The Obesity Epidemic: What Can Be Done to Stop It?

[mugaliens]

The study makes sense, and is in accordance with known glucose/fructose metabolism...

 

[Zubin]

By BMI I am obese, however, my blood test results indicate that I'm perfectly healthy. I lift weights regularly and I eat healthy foods but I just have a slow metabolism. Wasn't there a study suggesting "healthy" people with slow metabolisms tend to live longer?

 

[rolerbe]

The medical system will reimburse for your leg amputation due to the long term effects of out of control type II Diabetes (a disease highly mediated by obesity), but not for nutritional counselling by a Registered Dietitian that has been proven to reduce the overall incidence of such surgery being needed. Medicare is the worst in this regard.

That's just one example, 'nuff said.

 

[Jimmy Snyder]

My bmi, at 30.7 is just over the mark for class 1 obesity. My wife has been encouraging me to slim down. That means nagging while cooking the best Chinese food you can imagine. There is a pool at work now with about a dozen of us fatties to see who can lose the most weight by percentage. We have until late May for the final weigh in. We each put in $20 so there's a nice incentive. I expect to do well, but winning is probably out of the question since there is a ringer in the bunch. He is morbidly obese with a bmi over 40.

 

[Proton Soup]

My bmi, at 30.7 is just over the mark for class 1 obesity. My wife has been encouraging me to slim down. That means nagging while cooking the best Chinese food you can imagine. There is a pool at work now with about a dozen of us fatties to see who can lose the most weight by percentage. We have until late May for the final weigh in. We each put in $20 so there's a nice incentive. I expect to do well, but winning is probably out of the question since there is a ringer in the bunch. He is morbidly obese with a bmi over 40.

sure, if he really wants it. but there is also a thing called the Protein-Sparing Modified Fast, and if he's like most people, he wouldn't know about this secret weapon.

 

[mugaliens]

BMI is not to be used as any sort of prediction for overall health. It's nothing more than a ratio between one's mass and one's height, and only a vague means of estimating adiposity. If you're at 6% body fat, but built like a tank, your BMI will be through the roof (obese). But you can be above 30% body fat, but with little muscle and small bones, and still fall in the Normal range.

It should never be used as anything more than a very quick, and very dirty means of getting a general idea of one's adiposity. The fact that "it is the most widely used diagnostic tool to identify weight problems within a population" isn't surprising, however, as it is ridiculously easy and impossible to cheat.

I strongly object to it's use to "identify weight problems" and would rather see it being used to "screen for potential weight problems."

Furthermore, it excludes these four key factors:

1. Body fat percentage

2. Muscle strength

3. Muscle endurance

4. VO2 max

The first and the last are very easy to measure. Body fat is easily measured in less than a minute by means of an electronic device. The hand-held ones are ok, but for professional results, you lay down for about 3 minutes on a non-conducting mat with electrodes attached to wrists and ankles.

VO2 max is easily measured by means of a 5 to 15 minute sub-maximal treadmill elevation test. Your height, weight, gender, and percentage body fat are put into a computer. You wear a heart monitor, also tied to the computer. You select a comfortable walking pace. After a two-minute warmup, the elevation is increased one degree per minute until your heart rate reaches either 80%, 85%, or 90% (depending on how much risk the testers wish to accept) of your 220-age derivation for your max heart rate. The greater the risk, the greater the accuracy.

The computer uses your velocity, elevation angle, and your weight to computer how much work you're doing. It next compares your lean body mass and your heart rate to profiles obtained under actual VO2 max walk tests (tens of thousands have been done, so the parameters are fairly tight) to estimate your VO2 max/kg lean body mass.

Unfortunately, many VO2 max sub-max tests remain out there which determine VO2 max/kg total body mass, which will cause even the best of atheletes to score low if they're sporting love handles. The reason for this is that they were derived primarily for athletes for whom body fat isn't an issue, so simply using total body mass allows for good comparisons between those tested. The problem is when you attempt to use the results per total body mass for someone with extra adipose tissue: it seriously skews the results downward.

Let's consider a test case: A serious, daily cyclist weighs 167 lbs, and scores 70 ml/kg/min. The cyclist is put on a medication which causes weight gain, but he continues training at the same calories per hour level as before (and duration, frequency, etc.) but when he hits 210 lb, he'll measure 55.6 ml/kg/min.

Now: If we knew the cyclist began with 6% body fat, and ended with 25% body fat, we would also know his lean body mass never changes. Since his lean body mass is 157 lbs, his VO2 of lean body mass is 65.8 ml/kglean/min, both before and after his weight gain. It's just that the test results of 55.6 ml/kg/min are incorrectly calculate as it divides the raw score by non-contibuting, and therefore penalizing, fat.

Thus, we see, like BMI, the practice of calculating VO2 max by dividing by body weight in attempt to gain a score comparable between people of different sizes, was originally done for expedience, on atheltes of similar fat content, and thereby introduces a serious error when that practice is wrongly used to compare people of differing body fat.

