Obesity

[mellestad]

So, there are lots of news stories about obesity, or some politician or university that came up with a dumb idea to fight it.  It is fun to pick the ideas apart, naturally.

Does anyone have a opinion on what, if anything, *should* be done?  Just leave it alone and absorb the increased costs of care/loss of labor?  Use tax money to fund education programs or subsidize weight loss treatments?  Laws that punish parents for being obese or having obese children?  Tax incentives for being skinny?

Something outside the box?

[Declaration Day]

Install narrow doors on fast-food restaurants, and eliminate the drive-thru window?

[Nick1911]

Nothing.  You should be free to be as obese as you want.   Freedom to live your life and all that.

You should also be free to suffer the consequences of that decision, like anything else.

Unfortunately, 'free health care' seeks to force others to pay for the consequences of an individuals choices.

[makattak]

So, there are lots of news stories about obesity, or some politician or university that came up with a dumb idea to fight it.  It is fun to pick the ideas apart, naturally.

Does anyone have a opinion on what, if anything, *should* be done?  Just leave it alone and absorb the increased costs of care/loss of labor?  Use tax money to fund education programs or subsidize weight loss treatments?  Laws that punish parents for being obese or having obese children?  Tax incentives for being skinny?

Something outside the box?

Here's something outside of the box:

STOP PAYING FOR PEOPLE. Healthcare, welfare, whatever. If people have to absorb the cost of their own decisions, we don't have a "problem".

Our problem isn't fat people, it's the government paying for fat people.

The solution to a problem caused by government interference is not MORE GOVERNMENT INTERFERENCE.

For some reason, this comes to mind:

"I've got a fever, and the only prescription is MORE REGULATION!"

[BridgeRunner]

1) The usual measure of obesity is BMI.  This is dumb.  While people with high BMI's are usually fatter than people with low BMI's, when a fat person becomes healthy through exercise and diet changes, they often do not lose weight.  I've gone from zero regular exercise to working out a minimum of eight times/week and have not lost a single pound, intentionally.  While I'm not obese, even according to the CDC, I'm certainly considered overweight.  So, measurement is a problem, and using BMI to determine obesity and to impose consequences on obesity just sets fat people up for failure when they try to become healthier through exercise and diet changes.

2) Why is this the gov't's business again?  Yeah, I know there are all kinds of justifications.  But seriously, why is this the gov't's business?

3) One gov't program has taken some positive steps:  WIC now offers $16/month for fresh produce and provides less juice and less or no full-fat milk than they used to.  They also offer breastfeeding support.  The quality varies between local programs, but in some areas it is very good.  A friend of mine does peer support for her local WIC office.  Breastfeeding tends to reduce obesity.

4)  Food stamps should designate a proportion of each family's allowance to be used for fresh produce.  Many states have implemented programs that enable food stamp users to buy stuff at farmers' markets.  That is a step in the right direction.

5) Local charities and community organizations of very kinds should help people get physical exercise.  Many YMCA's offer reduced cost memberships for low-income people; that's a good start.  Senior centers should focus on exercise more, with walking groups, age- and mobility-appropriate lending libraries of video workouts. Ditto for community mental health organizations and county health departments.  You don't find out about low-cost YMCA memberships unless you go to a YMCA.  If you are poor, you probably don't go to a YMCA.  My YMCA hits their fund-raising goal every year.  I am confident that with more outreach and more charity, they could come up with the money to do more.  If the problem is facilities becoming overburdened, then they could partner with local schools to offer classes off-site.  This would also address the problems of transportation for seniors and for low-income people.  

6) medical providers should emphasize the importance of exercise more.  I've never been encourage by a medical professional to exercise.  This is pretty dumb, considering that I have recurrent problems with depression and there is substantial evidence that exercise is at least as effective as some medications in treating depression.  Similarly, after hanging around on running forums, I've learned that there are whole lots of people out there not taking expensive drugs every day simply because they run.  I'm one of them, to the tune of about $400/month.

7) Insurance companies should take of the above.  

8) Ultimately it is usually a personal choice.  I'm against obesity penalties either privately or publicly imposed for two reasons: the above-detailed problem of measurement and effectiveness and fact that living is a grossly oversized body is punishment enough, and incentive enouh to address the problem.  Most people who don't have other problems.  Why give them more problems?

