# Is our attitude on obesity more dangerous than obesity itself **URL:** \ **Category:** Great Debates\ **Created:** [June 11, 2005, 12:26am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817 "2005-06-11T00:26:09Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 29, 2005, 3:53pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/81 "2005-06-29T15:53:07Z")
> [@DSeid](#): > > Let us break down this discussion into component parts. > > First is obesity unhealthy? > > The evidence for this statement is overwhelmingly yes. And obesity coupled with inactivity is even more unhealthy. And obesity makes it less likely that someone will be physically active. The more obese the worse the risk, so even a moderate weight loss while staying in the obese class can still help significantly, especially if coupled with excercise. But of note, weight loss induced by surgery has significant positive effects as seen in [this study.](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15616203&query_hl=8) And the long term f/u of the 116,000 women is very significant. These were all nurses, none poor, and it showed that exercise helps but that avoiding obesity helps more… You say obesity is unhealthy, then you say a small weight loss will cause major health benefits. If a person with a BMI of 39 eats healthier and gets down to a BMI of 38 or 37, their health can improve drastically. It doesn’t matter that they are still in the heaviest 6% of the population. And as for the nurses study, as I said there are endless risk factors for cancer and cardiovascular disease that people can address instead of obesity. Since our war on obesity has so many negative effects perhaps it’d be better to tell fat people to eat more fiber, get screened for cancer and exercise instead of trying to have a BMI below 30 or 25. Their health risks will probably be the same if they do that instead, even if being overweight is in and of itself a major health risk. [http://www.techcentralstation.com/102604D.html](http://www.techcentralstation.com/102604D.html) Bariatric surgery also has dangers. 2% die within 30 days. ‘According to the surgeons’ own figures based on nearly 63,000 weight loss surgeries, an average of 2% of patients die within the first 30 days as a direct result of their primary surgery" Do you think that 2% of those obese people would’ve died within 30 days had they just been obese and not gotten surgery? The issue is not black & white, it is very complicated with many gray areas. > [@DSeid](#): > > Is it a significant probelm? > > Yes. A third are obese and have much greater mortality than those just a little less heavy. Healthcare associated with both overweight and obesity is driving up healthcare costs in this country significantly. Debate the exact amount but it is significant… In the study I listed only those in the most obese 8% of the population were at really high risk from their obesity. And the coorelation between weight and death was ‘statistically insignifigant’ according to the study. Combine that with the fact that poor, non white, uneducated, sleep deprived people under alot of stress with poor diets and lack of exercise are more likely to be obese, and its not the obesity that itself is the killer disease IMO. It may have health risks itself, but they are grossly overrated. > [@DSeid](#): > > Does “society” stigmatize the obese? > Yes. There are negative stereotypes that are unfair and unhelpful. An excessive focus on the scale and on weight per se is not useful. Media images are derogatory. Prejudice abounds. > > Does attending to the health risks of obesity for individuals and society mean using poor tactics? > > No. And it doesn’t mean increasing smoking rates. Or causing negative self-images. But for the individual it does mean an honest appraisal of lifestyle choices and a willingness to address behavioral choices. And for society it means looking at primary prevention: how do we arrange things so as to make obesity less likely to occur in the future? It is this discussion that the so-called liberterian crowd wants us to avoid. > > Are the healthy lifestyle choices associated with avoiding and treating obesity all that difficult? > > No. A healthy diet does not need to leave you hungry or unsatisfied. Exercise can be moderate and fun and still have significant benefits. Most people feel better when exercising regularly and eating healthily. > > BTW, your hypothetical? No doctor would ignore a sinus infection because they noticed someone was overweight. Only an exceptionally good doctor would bother to notice it in addition to the sinus infection and try to address it at all. I am all for healthy lifestyle. But as I said earlier, those with a vegetarian diet are still obese or overweight, just not as much. Why don’t we focus on healthy eating and exercise irrelevant of obesity? Where does that leave the 35% of american adults and 50-60% of adults in other developed countries who are not overweight/obese when you imply that being obese is a side effect of poor dieting and lack of exercise? Your implication that the war on obesity doesn’t increase smoking rates strikes me as hollow. Considering that a medical war on fat will justify and strengthen our cultural attitudes that fat is disgusting and bad, people will resort to further means to avoid being fat. You can’t condemn obesity then say ‘not my fault’ when studies show people smoke to avoid getting fat anymore than you can fund terrorists then say ‘not my fault’ when they fly a plane into your building 20 years later. As for your statement that ‘no doctor’ would ignore a sinus infection, I have my doubts that that has never happened. I got the idea when reading about a fat person who went to their doctor for a sinus infection and didn’t get medicine but got a lecture on weight instead. Plus as lee said doctors have ignored his health complaints until he lost weight. ---
