I took it to mean that you feel as if people who are truly diseased are justified in taking personal offense by the word “disease” being applied to the obese. My question is why? Saying a fat person has a disease takes nothing away from someone with diabetes or MS. It doesn’t belittle those diseases in anyway. If a person with something as serious as cancer is going to be upset by the words a fat guy uses to describe his condition, then they’ve got more problems than just cancer.
by me
by Jodi
But trauma is trauma, and when it comes to the condition of being severely burned, it doesn’t matter what factors led to the trauma. A physician is going to treat my burns the same way they’d treat Mr. Masochistic Pyromaniac’s (who also needs to see a psychiatrist), and his diagnosis (3rd degree burns) is going to identical for both of our cases. My point is, just because in one case the burns were inflicted intentionally and in the other one they were not, does not mean the world has to describe them with two different medical terms, lest people make the horrible mistake of thinking both of them were accidental.
And frankly, if my body was covered with big, weeping 3rd degree burns I wouldn’t be the least concerned that Mr. Pyromaniac was lumped in with me in the trauma ward. We both have burns. We are both abnormal. We both need medical attention. I gain nor lose nothing by the words used to describe his condition.
I’m very unclear on the distinctions between diseases and conditions, much less what implications those definitions might have on public health policy–and costs. Things medical sails right over my head very quickly, so all of this is offered in the sense of posing questions, not stating positions, okay?
I gather that clinical obesity (if that’s not mangling another specific term) causes or can cause the body to handle food differently; in effect, metabolic changes that reinforce retention of weight. So that in itself could explain the relatively sudden…epidemic, for lack of a better word, of obesity, right? IIRC something similar happened among Polynesian populations when exposed to western diets, along with other changes in lifestyles, so that isn’t unprecedented.
I’m in no way arguing that obesity isn’t a serious public health problem, and that it only makes sense, in terms of compassion and money, to address it. I guess I’m just stymied by what the medical community can actually do to treat “the disease instead of the symptoms”, so to speak. Education hasn’t helped, nor has the ruthless pop-culture emphasis on hard-body fitness.
Health care, insurance costs, drug costs, etc. are already a huge problem. Two friends have had bariatric surgery and it’s been, literally, a life saver for both of them. It was expensive, though undoubtedly far less than treating over time the horrendous health problems associated with obesity. But our insurance is being cut back severely again, because insurance costs keep spiraling out of control. Such surgery won’t be covered anymore. kallessa’s point about drug therapies is well taken, but just a few days ago new, much more rigid standards were issued for cholesterol. The solution suggested was a far greater number take drugs to prevent heart stroke, heart disease, etc. The problem is, far too many people can’t afford such drugs right now. My blood pressure medication has tripled in price over the past two years, and I’m lucky enough to be employed, with health insurance.
I’m not saying obesity shouldn’t be treated as a serious public health problem. I am, however, very ambivalent about how far and widely “spot solutions”, so to speak, can actually reach or be sustained. Somewhere in the mix, the way we live is slowly killing too many of us. So much of my muddledness centers on what’s actually workable in the short run, much less how to hit hard on prevention.
Having read the entire thread. I find myself confused as to why the “nonfat” feel so much venom toward the obese that they equate the attempt to declare obesity an illness (or condition if you prefer, I also agree with the posters who said it more fit that definition), with stating that obesity is “not their fault” or that they’re trying to “whinge” and so on.
FTR, I’m a PE instructor at a college. But I’ve had my own battles with the chub. I’ve never been obese, but I’m very small boned and after breaking my leg last year, I got WAY too heavy for my poor frame. VERY uncomfortable.
At any rate, I have many years of experience and instruction in my field, as WELL as having “walked in their shoes”.
I fail to see how this move, that to declare this a “disease” or a “condition” or whatever is so threatening to so many “skinnies”, or again, why they equate it with the obese trying to be all “it’s not my fault, I can’t do anything about it” regarding their weight.
This decision, should it go through, means that at last, SOMETHING is being done about this epidemic. And that IS what it is, whatever the cause. From the sources I’ve seen and read, the number of obese Americans is somewhere between 30% to 60% from some sources.
