Obesity

[zahc]

Medium summary--calories from carbs facilitate the deposition of body fat much more so than protein and fat calories, because of the way fat tissues works with insulin. A good deal of reasonable evidence backs this up, which is presented in the youtube. The Calories in<calories out=weight loss is true, but not very useful to real human metabolism because the body regulates its energy output, the effect of which is often greater than even a moderate exercise regime. And losing weight isn't usually the goal. Most people want to lose fat, and keep it off.


At the beginning of the year I cut my caloric consumption from who knows what (>3000 per day easily) to 2000 calories per day and I've lost about 15lbs since then. I'm not using a specially low-carb diet but my diet has always been fairly low carb (eggs and bacon yum).

[mellestad]

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.

I might as well get into the derail, lol.

This was always interesting to me.  Since certain foods trigger a positive response in the brain, it seems obvious that food can be addictive.  If every drug addict had to do just a little bit every day, but no more, would anyone ever be able to recover?

Obviously there is more going on than, 'weak will'.  If you get a kid fat, the chances of them ever being skinny over a long period of time are remarkably low.  Since the main fear about obesity right now is child obesity, calling all the fat kids 'weak' isn't really a helpful solution.  If it were, gym teachers would all be weight loss coaches and no-one would be fat :)

My argument has a couple of assumptions though.  1. Fat kids usually don't get skinny 2. Ridicule and 'cowboy up' are not successful motivators for weight loss.

[41magsnub]

As somebody struggling with obesity I will say it is very difficult for me to lose weight.  I have a very sedentary job.  I exercise in the mornings, watch what I eat, and take a walk in the evenings and it is slowly working, but not fast enough for my cardiologist.  I ballooned while suffering from congestive heart failure (before I knew it was happening and I was always chubby).  Now I have reduced energy because of the very high doses of BP medications and my size making exercise more of a chore than it should be.  He has threatened me with banding if I don't get straightened out by the end of summer.  I am actually considering telling him to do it now and just take that jump towards getting healthy.

[Brad Johnson]

Medium summary--calories from carbs facilitate the deposition of body fat much more so than protein and fat calories, because of the way fat tissues works with insulin.

Nice line. Even sounds all official and stuff.  It's still nutritional BS.  A little basic nutritional science skewed heavily in order to frighten. (or as is often the case, skewed by frightened people who have no nutritional knowledge other than what they see on YouTube).

Biology 101.  Fats and carbs break down into glucose.  Excess glucose is stored as fatty deposits.  Insulin is simply a regulator of blood glucose levels.  The whole "facilitates the deposition of body fat" is true, but in a healthy body without underlying medical factors it only happens when there is excess glucose in the bloodstream (i.e. you ate more calories than your body needed).

Summary, eat more calories than you burn and you get fat, no matter what the calorie source might be.

If you get a kid fat, the chances of them ever being skinny over a long period of time are remarkably low.  Since the main fear about obesity right now is child obesity, calling all the fat kids 'weak' isn't really a helpful solution. 

It's been my observation that many obese children are accompanied by their obese parents (often with a soft drink or some kind of snack in hand).  A parental example of proper nutrition and regular exercise is non-existant.  As a result the kids become listless couch potatoes who don't know what proper nutrition is.  Behaviours ingrained in childhood a tough, tough, tough to overcome as an adult.

Brad

[Jamisjockey]

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.

This.

I won't even entertain the mental exercise of reducing personal freedoms.

[AmbulanceDriver]

Nice line. Even sounds all official and stuff.  It's still nutritional BS.  A little basic nutritional science skewed heavily in order to frighten. (or as is often the case, skewed by frightened people who have no nutritional knowledge other than what they see on YouTube).

Biology 101.  Fats and carbs break down into glucose.  Excess glucose is stored as fatty deposits.  Insulin is simply a regulator of blood glucose levels.  The whole "facilitates the deposition of body fat" is true, but in a healthy body without underlying medical factors it only happens when there is excess glucose in the bloodstream (i.e. you ate more calories than your body needed).

Summary, eat more calories than you burn and you get fat, no matter what the calorie source might be.


It's been my observation that many obese children are accompanied by their obese parents (often with a soft drink or some kind of snack in hand).  A parental example of proper nutrition and regular exercise is non-existant.  As a result the kids become listless couch potatoes who don't know what proper nutrition is.  Behaviours ingrained in childhood a tough, tough, tough to overcome as an adult.

Brad

Biology 301....  :)

I'm gonna argue a couple of points here.  In short, you're both right.  The source of calories DOES affect the amount of calories deposited as fat.  However, excess calories will be deposited as fat, regardless of the source.

