Our current attitudes against obesity are dangerous. I have had doctors refuse to treat a strained arm because I was fat, try to blame ear pain on my obesity, refuse to really look at why I was having stomach pain, and prescibe me diets that were simply idiotic. One was to treat stomach pain, no fat, no salt, no spices, no acidic foods or beverages, no hot foods or beverages, no caffiene, no sugar, no foods that have ever triggered my allergies, and I think some other restrictions that I have forgotten. She wanted me to adopt that diet permenantly. I did try it for two weeks to see if it helped the pain, it did not. I never did find out what caused the stomach pain, it went away after a few months.
I have a better doctor now. When I have an issue, he actually tries to find out the real cause, generally gets it right first time with out many tests, and resolves it. I first went to him for a strained arm. It was caused not by my obesity as my other doctor had said, but by a trip to NYC where more than once I had other people’s luggage fall on my arm while I was already carrying a load. It was not getting better because I was not resting the strained muscles and tendons. He gave me a wrist brace that isolated the strained muscles and it healed with a few weeks.
I generally am healthy, my blood pressure is good, I have lots of energy, I do try to eat a good balanced diet, with a decent amount of vegetables and generally favoring less processed to more processed foods. I don’t have to see my doctor often, mainly when I have bronchitis, which can probably be blamed more on my heavily smoking mother than on my obesity. I think it does no good to pretend that people like me are already in poor health. I feel fine, and there is every indication that I have a healthy heart.
My weight gains have been after I have attempted to diet. I do have the will power to follow a diet for quite some time, but eventually I begin to feel sick and miserable if the diet restricts calories enough to trigger weight loss. After I begin eating more normally my appetite returns with a vengence and then, I tend to gain back the weight and then some. I don’t normally have a problem maintaining my weight, and through a moderate increase in activity, I sometimes have been able to effect a small weight loss that sticks, but not often. I do think keeping active and eating right are good health goals.
I think losing weight is generally not. Too often it makes me feel unhealthy and ultimately results in a weight gain. I do think it is a very lucrative goal for the weight loss industry to push at people. I really wonder given the data if weight loss programs result in more ill health than obesity.
I have a hard time believing this, You said you have had doctors (plural) refuse to treat you because you were fat? Perhaps there was a misdiagnosis, but what makes you think there wouldn’t treat you because you were fat.
Well if you are extremely obese, then most people like you are in poor or poorer health than people of normal weight. Should we pretend this is not the case when it is?
All this leads me to believe you don’t have the will power to stick with a diet. There is not wrong with that, and you are not alone there. But let’s not pretend it’s the diet’s fault. You can’t curb your appetite for long periods of time.
Losing weight doesn’t cause you to gain weight. Diets don’t cause you to gain weight. Not following a diet is what causes weight gain. People need to stop thinking losing weight will be just as easy as gaining it was. It’s hard and will be a miserable experience for most people. Most people will have caffeine, and sugar withdrawal, and will have constant headaches. I can understand why people don’t want to go through that, but let’s not pretend it’s anybody’s fault but the person not sticking to their diet and exercising regularly.
When I was looking for a doctor, I was told on more than two occasions that a particular doctor would not accept new patients who were as obese as I was. IIRC I was about 220 lbs. at the time. They had a nurse or someone conduct a phone interview and made a point of asking height and weight. I was also turned away by one ENT because of my weight when I sought treatment for an ear infection.
Studies are not clear on that. If you do not define obesity as a disease itself, then many of those in poorer health than normal suddenly are not. Underweight people are also in poorer health, and die sooner than moderately obese people.
My doctor said that I am in good health. Period, not in good health for someone so fat. Why would you want to pretend otherwise? My cholesterol levels were good, my blood pressure was on the low side of normal. I have energy enough that the thought of me having more energy intimidatesKellyM.
I had the will power to diet myself to the point I was losing my health and had to be taken to an emergency room at a stupid doctors orders and only stopped when another doctor convinced me that I was doing more harm than good. I had the will power to follow to the letter the diet I needed to while pregnant and six weeks afterward. I was quite sucessful it that I gave birth to a ideal weight daughter and the blood test that measure long term showed that I had kept my blood sugar under tight control.
Actually, experience and experiments show that dieting to lose weight does seem to cause people to tend to expend less energy even years after the caloric restriction stops.Here
Everytime I have dieted to lose weight, my quality of life, energy, and general health have suffered. I feel best when I am maintaining my weight, whatever it is. I can follow a diet if I have a good reason to, for as long as needed, but dieting is a hassle that I don’t want if I can avoid it. I have made permanent changes to my diet to make it more healthful. I don’t really care that I am fat, but I am quite fed up with those who do.