**Author:** ![Girl\_From\_Mars](https://avatars.discourse-cdn.com/v4/letter/g/3da27b/32.png) [@Girl\_From\_Mars](https://boards.straightdope.com/u/Girl_From_Mars)\ **Post date:** [June 29, 2005, 4:03pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/82 "2005-06-29T16:03:10Z")
> [@Wesley Clark](#): > > [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list\_uids=9382119](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9382119) > > PURPOSE: To determine the relationship between measures of body size and the risk of hip fracture in elderly women. > > Women with smaller body size had a higher risk of subsequent hip fracture compared with those with larger body size, while women with average and larger body sizes shared similarly lower risks of subsequent hip fracture. For example, the incidence rate of hip fracture was 9.35 per 1000 woman-years in women in the lowest quartile of total weight compared with 4.63 per 1000 woman-years in women in the highest quartile of total weight (age-adjusted relative risk 1.93, 95% confidence interval (CI) 1.34 to 2.80), while rates of hip fracture among women in the second and third quartiles of total weight (5.22 and 4.32 per 1000 woman-years, respectively) were not significantly different from the rate among women in the highest quartile (P \> 0.64). > > Essentially those in the heaviest 75% of the population had half the hip fracture rates of those in the lightest 25% of the population. Considering that about 65% of americans are overweight or obese, that means that the vast majority of those in the overweight/obese category have a better prognosis than those in the ‘ideal’ weight category for hip fractures. However, the conclusion of the study was that > [@](#): > > Older women with smaller body size are at increased risk of hip fracture. This effect is because of lower hip BMD [bone mass density] in women with smaller body size. I see nothing in the abstract that says the lower BMD is directly related to weight/% body fat - I can’t access the rest of the study, but I think this does not in any way back up your argument. Especially as they reckon this affects only 2.9% of the female population. Risks for heart problems and cancers are much higher. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 29, 2005, 4:03pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/83 "2005-06-29T16:03:21Z")
> [@Girl From Mars](#): > > At a societal level, we do know what will cause large numbers of the population to lose weight - they need to eat less, and exercise more. This message is basically shouted from the rooftops - so it’s not like society is hiding this secret information while laughing at all the fat people. > > What you choose to do with this information is up to you. The actual weight loss of a person is their own responsibility. The fact that you don’t want to live this lifestyle is up to you: This solution fails the majority of the time, and could be dangerous. The human body has adapted to starvation over the eons, people are designed to lose weight during a famine, then gain it back to protect themselves from the next famine. If people lost weight and kept it off w/o effort 30,000 years ago, they would die after one or two famines. only those who lost weight then regained it would survive famine, and these are our ancestors. Its really just simple evolution when you think of it, if you have people 30,000 years ago and a food shortage occurs, all will lose weight. Those who gain the weight back will survive the next food shortage, those who don’t regain the weight will die in the next food shortage. This is probably why 90% of people regain weight after they lose it, because we are genetically prone to do this as the majority of people who can lose weight and keep it off with minimal effort died off thousands of years ago. > [@Girl From Mars](#): > > But as Quicksilver has said (and from my own personal weight loss experience) if it is important to you, and you put a priority on it, you can make time and motivation to do the exercise and cut down on what you eat. > > I have a natural tendancy to put on weight - I bemoaned the unfairness of this for the first 25 years of my life, then finally realised that I needed to take responsibility for it - OK, if I don’t exercise and eat too much, I will put on weight. So I keep an eye on this and act sensibly, and have maintained a 40lb weight loss. I can’t eat what my naturally thin friends eat, and maybe that’s ‘unfair’, maybe I don’t always want to go out for a run or refuse the chips, but that’s life, and I feel better for being realistic about the situation. How long have you maintained the loss? As you said, you spent 25 years not able to keep the weight off. I don’t know how long you’ll keep the weight off now either. Plus since yo-yo dieting could be far more dangerous than 40 lbs, you could be making your health alot worse by doing this. > [@Girl From Mars](#): > > And as my previous post mentioned, there are major health benefits for obese people in losing weight: > > And nothing says this has to be mutually exclusive; eating more fibre and vegetables, reducing saturated fat intake, increasing exercise - these will all reduce your risk of cardiovascular disease while aiding in weight loss. Good. If losing a small amount of weight (5% of bodyweight or so) as an unintended side effect of healthy eating and exercise cuts diabetes risk then good. However would you say that losing 5% of bodyweight by eating pizza and being bulimic would cut the risk of diabetes? I still don’t think its the weight loss itself that is curing the disease, but the lifestyle changes that lead to mild weight loss. I mentioned earlier in this thread about Fred Anderson who started at about a BMI of 51 and ate healthier and exercised. When he started his blood sugar was about 180 with 2 diabetes drugs, by the time his BMI was in the high 40s his fasting blood sugar was in the 60-80 range without medication. So even though he was still in the fattest 2% of the population he got his diabetes under control. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 29, 2005, 4:12pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/84 "2005-06-29T16:12:46Z")
> [@Girl From Mars](#): > > However, the conclusion of the study was that I see nothing in the abstract that says the lower BMD is directly related to weight/% body fat - I can’t access the rest of the study, but I think this does not in any way back up your argument. Especially as they reckon this affects only 2.9% of the female population. Risks for heart problems and cancers are much higher. The study says those in the highest 75% of weight have half the risks of those in the lightest 25%. They mention body size as the risk factor. I will admit cancer and heart problems can be bigger risks than hip fractures. However I still don’t see how obessing over weight helps these issues with all the negatives this obession gives our society. The thread is entitled “Is our attitude on obesity more dangerous than obesity itself” And I still think it is. Even if its true that risks for cancer and heart disease are due directly to being bigger/fatter, I do not think our obsession with weight and the endless negatives it provides our society is worth the health benefits the small percent of the population who can lose weight and keep it off. Assuming they get health benefits. ---