Lets say for example that someone eats 1000 calories in excess per day.   For arguments sake, let's say that these 1000 excess calories all come from glucose (the simplest sugar your body can process).  A high percentage of those excess calories will be deposited as body fat, around 75%.  Where does that extra 25% go?  It's burned in the process of converting sugar to fat for long term storage.  

Now, calories from fat undergo one of two pathways.  Triglycerides are sometimes directly absorbed into the bloodstream and then redeposited in fat stores with almost no energy use.  Around 2% energy loss in that process.  Other fats, such as mono- and diglycerides, undergo a series of chemical reactions, ending up in what's called "de novo lipogenesis".  Basically, fat gets broken down, transported, and then rebuilt into a different kind of fat.  The energy requirement for this is significantly higher than that for simple lipogenesis from sugars.  

So quit arguing.  You're both right.  

And Brad, I have to share your observation regarding family size.  Most fat kids have fat parents.  And all too often the cycle simply can't be easily broken.

[mellestad]

This.

I won't even entertain the mental exercise of reducing personal freedoms.

Would you consider using public funds to create anti-fat programs a reduction of personal freedom?  I know many Libertarians would, I just don't know where you stand, specifically.  I can think of many options that do not directly curtial personal freedom but none that do not violate it indirectly, since you can argue that any form of taxation is a reduction of personal freedom.

Of course if that is the line then we are back to, "absorb the cost to society after the fact."

[lee n. field]

Something outside the box?

Something outside the box.  Like maybe actually talking to fat people.   Ask the right questions.  You'll likely get an earful.

Sorry, I'll start ranting soon.  There's a lot of feedback loops in the system.  The usual advice comes off (to me) as scolding.  And I don't react well to scolding.

[Jamisjockey]

Would you consider using public funds to create anti-fat programs a reduction of personal freedom?  I know many Libertarians would, I just don't know where you stand, specifically.  I can think of many options that do not directly curtial personal freedom but none that do not violate it indirectly, since you can argue that any form of taxation is a reduction of personal freedom.

Of course if that is the line then we are back to, "absorb the cost to society after the fact."

No, I wouldn't, and I see it as a terrible waste of government resources.  I'd like to see a rollback of most functions of our government.  Flat tax on individuals.  No federal taxation of corporations.  Elimination of all federal entitlements. 
Leave it up to private insurers on how they will handle fat people.  And, if someone can't get insurance because they are too fat, I don't care.  I really don't.  And I don't care if they die a miserable death in the street. 

[mellestad]

Something outside the box.  Like maybe actually talking to fat people.   Ask the right questions.  You'll likely get an earful.

Sorry, I'll start ranting soon.  There's a lot of feedback loops in the system.  The usual advice comes off (to me) as scolding.  And I don't react well to scolding.

Well, this is a good opportunity to rant, so go for it!

I hope someone has some constructive ideas.  Outside of the derailing about, 'why are people fat', I've only seen two suggestions:

1. Let broke people die.
2. Hope communities solve the problem on their own.

I don't see either one of those options as being particularly effective since 1 ignores the real cost of doing so and if 2 were going to work it would have already worked.  2 *might* work if someone had a novel way of going about it, but nothing has come up yet.

[Nick1911]

Alright.  Brainstorming session.

Force the food industry to only serve 500 or less calorie meals.  
One serving per person per order.
Ban, or heavy tax, non-diet soda.  
Ban the sale of sweeteners that aren't artificial.
Put huge taxes on food so people can't afford to overeat.  
Issue visa cards that track calories - when you're out of calories for the week, you can't buy any more food.  
Set some metric for obesity, then make going over that an criminal offense.
Set up a massive public awareness campaign, and pay for it with taxes on fast food. (tobacco model)
Make having a kid that's too fat be classified as child abuse.

[BridgeRunner]

Well, some legislator in NY just proposed a ban on added salt in all NYC restaurants.  I think that's kinda' cute.  In an idiotic sort of way.

[Jamisjockey]

Well, this is a good opportunity to rant, so go for it!

I hope someone has some constructive ideas.  Outside of the derailing about, 'why are people fat', I've only seen two suggestions:

1. Let broke people die.
2. Hope communities solve the problem on their own.

I don't see either one of those options as being particularly effective since 1 ignores the real cost of doing so and if 2 were going to work it would have already worked.  2 *might* work if someone had a novel way of going about it, but nothing has come up yet.

