On the flip-side, once my doctor said “Technically your BMI is in the near-obese/obese region…but I don’t put much stock in that. I mean, look at you. You could lose a little weight, but you’re just plain stocky. And all your blood-work is great.”
Not for everyone. For me, exercise helps control appetite. It also allows me to eat more and still maintain a caloric deficit.
And here is an illustration of the unfortunate consequence of focusing on the number “weight” (or BMI) as THE item.
Of course advice to begin some sort of exercise program is far from “flat out bad advice”; it is excellent advice, and better as medicine than any pill. Whether your BMI is 40 or 19.
As a means of weight loss, it is in and of itself only very modestly effective (critical though to maintaining weight loss once achieved). As a means of decreasing risk of all of the potential health harms of overweight and obesity though … amazingly effective, even with no weight loss achieved. (And of course for the sake of vanity it does a world of good even at the same weight.) And also very effective for preventing obesity in the first place. The list of the benefits of regular exercise range from prevention and treatment of depression and anxiety, to decreased risk of and length of common upper respiratory infections, to stronger bones, to better sleep, to less risk of developing erectile dysfunction, to decreased cancer risk, decreased diabetes risk, decreased heart attack risk, decreased future disability (physical and cognitive both) risk, decreased risk of premature death “all causes”, and much much more.
100% correct that the benefits can be gained without crazy levels of exercise. The biggest benefits are going from none to some. It doesn’t even have to be something you’d initially think of as “exercise” - just walk briskly 5 to 10 minutes at a crack a few times each day when going about your business, take the stairs a flight or so a few times instead of the elevator -it adds up to be enough to really matter. You don’t need to be a gym rat or do a 5K.
My point was that for someone who is obese, to get back to normal weight they need to lose tens of lbs - a substantial fraction of their total bodymass. A few brisk walks aren’t going to burn enough calories to matter. If their goal is to get their weight back to normal - and you know darn well that BMI is a statistical measurement of mortality, it absolutely is excellent evidence in favor of weight loss - they are going to need to do it by substantially cutting calories.
Which seems to be nearly impossible to do for most people. I tried for 2 years, didn’t get anywhere until I started taking metaformin off label. Not for the direct weight loss (I know it doesn’t cause much loss), but because it seems to suppress my appetite.
To be honest it seems to be a weak effect and not a cure for most people who are obese - I wasn’t obese when I started (was 3 lbs short of the line) and my entire childhood and early adulthood I was a normal weight.
Like you I think know as well, the real fix is either a really smartly targeted pharmaceutical aimed at some appetite control pathway in the brain, or to figure out which of the commonly used ingredients in mass-market food is making all of America fat. (Is it the trans fats, the corn syrup, the restaurant portion sizes, the sugary drinks, the carbs in everything, what is it?). Both of which are nearly impossible to make happen - the former because any such drug will have side effects, the latter because even if it can be conclusively proven which ingredients it is, cigarettes are still legal today…
It may have nothing to do with the food, and instead be a function of the weaponized psychology that is modern advertising and marketing.
Possibly. The “control group” as it were are countries with similar wealth levels to the USA but lower obesity rates.
The goal is not “to get back to normal weight.” The goal is to be healthier, to function better and feel better every day, and to have dramatically improved long term health outcomes (on average).
Regular exercise, even a little of it, helps achieve that goal to some significant degree even without weight loss. Add in modest fat loss of maybe 10%, hell even 5% of body weight, and a long term healthy nutrition plan and one has achieved those goals to a much larger extent.
An obese person who is setting their goal as “normal weight” should be talked off that ledge. The goals are being healthier and being happy.
Inexpensive, calorie dense and hyper palatable food is what I think is one of the major factors of obesity. Combine calorie density with ignorance on serving size and habitual over consumption is no surprise. A few cookies can be 25% or more of an adult’s daily calories for weight maintenance. It’s amazing.
Just swapping diet for regular soda is a big change in terms of calories. Eating carrots and radishes instead of fries will leave people just as full with 5% of the calories. But who craves a radish?
So in your opinion, they should remain fat until they turn into a corpse. Nothing can be done, medical science is too ignorant to have any ideas what to do*, no point in trying. Sort of reminds me of this doctor getting in trouble with the medical board for prescribing testosterone to both male and female patients. I mean, yeah, strictly speaking, it probably shortens their lifespan slightly, as the drug has negative side effects. But it might mean 10 more years of good sex and looking attractive. Most people, that’s a fair tradeoff.
*which is, strictly speaking, true. Very few therapies except bariatric surgery cause much statistically significant weight loss, and obviously the surgery kill as many patients as it saves.
I lost 12 pds in JAN. 185-173.
Mostly doing the meat diet. Cutting carbs. The real key seems to be removing stress. If you have long stressful days, it’s difficult to keep from saying “I’ve earned a reward.”
