What steps do medical systems take to address the obesity epidemic?

[DanP]

What are the steps the medical system takes nowadays to raise awareness in the public regarding obesity epidemic who rages through the western world , and to put an end to it ?
Is there a concerted effort to put it at an end ?

Should governments, through their healthcare policies, get involved in this issue ?

 

[leroyjenkens]

I don't think so. You can't help people who don't want to be helped. A lot of obese people really want to lose weight, they just don't want to put in the work to make it happen.
You can teach nutrition and exercise, but beyond that, it's up to the individual.
The exception is kids. The kids don't know any better. In that case, it's the parent's fault.
A lot of people blame the price of healthy food. They say it's more expensive than unhealthy food. I think that's just an excuse. Depending on where you live, fruits and vegetables aren't expensive. It's just that they're too lazy to make a real meal and instead opt for the meals that are already made, or are easier to make, which are generally more unhealthy.

 

[Count Iblis]

Governments should intervene by making nutrition and health topics mandatory in schools. We teach reading and writing in schools too, we don't say that everyone can learn to read and write themselves and then blame the inevitable high illiteracy rate on lazy parents/children who refuse to teach themselves to read and write.

 

[lisab]

The exception is kids. The kids don't know any better. In that case, it's the parent's fault.
A lot of people blame the price of healthy food. They say it's more expensive than unhealthy food. I think that's just an excuse. Depending on where you live, fruits and vegetables aren't expensive. It's just that they're too lazy to make a real meal and instead opt for the meals that are already made, or are easier to make, which are generally more unhealthy.

Mostly I agree, but it's not just parents. Have you seen what is served in school lunches? Total crap.

And yes, it's *much* cheaper to cook from scratch.

 

[mgb_phys]

Governments should intervene by making nutrition and health topics mandatory in schools.

Well that really worked with sex and drugs.

 

[Loren Booda]

I am obese due to some life-saving medication I take. Just a fact.

In high school I could do 15 pull-ups, run a 5 minute mile, and race up the ten stories of stairs at the Payne Whitney gymnasium.

I have gone from 170 pounds to a current 220.

I have seriously dieted, exercised, etc. The medicine (also used for anorexia) makes food taste better, metabolism less efficient, the stomach less sensitive, the brain more famished, the body more lethargic, fat stored more readily and eating more habitual.

Obesity is not always someone's fault.

I still rag on "fat" people like most do, though.

 

[mgb_phys]

The medicine (also used for anorexia) makes food taste better, metabolism less efficient, the stomach less sensitive, the brain more famished, the body more lethargic, fat stored more readily and eating more habitual.

Is that what they put in the water in the US?

(ps. you know I'm not getting at you - I'm sorry for whatever you need the medicine for)

 

[Loren Booda]

Better than Russian "little water"!

 

[Moonbear]

Well that really worked with sex and drugs.

You can lead a horse to water, but you can't make them drink. I agree that the best we really can do is offer the education, and then people still need to make choices for themselves about their own health.

Though, actually, sex education does work as they're discovering in those school districts where they abolished it for abstinence-only "education" and watched teen pregnancies and transmission of STDs rise.

And, I also agree with lisab that part of that education needs to be through example, by serving more nutritious, appropriately portioned school lunches.

Physicians can discuss with their patients healthy diets and exercise programs if they determine the patient is overweight or obese. But, again, they can't force their patients to do anything they don't want to do.

 

[TheStatutoryApe]

When I was in school we had a mandatory health class that taught about proper diet and basic dietary science such as what a calorie is and the difference between simple and complex carbohydrates. As with most classes I doubt many people really paid much attention.

Recently many state level politicians have been pushing to increase taxes on junk food and ban junk food from being sold in schools. Fastfood restaurants have been sued and several such as McDonalds (who of course was the target of bad publicity from the movie "Super Size Me") have been increasing the number of healthy options on their menus. Though many in other countries seem to think it obesity is not an issue that gets over looked in the US.

And yes, it's *much* cheaper to cook from scratch.

That's if people know how to cook from scratch and, more importantly, know how to cook healthy meals from scratch.

Cost isn't the only issue for people in the lower economic strata. Many people hardly know how to cook unless they were taught by their parents who probably gave little thought to the healthiness of their meals. Many poor families are single parent families where the mother works long hours and possibly even two jobs just to make ends meet and is stressed and exhausted by the time she gets home if she is even able to be home for her kids when they have dinner. And what time they have is usually short so quick and easy meals are preferred.