I’m getting ready to go back home to Alaska in about 6 weeks, but I’ve been living “outside” in Texas for the last 7 or so months. Dallas is one of America’s fattest cities. And recently, thanks to attention from the medical community among others, changes are being made to our schools, and education is starting to be more widespread.
Okay so there’s the “but I don’t want my tax dollars to go to someone’s gastric bypass” whingers (and talk about WHINGERS, jeeeminy christmas!!!). Um sweethearts, what makes you think that you have ANY control on where your tax dollars go as it is???
Can’t remember where I read this, some site or another, but the average American pays taxes in an amount which, when applied, can move an F15 about 8 feet.
Not to mention the other non disease diseases we already pay for, particularly alcoholism. Hell, at least fat people don’t act like idiots and kill people when driving their cars.
And lets talk about the extremely healthy fit and athletic. Do you folks have ANY idea how much it costs to rescue extreme athletes from Mt. McKinley when their expiditions fail and they are trapped?
Heck, I haven’t even mentioned the cost of keeping criminals in prison, and that is 100% “their fault” and we’re ALL paying for it by golly.
So if you’re complaining from the basis that it’s because declaring it a “disease” will mean more money comes out of your pocket, or that they (the obese) don’t deserve help because it’s all their own fault anyway for being lazy overeating pigs, then you’d better look to all of the other Americans that cost the government money just by being stupid, or otherwise addicted to things.
Declaring this a condition, or a disease, or whatever, even if the condition doens’t reaaaaallly fit the perfect definition of the word, is a GOOD thing. Education of the people (and YES folks, argue til the cows come home, even WITH the “calories in= calories out” math, the solution IS more complicated and takes more “tweaking” than that), is key to getting a handle on our country’s obesity problem.
And God knows, the useless mantra to the obese of “eat less, exercise more” and “willpower” has worked SO well so far right?? :rolleyes:
Can we stop judging and start WORKING on it??? Who cares what we call it, as long as we start working toward a solution?
It would probably help more if you read their posts and realized that they (at least Colophon) doesn’t have a problem with you (as a whiny obese person) trying to lose weight. They have problems with whiny obese people who are looking to get someone else to do the work for them, preferably with some nice, realitively free insurance money.
You do realize that diet is not synonomous with going hungry? There are ways to eat well that won’t leave you hungry. There are also ways to wean yourself of of shit and start eating right so your “willpower” doesn’t get sapped by the bogeyman of poorly concieved crash-dieting.
Granted, in part of your post that I’ve cut out, you mention that crap food is cheaper than healthy food, but seriously, how much of an argument is that for your typical suburban obese person? I understand that there is a portion of the population (and possibly a significant portion) that doesn’t have a proper grocery store within miles of their house and that it’s difficult if not impossible for them to eat correctly, but seriously.
Some of them? Sure. When I was sick, I was also fat. I knew that one condition was beyond my control and the other, in my case, was not. (And, yes, I understand that sometimes obesity is causes by underlying diseases and conditions beyond the control of the sufferer, like thyroid imbalance or drug therapy or OCD. But in the vast majority of cases, it is not.) I also knew what I suffered on a daily basis from being overweight and what I was suffering on a daily basis for being sick. They were not the same. They weren’t even in the same ballpark.
[quote]
Saying a fat person has a disease takes nothing away from someone with diabetes or MS. It doesn’t belittle those diseases in anyway.[/qjuote]
Actually, it does. You are taking a disease that is life-threatening, requiring immediate agressive and unpleasant treatment, and without a volitional component, to contract it or cure it, and you are comparing it with a condition that in the majority of cases is not life-threatening (though certainly unhealthy, and sometimes leading to life-threatening problems), does not usually require aggressive and unpleasant treatment, and has a volitional component both to getting “sick” in the first place, and in whether you get well. Imagine an exchange like this:
A: I’m having a tough time of it. I have cancer.
B: Whoa, I understand your pain. I myself have obesity.
It may strike you as odd that Person A would be irked by that implicit comparison, but it strikes me as completely natural.
Maybe so. But probably their chief problem is cancer. Whereas for the vast majority of people defined as “obese,” things are otherwise pretty okay.
