Anorexia and Obesity

Small British Shop Owner writes:

> Because it is obvious. What else could one need?

So you feel free to ignore the research of medical and psychological professionals if something is “obvious” to you? Look, either you’re capable of being shown that statements which seem obvious to you are sometimes wrong or you’re not. If you’re really that deep into thinkng that nothing you believe is obvious could ever be wrong, this thread is pointless. Nothing we can say will change your mind.

This may very well be the case, but I suspect that for 99% of the population it isn’t obese.

It’s interesting that the “official” recommendation in America is 2400-3000 calories… In the UK it’s 2000 for women, 2500 for men.

I am not particularly inclined to treat the word of people who have only studied the issue, rather than producing effective solutions, as gospel.

But that is not important.

All that you need to do to lose weight is eat healthily. Assuming you are a reasonably intelligent (hell, pretty thick) adult then all you need is willpower.

Assuming you agree with me so far (and I assume you do), then I reiterate my thesis: If one lacks the prescence of mind to conjure up this willpower, then perhaps a bit of mild social coercion could be a good thing.

I had to stop reading after your second post, Shop Owner, to say that in some cases, pressure to be thin sends people running in the other direction: “I can’t ever be as thin as that model/actor/person-held-up-as-example, so why bother trying?”

I accept that this is a possibility, nay, a certainty for a small number of individuals.

But almost all ideas have their pros and cons.

I think this is one of the most insightful comments I’ve seen about weight issues. It seems like many people have a hard time understanding that not everyone else experiences the world in the same precise way, and that different people have different kinds of struggles with this issue.

I again point out, as cited in post #14, that the more the percieved “social pressure”, the more dieting, the greater the odds of future obesity.

Need more? Dieting teaches habits that are counter-productive to weight management. Teasing about weight clearly increases the risk of disordered eating. This article perhaps says it best.

We are an obesogenic society and part of that obesogenicity is the constant barrage of the thinnest as the norm. Of course there is a lot more to it than that. We have an excess of poor nutrition high calorie food available and little need to exercise as part of our daily routine of survival. We have in general evolved to store energy in times of plenty as best we can since the very next season may be a famine and historically often was. This tendency is fairly hardwired as it kept many of our ancestors alive long enough to see children to reproductive ages and eventually to produce us.

So far in kids we know that family centered behavioral interventions work and that very little does. These interventions do not belittle the kids or pressure them as that has been proven to have the opposite than the desired effect (anecdotes notwithstanding) but instead get a whole family unit eating more healthy choices, more slowly, at family mealtimes, and exercising regularly as the endpoints in and of themselves. Without question the weight you are when you are eating healthy foods to the point that you are no longer hungry and stopping and exercising regularly is your healthy weight. As Gorgonzola eloquently articulates.

So you’d rather just go on your ‘gut feeling’? Since the people who study AIDS have not found an ‘effective solution’, are you free to believe that AIDS is caused by small dwarves living in your stomach?

All you need to do to maintain your setpoint weight is to eat healthily. That setpoint weight may not be what other people see as thin and attractive, and in fact may be ‘obese’ if you go by the BMI standards put out by the government. If you want to maintain modern standards of thinness, you may need to restrict your intake to a point below where the body is comfortable, and or exercise constantly. Then you get to spend your life having your body constantly screaming at you to feed it. What fun.

I’m 6’ tall. According to the BMI tables put out by the government, my ‘healthy weight’ is somewhere around 160-170 lbs. The only time in my adult life when I came even close to that was when I was working out five hours a day in Karate. Then I was at my low of 168 lbs. If I took so much as a week or two off, the weight would start coming on again. When I eat healthy, and don’t snack, and get just regular exercise, I’m about 210 lbs. And I look fine at that weight. I don’t have a gut or anything. If I turn into a slug for a while, or start snacking at night a bit, my weight goes up to 230. I will never, ever be able to maintain a weight below 200 lbs without either exercising half my life away or feeling constantly hungry and tired.