As ultrafilter was so quick to point out when it was a personal vingette of spicy healthy eating and enjoyable excercise leading to persistent weight loss: “That’s great and all, but let’s stick to data here and leave the anecdotes out of it.” Seriously, there is no question that the very obese are as a group at greatly increased risk for death and of serious morbidities. If you as an individual have no particular problems related to your obesity, have no decreased quality of life, can climb stairs well, have no joint aches, etc etc, then I am glad for you. But as a population the risk is much higher. The merely obese are at some but less significant risk.
Underweight (BMI less than 18.5) is also associated with significant increased mortality but is a very very small segment of the American population.
I have never heard of any of my profession refusing to take a patient who was obese and such strikes me as unethical. Refusing to do surgery unless there was no other choice because of increased risks, yes. But not refusing to care for them. That’s a bizzare story.
I am not a fan of diets; I prefer altering the way we approach food and excercise and setting those as the goals. If you do those things you will likely lose weight too, but that is less of the goal than the lifestyle. Success is another day of eating right and excercising. Period.
I said previously that I thought that BMI of 25 to 29.9 should be thought of as normal, not as overweight. It is interesting to consider what happens to the numbers if you do that. Obese (30 to 34.9) now has 117,000 more deaths than the new baseline, extremely obese has 169,000 excess deaths, and mildly underweight (previously called “normal”) has an excess of 87,000 deaths but less morbidity from htn and DM. Funny thing, by acknowledging that BMIs of 25 to 29.9 are actually desirable and limiting the definition of overweight and obese to roughly the upper third of the US population, we suddenly are nearly back up to 300,000 deaths associated with being overweight and obese.
They may have been right all along and didn’t know why.
How are my numbers wrong exactly? I admitted 111.909 of the deaths were among those with a BMI of 30 or higher, and 73% of those deaths were among those with a BMI of 35 or higher. If you take all those with a BMI of 25-35, add them collectively, they have a lower mortality rating than those in the 18.5-25 BMI range, even though about nine out of ten overweight/obese people have a BMI of 25-35. That isn’t to say the study didn’t find mortality among the obese, just that for the vast majority of those in an ‘unhealthy’ weight range the risks are small and the health benefits may be bigger.
Even these risks (and most likely benefits) may not be statistically reliable
“Fourth even the 25,814 deaths per year from obesity needs to be taken not just with a grain of salt but with enough to keep Chicago’s streets ice-free for an entire winter. That’s because the results are in many cases not statistically significant, though the authors don’t mention this. For example, in the 25-59 year old group the confidence interval for increased risk for the obese with BMI’s up to 35 is 0.84-1.72, meaning that we can’t be confident that even for this group there is any increased risk of early death. The same is true for those with BMI’s up to 30. Moreover, the RR figure – the Relative Risk for dying from obesity - is, in the authors’ words, “in the range of 1-2.” This means that there is at the very best a very weak association – notice, not a causal connection – between obesity and death.”
As far as the higher disease rates, are the illnesses you listed strongly coorelated with the vast majority of overweight/obese people or just the extremes? Do they increase death rates? Is losing weight the best intervention to treat them? Even if this is true why would promoting weight loss be a good goal since people like Gaesser have found studies showing promoting weight loss/weight cycling increases the risks from hypertension, gallstones, cardiovascular disease & type II diabetes? Essentially the treatment for being too heavy may make the diseases you refer to much worse. And your statement that the reason the overweight are healthier is because their extra physician attention overcomes the dangers of obesity is speculation.
“If we were to employ the logic of the anti-fat warriors, does this mean that we should be encouraged to gain weight so as to protect ourselves from, among other things, cancer, osteoporosis and most of the major pulmonary diseases?”
I don’t know for sure where Campos got the studies that being overweight or obese protects people from pulmonary diseases (you can email him if you want to ask him Paul.Campos@colorado.edu), but as a lung doctor if that is true wouldn’t that, combined with the fact that obsessing over obesity may increase smoking rates and discourage people from quitting make it a bad idea to promote thinness, especially in your field?
I never said it was impossible to lose weight, just that for the majority of people its not a workable intervention and that it may be risky. If you have an infection chances are it will be fixed 99.9% of the time with few side effects by the physician, plus infections don’t offer health benefits. If you are heavy the chances of you losing a good amount of weight and keeping it off hover in the 3-15% range. Since most medical interventions are designed to be as safe and effective as possible, this sounds like the type of success range reserved for last ditch experimental treatments rather than a primary medical intervention. Not only that but this ignores the fact that being overweight in and of itself may have health benefits, that losing weight and regaining it (which happens to most people) can increase disease and death rates.
