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.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Obese and overweight women are hungrier than their naturally thin counterparts. I have witnessed my overweight friends eating habits over the years and I can definitely see how they eat more because they are physically hungry. It’s no real accomplishment for me to be at a healthy weight when I am not hungry for more than my body requires. People need some humility and stop thinking that overweight people are needlessly eating food they are not hungry for.

I mean, it’s sad but it’s also a known thing now. People must guard against gaining weight. Parents must help their kids to stay at healthy weights. Yes, there are people who truly have disorders or are too poor to have access to good food that will gain weight no matter what, but not the current 75-80% of Americans. I was in rural NY watching an obese grandma and obese 10 yo boy buy frozen dinners and ice cream as their dinner. The store was well-stocked with produce and fresh meat. Part of it is culture, part of it is laziness, some of it is genetics. Once you are obese, it’s game over. It becomes much harder to ever be at a normal bmi again. The conversation has to shift away from losing weight to helping our kids learn to eat well and maintain a norma bmi.

If you really think that 75 - 80% of Americans have access to and can afford healthy, fresh food, you need to educate yourself beyond your current ignorance. When you take a breath from your assumptions about “culture”, go price out the differences per serving between “frozen dinners and ice cream” and “produce and fresh meat”. You seem to think you know what people can afford because you paused to sneer at them in a store.

You have $10 to spend on groceries for 3 kids for the week. Kraft Crap and Cheese is on sale, 5 boxes for $3. A radish bunch with leaves, maybe 8-10 radishes on it is $5. What do you buy?

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.

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?

Acknowledge that some weight gain in middle age is normal, and it is hormone driven, and may even be necessary for optimum health in old age.

The body is a machine run by chemistry that has to be extremely fine tuned to work properly; throw off one thing and others compensate or deteriorate. Food is chemical fuel for the body machine. It should be viewed almost like medicine, designed to manipulate the machine and help it function optimally. We already know that not every body can handle the same kinds of chemical inputs from food -- people have intolerances, allergies, physiological inabilities to use/absorb/process certain foods. Some bodies use certain inputs more efficiently than other bodies, some fail completely. We also know that when nutrients in our food supply are depleted, and they are, it affects the health of the local population. Nutrition is a science that needs to be elevated to an annual visit as part of a physical. Physicians have to look for root chemical sources of health problems and recognize that one size does not fit all when it comes to diet and nutrition. Nothing is more important than how the body processes or does not process the nutrition it gets. And yet, how many people have ever seen a nutritionist?

Unfortunately, Big Agra knows nutrients in its supply chain are a problem, and they will fight against any acknowledgement of this problem. Our bodies have changed so much as a result of this over the past several decades, and instead of addressing the food problem, Big Pharma steps in and treats the body with drugs and Big Diet and Exercise continue the body shaming campaign to sell more useless products that do nothing to address the underlying breakdown the the metabolic machine. Our food supply is killing us, and some human machines are more sensitive to it than others and are dying more quickly.

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.

For me, I’m 48 and weigh myself weekly. I work to make good choices just about every day. I focus on fruits and vegetables and low fat meats. I force myself to walk 10k steps a day and lift weights three times a week. I don’t unnecessarily limit myself but it’s constantly on my mind. My bmi is 21 or so. It’s not easy. It’s not fun. It’s a choice.

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.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Aside from the shaming aspect, we aren't giving enough attention to the fact that metabolism decreases with weight loss. Maintaining can be harder than losing and once you lose the first time you will never be at the same level as a naturally thin person. I once lost a significant amount of weight and maintaining it (which I did for two years) was harder than losing it. I was working out 2+ hours a day and eating around 1,000 calories. When I got pregnant with my first I gained a lot of it back, and the rest of it back when I was pregnant for my second (which also required bed rest). I've done weight watchers since and lost nothing. I still work out. I am significantly overweight.

The shaming is very real, too. Both DH and I have larger families. Our babies were born normal weight but gained weight quickly even EBF. Both of my kids had their weight flagged as problematic from about 3 months on... They already hate doctors.

Were you overweight as a child? It changes your physiology when you are fat as a child and makes it virtually impossible to be a normal weight adult. Stopping obesity before it starts is the only way to combat it

Yes, I was overweight as a child as were all of my siblings. My kids were "overweight" starting at around one month old (exclusively breast fed). Our kids see a dietician. It helps but they are still bigger than other children and I worry a lot about giving them more of a complex by trying to address this. I'm also not convinced by many of the methods people use to treat childhood obesity, i.e. limiting fruit (which I have tried) and stimulant medications (which I will not try). I have a good friend who is a dietician and I will say that most of her colleagues have never been overweight, many came into the profession because they judge the obese, many have disordered eating, and the failure rate long term is nearly 100%.