**Author:** ![QuickSilver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quicksilver/32/7832_2.png) [@QuickSilver](https://boards.straightdope.com/u/QuickSilver)\ **Post date:** [June 29, 2005, 4:48pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/85 "2005-06-29T16:48:01Z")
> [@Wesley Clark](#): > > I don’t know how you fit that much exercise into your schedule unless you get up at 5am. 4:45am. 🙂 > [@Wesley Clark](#): > > Nonetheless, the level of dedication you will resort to to lose weight (and you are a man, you are not treated nearly as bad for beign overweight as a woman would be) is proof of how deeply our loathing of fat as a culture runs. Except we all recognize the benefits of fitness and dangers of excessive weight. We are also creatures who are slaves of evolutionary selection forces. Just as infants barely a few weeks old respond favourably to attractive faces and negatively towards unattractive faces, we continue to respond to our ingrained senses of “beauty” throughout our lives. We temper and mask our negative reflexes as members of polite society but they are still part of our genetic makeup. > [@Wesley Clark](#): > > This is what I keep saying in this thread, no matter how dangerous, inefficient, destructive or counterproducitve our desire to make fat people thin is, no matter how many problems it causes, none of it is more powerful than the social force that causes a man who has kids to raise (Ie someone from a demographic with much less motivation to become thin than, say, a 21 year old woman) people to devote 15+ hours a week of their lives to exercise they may not want to do. I won’t deny that a large part of staying fit and thin has to do with vanity. My kids certainly won’t love me any less if I was 60lb overweight. But I want to set a good example for them and instill a healthy lifestyle in them by example. I want to enjoy an active healthy lifestyle with them right now. I want to live long enough to see them grown as successful, happy adults, perhaps with a family of their own if they so choose. I want my later years to be quality years where I’m not immobilized by weight related issues or illness. In addition, I’ll admit that spending 15 hours a week in the gym is not an ideal way to spend time. Sleeping, eating and relaxing is far more pleasurable than exhausting myself physically for 2 hours a day. Though there is something to be said for that runner’s high one gets from sustained physical effort. But something is wrong with my wiring. Something in my physiology doesn’t work right and doesn’t tell me I’ve had enough food to satisfy my hunger and supply my body with necessary nutrients for survival. If I let myself I can just keep eating, far more than I should, before the right triggers are set to signal my brain to stop the hunger implulse. That or my pleasure sensors for food are far too sensitive. Either way, I’m not wired optimally. Not for this day and age and society. So I have to make a serious concious effort to control my own impulses. In the end, you are correct, it’s what makes me happiest. Also, it is social and evolutionary forces that cause us to behave with relative civility towards one another. You can’t be a complete jerk 24/7 and expect to have lots of friends wanting to spend time with you, much less have sex with you. Society tends to de-select that kind of negative trait. It may be a cruel thing to suggest but perhaps social pressure and a general negative attitude towards heavily overweight people is a kind of environmental de-selection process as well, not previously observed because excess weight in pre-industrialized society has not been as big an issue. ---
**Author:** ![Girl\_From\_Mars](https://avatars.discourse-cdn.com/v4/letter/g/3da27b/32.png) [@Girl\_From\_Mars](https://boards.straightdope.com/u/Girl_From_Mars)\ **Post date:** [June 29, 2005, 4:55pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/86 "2005-06-29T16:55:47Z")
[QUOTE=Wesley Clark] This solution fails the majority of the time, and could be dangerous. The human body has adapted to starvation over the eons, people are designed to lose weight during a famine, then gain it back to protect themselves from the next famine. If people lost weight and kept it off w/o effort 30,000 years ago, they would die after one or two famines. only those who lost weight then regained it would survive famine, and these are our ancestors. Its really just simple evolution when you think of it, if you have people 30,000 years ago and a food shortage occurs, all will lose weight. Those who gain the weight back will survive the next food shortage, those who don’t regain the weight will die in the next food shortage. This is probably why 90% of people regain weight after they lose it, because we are genetically prone to do this as the majority of people who can lose weight and keep it off with minimal effort died off thousands of years ago. [quote] The reasons diets tend to fail is that people ‘diet’ - they don’t make the long term lifestyle changes to their eating habits and activity levels that are recommended by organisations like The Heart Association. People want a quicker fix than that, and either give up frustrated, or can’t maintain the strict diet long term. > [@Wesley Clark](#): > > How long have you maintained the loss? As you said, you spent 25 years not able to keep the weight off. I don’t know how long you’ll keep the weight off now either. Plus since yo-yo dieting could be far more dangerous than 40 lbs, you could be making your health alot worse by doing this. First of all, facinated that your first reaction seems to be quite negative and confrontational about this - you won’t be able to keep it off, you’re damaging your health… instead of asking a successful person what they did to learn from it. Was this intentional? But anyway… it’s your assumption I yo-yo dieted - I was very high-end healthy weight until 17 or so (and had to be careful), gained lots of weight over 18-19 at start of uni, dropped 20lb of this over 20-22, the next 10 over 24-25, then the last 10 over 27-28. Been at this weight for over a year, despite some very stressful times (I know I emotion eat; acknowleging that has been is part of my lifestyle changes) - I’m almost 30. Its been slow, but I have completely different patterns to those I used to have, so unlikely to slip back. Nothing wrong with my health at all. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 29, 2005, 6:16pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/87 "2005-06-29T18:16:15Z")
