My friend needed to lose about 40 lbs, and his doctor suggested that he eat salad with lemon and tuna. Like, that was his honest-to-god Doctor Advice for how to lose weight.
He got back from his appointment and we laughed and laughed about it. He’s lost 20 lbs since then - not by eating salad with lemon and tuna. lulz
Balsamic vinegar in place of the lemon. Amiright?
Actually foreign countries have their own equivalent to american soft drinks and snack foods.
Then throw in they have to do less manual labor. I mean you go from carrying water 2 miles a day from a community well to just turning on a spigot in your own home and your naturally going to gain weight.
Have you even met a two year old? An hour car ride with one would be enlightening.
Actually, no. Snack food isn’t much of a thing in very poor countries. Go look at one of those “this is a family’s food for a week” photo essays and check out, say, Chad. What in that photo do you want to sit around in front of the TV and eat? Basically all your food is raw produce, which means that if you want some peanuts (one of the very few snack foods in Cameroon), you are digging some peanuts up from the ground, shelling then, gathering some wood, building a fire, using some of the oil that you make on your own, roasting them, sprinkling them with salt that can only be purchased with cash (which your household may rarely see) and then eating them.
So snack foods are very special. They are things for holidays and visitors, because it’s a lot of work. Same with “soda”. West Africans drink bissap, a sweetened hibiscus tea. Making it involves gathering, drying and steeping piles of flowers. It’s delicious, but it’s something you drink a tiny plastic bag full (the preferred vending method) at a time. Nobody is drinking even a 12-oz can worth in a day, much less drinking large amounts every day.
Now middle income countries like India and China have lots of snack food. But very poor countries are unindustrialized-- as in “don’t have factories”-- and making your own snack food from scratch is pretty self-limiting.
Nor are people going from “walking two miles to get water” directly to cruising around in a Camry, but that’s another story.
Giving kids lessons on nutrition would probably only be effective for healthy families who are already interested in nutrition. Many would likely roll their eyes and still binge at home on pizza with their parents. Even if you only allowed healthy foods at school, many would just see lunch as a snack between fast food, or an ‘lesser’ alternative. I see fat people choosing the healthy option and they must be eating badly at other times. Instead of snack vending machines, schools should have cigarette vending machines. A new sport, involving hungry lions, would weed out the fatter kids, especially if the only exit to the playing field was a foot wide 
Which is why no single thing is “the” answer as the converse also holds true. A family can make only healthy foods available in the house and many would roll their eyes and binge on pizza at school … It is very frustrating for the families that are trying to eat healthy to have their efforts undermined as soon as the kids get to the school lunchroom.
Unhealthy options - pizza, burgers etc - were available when I was at school, hardly any of my classmates were overweight. One had diabetes at around 15-years old, he’d regularly bring doughnuts from home to eat, although he was as skinny as a rail. I think portion sizes in the canteen were very regulated, a teen eating a small pizza and drinking a single can of soda isn’t going to have health issues, it’s what their other meals and snacks consist of that are the problem.
And schools shouldn’t be relied on to bring people’s children up, what goes on in a kid’s home is much more important than at lunchtime. If a family wants control over their kid’s lunch meals they can provide a healthy packed lunch, and actively encourage the school to provide better food. If the family are concerned with what’s being served up, they’re more likely to take action; if they think the school’s lunches are healthy they’ll miss the fact their kid chooses to go to a burger place for lunch or on the way home.
We also played sports for five hours a week, not enough to combat obesity but enough to develop feelings (usually positive) about exercise. And almost no one was driven to school; we walked/took a train/bus/road a bike.
Revolutionary! Do you think she didn’t know that she was obese and needed to eat less?
That’s just what I’d want if I visit the ER with an asthma attack: the ER physician telling me that I need to eat less, without knowing my history or what my doc and I might be doing about it now, or if I’m in a program, or anything like that.
Is it even possible for a morbidly obese person to not know they eat too much?
I mean, I know there are people who mistakenly believe their obesity is due to glandular issues. But a doctor who is just meeting a patient for the first time doesn’t know enough about them to know if this is a mistaken belief or 100% accurate.
The early posts in this thread, and some later ones are terrifying. The authoritarianism on display would make Stalin blush.
Obesity is not something you solve through force of law, if someone against all rational advice wants to be obese that is their family and friends place to talk sense into them.