No, my solution is for government to butt the hell out.  You're just twisting those words into "letting broke people die".   

[Tallpine]

weight loss is simple formula

It is absolutely NOT

Look up something called "insulin resistance"

For some people, the more that they diet, the more weight they gain.

[Brad Johnson]

Those are the people that have the "valid medical condition" I mentioned.  It's a small percentage of the population.  For the rest the equation still stands.

Brad

[Creeping Incrementalism]

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)

That CDC study has been widely criticized for not taking into account all the junkies (e.g. skinny tweekers), alcoholics, smokers, and sick people who have a low to normal BMI because they are sick and can't eat enough.  BMI is in fact very good on a population basis.  I saw a study that showed that BMI actually understates the number of fat people because the same value is used for men and women, and by a body fat percentage, people tend to be even more are fat that the BMI indicates.  Especially women.

Now on an individual basis, yeah, BMI is terrible.  The BMI is not designed for that but used anyway.  Almost every man that works a good strength training program for not even a year will get into the BMI overweight category, even at fairly lean body fat % levels.

Regarding the sugar carbs versus "good" carbs, that is insignificant.  I would guess that the difference amounts to just a few pounds at most (if anything at all), from personal experience and what I hear of bodybuilders who are cutting.  (It is hard to tell for sure because almost all people who diet strictly do it the "good" way.)  A few extra pounds makes a big difference to someone in a bodybuilding competition or trying to make their weight class for some other event.  However, the problem is that people are typically something like 30 pounds overweight.  There are a lot of fat women who claim to always "eat healthy" and yet are overweight, and I believe them.  I created a spreadsheet and assuming 3500 Calories per pound of fat and a maintenance level of 4.5 Calories per day per pound of fat (a middle level based on the various estimates I have seen), a surplus of one plain bagel each day (290 Calories) will put on about 18 pounds to an average woman (average heightand a healthy weight) in one year.  This would move her from a size 2-4 to about a size 12.

For what to do about it, I think that is easy.  Make fat people pay higher health insurance premiums.  Since BMI sucks, a simple measuring tape is all that is needed to get a reasonably close body fat percentage.

[BridgeRunner]

I hate to break it to ya, but a size 2-4 does not equal a healthy weight for most women.  When I was in a 6 I was hovering on the edge of underweight.

Also, I am a woman who had a baby seven months ago.  I've also run 20 miles in the past week and done three hour-long lifting sessions.  Waist size isn't entirely about being unhealthy.  It has a little bit to do, in many women, with having housed a human being in there.

I don't have a skinny waist.  You can take your measuring tape and stick it where the sun don't shine.

[sanglant]

until the bmi index is fixed(i believe it twas the clinton twit that borked it ) or we start measuring actual bmi instead of guessing, it will just keep getting worse.

[Brad Johnson]

Since BMI sucks, a simple measuring tape is all that is needed to get a reasonably close body fat percentage.

I'll echo BW's sentiment here.  A resounding "No".

Brad

[Nick1911]

So, how do you measure the amount of body fat a person is carrying?

[Stickjockey]

I'd love to figure out a way to make the more nutritious stuff more affordable than the high-fat, high-sodium, empty carb-filled crap. Kraft Mac-n-Cheez is $.25-$.50 a box, and whole grain pasta is ten times that much.

[zahc]

So, how do you measure the amount of body fat a person is carrying?

Weigh them underwater. That's the best way.

[Brad Johnson]

Like zahc said, immersion method.  Weight in air vs weight in water.  Extremely accurate but takes specialized equipment.  There's also the caliper method (accuracy depends on the caliper operator) and the infrared method.

Brad

[Regolith]

Like zahc said, immersion method.  Weight in air vs weight in water.  Extremely accurate but takes specialized equipment.  There's also the caliper method (accuracy depends on the caliper operator) and the infrared method.

Brad

I've used the caliper method before.  From that, I learned that even if I had a 7% body fat (which is a little on the low side for men, but not much; IIRC 10% or so is normal), the BMI index would still consider me "obese."

I stopped paying attention to BMI after that.  Body fat percentage is a much better measure. 

[Monkeyleg]

Interesting that everyone seems to be discussing how to measure obesity, and not whether the government has any reason to be involved.

That the government is even considering getting involved means just one thing: taxes. I've been saying for years that, once smokers were made to be the vermin of our society (and taxed as such), food would be the next target.

This is public policy that can be sold as being "for the good" of everyone. People will be healthier. Medical costs will be lower. There's no downside.

The government will go after Big Food. They'll also find a way to get tax revenues from overweight people.