[Jamisjockey]

Dump all forms of public health care assistance.  Let people be whatever they want to be.  If they can't afford to pay for the decisions they make in life (eating too much, smoking, drinking too much...), then let them die.  Life is a bitch.

[BridgeRunner]

Um, why are we assuming that this is all abut poor people?  I mentioned charitable measures so that poor people can have some additional opportunities to fix their problems, but insured people have weight problems too.  And they have a high cost too.

[Fjolnirsson]

Leave it alone. Obesity should be none of anyone else's business, just like smoking, drinking or how much salt I like to eat on my gorram food.
One more reason to protest National Health Care. By making tax payers foot the bill, it gives them the right to intrude in others business.

I was obese in high school, when I was 185 lbs at 5'7". I was also on the cross country team, and ran 5 miles every school day. I had 8% body fat, but I was technically obese.
I am obese now, though truthfully in an unhealthy way. I am losing weight and shaping up on my own, without a gorram government program shaming me into it. If I wanted to sit on the couch and die at 35 with my face stuffed full of Cheetos, it is NOBODY's Business!
I could never weigh the BMI recommended 180 lbs or less at my current height, without looking like a concentration camp survivor.

I do agree with Bridgewalkers ideas, though. Oregon does Fresh produce for food stamps, which is a good thing, IMO. if we have to have the programs, better it be used on healthy foods.

[Jamisjockey]

Um, why are we assuming that this is all abut poor people?  I mentioned charitable measures so that poor people can have some additional opportunities to fix their problems, but insured people have weight problems too.  And they have a high cost too.

Government intervention will do nothing to curb the problem.  Or, it will curb the problem at the cost of our freedoms.  IMHO, Government offering social programs is part of the problem, because it creates the 'epidemic' out of it.  My point, is that if the Government spends tax dollars to provide health care, then fixing Obesity, smoking, etc become in the "National Interest". 

[Nick1911]

Um, why are we assuming that this is all abut poor people?  I mentioned charitable measures so that poor people can have some additional opportunities to fix their problems, but insured people have weight problems too.  And they have a high cost too.

You've confused me.

I have no problem with a person choosing to be obese.  This is not what I consider a societal problem that needs fixed, it is what I consider a personal choice.

It becomes a societal problem when the costs associated with the personal decision to be obese are placed as a burden on society.  To my knowledge, this isn't the case with those who have private insurance.  They pay higher premiums for their obesity, but the rest of us don't.  We, the public, only incur the cost when the obese person is using the services of a government program.

[Brad Johnson]

1) The usual measure of obesity is BMI.  This is dumb.  While people with high BMI's are usually fatter than people with low BMI's, when a fat person becomes healthy through exercise and diet changes, they often do not lose weight.  I've gone from zero regular exercise to working out a minimum of eight times/week and have not lost a single pound, intentionally.  While I'm not obese, even according to the CDC, I'm certainly considered overweight.  So, measurement is a problem, and using BMI to determine obesity and to impose consequences on obesity just sets fat people up for failure when they try to become healthier through exercise and diet changes.

Only problem with that is BMI is a terrible gauge for obesity, almost to the point of being medically useless.  It presumes everyone has exactly the same build, muscle mass, and fat distribution.  A better gauge is the ratio of fatty tissue to lean muscle mass, something that must be calculated on an individual basis.

It also has little to do with actual health.  A person with a "perfect" BMI (18.5-24.9) is statistically more likely to suffer health issues than an overweight BMI (25-29.9). Surprisingly, persons considered underweight (BMI less than 18.4) suffered the same rate of morbidity as people considered obese (BMI 30-34.9) (source: National Center for Health Statistics, CDC)

Health is better defined as a general state of physical well being as the result of proper dietary habits and regular exercise.  An overweight person who eats a balanced diet and gets regular exercise is (statistically) less likely to suffer health problems than a normal-weight person who is sedentary and has poor dietary habits.

As for the gov regulating obesity, they can take a hike.  It's a personal choice.

