Everything you know about obesity is wrong.

[Anonymous]

Anonymous wrote:

Anonymous wrote:More proof we’ve entered a post truth era, where people who feel insulted when a doctor suggests they lose weight because it’s obviously unhealthy, or won’t let them get a surgery they might need, because as a result of their obesity, the complications of that surgery could kill them, is what this article basically undermines.

I would agree with you except that no doctor can point to any weight loss plan that results in long (or even medium) term weight loss and maintenance in any studied population. If that existed, you’re right, this article would be post truth. But since it does not, you’re the one engaging in post-truth rhetoric, pretending there is any data supporting doctors asking patients to lose weight.

+1

That PP was an unintentional demonstration of the harm of the post-truth era: someone scientifically illiterate clinging to her own perception of truth rather than what is supported by actual science.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In a nutshell: fat shaming does not help.

I get that. I also get that the US needs to stop subsidies to big Agra and their health wrecking foods. Perhaps subsidize healthy foods instead and revamp the school lunch program so kids learn to eat better from a young age. Snap benefits should encourage purchase of healthy food over unhealthy food. Doctors should not fat shame but get to the root of the problem (whether endocrine or some other disorder, prescribe proven drugs, address mental health issues). Build trails and bike lanes in more places to encourage activity or subsidize gyms. I don’t what else, but address it like an epidemic. It’s a public health crisis. Use some of the money from defense to fight this.

Do all that. Where does that leave personal responsibility though? Not sure the article addresses that and I don’t have an answer. I personally know MC and UMC educated people (doctors even) who are clinically super-morbidly obese. Money and education are not an issue. They are not limited to eating processed foods like some poorer people are. They live in nice neighborhoods with green space. They choose to go on cruises, steakhouses, Disney, etc and eat at the food and festivals. Desserts and sugary cocktails galore. Fat shaming doesn’t work. They have access to healthcare and healthful foods. What more can be done for them? Or do we accept that they are just fine the way they are. It’s a lifestyle and they have similar weight friends so have support from each other—to stay the way they are, to celebrate it. Don’t fat shame but what? Give them a tax incentive or disincentive?

Super skinny and fit people do all of those things too. The difference is metabolic. You are shaming again without acknowledging the difference in body chemistry. The same meal will not have the same impact on two different bodies who engage in the same exercise.

Analogy: A man and a women of equal weight drink the same amount of alcohol -- the alcohol does not effect each of them the same way. An alcoholic man and non-alcoholic man drink the same number of drinks -- the alcohol does not have the same impact on each of them; one needs to drink much more to get a buzz, nor does it lead to the same follow up behavior (addiction). Alcohol interacts with body chemistry; food interacts with body chemistry. But you can't go cold turkey on food -- you have to eat to live and as others have pointed out, it takes more food to sustain the health of a formerly obese person. It's cyclical. That's why the amount of food needed to sustain the Biggest Loser star's weight was called a starvation diet -- it will starve him (i.e., start to negatively impact his health) to stay at the weight maintenance level of nutrition, even though it might be enough food for you.

So yes, we need to prevent kids from becoming obese in the first place by protecting their metabolism and acknowledging body chemistry (not every body is born with the same body chemistry so a big part of pediatrics needs to focus on figuring this out for each and every child), and by changing the "food" available to the general population and make sure kids can afford to each real food that never saw a box or a bag.

I don't understand this. Doesn't this just mean that after losing a lot of weight, in order to maintain that weight loss, you need less food than someone the same weight who hasn't been obese? But not that it's "starvation level." If you only need 1000 calories a day, and that's how much you eat, then you are eating as much as you need, right? Like it sucks that you can't eat more without regaining, but how are you literally starving if you are eating a reduced amount that is all your bodies needs?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For everyone pointing to more walking/biking/exercise, what did you make of the fact that studies where kids got more exercise didn’t change the obesity rates in the test population?

SMH it’s astonishing how people absolutely refuse to review and absorb data on obesity.

They don’t want to learn. They like being ignorant.