Absolutely. Go see the British TV show “secret eaters” on Youtube. These people think they’re doing all the right things and don’t understand why they’re fat. Of course all the take out and snacks and alcohol that never make it into their food diary have something to do with that.
Also, even if morbidly obese people know that they’re eating too much, they may not be aware of how much too much they’re eating and don’t know what a reasonable portion size would be.
I’m not even reading the rest of this because I’m sure it will be full of evidence-free assumptions and venomous hatred toward fat people.
Here’s my answer:
[ul]
[li]Realize that body size isn’t a problem per se.[/li][li]Encourage people of all shapes and sizes to engage in healthy behaviors that actually do have good evidentiary support as ways to be healthier. (No smoking, be active, don’t diet, do eat nutritious foods, maintain social networks, wear sunscreen, etc.)[/li][li]Make systemic changes that support pursuit of these healthy behaviors, from giving reasonable paid parental leave, to showing fat people being healthy and happy in media, to giving the poor enough support to buy healthful foods, to building communities that reduce sedentary lifestyle, and beyond![/li][li]Educate healthcare workers and the public in general that treating fat like a moral issue and shaming and hating people “for their own good” has never been shown to improve public health.[/li][/ul]
Somewhere, there must be middle ground between “fat people are all morally deficient gluttons” and “there’s nothing wrong with being morbidly obese that can’t be fixed to everyone being nice to each other”.
How about we should be nice to each other in any case and that we should figure out what systems changes would help decrease the rates of obesity related illnesses?
Crazy talk I know …
If people are unfullfilled for whatever reason they tend to find ways that will temporarily give them a sense of fullfillment. Food is just one of those ways.
Creative outlets of all kinds that will expose us to opportunities for validation amoungst our peers in a social envoroment seem to be lacking for a large segment of society.
Reconfiguring parks to support hobbies crafts and social meeting places using social media as a catalyst could go a long way toward healthier more fullfilling life styles. This is something that is feasable. Sports are supported by playing fields. Fine arts could be supported by stages, playhouses, and work areas in the same manner.
Yes but they picked people who were successful at losing weight and keeping it off, then asked them how they did it. They didn’t create a study where a significant random fraction was able to keep the weight off long term. I believe less than 10% of people succeed at keeping the weight off. The acceptance rate at MIT is about 7% so statistically a person is about as likely as losing weight and keeping it off via lifestyle changes as they are of getting accepted into MIT. So I don’t know to what degree that study you post will help increase the long term success rate. Asking that 7% of people who got into MIT how they did it doesn’t really change the overall 7% acceptance rate. Point being, I don’t really understand statistics but is going to the 5-10% of people who were successful and asking them how they did it going to change the 90-95% failure rate? Who is to say that those 5-10% didn’t succeed in part because they have an easier time (psychologically, biologically) keeping the weight off? In studies of overfeeding and underfeeding people’s bodies react differently. Some gain or lose tons of fat, some gain or lose little. One can assume that the same probably applies to regain, people regain at different rates. Picking the handful who succeed and asking them how may give some insights but maybe their bodies just didn’t fight to regain as hard as most people.
Are there studies where the long term maintenance rate is a decent amount (50%+)? I have seen studies using drugs where people kept the weight off for a year (I saw one for 3 years). I know surgery has a halfway decent maintenance rate. I’ve seen studies on phentermine, topamax, cimetidine and combinations thereof to show weight maintenance but even those studies usually only go out a year.
It would help to be able to say with more certainty at which levels of overweightedness/obesity and unfitness people should be starting to worry about increased risks.
Today, there are a lot of people who have a BMI over 25, which gets them kicked into the “overweight” box, but that’s pretty much meaningless: a fit person with a BMI of 26 is just fine, while an unfit person with a BMI of 29 is probably at increased risk for several diseases. (And probably even someone who’s unfit with a BMI of 22!)
Being able to tell someone “you’re at increased risk for X, Y and Z because you’re 12 kilos too heavy, but you can compensate for that by exercising at 75% HRmax for 160 minutes per week” is much more useful than simply “you’re too fat”.
It is my understanding that an obese person who tries to engage in other healthy behaviors can mitigate much of the risk of their obesity, even if the obesity itself doesn’t change. Seeing how difficult long term weight loss/maintenance is that may be the better strategy.
I agree- we should concentrate on obesity related illnesses not simply a persons body weight.