Next hardest was just getting used to the routine. Now i have to keep from falling into starvation mode
Yes. We should all live until we turn into corpses.
And we should all do the things that make that time be a good long time away and with that time as healthy and as happy as possible.
Preventing obesity in the first place is obviously one of the best means of achieving that. Given an adult who is obese though? Setting the goal to become “normal weight” is unrealistic and not required to achieve major benefits. And reality is that “normal weight” is more the exception than the rule. A majority of American adults are either “overweight” or “obese”. A little loss though goes a long way in impacting health.
A little cardiorespiratory fitness (CRF) also (and independently) does too. Maybe even more.
[quote=Importance of Assessing Cardiorespiratory Fitnessin Clinical Practice: A Case for Fitness as a Clinical Vital Sign
A Scientific Statement From the American Heart Association]
… after adjustment for age and other risk factors, CRF was a strong and independent marker of risk for cardiovascular and all-cause mortality. This observation has been made in healthy men and women, those with suspected or known CVD, and those with comorbid conditions, including obesity, T2DM, hypertension, and lipid abnormalities.12–23 In a growing number of studies, CRF has been demonstrated to be a more powerful predictor of mortality risk than traditional risk factors such as hypertension, smoking, obesity, hyperlipidemia, and T2DM. …
… each 1-MET higher CRF (a small increment achievable by most individuals) was associated with considerable (10%–25%) improvement in survival.
… meta-analysis also confirmed the previous finding that the greatest mortality benefits occur when progressing from the least fit and the next least fit group; lesser improvements in health outcomes were noted when individuals in the moderate- to high-fit groups were compared. …
… more than half the reduction in all-cause mortality occurs between the least fit group and the next least fit group. Relatively less is gained by increasing CRF between moderately fit and highly fit individuals …
[/quote]
Bolding mine.
You don’t have to lose a lot of weight to gain great benefit and you don’t have to do a lot of exercise to gain great benefit either. You may even still be more fat and less fit than average but the health gains would have been very substantial.
I don’t want to put words in DSeid’s mouth here, but what I think he’s trying to say is that if you’re morbidly obese, you’re likely to be 50-100 lbs overweight. That’s not the kind of thing you can just buckle down and lose- it takes what amounts to a lifestyle change, and that’s extremely hard to engineer and stick with.
So better to aim a little lower- say… lose 10% of your body weight, or 20 lbs, or something that’s actually achievable. Kind of like how NASA didn’t just start in 1962 and aim straight for the Saturn V and a moon landing. They started with relatively small Gemini missions at first, then got progressively more complex through that program, then did Apollo 7, 8, 9 and 10 before finally landing on the moon.
Aiming to go from weighing 300 lbs to weighing 180 is like aiming at a moon landing. But you don’t get there by just aiming at that far star and going. You do it in smaller stages- first you lose 20 lbs, and you figure out what works and what doesn’t. Then you do it again, and revise again, etc…
Losing weight is HARD; you start with several strikes against you. You’re working against physiological mechanisms that have evolved over millenia to make and keep you fat. You’re unable to just stop outright- it’s a game of “enough, but not too much” where that difference can be as small as half a cookie. You often feel rather cruddy- you’re hungry, lower energy than usual, etc… And to top it off, you have to keep this grind up for MONTHS on end- they don’t recommend people lose more than 2 lbs a week. So if you’re 100 lbs overweight, you’re looking at a full year of keeping up that 2 lbs a week weight loss rate, which is damned hard, especially considering that as you lose weight, you have to eat even less as you go to continue losing weight.
That’s why you aim at doing it for say… 10 weeks at a stretch.
Not quite, a bit beyond that.
I think people forget that losing weight isn’t THE be-all and end-all goal - it is part of achieving the goals that actually matter - being both healthier and happier and for as long as possible.
Improving cardiorespiratory fitness (CRF), even modestly, gets that job done to a very significant degree. The position of “But it may not help me lose weight!” is seriously taking the eye of the ball.
If unfit, doing just enough exercise to be out of the lowest tertile in CRF gets the largest chunk of the benefit. If obese losing just a modest 5 to 10% of body mass gets the largest chunk of the benefit.
The return on investment for a modest step up on fitness and a modest bit of weight loss is huge. The are marginal returns for losing more and becoming more fit but they are diminishing returns relative to effort required. The effort required, the probability of failure leading to quitting altogether, the impact of defining not hitting those absurd goals as failing, makes the overall impact on a long life health and happiness a negative for many. Fine for those who celebrate what they have done and aim for more, but also very very fine to be happy and … positive, with yourself and with your body … there.