> [@Girl From Mars](#): > > The reasons diets tend to fail is that people ‘diet’ - they don’t make the long term lifestyle changes to their eating habits and activity levels that are recommended by organisations like The Heart Association. People want a quicker fix than that, and either give up frustrated, or can’t maintain the strict diet long term . I’m all for long term lifestyle changes. But I do not think that their relevance to weight is important and I think tying long term lifestyle changes to weight loss does more harm than good. If healthier eating and exercise makes someone 100 lbs lighter good, if they don’t lose any weight then good. > [@Girl From Mars](#): > > First of all, facinated that your first reaction seems to be quite negative and confrontational about this - you won’t be able to keep it off, you’re damaging your health… instead of asking a successful person what they did to learn from it. Was this intentional? I don’t know what you mean. I was stating that many people who lose weight gain it back and for a good many of them it wasn’t their first attempt at weight loss. If you’re different then I’m wrong and I admit it. I didn’t ask how you did it successfully because I don’t think weight loss is relevant to health. Sorry if that sounded rude, it wasn’t my intent. But the reality is at this point medical science has not conducted any long term studies on the health benefits of weight loss because they can’t get statistically large numbers of people to lose weight and keep it off for 10 year period. On the surface it makes sense that a fat person who becomes thin will be as healthy as a thin person, but the situation is probably more complex. A fat person who becomes thin is just a person who has decreased the size of their fat cells, that it is. There is no long term evidence that decreasing the size of your fat cells decreases your odds of cardiovascular disease or cancer. The underlying biochemistry of a fat person still exists when they become thin, but their fat cells are smaller. > [@Girl From Mars](#): > > But anyway… it’s your assumption I yo-yo dieted - I was very high-end healthy weight until 17 or so (and had to be careful), gained lots of weight over 18-19 at start of uni, dropped 20lb of this over 20-22, the next 10 over 24-25, then the last 10 over 27-28. Been at this weight for over a year, despite some very stressful times (I know I emotion eat; acknowleging that has been is part of my lifestyle changes) - I’m almost 30. Its been slow, but I have completely different patterns to those I used to have, so unlikely to slip back. Nothing wrong with my health at all. Thats good if you have long term eating and exercise patterns. However if they invent drugs that cause weight loss while letting you eat pizza will you continue to eat healthy since one of your main motivations will be gone? Even if you do still eat healthy and exercise, don’t you worry that some of the people who are currently living that way will start to slack and go back to the old lifestyle? My concern is that by tying weight loss to healthy eating we are discouraging healthy eating and exercise for a variety of reasons. The reality is you are 30, most of the diseases associated with obesity (cardiovascular disease, cancer & diabetes) will not strike for another 20 years or so at the earliest. When you really need a healthy lifestyle will you still have it? Sorry if I came across as a dick to anyone. Quicksilver - [http://www.fitnessaustralia.com.au/newsitem.asp?id=6889&orgID=243&Oname=Fitness+Aus.&O1c=26&O10c=12](http://www.fitnessaustralia.com.au/newsitem.asp?id=6889&orgID=243&Oname=Fitness+Aus.&O1c=26&O10c=12) “During 17 years of follow-up, 1,531 participants died of heart disease. After adjusting for BMI and physical activity, caloric intake was unrelated to heart disease. Those who exercised more and ate more were both leaner and had less than half the cardiovascular disease mortality than did those who exercised less, ate less and were overweight. “Subjects with the lowest caloric intake, least physical activity, and who were overweight or obese had significantly higher cardiovascular mortality rates than those with high caloric intake, most physical activity, and normal weight,” Fang says. The difference in mortality rates was 55 percent. Those who eat less won’t necessarily be thinner, she says, and eating more does not have to translate into obesity. People who were overweight and exercised less at the start faced increased cardiovascular mortality, even if they ate less.” And again, do you think you’ll be exercising 15 hours a week when you are 50 or 60 when the diseases associated with obesity actually start to occur? If you want to be around to see your kids grow up (a laudable goal), you’d be better off getting quality health insurance, getting screened for cancer and cardiovascular disease reguarly, eating healthy, practicing preventive medicine and exercising 2-3 hours a week. Starving yourself and working out 15 hours a week may be unnecessary and counterproductive. I have read (no cite right now) that excess exercise like you are doing is unhealthy as it leads to extra free radical production. Suffice it to say, I’m just saying there are other ways to keep yourself healthy. There are 246 risk factors for cardiovascular disease and you can drastically cut your risk of dying by cancer by practicing preventive medicine. And you don’t need the level of exercise and diet you have to promote health. You also sound kindof young (I’d guess 30s or 40s) and the diseases associated with obesity are still years away. Are you certain you’ll still be exercising in 20 years? ---
**Author:** ![Dob](https://avatars.discourse-cdn.com/v4/letter/d/b2d939/32.png) [@Dob](https://boards.straightdope.com/u/Dob)\ **Post date:** [June 29, 2005, 6:51pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/88 "2005-06-29T18:51:06Z")
> [@](#): > > The point is that the level of healthy eating and exercise that you need to lead a healthy life may not lead to weight loss. This statement seems so…silly…I dont know where to begin. If I understand the basics of weight gain, you gain fat when the calories you take in, are less then the calories you burn. So if you burn more calories then you take in, you lose weight. Sure, people do these things to varrying degrees of success. For some people burning calories is easy, for others it is not so easy. In any case if you eat less and excersise more you will lose wieght. I hate to be mean, but I have little sympathy for the morbid obese. I can understand being 10, 15, hell even 100 lbs over weight. But when somebody reaches 200lbs overweight, that is their fault, and their fault alone. They allowed themselves to get that big, period. Its not like they woke up one morning and “poof” they were 200lbs overweight. I think for those people the only attitude we can have is one of stern resolve. They obviously have none of their own, so others need to do it for them. ---