On top of this is the issue of kids getting exercise. Many kids that live in the city don't have a whole lot of options for getting out and doing things. Skate boarding is a rather popular exercise activity for kids in an urban area and most places ban it. Most major cities have few if any places for kids, particularly teenage kids, to go and hang out and have fun unless they have money and want to play video games or some such which isn't exercise. At one of the apartment complexes I work at they had a body bag in the gym and some teenage kids decided to start going in there together to practice boxing and martial arts moves on the body bag (probably inspired by UFC). They got a bit rowdy on occasion but they caused no real trouble, only maybe annoyed some adults, and they always respected me as a security guard and listened when I asked them to keep it down or to not lounge around the exercise equipment. Management received complaints and now the body bag is gone along with the kids. Some of the kids also like to go and play basket ball or soccer on the courts for the complex. Already we are receiving complaints from residents about the noise when it is not even late. Poor kids playing sports and having a good time are just too often seen as troublesome hoodlums that are disturbing proper law abiding citizens. Unfortunately it is a general lack of anything to do and their preferred activities being denied them that usually leads to them going about tagging and causing mischief. In the end the only legitimate source of entertainment that most poor kids have is watching tv and playing video games.

 

[Moonbear]

When I was in school we had a mandatory health class that taught about proper diet and basic dietary science such as what a calorie is and the difference between simple and complex carbohydrates. As with most classes I doubt many people really paid much attention.

Yes, we had all of that taught when I was in school too. Along with sex ed and other health related issues.

That's if people know how to cook from scratch and, more importantly, know how to cook healthy meals from scratch.

Cost isn't the only issue for people in the lower economic strata. Many people hardly know how to cook unless they were taught by their parents who probably gave little thought to the healthiness of their meals. Many poor families are single parent families where the mother works long hours and possibly even two jobs just to make ends meet and is stressed and exhausted by the time she gets home if she is even able to be home for her kids when they have dinner. And what time they have is usually short so quick and easy meals are preferred.

You can make a quick and easy yet nutritious dinner. We had a lot of those when I was growing up, because when my father was alive, his work schedule could be very unpredictable and my mom often worked overtime too. Then, for a while, it was just my mom and us kids. I learned to cook at a young age so I could start dinner before mom got home (and we'd keep it warm for dad). We had a lot of meals that pretty much consisted of a frozen vegetable boiled (this was before we had a microwave), some type of potato, usually boiled or mashed (rarely, we had rice...I eat a lot of rice now, but my parents were never much into it), and meat either broiled or pan fried with just some basic seasonings (salt, pepper, garlic powder and onion powder...add some thyme for chicken). It was very basic, but that's what they could afford. We never had the pantry full of junk food (my aunt did, which is why she and my cousins were always overweight).

But, I think you're right that a lot of people today lack even that most basic skill of cooking a very simple meal, so get a lot of things that are microwaved or take-out.

Do they still teach home-ec in schools? I know a lot of those "elective" courses have disappeared over the years. But, that was a class that taught not just how to balance nutrition, but then how to actually cook the meal. When I was in school, it was a required class. Everyone had to learn a few basics of cooking and sewing (basically, just enough to mend a small tear in a seam or sew on a button, but that's more than a lot of people know). And, we also all had to take shop class, where we all had to learn to use some basic hand and power tools. I think these are important classes to continue, because everyone needs to know how to cook a basic meal, sew on a button, and do some minor repair jobs around the home. They're life skills that every high school graduate should have.

 

[TheStatutoryApe]

Do they still teach home-ec in schools?

In my junior high we had it as an elective class if I remember correctly. You could take it or something else. I don't remember being taught about nutrition in that class though. Maybe its just been a while. I do not remember having home ec in high school though. I think that there might be a bit of a PC stigma on home-ec class, especially around here. "Oh so you want to teach young girls how to be good little house wives while the boys are playing with their cars in shop class huh?"

I don't think we are very far apart in age (maybe you're even younger than me? ;-)) so you would probably be better informed about current high school classes from your students than I would be.

 

[vaatc]

The government should only push people along the path. For instance stop cutting physical education/health programs in the public school systems.

As for some of the comments above. Not all obese people are in that situation because they are unwilling to change, many of them just put themselves last and their health suffers for it. It has a lot to do with peoples own perception of their own self worth and less so with lack of motivation because many obesese people excell at other areas in their lives.

but with most behavioral issues there are many that are related to pure laziness and a lack luster view on life.

Mostly I agree, but it's not just parents.

Who sends their kids to school without a properly balanced meal?


EDIT: Just realized that you said "not just the parents", but most of the responsibility lays in the hands of the parents.


The parents.

 

[DanP]

I am obese due to some life-saving medication I take. Just a fact.

In high school I could do 15 pull-ups, run a 5 minute mile, and race up the ten stories of stairs at the Payne Whitney gymnasium.

I have gone from 170 pounds to a current 220.