Also, the "fat people are a burden on society so we have to penalize them" argument, that also falls flat with me.  It's a nanny-state argument.  The cost of society is... the cost of society.  The only way to make sure that everyone is perfectly healthy and societal costs are perfectly controlled is to encase each of us in plastic at birth and feed us through a tube for our entire natural life.

Brad

[Jamisjockey]

As for  BMI:
Back in the Marine Corps, the body builders were often on weight-waivers. It was idiotic that someone who was clearly physically fit, could always pass a PFT, and could bench press a small car had to go yearly for physical waivers.  I knew a few guys that had to have thier BDU's tailored to fit thier guns....and yet if you looked in thier SRB you'd just see 'weight waiver'.     BMI is useless in my book unless you apply it directly to each and every person's individual traits and physique.

[Chester32141]

3) ..... They also offer breastfeeding support.  The quality varies between local programs, but in some areas it is very good  .... Breastfeeding tends to reduce obesity.

Where can I sign up for some of this Breast Feeding support ... I could stand to lose a few pounds ...

[BridgeRunner]

I have no problem with a person choosing to be obese.  This is not what I consider a societal problem that needs fixed, it is what I consider a personal choice.

I wrote a long response, that my browser ate, so I'll just say that we disagree.  People in my community being unhealthy and often unhappy because of it is something I consider a problem.  The choice element here s pretty complex and often requires some help to address.

For the most part it shouldn't be a problem for the gov't to solve, but I consider this a great way to spend charity dollars and volunteer time--with the proviso that my suggestions are all geared towards improving health, not towards obese people losing weight, for the reasons mentioned in the thread.

[mellestad]

Letting people deal with the consequences of their own health is fine, as long as a society is prepared to deal with the issues around removing social safety nets.

But rather than start a thread about Libertarianism, I'll just mark those responses down as, "Just leave it alone and absorb the increased costs of care/loss of labor", since social safety nets are not going to be taken away any time soon.

I was more interested in practical ideas than idealized political platforms.

[Nick1911]

I wrote a long response, that my browser ate, so I'll just say that we disagree. 

Don't you hate it when that happens?  Naturally, the back button is useless in that situation. 

I can respect that we disagree.  I am interested in hearing more about your view point.

People in my community being unhealthy and often unhappy because of it is something I consider a problem.  The choice element here s pretty complex and often requires some help to address.

Maybe just due to my psychology or personally, but losing weight isn't very hard for me.

Case in point - last October, I had a health assessment, where I was told that I weighed 216lbs, which made me firmly overweight.  I hadn't really been consciously keeping track of my weight, so I decided that I needed to act.

Started using the scale daily, and enacted the long-lost secret miracle diet known as "Eat less".  Specifically, "eat less food energy".

As of today, I'm down to 190.5, and am aiming for 175.

Personally, I don't understand how this is a hard or complicated process.  Seems very straightforward and scientific to me.

For the most part it shouldn't be a problem for the gov't to solve, but I consider this a great way to spend charity dollars and volunteer time--with the proviso that my suggestions are all geared towards improving health, not towards obese people losing weight, for the reasons mentioned in the thread.

This, I agree with.

[Tallpine]

practical ideas

Well, for a start, hospitals and other institutions could stop serving unhealthy food composed mostly of white flour, sugar, and HFCS.   

I know of several formerly trim people who have come out of extended stays overweight.

[Nick1911]

I was more interested in practical ideas than idealized political platforms.

Ah, I see.

There's plenty of solutions.  I just don't know of any that won't take personal freedom from the individual. 

If someone chooses to eat too many calories, they will gain weight.  The only way around this is to not let them make this choice.

[Brad Johnson]

Personally, I don't understand how this is a hard or complicated process.  Seems very straightforward and scientific to me.

It is just that straightforward.  The whole "it's hard for (fill in the blank) to lost weight" is a purely societal construct.  Aside from the very, very, very small percent of the poplution with a truly medical reason for uncontrollable weight, the rest is pure excuse.  I know because I made them for years.  Weight control is intellectual, not physical.  If you make up your mind to control your weight and do the things necessary to make it happen, your body can't help but go along for the ride.