Busy day, so a brief reply and hopefully a fuller response tomorrow.
The numbers. They defined 18.5 to 24.9 as normal. So-called “overweight” BMI 25 tp 29.9 (which I believe is normal) had less mortality than “normal” by @ 89,000. Those with BMI’s over 30 had @117,00 more deaths than "normal. Together “overweight” and obese still had more deaths than "normal. The magnitutde of the increased death rate is merely lessened by lumping in the so-called “overweight” with the obese. Two thirds of Americans are not unhealthily fat; one third is dramatically so.
The morbidities do increase through the “overweight” and into the obese categories, but are most dramatic for the upper third that are obese. They do not increase death rates for the so-called “overweight” but do for the obese.
I may not be a pulmonologist but I am a pediatrician and know some of the studies. Obesity is not protective of pulmonary diseases. It is associated with decreased lung function and a higher incidence of asthma. The truely obese are prone to obstructive sleep apnea as well (Pickwickian syndrome).
The question of whether or not the underweight could change their risk by gaining has been asked and answered. it doesn’t help them. Apparently they are underweight for a reason that puts them at increased risk; it is not the underweight that puts them at risk.
Lasting weight loss helps the obese but more so excess weight is a screening tool for an unhealthy lifestyle. Agreed that the solution is not dieting but correcting the unhealthy lifestyle. Do that and the odds are that the weight will follow, but even if it does not you are going to be healthier and feel better. Diets are something you go on and then go off of. Diets are something you are likely to fail at.
The lifestyle associated with lasting weight loss is indeed doable by anyone. A healthy diet is not deprivation and is not going hungry. Eat all of what you should be eating and you are pretty full. Veggies, fruits, nuts, beans, fish several times a week, whole grain breads and cereals, lean protein sources (try out some bison, or venison, or ostrich, all available at many grocery stores now), using those plant stanol margarines (eg Benechol or Good Start), drinking some tomato or Pom juice. Just stop along the way for a few minutes and ask if you are really still hungry or just eating. Do not eat mindlessly. Snack on some unsalted nuts or high fiber cereal along the way. Spice it up. Have a glass of wine or a bottle of beer a day. Or even a shot of something instead. It raises your HDLs. Excercise is not torture that needs to be forced on you by a slavemaster. It can even be programmed into your day in little ways and have some benefit. Just start small and gradually do more. Have some fun at it.
But do not fool yourself. If your are obese it is likely because you overeat and eat crap and do not move enough.
I’ll agree that eating unhealthy and not exercising makes you fatter, but it does not make you fat per se. How fat or thin you are depends on genetics to set the framework, your lifestyle just lets you live and move around within that framework. I have a friend who when he eats healthy and exercises has a bodyfat of around 6%, and when he doesn’t exercise and stops eating healthy his bodyfat is around 14%. Mine on the other hand are around 24% and 35% respectively. Even among the mexican Pima, who have 23-26 hours a week of exercise and live off of a deprived, high fiber, low fat diet still have a 13% obesity rate which is close to Canada’s rate of 15%. So yeah, it’ll lower rates, but there is no guarantee it’ll lower them drastically for everyone. People will still be fat, just less so.
And encouraging people to go too far and too restrictive in regards to healthy eating and exercise could do more harm than good. Eating reasonably healthy is not hard, you just switch all your grains (bread, spaghetti, buns) for high fiber whole grain alternatives and you try to eat 3-5 servings a day of fruit & vegetables. If you encourage an overly restrictive ideal it may just drive people away and create an ‘all or nothing’ mentality where people try really hard for a few weeks then give up and do nothing.
And 1/3 of americans are not dangerously fat, 1/12 are. And again, the ties of death & weight (and maybe the health benefits & weight too) are statistically insignifigant according to the latest study. Even if there is a danger from weight and weight alone promoting weight loss is not a medically or morally acceptable answer to the problem. Even if you only promote it among the severely obese (BMI 35+) I still don’t know if I’d support it. You’d have to ask Campos where he got the info that individuals who are overweight & obese who have pulmonary diseases fare better than those in the 18.5-25 BMI range. I have no idea where he got the idea.
Another problem is similiar to the one you mentioned in your post, that obesity can be a side effect of unhealthy behavior. Poor diet and lack of exercise can encourage obesity, but so can other things. The poor are more likely to be heavy than the well off. Ethnic minorities are more likely to be heavy than whites. Sleep deprivation can cause lower ghrelin levels and higher leptin levels, chronic stress can cause weight gain too.