I have seriously dieted, exercised, etc. The medicine (also used for anorexia) makes food taste better, metabolism less efficient, the stomach less sensitive, the brain more famished, the body more lethargic, fat stored more readily and eating more habitual.

Obesity is not always someone's fault.

I still rag on "fat" people like most do, though.

Loren, I agree that obesity is not someone's fault in all cases, but for the vast majority, pretending it's not their fault is just denial.

In your case, did you consulted a specialist to make you a nutritional program which may help you get better ?

 

[Count Iblis]

Well that really worked with sex and drugs.

I agree with Moonbear. I think sex education and education about drugs work ok. I think education about health can be improved a lot. Today's children don't exercise enough, don't sleep enough and the diet is not optimal. If you are below the age of 20 and generally healthy, you can get away with being in poor shape. You can still physically exert yourself enough witout being confronted that you are not in shape.

Bad habits can easily slip in this way. If you get older, then the body will store far more fat compared to someone who is in good physical shape even if they eat the same diet.

 

[Count Iblis]

I am obese due to some life-saving medication I take. Just a fact.

In high school I could do 15 pull-ups, run a 5 minute mile, and race up the ten stories of stairs at the Payne Whitney gymnasium.

I have gone from 170 pounds to a current 220.

I have seriously dieted, exercised, etc. The medicine (also used for anorexia) makes food taste better, metabolism less efficient, the stomach less sensitive, the brain more famished, the body more lethargic, fat stored more readily and eating more habitual.

Obesity is not always someone's fault.

I still rag on "fat" people like most do, though.

I know from my own experience when I was in high school that I could do that too even if I was unfit (e.g. just recovered from flu). If you are older then you do need to be in shape to run for 5 minutes at high speed.

The real test is if you can run nonstop for 30 minutes or so.

 

[DanP]

The real test is if you can run nonstop for 30 minutes or so.

The real test for what ? And running non-stop for 30 mins at what % of V02 max ?

Anyone can run 30 mins nonstop with several months of practice. Its not a big deal.

 

[leroyjenkens]

You don't even have to know how to cook to make a healthy meal. It's just that it might not taste as good as the unhealthy alternative. But you should eat to live, not live to eat.
Make a salad with spinach and other vegetables and a can of tuna mixed in for some taste. Then instead of pouring on the fat based dressing, use vinegar. Still hungry? Eat a can of beans. Still hungry? Drink some water and see if that works. That's what I do.

I think the problem is people sitting at home too much. They sit there at home watching TV or on the computer and they have food right there for them to eat all day.
If you're out doing something, away from home, you don't have the food available to you and you only eat when you really are hungry.

 

[FredGarvin]

Is that what they put in the water in the US?

And we all know that there are no obese people in GB...

 

[mgb_phys]

And we all know that there are no obese people in GB...

yes, but it's glandular

 

[Count Iblis]

The real test for what ? And running non-stop for 30 mins at what % of V02 max ?

Anyone can run 30 mins nonstop with several months of practice. Its not a big deal.

I mean really running and not just "fast jogging". I agree that most healthy persons should be able to get in shape in few months time. If you exercise about 30 minutes intensively every day, you are unlikely to get obese. That is not because you'll burn a little more calories due to exercising, but because the feedback loop that regulates your metabolic rate to keep your weight the same regardless of how much you eat (within some reasonable bandwith) works better if you are physically fit.

 

[Loren Booda]

In your case, did you consulted a specialist to make you a nutritional program which may help you get better ?

You know, a nutritionist may actually help.

 

[leroyjenkens]

I mean really running and not just "fast jogging".

So sprinting for 30 minutes? There's probably very few people in the world who can do that.

 

[DanP]

So sprinting for 30 minutes? There's probably very few people in the world who can do that.

No he doesn't mean that. *Nobody* can sprint over a distance of more than 200m. In track and field all events over 400 are getting into middle distance. 400m is already not a true sprint event.

 

[DanP]

You know, a nutritionist may actually help.

Im almost sure it will help. Most ppl I know who took on a light exercise program and got a sound nutritional program made great improvements in the quality of life. And this is why it's worth doing. Not because you'll look prettier in the mirror, but because it makes your life better.

You don't have anything to loose. I say, get clearance from your MD and get it rolling.

 

[whs]

I mean really running and not just "fast jogging". I agree that most healthy persons should be able to get in shape in few months time. If you exercise about 30 minutes intensively every day, you are unlikely to get obese. That is not because you'll burn a little more calories due to exercising, but because the feedback loop that regulates your metabolic rate to keep your weight the same regardless of how much you eat (within some reasonable bandwith) works better if you are physically fit.

