize alcohol consumption, don't smoke, eat fewer calories, mostly plants, exercise daily, and get enough sleep.

This type of advice becomes controversial, because it collides with private sector commercial objectives to sell more alcohol, cigarettes, food, and specifically processed foods. These industries have a multi-pronged strategy: lobby to entirely eliminate the practice of government providing food advice, lobby for modified government messages in any advice that does get published, buy off the registered dietician professionals, and finally as a last resort: introduce FUD to combat any undesirable advice that manages to get past all that.

Skeptics are sometimes good at identifying the FUD, but too often we're not there yet. When the sugar marketing board launched a FUD war against Aspartame, skeptics identified it as such... within about 15 years. We're a little further behind on their attack on another rival product HFCS - I'm still seeing skeptics demonizing HFCS. And we're way behind on the Diet Wars. I have skeptical peers demonizing saturated fats, other demonizing carbs, and my conclusion is that this is just skeptics as normal interested sincere food and media consumers unintentionally echoing industry talking points.

 

[casebro]

Syndrome X = "Vagus Syndrome"?

Syndrome X is the combined: obesity, diabetes, hypertension, and high cholesterol. It's probably the highest risk factor for cardio vascular incidents. The X stands for the pour points.

The vagus nerve goes to: heart/aorta,to control blood pressure; the stomach to control digestion and sense satiety; the pancreas to control digestive juices and possible insulin output; cholesterol levels are in response to digestion of fats, so maybe that too. So I'm coining the phrase "Vagus Syndrome".

The vagus nerve can be interfered with at several places including the neck form discs or arthritis, the Hiatus( the hole in the diaphragm that the esophagus passes through), the hole in the bottom of the skull where the vagus passes, and inside the skull by "arterial compression", where an artery impinges on it with every pulse.

Several of these points of impingement can act as positive feedback loops. Examples- that pulsing skull artery impinges on the nerve, which confuses the signal to the brain re: blood pressure. Brain increases blood pressure, which causes the pulse to hit harder, confusing the signal, brain raises B.P.... Or a full stomach pinches the nerve at the hiatus, which interferes with the signal that would tell the brain that the stomach is full, stop eating. Brain continues to feed the stomach. Full stomach pinches the nerve....(diabetics have a known problem called "delayed emptying" Maybe Vagus related, if the brain never gets various signals from the tummy?).

Think Carpal Tunnel Syndrome of the gut. And problems caused by numbness and tingling. Ever have a "leg fall asleep" ? Myabe wa have a situation of "gut falls asleep"?

And now that I have introduced you to neuro/metabolic probs, is Sleep Apnea one too? I have no prob keeping my palate open when awake, how come I choke when asleep? Sleep apnea is also related to obesity, but even more tightly tied to neck size over body fat. ( the X in "syndrome X is for the four points. Maybe it ought to be "Syndrome V", for five?)

Sorry, no links or foot notes, I'm not writing a high school term paper. I'm just here to kick around an idea. But each one of my points is out there. What I want to do here is kick around the concept in toto.

Who wants to be the first to kick?

 

[Jono]

The fact remains that the only way to gain weight is by overeating, regardless of the source or reason.

That's another odd and off-the-wall claim. The only way? I'm not disagreeing that dietary habits are a major factor but... do you know how many people I've known who've gained lots of weight by taking birth-control pills, psycho-pharmaca et al without overating? I've gone through this already. Feel free to ignore Linda Bacon, whoever that is, I didn't find her listed in the study I linked to except as a partial author of one of the 28 sources given by that study (which had crickets shirping in this thread regarding its data). All woo? Hmm, you're propogating a very harmful myth is what you're doing, when you say things like that. At least that's the way it comes across. As with one's private economy, whether one is consistently struggling with trying to make ends meet and the variations thereof, it is not certain that someone with a better economy is necessarily practicing/applying a better economic sense. Nor is is certain that someone who has found him/herself knee-deep in debts needs to be blames as having made poor financial choices, likewise... the bank of one's weight works in a similar way, only the expenses and income variables trade places for the comparison. I.e it's not just one thing with one cause, as TheAtheist would have it, giving green light to fat-shamers and their need to spew their repulse.

 

[Jono]

What percentage of obese people do you think fall into that category? 2%? 3%? I'll be astonished if it's more.

Of course, 'cause how would you then be able to yell "get out of the couch you disgusting fatso" with good conscience?

 

[rustypouch]

That's another odd and off-the-wall claim. The only way? I'm not disagreeing that dietary habits are a major factor but... do you know how many people I've known who've gained lots of weight by taking birth-control pills, psycho-pharmaca et al without overating? I've gone through this already. Feel free to ignore Linda Bacon, whoever that is, I didn't find her listed in the study I linked to except as a partial author of one of the 28 sources given by that study (which had crickets shirping in this thread regarding its data). All woo? Hmm, you're propogating a very harmful myth is what you're doing, when you say things like that. At least that's the way it comes across. As with one's private economy, whether one is consistently struggling with trying to make ends meet and the variations thereof, it is not certain that someone with a better economy is necessarily practicing/applying a better economic sense. Nor is is certain that someone who has found him/herself knee-deep in debts needs to be blames as having made poor financial choices, likewise... the bank of one's weight works in a similar way, only the expenses and income variables trade places for the comparison. I.e it's not just one thing with one cause, as TheAtheist would have it, giving green light to fat-shamers and their need to spew their repulse.

You seem to be getting in Million Dollar Challenge territory here.

Are you really claiming that people's bodies can create mass from nothing?

 

[marplots]

You seem to be getting in Million Dollar Challenge territory here.

Are you really claiming that people's bodies can create mass from nothing?

I immediately thought it meant we could solve a country's starvation problem by shipping them birth control pills. Those starving kids don't need to eat more, they only need to retain more of what they eat.