Well, then this isn’t a very good analogy is it? Because implicit in all the defensiveness about obesity is the understanding that the condition cannot be treated the same way all the time, and that the factors leading to the trauma do matter. A burn patient is treated with the same protocols regardless of how he or she was burned (leaving aside such distinctions as chemical v. non-chemical burns). An obesity patient is not.
Who said they had to be described by two separate medical terms? My point is that while having a disease is not a badge of honor, a person might not like having their serious nonvolitional disease considered on par with a less serious, frequently volitional condition.
Until you, with your big, weeping 3rd degree burns, in between skin grafts and dressing changes, meet a person who says, “Hey, I feel ya. I remember when I touched that hot stove when I was five. Boy, my finger musta stung for a week!” This might not bug you – all’s fair and fine between “burn victims,” and, hey, if you’re nettled then “you’ve got more problems than just your burns” – but it would bug a lot of people.
I have had a disease. I have been obese. They were nothing alike. At the level of mild to moderate obesity suffered by most otherwise healthy Americans, the experience of the two is highly unlikely to be comparable. In any event, this is, to me, the minorest of side points. My main objection is not the elevating (or lowering) of this condition to the status of a disease; it is the risk that having decided it is a disease, we then naturally decide that the best way to treat it is as we treat diseases – with drugs and surgery, as opposed to with nutrition and exercise, education, and counselling.
I don’t know what the point is here. There are a lot of diseases and many of them are nothing alike. I’ve had illnesses that were serious enough at the time (I recovered), but I would not compare them to cancer, or obesity, or diabetes, or a number of other physical conditions.
I’d expect that a cancer patient, for instance, would not appreciate me saying that I “understood” their suffering, because I had some less severe illness or disease, no matter how “legitimate” of a disease that it was. There are also milder “diseases” out there—are we offended because they are classified as a “disease,” even though they are not very severe?
Ehhhhh, wtf? Now we’re speculating on what someone with a disease may or may not think about someone else’s condition???!? Only an idiot who DOES wear their disease like a badge of honor WOULD care about such an asinine thing.
Thank goodness the people I’ve encountered who need medical attention aren’t in this group of people who may be putting diseases in order and assigning some kind of hierarchy to them. For chrissakes that is absurd. Why on EARTH does it matter to anyone how it is labeled? Do you honestly think it will make a difference to the health care provider who is administering the treatment if it is a “volitional condition” or not? We’re required to provide assistance to all who need it whether they got that way by eating too much, smoking too much, or getting shot while trying to kill someone. Be real.
Lastly, the OP says ILLNESS not disease so if we’re going to nitpick, let’s stay focused.
I don’t think it’s remotely ‘fatties vs. skinnies’ , though there are plenty who’re all too eager to reduce the equation to “I’m fine, so fuck you, loser.”
Doing something just might be ultimately more destructive if that ‘something’ is just a palliative instead of a cure. Ways and means. Not whether something should be done but what actual good it will actually do for real people within an actual system.
I’m not saying it couldn’t be done, CanvasShoes, just that I can’t see it being ‘the answer’. Maybe it’s the wake-up-call for a much broader solution.
No, you’re right, I didn’t mean it to sound like “fatties vs. skinnies”, more I was complaining of those who seem, in this thread and some IRL, to equate any explanations of the hows and whys of obesity as attempts to “whine” or explain it all away because it’s 'not their fault". There ARE reasons other than pigging out and laziness. And addressing THOSE reasons is necessary for success of weight loss in a large number of cases.
If, a person IS just sitting around whining and doing nothing else to help themselves, then yeah, THOSE people should either accept themselves the way they are, and hush, or else do something about it. But for a person to say “I’ve tried and tried and nothing works” is not the same as them saying ‘it’s not my fault". Maybe they need to hear that as not "it’s not my fault’, but the “I want to lose weight, nothing I’ve tried works, how CAN I do it then”? that it’s meant to be instead of instantly passing judgment.
Anyway, it seems as if too many people think that the 'do something about it" can be limited to tossing a simplisitic “eat less, exercise more” comment over their shoulders, and that’s supposed to do the trick.
As so many have said, if it WERE a simple matter of these people just not knowing the math, then half of our countrymen wouldn’t be fat. They’d consult a chart and subtract the appropriate number of calories from their daily intake.
