Food is indeed one of the pleasures of life. I still don’t see how fresh, healthy food seems more insidiously evil to you than say globally manufactured gluttony from the drive-thru window.
And I think ‘efficiency’ is part of this problem. It’s more ‘efficient’ to not think too much about what you’re actually eating by just buying something you don’t even have to get out of the car for.
If they have indeed tried for years, then there is something lacking in the process.
I’m not sure of the superior attitude you’ve experienced; I think that a life that seems basically controlled by food almost every waking moment and often to the detriment of other pleasures seems curious to a lot of people.
I don’t know which ‘physical fitness type’ you mean - there are people who are very sports minded and physically active whose diet still leads them to diabetes, or heart disease, or liver and kidney problems.
I think that positive change in diet actually works for most people; I’m surprised that you really believe that it doesn’t work for the majority.
Well, no, not true. There are many, many different causes for obesity, and undoubtedly more yet to be discovered. Gentic predispositions, the interplay of hormones, especially estrogen, testosterone, cortisol, T3 and T4, and insulin, viruses, intestinal bacteria and fungi, insulin receptors and their sensitivity, number and health of mitochondria, etc, etc, all play as much of a role as what you eat, how much you eat, what kind of exercise you do, and at what intensity. Sometimes several of these factors have a synergistic effect. This is why obesity is so damn hard to treat.
Since this drug works on the pleasure centers, it might be useful for people whose major problem is addictive behavior. But it doesn’t address metabolic concerns, so I wouldn’t take it.
There are people who do eat fresh, healthy food, not stuff from the drive through window, in moderate quantities, and who do exercise and move around, who are still obese. Yes, some folks are obese because they overeat the wrong foods and sit all day. But not everyone.
I am type 2 diabetic, it started way back when I was skinny and an athlete with a case of gestational diabetes that simply stayed. For 30+ fucking years I behave myself. I watch what I eat with anal suspicion. I avoid fast foods, candy, anything not approved by my various nutritionists as assigned by an endo. Up until my body crapped out I exercised assiduously. At one point back in 1990, something crapped out in my body and I gained 150 pounds over 3 years while exercising and eating the diet prescribed to me by my nutritionist. I took my meds as prescribed by my endocrinologist.
I would fucking love to be able to wander into a restaurant, grocery store, friends kitchen and pop open the fridge and rummage for a snack. I would love to be able to run into the convenience store when I get fuel for the car and grab a candy bar, or hit the drive through at Dunkin Donuts or Timmy Hortons and get a double double and a maple glazed. I would FUCKING LOVE to just once be able to run through a grocery store and buy whatever I wanted to make for dinner and get the makings for a honking HUGE batch of chocolate chip cookies.
I am genetically wired to want to get fat and pop babies out every 2 years like the energizer bunny on IVF drugs. I am wired to start pigging out in the late summer to get fat and happy to survive winter. And I am definitely wired to want to chow down on a huge plate of waffles just swimming in butter and maple syrup, with half a pigs-worth of bacon and sausage, and 4 or 5 eggs over easy with toast soldiers to soak up the yolks.
Do I do this? [well OK I did have a hysterectomy so popping the kids out is problematic] No. You know how fast I would die if I tried? Do you know how much I have lost over the past 20 years of keeping to the exercise and nutritional requirements? None. I gained 150 pounds. At best I am keeping it at bay [and it still creeps on a pound here and a pound there.] I can’t exercise - from the waist down my body has pretty much fallen apart. The only real exercise I can manage is whatever I can do in water. And I have no access to water other than a hot tub. We have 1 working person, and 1 vehicle running. I can’t run mrAru to work and just randomly go somewhere, he works 60 miles away each direction. On a single full time job we can not afford to either buy a second car or for me to add 120 miles a day to the one car we have. Perhaps after we recoup the money spend in his 6 months out of work we can tentatively add 1 day a week for a total of 18 days [all the sessions of PT that tri-care will pay for. it is $80 per session copay] in a years timeframe.
Would I pop a pill to lose weight? If I could guarantee that it will not affect me adversely and combine well with all my other medications, yes. Do I see it as evil, or somehow against the damned puritan ethic that cripples the US? No. There is no benefit to suffering, or having to struggle for anything, that is antiquated religious twaddle that should be stomped out with extreme prejudice. The only consideration about better living though modern chemistry should not be based on whether or not YOU [generic you not specific you] think it is somehow ‘dirty’ or ‘lazy’ or anything other than if the chemical is safe for human consumption [or the side effects are deemed within reason for the physical results] or not.
If it were safe, hell yeah I’d try it. I’d be happy with a 10% weight loss. As aruvqan says, pointless suffering is pointless.