And circling round back to the OP - negatively judging, even implicitly, those who have accomplished the goals of becoming more fit and a bit less fat, and who are thereby much healthier and with much better odds of a longer and healthier life, solely on the basis of a number or on superficial appearance, is unhelpful.
cancers fueled by obesity are going up for millennials
Even Michelle Obama was accused of fat-shaming for her anti-obesity campaign:
Any discussion of systemic obesity that doesn’t address the culpability of the food industries is inherently flawed. Last year I got an A1C test that was just skimming the pre-diabetic range and I decided to do something about that. I cut most carbs out of my diet–completely cut out processed carbs as much as humanly possible, while basically ignoring any carbs that came to me in the form of fresh, unprocessed foods. So a baked potato dinner is okay, while French fries are not.
Basal metabolism for my age and height is about 1600 calories a day and I did not bother calorie counting–matter of fact, I ate like a pig, but all lean meats, fresh veg and fruits, no processed sugar and extremely limited processed food of any kind. Upshot is that I lost 25 lbs without even noticing it was happening after being stable in my weight for close to a decade. My blood glucose numbers declined out of pre-diabetic range. And this was all occurring while dealing with an incredibly painful frozen shoulder that limited exercise severely.
My takeaway from the last year is that it’s not the fault of the fat people, it’s the food (or perhaps “food”) industries that are calculatedly fattening people up to improve their profit margins. You have no idea until you go low-carb just how much of the local supermarket is completely off limits to you–seriously, I just take a lap around the outside wall, hitting produce, meat and dairy while not going up or down any other aisles. Because those aisles are packed to the rafters with high-carb, nutrition free “food.” It’s kinda scary, really.
Yeah. We tsk-tsk about the importance of calling out the obesity epidemic as a public health risk, just as we would do for, say, malaria, but we fail to notice that malaria epidemics are usually not being actively promoted by massive industries for the sake of their own profits.
And if they were, we as a society would be up in arms about it. If some company’s manufacturing process, say, was creating massive amounts of mosquito-breeding standing water that was spawning catastrophic malaria outbreaks, we wouldn’t just be scolding the malaria patients for their own shortsightedness and weak-willed nature in not being careful enough to wear long sleeves and bug repellent and stay indoors after sundown. No, we’d be demanding that the company stop recklessly endangering public health for the sake of profit.
But when the prepared-food industry is knowingly endangering public health by grossly distorting the balance of available food, so that the cheapest (and most profitable) foods are the most abundant and convenient and least healthy, we look at the absolutely predictable public-health disaster that results and blame it all on the greediness and lack of willpower of individual consumers.
To be fair, we DO overlook and excuse massive issues with harmful externalities of business interests. Mountain top removal mines bury entire rivers and watersheds in super toxic sludge so thousands of people can’t use any of their water and nothing happens. Fracking causes earthquakes and likewise poisons drinking water and meh, nothing gets done. Aggressive tactics are employed to deploy oil pipelines everwhere and they leak toxic shit onto people’s farmland and in their water and nobody does a thing. Corporations are massively more responsible for every form of pollution and escalation of greenhouse gases yet we can’t get even the slightest amelioration of the situation or more than a slap on the wrist for the perpetrators. Factory CAFO farms have shit lagoons that are prime breeding places and cross species DNA exchanges for viruses to become ever more virulent–nothing was done even when massive flooding overran those shit lagoons and spread them far and wide into the surrounding water supply. PG&E ducks out of infrastructure spending and maintenance and burns thousands of homes and kills hundreds of people and what’s happening? Yeah, they’re declaring bankruptcy and leaving the people they fucked holding the bag of nothing that their lives have become. In this country, trying to do ANYTHING that might pull the reins in on a corporation will be stomped on like a bug while their lobbyists blithely continue to write the laws that “regulate” them. The food industry is no different, every facet of our lives is lived in the tiny margins the corporations have left us in order to continue to be their captive economy.
The problem with blaming it on the manufacturers is one of personal responsibility of course.
You want to take any and all responsibility of the people eating the crap that is literally killing them, away from them and place it on someone offering a choice. A choice that if used in moderation, isn’t life threatening, or even really all that bad.
Personal choice isn’t going away anytime soon. We should all learn to place responsibility exactly where it belongs.
Nonsense. Nobody is saying that individuals have no responsibility for their lifestyle and nutrition choices.
What we are saying is that companies ought to be held responsible for their (very successful) attempts to pressure individuals into making bad choices. When food-industry strategies ensure that most of the food readily available to people in everyday circumstances, and/or advertised to people, and/or designed to appeal to people as tasty and satisfying, is largely quite bad for them from a nutritional standpoint, then the choices of individuals are being pervasively influenced in an unhealthy way.
The trouble is that you and similar corporate apologists aren’t willing to do that. You are trying to place all the responsibility on individuals for their individual nutrition/lifestyle choices, while ducking the food industry’s responsibility for its massive efforts to pressure individuals into making bad choices.