My grandfather was a farmer who worked in the fields all day. He ate a typical farmer’s diet. He didn’t snack. I never saw him eating potato chips or anything like that. He was 210 lbs. I look just like him. My brother is five inches shorter than I am, and he’s 190 lbs. My grandfather had three brothers, and they all weighed about the same. One of them is still alive and he’s 93 now. He had four sisters, and they were all stocky women - not a slender one in the bunch. And all of them but one are still alive well into their 90’s. The oldest just died at 102. Clearly, their ‘overweight’ bodies were not unhealthy. It’s just where their setpoint was at.

Unless, you know, they’re at their setpoint weight and perfectly healthy and comfortable, but just don’t happen to look like someone on the cover of a fitness magazine. Then that ‘mild social coercion’ is just discrimination.

No one is disputing that there are many people who are obese because they have poor diet and exercise habits. Too much fast food, too many sugary soft drinks, too much late-night snacking. Those people (and that often includes me) could learn to shape up and eliminate their vices.

But long before there was fast food and abundant snacks, there were people of all body types, including many who were ‘overweight’ by today’s standards.

It is the case – for everyone – and thanks to regression toward the mean, I wouldn’t expect anything with that sort of heritability to appear in 99% of the population. In developed countries where food is readily available, you should expect a normal distribution of biologically predetermined set points across the weight range to emerge.

I’m not American, and it’s not an “official” recommendation. It’s an observation about an average range of calories most likely to maintain set point weight in the context of 20 years of experience and study in this field.

I have a better solution for you – eat healthily, be active, and stop giving a tinker’s damn about what the scale or the BMI chart says. For plenty of evidence on the impact of this approach on wellness and longevity, read Glenn Gaesser’s book Big Fat Lies. While I don’t endorse every word therein, he does a good job of refuting the lazy mode of thought that weight alone is the crucial indicator for longevity and health over the life span.

Mild social coercion might make a difference with habitual overeaters and underexercisers, but if you’re truly that concerned about people’s well-being and longevity, I invite you to take on the far more effective tactic of forming therapeutic alliances with every habitual overeater and underexerciser you meet, and attempting to convince them of the need to change their ways. Alliance is far more effective and reliable as an agent of change when compared to mild coercion. Coercion has the added negative potential of provoking resistance in many personality types, encouraging even greater identification with and protection of the self-destructive behaviour. Coercion is often a first choice among those judge quickly and without compassion, and enjoy a feeling of power over others “for their own good.” I understand it well, but in my experience it’s rarely effective in the presence of fully functioning brains.

Of course, even if you are successful in convincing overeaters and underexercisers to diet, there is also the danger that deprivation caused by excessive caloric restriction will set off binge drives – and binge drives often lag behind the return to set point weight, because once again the body has no idea that the food has been available all along and you’ve just been resisting its natural drives to eat it. So your obese people may just end up more obese in the end if dieting is not undertaken with great care.

Thank you for this post, I feel like a light-bulb just went off. I have a set weight that is about 20 lbs more than my “healthy” weight, it seems. I’ve put on weight above that amount for various reasons, and have found it not too hard to lose, up until I hit about 160lbs, and then it’s like pulling teeth. I plateau, and any further calorie reduction/increased activity does NOT got over well with my body. I’ve never been able to get more that a few pounds below. I’m hungry all the time. I think constantly about food. I even dream about food. I’m ten times hungrier while dieting then while not, and I could never understand why. I hold the lower amount for a time, until I’m miserable and my life is consumed by obsessing over this diet.

So I give in, declare myself a failure, got get Ben & Jerry’s and put everything I lost back on (and then some). I wonder if I just stopped at 160 I could hold it there rather than yo-yo-ing in persuit of that “correct” weight.

I will look at these cites more closely later, but if they are good science then they will be an excellent arguement against my thesis.

Comparing the two is a wee bit silly, don’t you think?

This is a strawman. Someone with a natural build such as yourself does not look fat, overweight, obese, etc. These guys are probably technically obese, but they are not what I am talking about.

Well, for what it’s worth, it definitely works in the other direction too – i.e. trying to gain much past your set point can be very difficult too. Years ago I was doing some sort of info display about eating disorders at a high school, and a lanky teen boy approached me. He had been told by his football coach that he needed to gain fifty pounds over the summer! I told him flatly that this was impossible. Even though the typical approach for weight gain goes slowly and plateaus frequently, this is usually related to the low caloric level that the process begins at, not sheer bodily resistance to gaining. Still, it is not unheard of, especially in young people, to eat 4000 kcal/d without engaging in any compensatory behaviours (i.e. purging, laxatives) and still not gain – a healthy BMI for youth and young adults is often just a bit below 20, and tends to rise over the lifespan.