**Author:** ![QuickSilver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quicksilver/32/7832_2.png) [@QuickSilver](https://boards.straightdope.com/u/QuickSilver)\ **Post date:** [June 29, 2005, 8:27pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/89 "2005-06-29T20:27:32Z")
> [@Wesley Clark](#): > > “During 17 years of follow-up, 1,531 participants died of heart disease. After adjusting for BMI and physical activity, caloric intake was unrelated to heart disease. Those who exercised more and ate more were both leaner and had less than half the cardiovascular disease mortality than did those who exercised less, ate less and were overweight. > “Subjects with the lowest caloric intake, least physical activity, and who were overweight or obese had significantly higher cardiovascular mortality rates than those with high caloric intake, most physical activity, and normal weight,” Fang says. The difference in mortality rates was 55 percent. Those who eat less won’t necessarily be thinner, she says, and eating more does not have to translate into obesity. People who were overweight and exercised less at the start faced increased cardiovascular mortality, even if they ate less.” A lot depend on genetics and your predisposition to heart disease or other late onset illness. But health problems can be mitigated by diet and exercise. Recently, one of the top professional cycling riders collapesed from a heart attack. He was around 30 and in top physical shape. My point, if I have one, is that there are exceptions to almost every rule. Is your point that it’s all futile and nobody should attempt anything that is demanding because we’ve all got to die of something sooner or later? > [@Wesley Clark](#): > > And again, do you think you’ll be exercising 15 hours a week when you are 50 or 60 when the diseases associated with obesity actually start to occur? That’s my goal. Beyond the obvious health benefits, I also enjoy the gym friendships I’ve established. My inspiration is a good friend who is in his early 60’s. He’s been athletic and fit most of his adult life and is enjoying the benefits even now. We often do leg workouts together and he can match me pound for pound and rep for rep on the [leg press](http://www.exrx.net/WeightExercises/Quadriceps/SL45LegPress.html). We’ve pushed upwards of 800lb. He also regularly gives me guided tours of the squash court. All four corners. 🙂 > [@Wesley Clark](#): > > If you want to be around to see your kids grow up (a laudable goal), you’d be better off getting quality health insurance, getting screened for cancer and cardiovascular disease reguarly, eating healthy, practicing preventive medicine and exercising 2-3 hours a week. Starving yourself and working out 15 hours a week may be unnecessary and counterproductive. I have read (no cite right now) that excess exercise like you are doing is unhealthy as it leads to extra free radical production. It’s not a case of one or the other. I workout. I do preventive medical care visits. It’s all preventive in my opinion. Not sure of the free radicals issue or what that means exactly. My workouts and diet regimen are absolutely necessary and highly productive. I’d be unhappy if I was heavy and in poor physical condition. No amount of food (which I love) would make me happy. > [@Wesley Clark](#): > > Suffice it to say, I’m just saying there are other ways to keep yourself healthy. There are 246 risk factors for cardiovascular disease and you can drastically cut your risk of dying by cancer by practicing preventive medicine. And you don’t need the level of exercise and diet you have to promote health. You also sound kindof young (I’d guess 30s or 40s) and the diseases associated with obesity are still years away. Are you certain you’ll still be exercising in 20 years? I’m 41. Not exactly young but I sure don’t feel old. There are degrees of “healthy”. I look at a triathlete and consider myself to be in inferior physical condition in comparisson. Most people at my healthclub, including those half my age, can’t do my usual 2 hour workouts even at 70% level of my intensity. It’s all relative. I’m healthy. A person 40 pounds heavier than me but my height and age might also be considered healthy according to some standards you’ve presented. But all things being equal, he’s got to work that much harder to carry that extra weight in a sprint or a hill climb or simply walking up a flight of stairs. His heart has to work that much harder due to the extra weight. His joints need to support that extra weight with each step. I have to be honest. I’ve been on both sides of the fence. At 60+ pounds overweight, I struggled for a breath after having climbed two flights of stairs. Running a flat mile was a physically draining and painful experience. I felt I was missing out on life because of lethargy and discomfort in my own skin. I’m now on the other side of the fence. It’s not been easy but once I made the commitment, the results made me even more commited to my efforts. I’ve stumbled a number of times but managed to press on. There is a price that I pay every day to maintain my goals but I have to say, for me, the grass is definately greener on this side. Not saying everyone needs to do as I do. I can understand that some people don’t feel the need or have the desire to make these kinds of changes in their life. I’m just trying to relay my personal experience with significant weight loss and the impact it’s had on my life. ---
**Author:** ![alice\_in\_wonderland](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alice_in_wonderland/32/176_2.png) [@alice\_in\_wonderland](https://boards.straightdope.com/u/alice_in_wonderland)\ **Post date:** [June 29, 2005, 9:15pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/90 "2005-06-29T21:15:43Z")
> [@Wesley Clark](#): > > The study says those in the highest 75% of weight have half the risks of those in the lightest 25%. They mention body size as the risk factor. This has nothing to do with fat percentage and everything to do with frame size. A woman who is 6’ tall is going to be heavier and have thicker bones than a woman who is 5’ tall. Period. If we were to believe your conclusion, short, small framed women could reduce their risk of hip fracture by putting on 100 lbs. This is NOT the case. I think your point of view is interesting and deserves discussion, but some of the conclusions you’re making, based on the studies you’re quoting, are flat out wrong. ---