Well, for a start, hospitals and other institutions could stop serving unhealthy food composed mostly of white flour, sugar, and HFCS.   

Has nothing to do with what kind of food (and I will patently disagree with you on the whole white/flour/HFCS thing, which I consider a nutritional sham).  It's stricly an issue of how much.  Weight gain in a clinical setting has everything to do with lack of exercise and consuming more calories than you burn.  That's what heppens when you lay in bed 24/7 but are still getting meals folmulated for the caloric rerquiement of a healthy active adult.

Brad

[BridgeRunner]

Maybe just due to my psychology or personally, but losing weight isn't very hard for me.

I'm gonna go with your psychology or personality.  It is very hard for many people, particularly people with mobility limitations, extreme financial hardship, or time constraints.  For some people, medical problems can make it more difficult. 

Moreover, to dismiss all the psychological issues that go along with it as just people being weak-minded or choosing not to change is arrogant, not to mention wrong.  (No, you didn't--I'm not responding directly to you.)  I guess I know too many fat crazy people to dismiss their problems are being all about their bad choices.

[BridgeRunner]

It is just that straightforward.  The whole "it's hard for (fill in the blank) to lost weight" is a purely societal construct.  Aside from the very, very, very small percent of the poplution with a truly medical reason for uncontrollable weight, the rest is pure excuse.  I know because I made them for years.

With all due respect Brad, you are not everyone.  For many, it is about excuses.  For others it is more complex.

I found quitting smoking pretty easy, all things considered.  I found quitting other addictions really, really hard.  Some people struggle for years to quit a maladaptive behavior, and those are often just stopping an action that is harmful.  The trouble is that everyone has to eat.  How much and what can be very, very hard for some people to change.

[mellestad]

Ah, I see.

There's plenty of solutions.  I just don't know of any that won't take personal freedom from the individual. 

If someone chooses to eat too many calories, they will gain weight.  The only way around this is to not let them make this choice.

And that is fine, I just didn't want a politics thread.

The problem is, either way there *are* consequences to a society even if you do nothing.  If you do nothing then you deal with things like poverty due to higher medical costs on a large (haha) segment of society and increased strain on insurance companies, hospitals and communities.  I understand that in an ideal Libertarian world those consequences are limited because people will, in theory, keep themselves out of trouble.  But since that ideal Libertarian society is not likely to happen before the current generation gets to deal with the massive health and productivity consequences of obesity, I hope someone can come up with some good workable ideas to mitigate the impact to the society that we will all be living in.

[Brad Johnson]

With all due respect Brad, you are not everyone.  For many, it is about excuses.  For others it is more complex.

No, it isn't.  The psychology behind it notwithstanding, weight loss is simple formula.  And I am "everyone".  I made every excuse in the book, and did so for years.  I even had a doc tell me that the weight wasn't my fault. Made me feel good to know that I had no control over it and could basically do whatever I wanted.  Know what?  It was complete and utter crap.  I'm living proof.

People who have a psychological problems, well.. I know there are a few.  But I work around people all day and can tell you for absolute fact that most of the "problems" aren't psychological.  They're social and societal.  People have been so conditioned to thinking a certain way that they become unable or unwilling to consider any other option.  Again, I know because I was one of 'em.  I finally wised up, info'd up, got my fat behind off the couch and out of the fridge, and made the conscious decision to stop using everyone else's excuses and make my own thing happen.

Brad

[zahc]

Has nothing to do with what kind of food (and I will patently disagree with you on the whole white/flour/HFCS thing, which I consider a nutritional sham).  It's stricly an issue of how much.

I don't think so. Only to a first approximation/binary sense. Everyone should watch this before continuing the discussion:

http://www.youtube.com/watch?v=AVvZP2av5Mk

(long. summary:carbs are bad)

[Brad Johnson]

I don't think so. Only to a first approximation/binary sense. Everyone should watch this before continuing the discussion:

http://www.youtube.com/watch?v=AVvZP2av5Mk

(long. summary:carbs are bad)

Short summary - nutritional BS.

Carbs are no worse than fats or proteins.  Your body needs, and is designed by nature to process, all three.  It's general overating in incorrect ratios of fats, carbs, and proteins, that are the problem.

Brad