So it may not be the fat itself and never was that is dangerous, at the very least the fat is not totally causal and has ties to a variety of unhealthy behaviors. It could just be that those who are under alot of stress, who are sleep deprived, who eat bad diets, who don’t exercise, who are ethnic minorities and who are poor are just a little more likely to be fat than those who are not. If so, then encouraging people to lose weight for health reasons is like telling a smoker to dye his teeth white out of fear that his yellow teeth are causing his lung cancer.
Obesity is not genetic, per se. With a healthy diet and moderate excercise some of us will be thin and some will be that so-called “overweight” but very few would be obese. Few of our grandparents were as obese than we are. Our genetics haven’t changed dramatically over the past few decades but obesity rates have. Our lifestyles are what has changed.
These are significant numbers. Relative to “normal” the obese (the upper third) had 112,000 excess deaths with a 95% confidence interval of 53,754-170,064 (not the 26,000 that your cite claims, and given that they’ve gotten that imple but critical fact wrong I’ll take the rest of their analysis of the stats with some of that salt). Again, relative to what I’d call normal, the lowest mortality middle third, they are much higher than that. Your point is that the excess deaths are concentrated in those with BMI’s of over 35 is a bit true but consider the difference in mortality rates between the so-called “overweight” and the mildly obese: as I’ve pointed out before the mildly obese are still 117K excess deaths over the next lower grouping. That’s a big jump in mortality rates between so-called “overweight” and the bulk of the obese. A few pounds more matters a lot.
I have no idea where Campos got that idea either but it is not in the medical literature. A PubMed search only brings up multiple studies documenting the association of obesity and increased risks (although one study does question which causes which). If you want support for your cite,then you can e-mail him, I’ll just classify him as making stuff up.
As to the association of poverty and obesity … healthy food costs more, fast food is cheap. Excecise has become a luxury item. Many American minority groups were only pleasently plump if not outright lean and trim in the lands in which they were a majority until those lands became Westernized in their habits. Even today you see little obesity in Africa, but American Blacks are tipping the scales on the high end.
You’ve gotten some numbers from some places that are misrepresenting them, and you are confusing “weight loss” with “dieting” and dieting alone. Dieting alone doesn’t workfor persistent weight loss. Recognizing that obesity (not “overweight”) is a marker for significantly increased risks, and making lifestyle changes in reaction does work. It may not be easy to do that, developing new habits rarely is, but is not that hard, and it has proven benefits. It sickens me that the gluttony industry is misrepresenting these recent findings so horrifically in a pathetic attempt to convince people that their supersized triple cheeseburger (yeah I’ll take fries with that) really isn’t so bad. It’s just fine to be fat. No worries mate. Sorry. Worries. The most recent study merely showed that the arbitrary definition of normal was sloppy thinking and that healthy may be with a little bit of a love handle. It did not significantly change the degree of risk for those with BMI’s over 30.
BTW, my favorite BMI calculator is on-line. It is a crude measure at best, but better measures are just not practical for most of us.
Within reason I will agree with you. With a healthy diet and exercise obesity rates will be cut, but there is no guarantee.
Your arugment seems to be that healthy eating and lack of exercise are unhealthy, and obesity is a sign of a lack of these. I don’t totally agree. The HAES study I listed above showed that individuals lost no weight but managed to quadruple their exercise rates and improve their health ratings on several fronts. A famous study showing 58% lower rates of diabetes among those put on a diet & exercise program only showed a 5-7% weight loss over 3 years. My understanding is they went from an average BMI of 34 to an average BMI of 33. They were still obese but their health profiles increased dramatically in regards to diabetes (and probalby in regards to cancer, hypertension & cardiovascular disease as well since a low fat, high exercise, high fiber (assuming they ate a high fiber diet) cut risks of these too). Steven Blair has run studies showing that activity levels and found this
“You’re worse off, I suppose, if you’re obese and sedentary. What’s one of the striking things about our research is that the death rates in individuals who are obese but also fit - as determined by an exercise test on a treadmill - the ‘obese fit’ individuals have a death rate that is about one half that of the lean individuals who are unfit. It’s the lack of fitness that’s really a much stronger predictor than obesity.”
If you saw some of them (ie those from Blair’s study or the diabetes study) and judged based on looks you’d probably assume they were unhealthy and a person with 18% bodyfat who you didn’t know ate doritos all day and never exercised was healthier. A proper way to test someone’s health is to run tests on them. Various blood tests for cholesterol, glucose, blood pressure, etc. A fitness test would also help. You can’t just look at people and assume how healthy they are. Hell something as simple as walking 30 minutes a day 4-5 days a week is probably enough to get major health benefits, and that is not going to lead to any weight loss. Besides there are a million other healthy things a person can do that are unrelated to weight. They can quit smoking, get screened properly for cancer and cardiovascular disease, engage in preventitive medicine for major diseases, have access to competent medical care, etc.