**Author:** ![Boo\_Boo\_Foo](https://avatars.discourse-cdn.com/v4/letter/b/e274bd/32.png) [@Boo\_Boo\_Foo](https://boards.straightdope.com/u/Boo_Boo_Foo)\ **Post date:** [June 29, 2005, 10:40pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/91 "2005-06-29T22:40:05Z")
> [@alice\_in\_wonderland](#): > > If we were to believe your conclusion, short, small framed women could reduce their risk of hip fracture by putting on 100 lbs. This is NOT the case. I think your point of view is interesting and deserves discussion, but some of the conclusions you’re making, based on the studies you’re quoting, are flat out wrong. Hear, Hear. The vibe I’m getting from the author of this OP is one which reeks of a classic example of having reached dubious conclusions prior to creating the debate, and then clutching at ridiculous surveys to somehow validate those conclusions. The OP states that they’re happy to concede that weight loss MIGHT lead to better health. What sort of concession is that? It’s like trying to argue you can be half pregnant. Either you believe it or not. If you don’t believe it, fine, but the vast majority of society disagrees. Don’t be surprised when people dump on you for throwing up pissweak empirical evidence to prop up an inherently indefensible position. It IS the Straight Dope Message Board after all! ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 30, 2005, 1:16am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/92 "2005-06-30T01:16:24Z")
> [@alice\_in\_wonderland](#): > > This has nothing to do with fat percentage and everything to do with frame size. A woman who is 6’ tall is going to be heavier and have thicker bones than a woman who is 5’ tall. Period. > > If we were to believe your conclusion, short, small framed women could reduce their risk of hip fracture by putting on 100 lbs. This is NOT the case. I think your point of view is interesting and deserves discussion, but some of the conclusions you’re making, based on the studies you’re quoting, are flat out wrong. I don’t see how you got your conclusion, the study mentions things like BMI and fat mass by name. “Similar associations were observed between hip fracture risk and all measures of body size including total body weight, percent weight change since age 25, hip girth, lean mass, fat mass, percent body fat, body mass index, and modified body mass index.” Many of these traits involve BMI and/or fat amount, however I will give you that alot are dependent on height. Hip Girth, lean mass, fat mass, body mass index and probably modified body mass index are all relative to fat amount and BMI. They even mention fat mass by name as one of the factors. [http://physician-assistant.advanceweb.com/common/editorial/PrintFriendly.aspx?CC=54165](http://physician-assistant.advanceweb.com/common/editorial/PrintFriendly.aspx?CC=54165) Body mass index (BMI) is a predictor of low bone mineral density (BMD) and fracture, as is weight loss. [http://courses.washington.edu/bonephys/oldnews/opnew03.html](http://courses.washington.edu/bonephys/oldnews/opnew03.html) A Meta-analysis of Body Mass Index (BMI) as a Predictor of Fracture Risk C. E. D. De Laet - - Study of 190,000 person years, showed relative risk of hip fracture 4.18 with BMI of 15 vs 25, and 0.52 with BMI 40 vs 25. A woman with BMI of 20 was almost twice as likely to fracture her hip a woman with BMI of 25. > **[Changes in body weight and incidence of hip fracture among middle aged...](https://www.bmj.com/content/311/6997/91.full)** > > Lean body stature is an important risk factor for hip fracture.1 We assessed prospectively the relation between intrapersonal change in body weight and the incidence of hip fracture. > > We followed up 21 510 women and 21 157 men born between 1925 and... Encouraging people to lower their BMI and lose weight would increase their risk of fractures. Here is another study showing mortality rates higher in the lower BMI groups in those 70+ > **[Body mass index, weight change and mortality in the elderly. A 15 y...](https://pubmed.ncbi.nlm.nih.gov/11423925/?dopt=Abstract)** > > Low BMI and weight loss are risk factors for mortality in the elderly and smoking habits did not significantly modify that relationship. The BMI ranges with lowest risks for 15 y mortality are relatively higher in elderly. Exclusion of early deaths... CONCLUSION: Low BMI and weight loss are risk factors for mortality in the elderly and smoking habits did not significantly modify that relationship Incidentally I love that this is what I’m doing with my free time this summer, researching broken hips in the elderly. Dob - Cancer victims who die are just as responsible for their fate as fat people. Once you strip away the phony medical justifications we use to mask our hatred of fat all we are left with are attitudes based on blind prejudice hiding behind moralizing medical advice. In a developed country you are supposed to be fair and evenhanded, let people live their own lives as they see fit and not judge based solely on physical characteristics. Our war on fat violates all three of these civilized norms we expect from people. Because we get to hide these prejudices against fat people behind junk science most people feel free to indulge in them. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 30, 2005, 1:27am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/93 "2005-06-30T01:27:29Z")
> [@Boo Boo Foo](#): > > Hear, Hear. > > The vibe I’m getting from the author of this OP is one which reeks of a classic example of having reached dubious conclusions prior to creating the debate, and then clutching at ridiculous surveys to somehow validate those conclusions. LMAO. You realllllllllllllllllly need to look in the mirror. Realllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllly. You haven’t addressed a single one of my scientific studies. Not a one. The best you can do is misread them and have me correct you. Alice misread the study which mentioned BMI by name and since that wasn’t enough I dug up other studies showing a lower BMI increased the risk of fractures and mortality among the elderly. Are we going to ignore those studies too? Don’t answer that, we both know the answer. > [@Boo Boo Foo](#): > > The OP states that they’re happy to concede that weight loss MIGHT lead to better health. What sort of concession is that? It’s like trying to argue you can be half pregnant. Either you believe it or not. If you don’t believe it, fine, but the vast majority of society disagrees. The vast majority of society used to believe that that pope was chosen by god to run the world. Doesn’t make it true. [Prophecy](http://www.medicalnewstoday.com/medicalnews.php?newsid=26694) The reason I won’t fully concede that losing weight will lead to better health is because 1. Studies have shown weight loss may increase death risk 2. There have been no long term studies on the health benefits of long term weight loss since scientists can’t get large numbers of people to lose weight and keep it off for a longe nough time. 3. A fat person who loses weight ‘just’ makes their fat cells smaller. Their biochemisty remains the same. 4. Many of the health risks of obesity could be due to factors other than fat like ethnicity, income, diet, exercise, etc. Weight loss does not effect these. 5. The health benefits of excess weight could be lost if people lose weight. 6. Short term studies on weight loss are contradictory according to Campos and Gaesser (some show benefits, some dont). 7. The benefits of short term weight loss could be due to better diet and exercise, and not weight loss itself. 8. There are other interventions that are safer, more effective and less dangerous than weight loss we can try instead for cancer and diabetes. Convince me that I’m wrong. > [@Boo Boo Foo](#): > > Don’t be surprised when people dump on you for throwing up pissweak empirical evidence to prop up an inherently indefensible position. It IS the Straight Dope Message Board after all! I hope this was directed at me. God that is funny. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 30, 2005, 1:31am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/94 "2005-06-30T01:31:33Z")