NP, but to be fair, I personally think there's a difference between lifestyle (walking more to work, errands, etc.) and purposeful exercise. I live in the suburbs, never walk anywhere, but exercise very regularly. It does nothing for my weight. I do wonder all the time though that if I lived a more "walkable" lifestyle, if that would factor in.

I don't know, I know lots of people who have lost substantial weight through diet and exercise. And they have kept it off for years. So it does work for some people.

[Anonymous]

Anonymous wrote:More proof we’ve entered a post truth era, where people who feel insulted when a doctor suggests they lose weight because it’s obviously unhealthy, or won’t let them get a surgery they might need, because as a result of their obesity, the complications of that surgery could kill them, is what this article basically undermines.

Bu bu bu but, my body chemistry is different! Never mind we are seeing obesity at rates never before seen in human history, it’s body chemistry! It’s food additives! It’s anything but making good choices day in and day out. SMH

[Anonymous]

Anonymous wrote:

Anonymous wrote:More proof we’ve entered a post truth era, where people who feel insulted when a doctor suggests they lose weight because it’s obviously unhealthy, or won’t let them get a surgery they might need, because as a result of their obesity, the complications of that surgery could kill them, is what this article basically undermines.

Bu bu bu but, my body chemistry is different! Never mind we are seeing obesity at rates never before seen in human history, it’s body chemistry! It’s food additives! It’s anything but making good choices day in and day out. SMH

It is always remarkable to me how people like to demonstrate their own scientific illiteracy like they are proud of it or something.

[Anonymous]

Anonymous wrote:

Anonymous wrote:While I think subsidizing healthy food is good, it will not make much of a dent in the hesitant epidemic. Portion control is free and you don’t see overweight people doing this.

Just look at which foods kids choose when given the option. Every class party, the donuts get eaten in five seconds while the apple slices or bags of carrots get left behind. Adults are no different. Adults are choosing to eat crap because it tastes good, is satisfying, and gives them pleasure. They aren’t controlling their portions because they aren’t eating to address hunger.

With inflation now, I’ve noticed that the fresher healthy food IS cheaper than the nutrition less, high calorie, processed snack food. A large bag of apples was 2.99 while a bag of cookies Oreo, Nilla wafers and all the rest of the brands were 4.59 or more. A dozen eggs were $3 while the cheapest on sale cereal was 3.99. Yet people who can afford it and probably a lot who can’t are still buying cookies and cereal.

There was an article a while back on why lower income families give in to kids asking for junk food more than UMC parents. The researchers discovered that since the lower income parents couldn’t afford other rewards/gifts like toys or experiences they used junk food as something they could afford to make their kids happy.

Food companies sell products that people buy. They have focus groups and adding sweetener wins, so they make this. During the lockdowns, the cookie and chip aisle was bare while the kale chips still didn’t move.

I honestly don’t know where to begin with the profound ignorance shown here. Every sentence demonstrates a deep lack of comprehension.

DP. What is wrong with this post? I think each of these statements is true, with the possible exception of adults not eating to address hunger (maybe that is true, maybe not, maybe depends on the person and the situation).

But yes, I noticed the price of processed food has gone up sharply while produce is about the same. I buy a lot of both! I also saw the same article about lower income families providing junk food and treats are rare luxuries (and I am also guilty of this myself). As for the food companies adding sweetener to sell products, isn't that what half or more of the posters are commenting on as what should be the focus to reduce obsesity?

[Anonymous]

Anonymous wrote:

Anonymous wrote:There seems to be several posters (or one?) who ridicules every idea. Let’s just speak for ourselves and stop morphing the conversation to the nameless others who live far from a grocery store, who work 3 jobs, who don’t have access to healthcare etc. etc. In truth there are lots of people in the DMV area with good incomes and access and they are still gaining weight. What would help these people? I’m not talking about the ones trying to lose weight but the ones trying to maintain a healthy weight. We see post after post on this forum about people struggling with weight gain in middle age. What are the strategies for them? We are not going to get large numbers of Americans to lose weight and keep it off. So what can we do to prevent it?

OP. First, thanks for the great discussion. This went better than I thought it would, as I have frankly a low opinion of DCUMs understanding of obesity in general. But this has been pretty good.