The overall health consequences of yo-yo dieting are not well defined. While the strict anti-dieting crowd is eager to link weight cycling to immunocompetence and cardiovascular risk, the true negative effects seem to be psychological and perhaps metabolic, as the practice often results in incremental weight gain. Whether this is due to actual underlying metabolic change or a simple overeating response to deprivation, I can’t say for sure.

The problem with being overweight is that food is both the source of your problem and the source of comfort.

As a child, my parents ending up locking the pantry doors (this was before the advent of childlocks) because if allowed, I would just eat and eat and eat. It’s like I don’t have the mechanism that tells me I’ve had sufficient.

As a child, my parents closely monitored my weight, taking great displeasure in any gains and making me feel ugly, unloveable and ashamed. I was not allowed to eat without permission and was denied the treats that my brothers and parents enjoyed.

As a result, I’d ‘steal’ food from the kitchen and scoff it down in private in my bedroom. Food became something that I yearned for but wasn’t allowed, so any opportunity for free access to food resulted in bingeing before I was caught.

By making food both the enemy and the thing I wanted most, I was constantly struggling. In many ways, I wasn’t enjoying the food I was binge eating - you’re trying to eat so fast, there’s no enjoyment of the taste, the texture, the smell. It’s just about eating as much as you can at the time. There’s little pleasure in the actual eating, only in satisfying the inner voice that’s saying “Feed me!”

As an adult, I’m now obese. I’ve gone through periods of being just a bit overweight (thanks, bulemia!) to being extremely obese. Over my adult years, I’ve learnt to control my eating by learning about portion sizes, doing the points program with weight watchers, and observing how much other people eat and trying to match that.

My cholesterol and blood sugar levels are well within the healthy ranges and I don’t knowingly suffer any health issues as a result of my weight at present.

I’m constantly fighting a battle where my body is telling me EAT EAT! I WANT FOOD! yet I know I have had my daily ‘allowance’ and shouldn’t eat anymore. But that inner voice is really strong, and sometimes I give in to temptation. When I’m eating to my points, I don’t ever feel ‘satisfied’ in the way that others feel (I’ve asked several friends and my husband), I always want more more more.

When I’m not thinking about how fat I am, I’m thinking about what I could eat. I don’t seem to be able to stop those voices goading me to eat. I try to keep busy with social activities, work, and exercise, but any down time means those voices come back.

OK, by now you’re probably thinking ‘what a mental’, but from other overweight people I’ve known over the years, this is a pretty common scenario.

Yes, I know how you feel. Food is my best friend and my worst enemy. And I can’t just drop it and learn to live without it.

sandra nz, I hear you, too. ((hugs)). I think that’s exactly what it’s like for others, too.

It reminds me of The Lost Weekend - I remember reading that when I was a teenager and thinking, swap french fries for booze and that’s me, to a T!

The only things that really work for me are good sweaty exercise, avoiding specific trigger foods, being really busy, and loving my fat-ass self! Focusing on numbers – whether weight, pants size or calories – just sets me off. I feel like my 10 years of bulimia “broke” some kind of switch in my brain, so that any time I set up restrictions or put pressure on myself, I panic.

Also, I find that some forms of sugar make me depressed. Small quantities of dark chocolate are OK (after dinner), but a Pepsi or mac 'n cheese send me into a downward spiral about 90 minutes later.

((hugs)) for you too Fessie. My problem was more related to anorexia then bulemia, but I strongly empathize with your post.

I don’t starve myself like I used to, but still have major issues with body image and food. I know that objectively, I’m not that overweight…I weight 173 pounds as of this morning (another problem, I need to stop weighing myself so much!) and wear a 31 inch waist. I still see myself as needing to lose a lot although realistically another 10-15 pounds would be fine. My struggle tends to be trying to resist taking a diet too far. “Hmm, if I cut the snack out of the suggestions by Weight Watchers, I can lose that much more!” which is a very bad way to think I know, but it’s hard to overcome.