> [@Girl From Mars](#): > > Relevant article in [The Times](http://www.timesonline.co.uk/article/0,,2087-1669568,00.html) today comparing the health benefits of overweight vs obese people losing weight: > > The paper, to be published in a science journal tomorrow, **stresses that the findings did not apply to the obese or to overweight people with related conditions such as diabetes.** > > For such groups the relative benefits of weight loss are likely to be far greater, especially if accompanied by taking more exercise. I find that funny since they excluded people with related conditions. How do they know its safe if they intentionally excluded these people? “The researchers cut out data from anyone suffering from diabetes or from other serious illnesses because these often cause weight loss.” So basically you have a study where you cut out people with diabetes, found those w/o comorbidities got sicker when they lost weight and said people who already have diabetes should still lose weight even though you already cut them out of the study? Granted, small amounts of weight loss improve diabetes. But that could be due (and probably is due) to better diet and exercise, not weight loss. People can still be obese and drastically cut their risk of diabetes with a healthier lifestyle. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [June 30, 2005, 2:53am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/95 "2005-06-30T02:53:21Z")
Wes, you are doing a good job of ignoring what you don’t seem to want to hear. Hard to find a study on weight loss that doesn’t also have people eating healthier foods and excercising more … since that is how you generally lose weight and keep it off … but it is there, sort of. I already cited it for you. That was the point of the bariatric surgery article, not to promote it cavelair use. Ten year follow-up, weight stayed off, benefits like recovery from diabetes and improvements of the lipid profile persisted. Now is this clean of exercise effects? No. In addition to eating less and losing weight those who lost weight started to exercise more. So _maybe_ it was an indirect effect. But weight loss alone resulted in changed biochemistry and an improved lifestyle. Weight loss alone is important. Exercise is important too. The kinds of foods are important too. Sure, do just two out of three and you have some significant benefit. Do all three and you are better off yet. And you keep equating the war on obesity as a public health issue with loathing the obese. This is specious. Yes there is a prejudice against fatness. And there was well before the health risk were identified. Twiggy syndrome predates Twiggy. Go back as far as you want in art and literature: obese was never an ideal body form that was strived for, Rubenesque, maybe, but not obese. The image of fat=lazy gluttonous, etc. is not a result of a recognition of the health risks. Smoking? No kids do not start to smoke to lose weight. Maybe some are afraid to stop becuase they are afraid to gain, but not because of health concerns. More are likely rationalizing why they won’t quit. Lots of excuses. Society’s prejudice against fatness is not the result of addressing obesity as a public health risk and it is no excuse for not addressing the public health risk, if done wisely. Your cites for hip fractures? The BMJ cite clearly shows an association with weight loss in the elderly and hip fractures. Hmmm. Was this weight loss the result of these elderly individuals suddenly dieting successfully? Or perhaps the result of declining health and ability to self-care? Somehow the former seems pretty unlikely. Still, I’d take this like I’d take the data on the obese. A flag. If an elderly individual is losing weight I want to look at them closely. Why are they losing? They may be at risk. Are they lean and active or frail? Likewise if someone is obese, what is going on in their lifestyle? Are there factors that can be changed successfully? There are no interventions for cancer, heart disease, and diabetes prevention more important than preventing and treating obesity with lifestyle changes and healthy diet that are not already being addressed as much as is reasonably possible already. You also have this bizzare idea that heart disease only starts in your fifties. Atherosclerosis begins to build in childhood. The vascular damage of DM begins with onset which increasingly is in the obese pediatric patient. It kills you later but the damage needed to be prevented young. It handicaps you sooner. I again agree that for the individual to focus on the scale rather than on the lifestyle is ill-advised (even though the data is that obesity is a risk even with a healthy diet and with exercise). Focus on the behaviors not the numbers. The numbers will frustrate you. There are several on this thread who have adopted regular exercise habits and healthy eating with persistent weight loss as a result ( **BooBoo** _I_ do triathlons!) but while we may have started our habits for health or for vanity or even both, we keep it up because we enjoy it and we like how we feel now, fitter and healthier than before. So yes, I’ve been exercising for eight or so years and I expect to be exercising in my seventies and eighties … and maybe beyond. But for society to ignore the importance of preventing obesity in the first place would be negligence. ---