To answer the question above, here are some things I think need to happen:

1. End any and all subsidies to the sugar companies.
2. Treat chips, soda, and candy like cigarettes: highly taxed, black boxes, stored behind locked cabinets, children can’t buy them.
3. Ban Round Up and Round Up ready seeds from the food supply.
4. Sharply decrease the routine use of antibiotics in treating childhood illnesses, no routine use of amoxicillin for ear infections, for instance.
5. Remove hydrogenated oils from the food supply.
6. Remove willpower and personal responsibility from any discussion of obesity (since that has been proven over and over to not work).
7. Provide tax subsidies for people who commute by bicycle or who otherwise remove personal cars as their primary mode of transportation.
8. Provide significant tax incentives to food companies to sell fresh vegetables, lean meats, and whole grain foods (much more than the corn and sugar subsidies they currently get).
9. Ban advertising for junk food entirely, particularly for kids.

This is just a start but I do not believe we will ever fix the obesity crisis without societal steps like this. I also firmly believe that in 100-200 years, how we treated obesity during this time (with the focus on personal failings as the primary cause of obesity) will be seen as scientifically backwards as phrenology or the humoral theory of illness.

While I think this is important, I wonder if we should also move to ban the use of antibiotics in agriculture except for genuine medical need? I know we should do that for basic public health reasons, but I wonder if the constant low level antibiotics fed to livestock for "growth enhancement" also effects humans as the end consumers?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In a nutshell: fat shaming does not help.

I get that. I also get that the US needs to stop subsidies to big Agra and their health wrecking foods. Perhaps subsidize healthy foods instead and revamp the school lunch program so kids learn to eat better from a young age. Snap benefits should encourage purchase of healthy food over unhealthy food. Doctors should not fat shame but get to the root of the problem (whether endocrine or some other disorder, prescribe proven drugs, address mental health issues). Build trails and bike lanes in more places to encourage activity or subsidize gyms. I don’t what else, but address it like an epidemic. It’s a public health crisis. Use some of the money from defense to fight this.

Do all that. Where does that leave personal responsibility though? Not sure the article addresses that and I don’t have an answer. I personally know MC and UMC educated people (doctors even) who are clinically super-morbidly obese. Money and education are not an issue. They are not limited to eating processed foods like some poorer people are. They live in nice neighborhoods with green space. They choose to go on cruises, steakhouses, Disney, etc and eat at the food and festivals. Desserts and sugary cocktails galore. Fat shaming doesn’t work. They have access to healthcare and healthful foods. What more can be done for them? Or do we accept that they are just fine the way they are. It’s a lifestyle and they have similar weight friends so have support from each other—to stay the way they are, to celebrate it. Don’t fat shame but what? Give them a tax incentive or disincentive?

Super skinny and fit people do all of those things too. The difference is metabolic. You are shaming again without acknowledging the difference in body chemistry. The same meal will not have the same impact on two different bodies who engage in the same exercise.

Analogy: A man and a women of equal weight drink the same amount of alcohol -- the alcohol does not effect each of them the same way. An alcoholic man and non-alcoholic man drink the same number of drinks -- the alcohol does not have the same impact on each of them; one needs to drink much more to get a buzz, nor does it lead to the same follow up behavior (addiction). Alcohol interacts with body chemistry; food interacts with body chemistry. But you can't go cold turkey on food -- you have to eat to live and as others have pointed out, it takes more food to sustain the health of a formerly obese person. It's cyclical. That's why the amount of food needed to sustain the Biggest Loser star's weight was called a starvation diet -- it will starve him (i.e., start to negatively impact his health) to stay at the weight maintenance level of nutrition, even though it might be enough food for you.

So yes, we need to prevent kids from becoming obese in the first place by protecting their metabolism and acknowledging body chemistry (not every body is born with the same body chemistry so a big part of pediatrics needs to focus on figuring this out for each and every child), and by changing the "food" available to the general population and make sure kids can afford to each real food that never saw a box or a bag.