As far as the argument that healthy food tastes bad, or that you can simply retrain your taste buds, both are misleading. Habits form when your nerual circuitry runs the same path over and over. You can form new habits (new pathways), but you can’t undo old ones. They are always going to be there.
So yeah, when I’m eating lots of fruits and vegetables, I crave fruits and vegetables. When I’m eating junk food, I crave junk. Both exist at the same time as potential pathways in my brain, and therefore both can be equally as reinforcing.
ETA: In fact, I would argue that the bad food cravings will be more reinforcing and more of a habit for at least 30 years of eating healthy food, because my brain has spent way more time traversing those unhealthy neural pathways than it has enjoying vegetables.
Also, arguing that people can easily lose weight with diet and exercise is stupid. It’s like saying people can easily quit smoking by smoking fewer cigarettes. No shit?
That is simply not true. I went for 18 months with a personal trainer, exercising at least 5 days a week and following the diet plan he gave me. I was motivated to lose weight. I worked hard at it and did get in better shape - but over the entire course I only lost about 50lbs.
There are medical issues that make it extremely difficult for some people to lose weight. Not every obese person you see sits on the couch all day eating fried chicken and Twinkies. There are some people who do, of course, but such a blanket statement is false.
I don’t think you, or anyone in your position is ‘dirty’ or ‘lazy’ aruvqan; I think what has happened for you is really unfortunate and I hear your incredible frustration.
Thank you for giving me another perspective on the complex range of issues that lead to obesity.
I’m just not one who goes for the whole ‘just pop-a-pill’ thing, but I concede that if it works for others then really, what is the point of objecting?
If it is safe and effective, the pill will no doubt be very helpful to many individuals.
But it will not address the obesity epidemic, because the obesity is not a biological problem. The whole world didn’t suddenly develop weird reward circuits or screwed up metabolism. China isn’t just now getting childhood obesity because they had some crazy genetic shift. What has changed is our relationship with food, and that is a public health problem, no a problem of individual biology.
The US has fat cities and skinny cities (even corrected for ethnicity, gender, etc.) There are parts of the US where nearly everyone is overweight, and other places where it is still rare to see much obesity. If we are really interested in promoting health, we should be figuring out what those differences are (and I’ve got my opinions on that ahem transportation). This is especially true now that the link between childhood and adult obesity is so well understood. Wouldn’t it be better to look at places with low rates of childhood obesity, figure out what they are doing that is different, and promote those practices? Isn’t that better than pre-disposing our kids to obesity and then giving them a pill to buy?
I totally agree even sven; and if there is another way, for those convinced that medication is the only answer I guess they should be given the option.
Yup, I love sitting in front of a doctor who refuses to do anything except to tell me to stop sitting on the sofa watching soaps and popping bonbons all day when I go in and try to see what is wrong. mrAru was with me, and he went to the patient ombudsman at the base hospital and danced o his desk for a while and I got a very grudging and backhanded apology from the fuckwad. As a diabetic of 30+ years who has absolutely no retinopathy and no neurological damage, I am anal about my diet and meds.
I don’t necessarily disagree with the conclusion you make even sven, that it is a public health problem and the best solution is a systems approach, but it in the context of the simple conclusions others make, some other things must be pointed out:
People did not suddenly become gluttons or develop less self-discipline either. What has changed is not so much “our relationship with food” but the foods themselves. The concept is that much of the food of the modern world functions as “a supernormal stimulus” triggering reward centers that have evolved for a different environment with maladaptive behaviors resulting in many cases.
Those foods actually do result in “weird” reward centers and obesity itself results in screwed up metabolism. These foods cause inflammation and alterations in the brain’s reward centers which precedes the weight gain; there is some evidence that this process begins even with prenatal exposure, priming individuals fetally to be further predisposed to obesity if placed within an obesiogenic environment.
To Beastly:
What do you actually hope to accomplish by using the charged “gluttony” verbiage? Other than insulting people?
Satiety, reward, and palatability are related concepts. Some have a delay in getting the satiety message to the brain, some have weaker satiety messaging, and some have greater reward signaling, for a variety of reasons. We each respond to different environments in different ways and the process is much more interesting than a reduction to “Obesity = gluttony.” SnakeCatLady, even if that is not a typo and it was less, I must once again point out that if improved health outcomes is your goal then 5 to 10% weight loss achieved and maintained by improved nutrition and regular exercise achieves most of the improved health outcomes, even if that loss leaves you still wanting more for the purposes of vanity and shutting the rude folks up. Even if you were over 300 pounds that means less than 30 would do it. What you presented was a success story even if the weight loss was less than you described.