As for the “doing something”, from what it looks like, there are many segments of society that are already viewing this as a major health issue and doing something about it. Programs for proper nutrition and exercise are being implemented in the school systems for one. Though I’d like to see similar education for adults, it’s nice to stop the cycle when they’re kids. Maybe this is a bit of a hijack, but perhaps it’s time to rethink the taking the sports programs out of the schools thing?
I don’t know how widespread this is, but several companies in my home state were starting education for obesity, including offering workshops on health and nutrition. A company I worked for had a health perk. Each year each employee had access to a certain amount of money to be used toward healthful pursuits. I usually used mine for my gym membership.
One of my major gripes has always been that too many people don’t know what it MEANS to “eat less, exercise more”. Without training, they often go from one extreme to another and translate 'eat less" as “starve yourself, don’t you DARE eat one yummy thing, and you must subsist on lettuce and tofu forever amen”.
Then they tend to see 'exercise more" as “spend 4 hours a day in the gym, wrapped in a sweatsuit, and never ever rest of take a day off”. A lot of people don’t realize that, especially when a person is over 40, it can take as long as 8 weeks for any OUTSIDE changes to show up at all.
Can some of you “stop whinging and just do it” people see where an already depressed, and severely obese person, might get discouraged and quit?
That is, after trying to do this on their own (and likely many, MANY tries over their lifetime), by starving and aerobicizing themselves to death, and then NOT seeing any changes for 2 months that they would get discouraged and honestly believe that “nothing works”???
And could you possibly see how redefining obesity as an illness, and then helping these people see the way to do it properly, including educating them on how weight loss really works (how long it will take to see results, and how to keep motivated and so on, and so on), and how to do the right TYPES of exercise (no, aerobicizing for 4 hours isn’t the right way), and the right ways to eat that are both yummy and healthful would help? And help better than tossing useless mantras at them?
Will there still be some who are fat and happy and don’t want to do anything? Of course, but the insults and buzzwords haven’t worked, now it’s time to give something else a try.
And as I said in my previous post. It’s not as if the feds are going to come knocking on your door getting extra money for this, we ALREADY have no control over where our taxes go.
I for one, am a lot more irritated at having my tax dollers go to fund some alky drunk tank halfway house (you’re an alky?? hey stop drinking and get a job!! yeah, it’s sarcastic, but it’s the same damn thing), or for funding some extreme, testosterone-laden, idiotic sportster’s failed climb up Mt. McKinley, than I am at it going to help with such a widespread problem as obesity in our country.
And last but not least, as so many other posters have pointed out regarding the money, we’re ALREADY funding the obesity related diseases such as diabetes, joint ailments, and depression. Decreasing obesity would decrease the need to fund these illnesses.
Remember, all that is currently happening is that Medicare is investigating covering treatment for obesity. Questions like what should be covered and in what circumstances have yet to be determined. Private insurance won’t necessily add coverage for obesity if the government does, but, it there is reason to believe that they will make more profit (pay out less in claims) such coverage may be added. Frankly, our medical costs are so out of line that adding another covered condition doesn’t strike me as being the straw that breaks the camel’s back.
Surgery is one treatment that could be covered, but hopefully that wouldn’t be the first option for any patient. Sessions with a nutritionist or dietitian, added coverage for therapy related to weight, physical therapy so that exercise can be structure to be the most effective, bloodwork or other testing necessary to rule out other causes for weight gain, hypnosis or acupuncture (very radical, I know, because not everyone agrees these are indeed medical treatments, but I’m casting a wide net), payment or reimbursement for cost of certified weight loss programs–all things that could be looked at in addition to the new drug therapies that may be effective. Should Medicare pay for a health club membership of the cost of running shoes? Maybe, if it proved to be cost effective.
I’d like to think this is one step towards complete recognition of the problem and thus a more comprehesive solution. How about teaching nutrition in schools? Hell, how about just providing a variety of nutritious meals in school lunch programs? You and I, we’re smart, literate folks. We can, and have, educated ourselves about food choices, but some people aren’t so smart and they’re raising kids that don’t know that ketchup is not a vegetable (and plenty of smart people are doing this, too). You say education hasn’t worked–I say we’re aiming it at the wrong people. How many parents stopped smoking because junior learned in school that smoking was bad and bugged his folks everytime they lit up? We live in a society that has plenty, let’s teach the kids to be good consumers, give them the tools to make the right choices. And create some programs that will reach out to adults and help them make better food choices, standardize the information of packaging so that it makes sense to the average person–how many people really know what an appropriate serving size is?