I don't understand this. Doesn't this just mean that after losing a lot of weight, in order to maintain that weight loss, you need less food than someone the same weight who hasn't been obese? But not that it's "starvation level." If you only need 1000 calories a day, and that's how much you eat, then you are eating as much as you need, right? Like it sucks that you can't eat more without regaining, but how are you literally starving if you are eating a reduced amount that is all your bodies needs?

You’re assuming your body couldn’t need more nutrients than you can get without regaining weight. But that doesn’t follow.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For everyone pointing to more walking/biking/exercise, what did you make of the fact that studies where kids got more exercise didn’t change the obesity rates in the test population?

SMH it’s astonishing how people absolutely refuse to review and absorb data on obesity.

They don’t want to learn. They like being ignorant.

NP, but to be fair, I personally think there's a difference between lifestyle (walking more to work, errands, etc.) and purposeful exercise. I live in the suburbs, never walk anywhere, but exercise very regularly. It does nothing for my weight. I do wonder all the time though that if I lived a more "walkable" lifestyle, if that would factor in.

I don't know, I know lots of people who have lost substantial weight through diet and exercise. And they have kept it off for years. So it does work for some people.

DCUM is always full of posters who are sure that there are many, many people who have kept substantial weight off for years, yet oddly the scientific studies about exactly this show very, very few people for whom that remains true. This has been extremely well-studied. And yet, posters insist that their lived experience is entirely different than what years of population studies show. It’s a fascinating disconnect.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There seems to be several posters (or one?) who ridicules every idea. Let’s just speak for ourselves and stop morphing the conversation to the nameless others who live far from a grocery store, who work 3 jobs, who don’t have access to healthcare etc. etc. In truth there are lots of people in the DMV area with good incomes and access and they are still gaining weight. What would help these people? I’m not talking about the ones trying to lose weight but the ones trying to maintain a healthy weight. We see post after post on this forum about people struggling with weight gain in middle age. What are the strategies for them? We are not going to get large numbers of Americans to lose weight and keep it off. So what can we do to prevent it?

OP. First, thanks for the great discussion. This went better than I thought it would, as I have frankly a low opinion of DCUMs understanding of obesity in general. But this has been pretty good.

To answer the question above, here are some things I think need to happen:

1. End any and all subsidies to the sugar companies.
2. Treat chips, soda, and candy like cigarettes: highly taxed, black boxes, stored behind locked cabinets, children can’t buy them.
3. Ban Round Up and Round Up ready seeds from the food supply.
4. Sharply decrease the routine use of antibiotics in treating childhood illnesses, no routine use of amoxicillin for ear infections, for instance.
5. Remove hydrogenated oils from the food supply.
6. Remove willpower and personal responsibility from any discussion of obesity (since that has been proven over and over to not work).
7. Provide tax subsidies for people who commute by bicycle or who otherwise remove personal cars as their primary mode of transportation.
8. Provide significant tax incentives to food companies to sell fresh vegetables, lean meats, and whole grain foods (much more than the corn and sugar subsidies they currently get).
9. Ban advertising for junk food entirely, particularly for kids.

This is just a start but I do not believe we will ever fix the obesity crisis without societal steps like this. I also firmly believe that in 100-200 years, how we treated obesity during this time (with the focus on personal failings as the primary cause of obesity) will be seen as scientifically backwards as phrenology or the humoral theory of illness.

While I think this is important, I wonder if we should also move to ban the use of antibiotics in agriculture except for genuine medical need? I know we should do that for basic public health reasons, but I wonder if the constant low level antibiotics fed to livestock for "growth enhancement" also effects humans as the end consumers?

I’m the PP and you are correct about this. That should have been on my list.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In a nutshell: fat shaming does not help.

I get that. I also get that the US needs to stop subsidies to big Agra and their health wrecking foods. Perhaps subsidize healthy foods instead and revamp the school lunch program so kids learn to eat better from a young age. Snap benefits should encourage purchase of healthy food over unhealthy food. Doctors should not fat shame but get to the root of the problem (whether endocrine or some other disorder, prescribe proven drugs, address mental health issues). Build trails and bike lanes in more places to encourage activity or subsidize gyms. I don’t what else, but address it like an epidemic. It’s a public health crisis. Use some of the money from defense to fight this.