**Author:** ![Boo\_Boo\_Foo](https://avatars.discourse-cdn.com/v4/letter/b/e274bd/32.png) [@Boo\_Boo\_Foo](https://boards.straightdope.com/u/Boo_Boo_Foo)\ **Post date:** [June 30, 2005, 3:04am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/96 "2005-06-30T03:04:17Z")
> [@Wesley Clark](#): > > Dob - Cancer victims who die are just as responsible for their fate as fat people. **Once you strip away the phony medical justifications we use to mask our hatred of fat all we are left with are attitudes based on blind prejudice hiding behind moralizing medical advice.** In a developed country you are supposed to be fair and evenhanded, let people live their own lives as they see fit and not judge based solely on physical characteristics. Our war on fat violates all three of these civilized norms we expect from people. Because we get to hide these prejudices against fat people behind junk science most people feel free to indulge in them. (bolding mine) Wesley Clark, where are you going with this thread? Seriously? What’s your goal? Nobody, absolutely nobody but YOU has used the words “hatred of fat” anywhere, at anytime in this thread. Not one single person in this thread (other than you) has indicated they have a probem whatsoever with obese people. Do you know how projection works? Imagine walking into a party full of happy people and you’re in a foul, rotten mood. Imagine throwing around your surly bad manners until people finally started saynig to you “What the fuck is your problem?” Imagine, at that moment, that you then asked incredulously, “Why are you all being so mean to me? Why are you treating me this way?” Well, that’s called projection. In such a situation, the guilty person is projecting their own issues onto other people until those issues start getting reflected back at them. And that’s what you’re doing here. This thread isn’t a debate. Granted, it’s cleverly masked as one, but it isn’t truly a debate. This thread is actually a long winded exercise in projecting your own issues onto other people who aren’t fat. Now, I mean this most sincerely, Wesley… best of luck with your efforts and goals - whatever they may be. But for the love of little baby Jesus - stop accusing everyone in the Western World of being guilty of being a fat bigot and hiding behind “junk science” to hide their “true” bigotry. That particular one trick pony is getting real old, real fast. ---
**Author:** ![alice\_in\_wonderland](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alice_in_wonderland/32/176_2.png) [@alice\_in\_wonderland](https://boards.straightdope.com/u/alice_in_wonderland)\ **Post date:** [June 30, 2005, 3:57am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/97 "2005-06-30T03:57:48Z")
> [@Wesley Clark](#): > > Alice misread the study which mentioned BMI by name and since that wasn’t enough I dug up other studies showing a lower BMI increased the risk of fractures and mortality among the elderly. No, I didn’t. You are misrepresenting the results of that study to suit your own needs. While having a very low BMI and losing a good deal of weight does increase the risk of a hip fracture, being obese or increasing the BMI to obese levels does NOT reduce it. That is flat out incorrect. Wrong, with a capital W. The fact that you’re pulling snipits out of that study, and fudging them to support your own eronious conclusions, frankly makes me question _EVERY_ conclusion you’ve reached in this thread. And in case you’re wondering why I know so much about bone density studies, it’s because I’ve been a participant in one as a control, and received an entire post-study brief. The research concludes that heavy boned women (who also tend to be heavier and larger) have a decreased risk of hip fractures. Thin boned women, be they fat or thin, have an increased risk. So there is no protective effect of increasing BMI for a small boned woman. None, whatsoever, and the fact that you keep acting as if the study you quoted says that their is, makes me question your reading comprehension, and your motives for quoting it at all. It’s almost as if you selected _EVERY_ study that indicated some positive effect to an elevated BMI, and quoted all of them, without bothering to parse them at all. Bad form. ---
**Author:** ![alice\_in\_wonderland](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alice_in_wonderland/32/176_2.png) [@alice\_in\_wonderland](https://boards.straightdope.com/u/alice_in_wonderland)\ **Post date:** [June 30, 2005, 4:00am UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/98 "2005-06-30T04:00:34Z")
Pardon me… “So there is no protective effect of increasing BMI (_to an obese level_)for a small boned woman.” A woman with a BMI of 16 or 17 could probably somewhat reduce her risk by increasing her BMI to _NORMAL_ levels (ie between 20 and 25). ---
**Author:** ![HWPMan](https://avatars.discourse-cdn.com/v4/letter/h/91b2a8/32.png) [@HWPMan](https://boards.straightdope.com/u/HWPMan)\ **Post date:** [July 1, 2005, 3:26pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/99 "2005-07-01T15:26:29Z")
Wesley Clark is losing the debate here and went to [Google Groups](http://tinyurl.com/b7aow) looking for help. 😃 ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 4, 2005, 10:41pm UTC](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817/100 "2005-07-04T22:41:45Z")
Well then. Moving along … For the interest of discussion, let me reframe the discussion. Given: obesity, lack of exercise, and poor nutritional choices are all unhealthy and have significant consequences to individuals and to society as a whole. As a public health concern we want to address all three. What are the most effective ways to do this? Should the focus be on obesity per se, or be on healthy lifestyles choices and downplaying obesity reduction as an end in and of itself? Since the usual means to address obesity are by promoting the other two factors, does the focus on the numbers add anything of value to the public health effort, or merely add to a sense of failure and frustration when weight loss is slow to achieve despite maintaining healthy lifestyle choices? What kind of interventions are justified by the public health costs associated with poor diet, poor exercise habits, and obesity? Warning labels on foods and sedentary entertainment devices aimed at children? Taxes on snack foods and electronic game systems? Tax credits for documented participation in exercise programs? Mandated nutritional content of packaged foods? Revision of our transportation system to force more walking? FARE (Food Abuse Resistance Education) programs in the schools? Or what? (One, IMHO, misplaced effort here in Illinois is to have us pediatricians chart and report BMI percentiles to kids and to the the school system. Never mind that the percentile scales were incorrect even when first published, classifying more than 50% of children as heavier than average, and more than 15% as above the 85%ile, even if accurate, the negative labelling of individual children as “overweight” or “obese” is not a useful tool in combating this triad of hypoactivity, poor nutrition, and obesity.) [Previous page](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817.md?page=4) [Next page](https://boards.straightdope.com/t/is-our-attitude-on-obesity-more-dangerous-than-obesity-itself/307817.md?page=6)