I bet almost anyone has the ability to run 30 min non-stop without any training whatsoever. I also think the majority of those people would mentally quit before they hit that target. Sure they might feel horrible afterwords, throw up, break a bone what have you, but its possible.

I think many factors go into people being obese (that can help it). Number 1 and 2 are definitely exercise and eating habits. But those 2 factors seem to just be a part of peoples state of mind. Are there really adults out there that truly want to lose weight but have no idea how to accomplish that?

I agree with DanP about the nutritionist. Many people formulate numbers in their mind about their healthy body weight, when in reality they vary widely.

 

[DanP]

Many people formulate numbers in their mind about their healthy body weight, when in reality they vary widely.

For any non-athletic population, they should strive for a BMI in normal range, where health risks are minimal. Any rationalization over their over-weight is wrong.

BMI is a lousy measure for athletic populations. The issue is, I seen this reality used as a rationalization for overweight by non-athletes. It goes like this "I go to gym 3 times a week, hit the weights, so I can have 95kg at 180cm I am an athlete." No ****. You are an athlete with an 107 cm waist ? Those guys usually try to rationalize this way serious chunks of body fat percentage. If it would only work this way.

Correlating BMI and WHR gives a good image in most cases.

 

[gravenewworld]

I don't think so. You can't help people who don't want to be helped. A lot of obese people really want to lose weight, they just don't want to put in the work to make it happen.
You can teach nutrition and exercise, but beyond that, it's up to the individual.
The exception is kids. The kids don't know any better. In that case, it's the parent's fault.
A lot of people blame the price of healthy food. They say it's more expensive than unhealthy food. I think that's just an excuse. Depending on where you live, fruits and vegetables aren't expensive. It's just that they're too lazy to make a real meal and instead opt for the meals that are already made, or are easier to make, which are generally more unhealthy.

For most of us that is completely false. The way our food industry works is completely backwards. We make it cheaper for high calorie low nutrition foods, and make it much more expensive to buy wholesome products. It's no secret that the poor tend to have much higher rates of obesity, diabetes, and high blood pressure compared to their more wealthy counterparts.

http://www.csrees.usda.gov/newsroom/impact/2008/nri/03191_food_prices.html

The researchers found the price of calorie-dense food was less likely to rise as a result of inflation. During the 2-year study, the price of high-calorie food decreased by 1.8 percent, whereas the price of low-calorie foods increased by 19.5 percent. Considering most bargain shoppers are trying to stretch their incomes as far as possible, the findings may help explain why the highest rates of obesity are among people in lower-income groups.

Based on a standard 2000-calorie diet, the researchers found a diet consisting primarily of calorie-dense foods costs $3.52 a day, but a diet consisting primarily of low-calorie food costs $36.32 a day. The average American eats a variety of foods throughout the day, spending $7 a day.

The obesity epidemic is a multi faceted problem from personal choices to government policies. Why not take care of the problems that can be addressed through legislation? You can't force people to eat healthily, but you CAN make it much more appealing for them to do so. First off end corn subsidies. Ever since Nixon's presidency we have been paying farmers to vastly over produce corn with subsidies. Corn makes its way into our diets in a myriad of ways. Animals are no longer allowed to feed on grass because they can be fattened up much more quickly on a diet of corn, which can be bought extremely cheaply since it is overproduced. Steaks that come from a cow that is fattened up on diet of corn (which makes up 95% of beef that is sold in grocery stores) contain 6x's more saturated fat than a steak that comes from a cow that is grass fed. Not only that, but grass fed beef is also safer to consume. Chicken today contains 130% more saturated fat than it did in the 70's because chickens are pretty much only given corn to eat. Study after study has correlated higher rates of high fructose corn syrup consumption with higher levels of obesity. HFCS is in almost everything you eat that is not fresh because subsidies have made HFCS cheaper than real sugar.
No one is denying the role personal responsibility plays in obesity, but how many people ask questions about what happened to the quality of our food?

 

[Count Iblis]

So sprinting for 30 minutes? There's probably very few people in the world who can do that.

No, as DanP said, that's not what I meant. Look, there is a difference between "jogging" and "running". I work out almost every day for 25 minutes at quite a fast speed, but of course not "sprinting speed".

I'm sure most people will not be able to keep up with my pace. People who are not fit could perhaps keep up with me for 2 minutes and then have to stop. They could also run for 30 minutes at slow jogging speed and then, as whs said, feel horrible afterwards.

 

[Evo]

Chicken today contains 130% more saturated fat than it did in the 70's because chickens are pretty much only given corn to eat.

Please post the study that shows corn is the reason that chicken contains more fat and not a change in breeding.

The only thing I could even remotely find is this article, which at the end is disputed.

http://www.timesonline.co.uk/tol/news/uk/article376661.ece