Do all that. Where does that leave personal responsibility though? Not sure the article addresses that and I don’t have an answer. I personally know MC and UMC educated people (doctors even) who are clinically super-morbidly obese. Money and education are not an issue. They are not limited to eating processed foods like some poorer people are. They live in nice neighborhoods with green space. They choose to go on cruises, steakhouses, Disney, etc and eat at the food and festivals. Desserts and sugary cocktails galore. Fat shaming doesn’t work. They have access to healthcare and healthful foods. What more can be done for them? Or do we accept that they are just fine the way they are. It’s a lifestyle and they have similar weight friends so have support from each other—to stay the way they are, to celebrate it. Don’t fat shame but what? Give them a tax incentive or disincentive?

Super skinny and fit people do all of those things too. The difference is metabolic. You are shaming again without acknowledging the difference in body chemistry. The same meal will not have the same impact on two different bodies who engage in the same exercise.

Analogy: A man and a women of equal weight drink the same amount of alcohol -- the alcohol does not effect each of them the same way. An alcoholic man and non-alcoholic man drink the same number of drinks -- the alcohol does not have the same impact on each of them; one needs to drink much more to get a buzz, nor does it lead to the same follow up behavior (addiction). Alcohol interacts with body chemistry; food interacts with body chemistry. But you can't go cold turkey on food -- you have to eat to live and as others have pointed out, it takes more food to sustain the health of a formerly obese person. It's cyclical. That's why the amount of food needed to sustain the Biggest Loser star's weight was called a starvation diet -- it will starve him (i.e., start to negatively impact his health) to stay at the weight maintenance level of nutrition, even though it might be enough food for you.

So yes, we need to prevent kids from becoming obese in the first place by protecting their metabolism and acknowledging body chemistry (not every body is born with the same body chemistry so a big part of pediatrics needs to focus on figuring this out for each and every child), and by changing the "food" available to the general population and make sure kids can afford to each real food that never saw a box or a bag.

I don't understand this. Doesn't this just mean that after losing a lot of weight, in order to maintain that weight loss, you need less food than someone the same weight who hasn't been obese? But not that it's "starvation level." If you only need 1000 calories a day, and that's how much you eat, then you are eating as much as you need, right? Like it sucks that you can't eat more without regaining, but how are you literally starving if you are eating a reduced amount that is all your bodies needs?

No, you are confusing the amount a given body "needs" for maintaining the lower weight with what the body "needs" to keep the human body functioning and alive. If the former is lower than that latter, then trying to maintain that lower weight will kill you faster than living at a higher weight will. You are starving the body of the nutrition it needs to function for sake of not letting the nutrient-rich fuel add fat or muscle weight.

[Anonymous]

I am against shaming anyone and I think it's horrible that obese people can't get proper medical care and are bullied.

That said, we can't throw the baby out with the bathwater. There should still be a call to action to address obesity. Let's continue to talk about making healthy choices with food and activity, and try to give our kids a better start.

[Anonymous]

Anonymous wrote:I am against shaming anyone and I think it's horrible that obese people can't get proper medical care and are bullied.

That said, we can't throw the baby out with the bathwater. There should still be a call to action to address obesity. Let's continue to talk about making healthy choices with food and activity, and try to give our kids a better start.

But that hasn’t worked in studies. I don’t know what the answer is. But it’s been studied many times and it doesn’t even help with *childhood* obesity rates. And it’s not for a lack of trying it.

I don’t know what the answer is but people have to get it through their heads that the intuitive solutions of education and doctor interventions has failed.

[Anonymous]

healthy eating, activity, and sleeping habits should be touted as cornerstones of happy lives.

that's the point. they are. Yet still ppl end up obese.

[Anonymous]

I have two genuine questions. If obesity is out of people’s control and is all about body chemistry, then:

1. Why are we seeing obesity rates that are unprecedented in human history?

2. Why is the USA dealing with rates of obesity that are so much higher than most other countries?