Your argument about blacks and Africa is no different than mine above about how only those who have their free will taken away are able to get and stay thin in statistically signifigant numbers. When blacks had no choice in the matter they were thin, the second they were given a choice to become fat they became fat. Eating high fat/high sugar food and being sedentary are evolutionary beneficial, those who eat alot of calories and don’t expend many are more likely to survive a famine than those who eat low calorie foods and exercise alot. Promoting an extremely healthy diet across the board is like promoting abstinence across the board and getting mad when people don’t do it. You can’t turn back billions of years of evolution in the name of a social fad that only started a hundred years ago. Its possible, sure but unlikely. You might as well get mad because we have social security or consumer protection agencies because people are too lazy to save for their own retirement or research their purchases ahead of time. Interventions that work with human nature will work better than those that try to fight it. The level of healthy lifestyle to go back to 3rd world lifestlyes may be unnecessary and excessive for promoting health. Even if it did improve lifespan by 1-2 years (over a more moderate approach to exercise and diet) why would 50-60 years of that kind of life be worth an extra year or two of life? You can improve your lifespan by a year or two by making friends, by having access to better medical care, by taking nutritional or pharmaceutical supplements, etc. Given the choice I’d rather eat a moderately healthy diet, exercise moderately for a couple of hours a week and make some friends to live to 86 than eat an overly restrictive diet while exercising 5-10 hours a week for the rest of my life to live to 86.
The 26,000 figure is after subtracting the lives saved from being overweight from the lives lost from obesity since the study was designed to check the mortality due to high and low weight, not just due to a BMI of 30 or higher. They didn’t get anything wrong, you misunderstood the statistics and how they got them (111,909 - 86,095 = 25,814). However if you want to only talk about the obese then that is fine. The reality still is that those in the BMI 35+ range have a 1600% higher mortality rating than those in the 30-35 range. So focusing on the 30-35 may make for legimizing the war on obesity, but they are not at signifigant health risk. And even if they are/were, the level of healthy activity necessary to improve their health may not lead to any weight loss.
Why are you so mad about someone eating a cheeseburger? Do you know of any legitimiate critics of the war on obesity who support unhealthy diet and lack of exercise? Do you think one cheeseburger will change much in regards to bodyweight? Since most diseases associated with obesity do not occur until the 50s at the earliest why would teenagers or 20 soemthings eating cheeseburgers anger you? Do you think those people wouldn’t eat a cheeseburger before that study was published? Do you think everyone who eats a cheeseburger will become one of the most obese 8% of americans who could be under signifigant health risk from weight (and we are the fattest nation on earth, for other developed countries those with a BMI of 35+ are probably only 3-5% of the population). Do you get mad when people don’t wash their hands? Not washing hands is a major health risk too. What if they don’t get properly screened for cancer, does that anger you? What if they smoke? What if they drink excessively? What if they don’t walk around the block 2 hours a week? What if they don’t have friend (having friends is tied into having better health)? What if they don’t have health insurance? What if they aren’t religious? All of these things are tied into health.
I’ll email Gaesser about the osteoperosis/lung disease situation. It was originally him who found the data.
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. And that the level of eating & exercise you are talking about (3rd world levels) may not offer many/any health benefits over more moderate approaches. And that such an intense level of dedication may not be worth the benefits anyway. Spending decades with that level of dedication to live an extra year or two probably isn’t worth it IMO since there are several ways to improve health and lifespan that are just as effective.
Wes, we are starting to talk at cross purposes here. First off, what your cite claimed was that “the number of deaths due to obesity in the US is closer to 26,000 not 400,000 as previously reported” … obesity, not overweight and obesity. Obesity is only those 30 and over. Ah well, a little hyperbole I guess. The point is that they are spinning it so that the health of those with BMI’s under 30 offset the unhealth of the obese by lumping them together. Instead it should be noted how much different it is to be 30 and above compared to a few pounds lighter and under 30.
Why am I so angry about the way this is being spun? Well “The Center for Consumer Freedom” is a coalition of resturants whose interest is not freedom but in selling triple cheeseburgers. Their spin is to say that obesity isn’t dangerous because another group that isn’t obese but just the so-called overweight has so litttle mortlity. I should have problem with that misrepresentation?
Their interest is not this nation’s health. It is not in promoting less crappy eating and more excercise. They don’t care if people die or live as long as they can sell their products in large amounts without regulation. They are selling the idea of don’t worry, be happy, eat it all up and order another, it’s not really bad for you at all.