How about adding physical education back into the school day?–real stuff that encourages kids to be active and aware of their bodies and to be proud of those bodies even if they don’t look like the latest skinny girl or perfectly muscled model. My 13 year old neice–my beautiful, athletic, graceful niece without an ounce of extra fat on her told me she hated her body because her shoulders are too wide, she’s too short and her legs aren’t long enough. Oh well, I guess she’ll never be as hot as those girls in Paris. So sad. Too bad there’s not a way to make her feel valued for her intelligence, her artistic talents, her concern for animals, the simple fact that’s she’s a person and so is worth treating with respect regardless of her body (which is perfect anyway–it’s healthy and strong and everything works).
How about admitting that companies that aim food comercials specifically at children, with clowns and cartoons and toys, aren’t doing anybody any favors? Not saying they can’t advertise, but let’s advertise to the people that pay for it, not the four year olds. Or let’s remind each other that a 2 year old will be satisfied with water or milk and doesn’t really need a 32 ounce Big Gulp of carbonated sugar water, or juice for that matter.
You want to tax junk food–I say bring it on. I’d pay 15 bucks for ice cream, but not as often, which is the point, right? What about convenience food like TV dinners or packaged “just add water” meals that are loaded with calories? Cooking the same meal from scratch could really reduce the calories and may add to the nutritional value, so let’s tax that, too. Tax fast food, all or it, because you can make a better, cheaper hambugers at home and way too many people (not us smart people, but people with little real education) think that fast food is already cheaper than making it yourself.
Let’s make sure we have safe parks and walking paths so people can exercise for free, and bike lanes so riding to work or for pleasure doesn’t get you killed. Let’s demand resturants serve smaller portions and just stop buying the tub of popcorn that you’d never eat except it’s at the movies so somehow it’s okay. Let’s write letters to Hollywood and demand that Kathy Bates play the love interest opposite Harrison Ford, and that Reece Witherspoon fall in love with Jack Black across a crowded room–because all these people are talented actors and why shouldn’t these parts go to them? How about accepting the fact that the average, in shape, normal American woman is a size 12 or 14 and that’s not fat on on an average height, average build normal woman?
The government can’t solve this problem, though they can call attention to it and treat it with dignity. Maybe that will remind each of us to treat the other with compassion and open the door for real solutions.
I see nobody has picked up on my comment about American portion sizes. While I think the folks suing fast-food chains for making them fat are wasting everyone’s time, they do have a point in that the ridiculously huge portions don’t make it easy for people to eat sensibly.
As I said, I travelled to the US last year, and was gobsmacked at the amount of food that would get plonked down in front of me. I’d pay the equivalent of four or five pounds for what I thought would be a light lunch, a sandwich or whatever, and I’d get a foot-long monstrosity stuffed with all manner of fried meat, oozing sauces, melting cheese etc, and accompanied by a “salad” drowned in dressing, with cubes of yet more cheese, and so on. You get the picture. Goddamn, it was tasty, but I spent most of my time feeling guilty about leaving enough on my plate to feed a family, and still feeling like I’d swallowed a bowling ball.
There are things that would help obese people- a sugar and fat tax, subsidised fruit and vegetables, enforced rationing, shops being forbidden to sell certain types of food to obese people.
Realistically, I can’t see any of that happening.
I’m currently in Australia, working in a hospital in a small town in the outback. The population is 900, 60% of whom are Aboriginal. Unemployment and alcoholism affect a large proportion of the people here, most people have substandard housing and very poor (I’m talking 3 or 4 years of school) educations.
There are 2 shops, one is a convenience store that sells goods at 3 times the price of the larger town 200kms away, and the pub, which is cheaper, but where the temptation to spend the dole money on drink is ever-present. Fruit and vegetables are scarce, as they have to be sent up from Sydney or Adelaide, since the local countryside is not approriate arable land, and what does arrive is usually past its best and very expensive. The local diet consists mostly of coca-cola, pre-frozen white bread, fish caught from the river and “bush-tucker” meat.