This accurately describes my experience with nutritionists. I actually don’t think I’d ever recommend that an obese person see a nutritionist, absent concrete proof that nutritionist is not like 99% of their shockingly ignorant colleagues.

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?

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?

Are you the poster who posts here all the time about their fat friends who post pictures of their cruise meals (with cocktails) on Facebook? I’m not sure I’ve ever seen a thread on obesity here on DCUM without that bizarrely obsessed poster and you sound like her.

Anonymous wrote:I have one daughter who is fat. A second daughter who is skinny. They both ate the same things, drank the same milk, do the same things. But one is significantly heavier than the other. They are both not even teenagers yet. Explain that to me - one is just weak-willed? Eats more for some primal reason? Or perhaps there is some other biological mechanism that causes younger daughter's body to hold on to energy stores more than the older one?

When we go to the doctor, though, it is often mentioned that she needs to watch what she eats. I watch - I don't see her eat more or worse than the other one.

I think it has to do with gut microbiome. I think some people's guts don't recover after taking antibiotics, or some other drugs.

Anonymous wrote:

Anonymous wrote:Aside from the shaming aspect, we aren't giving enough attention to the fact that metabolism decreases with weight loss. Maintaining can be harder than losing and once you lose the first time you will never be at the same level as a naturally thin person. I once lost a significant amount of weight and maintaining it (which I did for two years) was harder than losing it. I was working out 2+ hours a day and eating around 1,000 calories. When I got pregnant with my first I gained a lot of it back, and the rest of it back when I was pregnant for my second (which also required bed rest). I've done weight watchers since and lost nothing. I still work out. I am significantly overweight.

The shaming is very real, too. Both DH and I have larger families. Our babies were born normal weight but gained weight quickly even EBF. Both of my kids had their weight flagged as problematic from about 3 months on... They already hate doctors.

Were you overweight as a child? It changes your physiology when you are fat as a child and makes it virtually impossible to be a normal weight adult. Stopping obesity before it starts is the only way to combat it

Yes, I was overweight as a child as were all of my siblings. My kids were "overweight" starting at around one month old (exclusively breast fed). Our kids see a dietician. It helps but they are still bigger than other children and I worry a lot about giving them more of a complex by trying to address this. I'm also not convinced by many of the methods people use to treat childhood obesity, i.e. limiting fruit (which I have tried) and stimulant medications (which I will not try). I have a good friend who is a dietician and I will say that most of her colleagues have never been overweight, many came into the profession because they judge the obese, many have disordered eating, and the failure rate long term is nearly 100%.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Obese and overweight women are hungrier than their naturally thin counterparts. I have witnessed my overweight friends eating habits over the years and I can definitely see how they eat more because they are physically hungry. It’s no real accomplishment for me to be at a healthy weight when I am not hungry for more than my body requires. People need some humility and stop thinking that overweight people are needlessly eating food they are not hungry for.

I mean, it’s sad but it’s also a known thing now. People must guard against gaining weight. Parents must help their kids to stay at healthy weights. Yes, there are people who truly have disorders or are too poor to have access to good food that will gain weight no matter what, but not the current 75-80% of Americans. I was in rural NY watching an obese grandma and obese 10 yo boy buy frozen dinners and ice cream as their dinner. The store was well-stocked with produce and fresh meat. Part of it is culture, part of it is laziness, some of it is genetics. Once you are obese, it’s game over. It becomes much harder to ever be at a normal bmi again. The conversation has to shift away from losing weight to helping our kids learn to eat well and maintain a norma bmi.

If you really think that 75 - 80% of Americans have access to and can afford healthy, fresh food, you need to educate yourself beyond your current ignorance. When you take a breath from your assumptions about “culture”, go price out the differences per serving between “frozen dinners and ice cream” and “produce and fresh meat”. You seem to think you know what people can afford because you paused to sneer at them in a store.

Ice cream is actually pretty expensive for something as useless nutritionally.

My parents received food stamps.

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.

Anonymous wrote:I have one daughter who is fat. A second daughter who is skinny. They both ate the same things, drank the same milk, do the same things. But one is significantly heavier than the other. They are both not even teenagers yet. Explain that to me - one is just weak-willed? Eats more for some primal reason? Or perhaps there is some other biological mechanism that causes younger daughter's body to hold on to energy stores more than the older one?

When we go to the doctor, though, it is often mentioned that she needs to watch what she eats. I watch - I don't see her eat more or worse than the other one.

My sister and I were like this. She was quite heavy in pre-teen and early teen and I wasn’t. Both slender now, though it has messed with her psyche. I think it was just storage before growth. She is an inch taller than me. She hasn’t ever had to diet as an adult, so yes was not a food thing. In fact, we’ve both had to deal with colleagues trying to force us to eat sweets, which is for another thread.