I am a pediatrician. We are seeing a manyfold increase in the rates of pediatric type 2 diabetes and hypertension, much of it associated with obesity. Meanwhile contributors to “The Center for Consumer Freedom” advertise crap to these kids nonstop. Supersized. These are not problems restricted to the 50’s and beyond and it is not “a cheeseburger”; it is a poisonous lifestyle.
And damn straight that a campaign telling people that it is okay to smoke, or that drinking to excess is just fine, that seatbelts are overrated, and so on, would piss me off too. The state of health coverage and of access to care in this country really gets me going.
Your cite actually supports my POV. Obese individuals were identified, their lifestyles were addressed and improved upon, they lost 5 to 7% of their body weight, and dramatic health changes resulted. Bingo! That’s the way to do it.
No doubt a fit obese individual is healthier than a Doritos stuffing couch potatoe who for some reason is thin. But face it, fewer obese individuals are fit and more thin ones are. No cite available but take a hundred random obese individuals and a hundred from the middle quartile, and on average the latter will be much fitter. Documented they’ll have less of an incidence of htn, DM, dylipidemias, and asthma. The obese get winded more easily on average. Once obese an individual is less likely to excercise.
As a doctor I should and do promote a healthy lifesyle to all my patients, but it would be foolish of me not to recognize that the obese are at greater risk and in more need of developing and maintaining that healthy lifestyle than the thinner.
You misunderstand the point about Black Americans: it is not ethnicity; it is lifestyle that matters.
The main thing is your last point: that a healthy lifestyle is so hard. It isn’t. Or if it is, it is only because our society has made being sedentary and eating crap too easy of a default option.
I’m aware the center for consumer freedom and tech central station are libertarian orgs that probably get funding from restaurant industries. However according to Paul Ernsberger, Paul Campos, Laura Fraser, etc. most of the studies which show obesity to be dangerous are funded by pharmaceutical or diet companies. So both sides are biased, I’ll admit that.
‘Obesity’ is a word that is used to describe the issue of excess weight as well as those with a BMI above 30, when people say ‘the obesity epidemic’ they usually refer to the doubling of the overweight category as well. I have also heard of the phrase ‘65% of americans are overweight’, which is true but half of them are also obese. These terms are not set in granite.
Again, I have never met a legitimate critic of the war on obesity who discouraged healthy eating or exercise. They just discouraged weight loss as a medical intervention and discouraged the idea that healthy eating and exercise will lead to massive weight loss partially out of fear that when people don’t lose weight they will stop doing them, and partially out of fear that peolpe will become too restrictive and controlling and lose nothing while developing an all or nothing mentality on the issue.
The point with the 5-7% weight loss was that even with a healthier life people are/were still fat. There is no guarantee that living healthier will result in massive weight loss. If people focus on massive weight loss they may do things they can’t maintain over the long run or take dangerous shortcuts.
Regular exercise and a high fiber diet will do alot to reverse and prevent type II diabetes, as well as potentially lead to some weight loss. I’m not disagreeing. I am saying however that our obsession on thinness increases smoking, discourages exercise, discourages healthy/competent doctor & patient relationships and discourages healthy eating, all of which cause diabetes.
The levels of physical activity necessary for health are not extreme, walking 2 hours a week is probably enough and that will not lead to major problems. When I started exercising I weighed 302 and had a BMI of 41 but I had no problems after a couple of workouts with cardiovascular or lung capacity. Even when I was among the heaviest 3-4% of the population I had no trouble getting fit, no being bent over heaving and running to my car to shove twinkies in my mouth or anything like that. If the obese are less likely to exercise it can be argued this is due in part to our idea that exercise = thinness. Plus I have heard fat people say they don’t want to go to a gym for fear peolpe will stare at them for being fat. So again, our obsession with thinness discourages exercise, just like it did in the HAES study I listed in my OP showing those who were taught to idealize thinness had baseline exercise levels and those who were taught to tolerate their bodies and focus on the physical & mental benefits of exercise quadrupled their exercise levels.
And again, none of this addresses the central idea of my thread, that our intolerance towards obesity and fat causes endless physical and psychological problems that negate the benefits of our obsession over the subject. While I can agree that 3rd world levels of activity and eating will dramatically reduce obesity and overweight rates, I don’t agree that they are necessary or a good idea.
The terms actually are set in granite; they are just misused by various players to manipulate the debate. Over 25 is overweight. Over 30 is obese.
“The war on obesity” is essentially promoting healthy eating and exercise. True, some go about it in ineffective ways (focusing on the scale alone and on diets rather than on lifestyles) but that is not the party line. The problem is the tactics they use.