Here’s the thing though. Let’s say the answer is ultimately something like transportation. Let’s say we did some very good data analysis and found that in “skinny cities” people walked an average of 3.5 miles/day and in “fat cities” people walked an average of 0.25 miles a day. This difference did not come down to “skinny city” residents making a concerted effort to walk more, but rather naturally they ended up walking more just to get go about their daily business and get from point A to point B. Our options are now
Drastically alter “fat city” landscapes so that distances from point A to point B are walkable but not really driveable, make bike lanes and sidewalks, and put policies in place to discourage driving
Tell all overweight people they need to just walk more, either on trails, sidewalks or treadmills (at some level, we are already doing this and people already know this and they are just too tired, depressed, or perhaps poor, etc to go out and do it)
Use a drug/surgery which will get people to eat less and circumvent the whole thing (yes, it will/they do have side effects. Obesity arguably has worse side effects.) People can and probably will “work around it,” like has been discussed before. But it will work for some people.
I think this type of analysis could be applied to any ultimate cause that might be found to be driving the BMI in “fat cities.” Let’s say the problem turns out to be food deserts and not enough access to healthy foods for people in fat cities. Again, the same options present themselves.
I am totally baffled by people who are against taking medications for this. So many things that we take medications for could also be handled by making lifestyle changes that we simply find too onerous. Do you take claritin? Just don’t expose your self to allergens! Etc.
I would also like to add that I personally do think that weight is simply a matter of calories in vs. calories out. The thing is, altering either of those things is really, really hard for most people over a long term basis. Those who can do and have done it, and I mean this sincerely, congratulations. You have jumped a psychological hurdle that many (if not most) people struggle with all their lives. But the fact of the matter is, many people try and for whatever reason cannot break down the barriers that cause them to eat too much and not exercise enough. If we could afford intensive psychological therapy and nutritional therapy for all these people it would be great. But at this time, that is not realistic either.
Controlling the environment is reasonable ways is the first line for allergy control: keep the windows shut and the AC on; keep the pets out of the bedroom at all times; so on. And for many that is not enough and then medication is a godsend. But it will only do so much good for someone who is allergic to cats and won’t give their cat away. Medication for obesity may be like that. If it is used as a substitute for altering or having nutrition and exercise plans then it will not work too well. (And if the nutrition and exercise plan is followed the health benefits will like be there even if obesity persists.)
Also if a city found that a majority of its citizens were allergic to the elm trees they were planting, I’d think it would make long term sense to start picking different trees to plant in the future. Such would not be a quick fix but longer term it would be more effective than developing better allergy meds and having individuals get better at keeping their windows shut and AC on. Not a substitute for though.
We implement common-sense solutions that will gradually transform our communities into places where it is easy to do the healthy thing. Whenever anyone builds something new, they have to account for all kinds of things, including how their development is going to affect traffic and parking. Why shouldn’t new development also account for how it affects the walking population? When you lay down a road, it stays there forever, so why should we decide to lay down roads that can never be adapted for public transit, rather than taking a few simple steps to ensure that one day in the future it’s a possibility?
For example, the very nice new supermarket near my hometown is separated from the sidewalk by a small but impassible ditch. Cars reach the parking lot through a scenic windy little access road. But it’s a good half-mile of road with no sidewalk. Why should they be allowed to do that? They wouldn’t be able to decide to up and build a supermarket with no parking, so why can they build one with no reasonable sidewalk access? How hard would it be for them to build a small pedestrian bridge over the literally four foot wide ditch?
I live in California, and I’ve seen a lot of brand new suburbs go up. The trend has been to surround the suburb with a greenbelt, and then build parks, schools, and shopping areas (all of which developers are required to account for) outside of the greenbelt along the main access road. This makes it impossible for kids to walk to school, or for people to take a quick walk to the store. How hard would it be to build this critical infrastructure towards the center of the development, where it would be accessible by foot?
My friend lives in a new housing development that is basically built around one long snake-like road that winds about two miles in a small area. He lives smack in the middle of it, so to get to the main road (only a block or two away as the crow flies) he has to walk a solid mile. It would have taken nothing at all to build a couple of small pedestrian paths that would have made the place a walkable, transport-friendly community. But instead, for the next hundred years or however long that place stands, people who live there are going to have a huge disincentive towards walking as a part of their daily life.
Rome wasn’t build in a day, and it will take decades for the average American city to be truly walkable. But the things we are doing now are literally so bonehead dumb that even the smallest attempt will bring huge returns. Let’s make it possible for kids to walk to school. Let’s bring back recess and real food in our schools. Let’s stop making it easy to build cities that kill and cripple their inhabitants, and instead encourage infrastructure that makes a healthy and active lifestyle a seamless, effortless thing.