It will not surprise you that obesity and it’s subsequent sequelae of diabetes, kidney failure, peripheral vascular disease, skin ulcers and heart disease is rife.
A local woman died 2 weeks ago, simply because she was so obese she could no longer breathe. She was 39.
In the case of this town, obesity itself is not a disease, it is a symptom of wider social problems. Although conditions in the USA aren’t as extreme, I suspect that the root causes are similar.
People are not designed to eat what currently passes as a “western” diet. When they do, for whatever reason, they become obese. I don’t feel that obesity itself is a disease. Personally, I feel that whatever caused the obesity is what should be targeted. Whether that is poor education, an addiction to food, using food as an emotional crutch, eating a poor diet because it’s all you can afford, simply liking food too much, whatever it might be.
Waiting until someone has a BMI of 30 before you “treat” them is too late.
No-one should get to that point.
I did. Last paragraph, second sentence. And it’s not just fast food resturants. Some of the really expensive resturants still serve that minimalist, empty plate cuisine–an extreme in the other directions–but many upscale places serve 12 and 14 oz. steaks, or a giant piece of fish, with a huge side of potatoes and a smaller side of veggies. My Mom and I regularly order one entre’ for the two of us and pay the five dollars or so plate charge. We still get too many potatoes, but we’re not clean your plate people, so that’s not a big problem.
If a resturant is good enough that I’ll want to come back, I specifically tell the server or the manager if the portions were too large and suggest that they create a small plate. My favorite resturant now does this–two egg omelets as well as three, most sandwiches can be ordered as a half and a 6 oz. steak (among many other choices). they charge a dollar less for a small plate, and I imagine they have a higher profit margin on them. That’s one reason why I suggested that people begin to demand resturants do this (in my post above), because I know that they will listen to customers.
Of course, I also once told a little boy (he looked about 5) whose mother had just bought him a 32 oz. Big Gulp (and one for her) that if he kept drinking that stuff, he’d grow up to look like me–that ought to give him nightmares–but that he could be Spiderman if he drank milk or water. Soda pop for kids is one of my hot buttons.
Remember that lawsuit against McDonalds? Now that obesity is a disease. this will pave the way for fat people to persue litigation against the food pushers (fast food outlets, soda companies, potato chip mfgs.)
Our legal friends must be jumping for joy! This will unleash a flood of very profitable litigation…the judgements will make the tobacco stuff look like small potatos!
The ABA will shortly issue “Guidelines for Lawsuits Against Food providers”-don’t say i didn’t warn ya!..And warrants have been issued for the arrest and prosecution of Ronal McDonald!
Ironically, unless you specified skim milk, a kid drinking 32-oz Big Gulps of whole milk is going to put on the pounds just as fast, if not moreso. Espeically since so few kids will drink milk without adding chocolate. Bad advice…
The post about the australian aboroginal people becoming fat (after eating a “western” diet) made me think: I have also read about Native American people, who were very slim (eating the food they were accustomed to). When they started eating white bread, potatoes, and fried foods, the got fat. Paul Theroux relates how the South pacific islanders got used to eating spam, because they obtained it from the US Army troops during WWII…now, this stuff is one of their favorite foods…with the result that these people now are obese, and suffer from hypertension, diabetes, etc.
I f we all live on non-processed fruits and grains, with lean 9wild) meat and fish, we would be a lot better off…in fact, if we eliminated sugar from our diets, we would probably avoid dental caries as well.
What did our stone age ancestors get by on? Were they healthier than us?
This is a great example of why “a calorie is a calorie” can be misleading. Sure, 32 oz of whole milk probably has more calories than 32 oz of soda. It sure has a lot of fat and protein not present in the soda. But ironically that’s what makes it a better choice. Because it’s pretty hard to choke down 32 oz of whole milk in a sitting. The soda, on the other hand, is easy to slurp down and lacks the protein and fat, so it makes your blood sugar spike up, then drop off, which causes you to feel really hungry soon after.
It’s issues like this that make “eat less, exercise more” far too simplistic. People need to learn how we can eat fewer calories without feeling hungry, how to exercise more without getting injured, and so on.