Is the benefit of exercise due to increased leanness or the exercise? It’s both.Really.
Is it especially bad to be a low fitness obese individual? Yes and half of all obese men have low fitness.
I’ll try to check the facts on your link to techcentral, but color me skeptical. I suspect some cherry picking of studies. Something has been changing that our society has been steadily getting heavier over the past several decades. Personal observatiion tells me that kids have less active physical play now then they did 20 and 30 years ago. You do not have to be an epidemiologic genius to observe that obesity rates have skyrocketed as China and other nations has become more Westernized in their food habits.
A point of agreement. Intolerance to the fat is intolerable. Promotion of healthy lifestyles is not likely to succeed by coercive means. The reality is, however, that people get motivated by numbers. We like to measure success. Lifestyle changes are hard to quantify. So even if the numbers are crap we tend to stick with them until we have better numbers to use.
Increased sedentary behaviors with increased risks for obesity and morbidities even with similar time spent exercising.
I imagine time on the net counts the same. Sigh.
It goes on. Study after study shows that leisure time designated as exercise has indeed been stable or perhaps marginally increased, but that we are more sluglike the rest of the time. Sitting at our desks, typing at our monitors, and watching TV. Moreover, when we do those things we tend to snack on poor dietary choices. The result is a net decline of activity whilst increasing the amount of empty calories in.
As far as dietary changes, beyond the increased amounts documented in the first cite- We eat more fast food now and its increased consumption is strongly correlated with weight gain.
It is certainly lifestyle, not ethnicity, that causes the obesity since immigrant groups begin to take on American obesity rates more with increased duration of residence.
I think with regards to your original question “Is our attitude on obesity more dangerous than obesity itself”, I think the attitude is not more dangerous.
In world one, there will be some people who attempt to control their weight in dangerous ways that may be more unhealty. But there will be many more people who control their weight sensibly because of society’s attitude.
In world two, I think many more people would be overweight. I know I would.
The hypothetical women you describe in world two who bases her worth on her waistline would probably have self-esteem issues regardless of which world she lives in. If it’s not her waist she’s worried about, it’s her clothes. If it’s not her clothes, then it’s her car. If it’s not her car, then it’s something else.
However, I do think it would be better if society better understood how hard it is to lose weight. I think it would be better if society understood how sometimes it can be very hard to control how much you eat. Would you blame an addict for continuing to use if he was surrounded by his drug of choice?
I don’t think that society should think of obesity like balding or bad teeth. Obesity is controllable (even if it is hard to do), and society’s negative attitude towards it prevents some people from going down that path.
[Warning!] This is long. A large portion of it is personal experience, which I use to illustrate the prejudice overweight people endure. Please, bear with me.[/ Warning]
I will start, by openly stating that I am obese, that is, I have a BMI over 35.
It is not, and will not be, my “dirty little secret.” Not only is it usless to attempt, since I do not have the ability to become invisible, but destructive, in that it labels me as bad, lazy, unmotivated, stupid, or various other unflattering, or negative adjectives.
I was not always overweight, in fact I was “too thin” through childhood through mid-life. I have always physically active.
At about age 27, I weighted 130 pounds. I am 5’4" tall.
The man I was dating would tell me “If you weight 100 lbs, I would love you more.” Being young, I believed him, and began a rigorous exercise program along with a low carb diet. In a few months I’d lost 30 lbs. The day I stepped onto the scale at exactly 100 lbs, he announces he had been seeing someone else for months and had decided to marry her.
All for the best, except when I looked at myself in the mirror through my own eyes, rather than his, I saw the coat rack I had created of my body. Why? Because I believed someone else’s preception of beauty. I was healthy before, during and after my weight loss.
Over the next 10 years I gained the 30 lbs back. I continued to exercise, but because of changes in my life, I had less time to do so.
By 33 I weighed 160 lbs, and felt desperate to get it off. Not because I felt bad, not because I had lost energy. I still swam 3 miles every day, but because I wasn’t “pretty.”
The hospital where I worked started an Optifast® Program. I decided to try it. I was interviewed and accepted into the program. They required a complete physicial prior to the start of the diet. I was completely healthy. During the assessment, they set my ideal goal at 105 lbs. The program included group therapy with a psychologist. We were told that most people gain weight because they have unresolved emotional issues, so each week we were asked to re-invent our lives. We were told that this three months of soul searching would free us from the demons of our collective past. We would never have to over eat again, because we were removing the real reasons we eat to excess. Not true.
In 3 months I’d lost 55 lbs. I was a size 3 pants and a size 8 top.
During the program, I had added weight training to my swimming. I continued at that exercise level for 2 years, eating a relatively healthy diet, with only occasional lapses. Gaining about twelve pounds of muscle.
It was harder, being a travel nurse, to find time and places to follow my program. I traveled for 3 years, gaining a few pounds each year.
Age 35, I’m back at Optifast®. Same routine, different city. Still very healthy. After 3 months, I was again on track.
Both times the health benefits were the main focus of the program, but I had no health problems.
Still swimming, I again added weight training to my exercise routine. At age 45, I was strong, with tons of energy, but my trainer kept warning me that the 140 lbs was too much. He wanted me to start competing in body building but my weight prevented him from entering me in an event, he said.
Then I got hurt. For several weeks I was not allowed to weight train. When I was once again able, I’d lost motivation. I was having increasing symptoms of menopause. My family phenotype is weight gain at menopause.
I started having pain in my hands and feet. Then my back started to hurt. Diagnosed with Fibromyalgia, I was told to discontinue exercising (!?) because it would make it worse.
The pain got worse anyway. I was referred to another doctor. No, I didn’t have Fibromyalgia. He gave me cortisone shots in both feet and all of my fingers. It helped, but explained nothing.
Referred to a neurologist. My first encounter with a “Fat Bigot.” His first reaction was a look of distaste. Without examining me, he said he knew what my problem was. I was depressed. I should lose weight, and I’d be fine.
I then told him I was a critical care RN and would like a little more thorough examine, and an explaintion as to why he thought I was depressed.
He said I couldn’t possibly understand, his explaination, would be too technical for someone like me. I asked what he meant by that. No answer. He was done, left the room.
After that I stopped consulting doctors. They all had focused on my weight, even in the face of objective findings that I was completely healthy, except for the pain.
Then my son died. I then, was depressed, and my weight skyrocketed.
And now here I am, morbidly obese.
I recently decided to once again seek medical help.
I went to my assigned doctor, and asked about a lap band procedure. She was in full agreement. She ordered the necessary labs, and told me the GI clinic would notify me when they scheduled.
A week later I got a letter from the GI clinic saying, based on my labs and vital signs I would not qualify for any weight loss surgical procedure. Why? I’m too healthy.
My weight alone is not enough. Because I am otherwise healthy.
I agree that healthy eating and excercise are important, but other health issues shouldn’t be obscured by assigning all health issues to obesity. As my own history shows, obesity is not always or even usually the reason for other health problems.
The current recommendations for decreasing risk of cardiovascular events is the loss rate of 2 pounds per month. At that rate, I will be within the normal weight range for my age and height in a little over 6 years.
Many cardiovascular/obesity studies show that a weight loss of as little as 10% of one’s excess weight is enough to improve life expectancy.
Your simplistic weight loss recomendation would be laughable were it not such a blatant example of fat bigotry.
You are absolutely right, if one expends more calories than one takes in, weight loss will be the result. However, genetics, muscle mass, and menopause, even stress levels play a part in metabolism.
Generally, obese people have less muscle mass, so their metabolism is slower than normal. So, just cut more calories, right? But add in menopause, and a fat mom and dad, the number of calories to maintain one’s weight is pretty low.
Unfortunately, we are still governed by our distant past, that protects us from famine.When intake drops below about 1000 calories per day, our bodies go to starvation metabolism where as intake drops, metabolism slows, becoming a self-fulfilling prophesy.
Also, food is woven into our lives and psyches. Our mothers rewarded us with it. We socialize with it. We are bombarded with ads for empty calories. Unlike other unhealthy habits, we can’t just turn it out of our lives.
Using will power alone to diet is just another way to fail. There is a reason Jenny Craig sells lifetime memberships. Diets fail, because we, the obese are not stupid, but neurotic, often obsessed with food. ** That does not make us bad, lazy or any of your other bigoted adjectives.** It does make weight loss difficult and complicated.
Addiction is most often familial, and may have a genetic basis, so the assertion that treatment has not caused the number of abusers to decrease is not a valid argument. Although, I’m unable to find statisical data one it at the moment I believe the number of practicing alcoholics has decreased since treatment programs came into existence. Do you have a cite, to the contrary?
Maybe you, or one of the other fat bigots, could answer a question that has puzzled me for a while. What is it about us, the obese, that you take so personally? Why do you feel such disdain, even anger? Do we take up too much of your space? Are we breathing too much of your air? Or is it simple fear that the same thing could happen to you?
I am not a threat to you. We deserve to be treated with respect, maybe even a bit of compassion. Fat does not kill brain cells, so why don’t assume we are stupid or uneducated.