Muscle strength and muscle endurance are not objective, comparable measures between individuals and are highly task dependant. They may be useful measures of one's ability to carry a 150-lb person in a fireman's carry for 50 yrds, or for toting 20 lbs of body armor along with a 40 lb pack, but only if those tests match the tasks for which one is being tested.

 

[Count Iblis]

My BMI is 22 now. When I was younger, I was borderline underweight (BMI of 18.1).

 

[Jimmy Snyder]

sure, if he really wants it. but there is also a thing called the Protein-Sparing Modified Fast, and if he's like most people, he wouldn't know about this secret weapon.

I don't need to fast. If I lose 3 lbs a week, I will go to underweight, a condition I have no intention of reaching.

 

[Proton Soup]

I don't need to fast. If I lose 3 lbs a week, I will go to underweight, a condition I have no intention of reaching.

you could easily lose a pound a week just on calorie restriction. boring old "eat less and exercise more" really does work, but you'll probably want to do some calorie counting to make sure you're not fooling yourself. but if you are intent to win, a ketogenic (no carbs) diet in the last few days will cause you to temporarily lose some body water and lose a few extra pounds.

thing is, you're right that the other guy has an advantage. even his basal metabolic rate is probably higher from carrying around all that fat, so he can shed pounds fast if he wants. at least initially. but he also didn't get where he is by having more self control than you, so you've got that advantage.

 

[Jimmy Snyder]

This morning I passed from class 1 obese to merely overweight. That is, according to the bmi calculation.

 

[lisab]

This morning I passed from class 1 obese to merely overweight. That is, according to the bmi calculation.

Woot !

 

[Count Iblis]

I just weighed myself. I'm 64.7 kg, but that's while wearing clothes, a thick winter jacket and shoes.

 

[Jimmy Snyder]

Today I fell below 29 BMI. As we near the quarter pole, I am in the lead.

 

[Borek]

Go, Jimmy, go!

 

[Agleh]

This issue may be solved the hard way, as the essential commercialized food production and distribution systems become too expensive with the general collapse of much of the rest of industrial civilization. Within thirty years people will be a lot thinner, as much more food will be grown locally and transportation fuelled by petroleum will become too expensive for most people. (for anyone confused by this, google "peak Oil" or look for the work of M.King Hubbert, Colin Campbell Colin (2002 “Petroleum and People” Journal of Population and Environment Vol.24, No. 2, pp. 193-207) and Albert Bartlet. Bartlet wrote a neat paper on the timing for the decline in world wide oil and other fossil fuels in the journal of Mathematical Geology in 2000(Alfred Bartlet, 2000, An Analysis of U.S. and World Oil Production Patterns Using Hubbert-Style Curves “ Journal: Mathematical Geology Volume 32, Number 1 / January, 2000 Pages 1-17 Springer Netherlands ISSN 0882-8121 (Print) 1573-8868 (Online); see also Bartlett, Albert A. 1978. “Forgotten Fundamentals of the Energy Crisis.” American Journal of Physics 46: 876-888). Bartlet also gives a great lecture on the whole issue we are facing in our civilization: see his video lectures on this subject, such as: http:// www.youtube.com/watch?v=-3y7UlHdhAU&feature=related
See also Youngquist, Walter. 1997. Geodestinies: The Inevitable Control of Earth Resources Over Nations and Individuals. Portland, Oregon: National Book Company.

This is not to minimize the agony of the many who suffer from overweight today. I think one thing that has hardly been mentioned is the role of infant feeding practices. It is known that the ultimate size of the adipose organ in humans is influenced by the degree of over (or under-) feeding in the first year or so of infancy. Breast feeding is the best for babies, although not jest for this reason. Mothers who bottlefeed often overdo the amount of infant formula fed, as they tend to want to "finish" set amounts in a bottle etc. A newborn's stomache is the size of a marble (ordinary) and only gets to the size of a shooter marble at about 10 days. That is TINY. And it needs to be refilled quite often (sometimes every twenty minutes) during the first month of life. Many parents do not know this and insist that baby is not getting enough, so they charge in with extra bottle feeding packed with more nutrients than is really optimal. the result is often a baby that gets quite plump (and oh so praised for being a big healthy looking baby!). Buyt the target size for the fat organ is being set in this period, by the rapidity with which the fat cells must reproduce to store all the extra nutrients. Some adults who are obese wind up with 2-300% more fat cells than a normal person!
When they diet, each of these fat cells shrinks down to the point where, in a normal person, their situation would be reaching some critical limit of fat storage, and the cells starts sending hormonal emergency messages to the brain to motivate greater interest in food. this makes a fat person very unsuccessful at dieting.

So, as far as I recall, this is another factor to consider when talking about the epidemic of obesity.

 

[Klockan3]

And what are some examples of these cheap high calorie foods? Because the vegetables I make my salads out of and the fruit I eat is pretty cheap. Same with my cans of beans.

Are you serious? When gauging the cost of food, look at calories per dollar. Buying raw pasta will net you ~2000-4000 Calories per dollar so roughly a dollar for most of your days calorie intake and after that just add a bit of meat and vegetables and you are set with ~3 dollars a day. Also note when they say calorie dense they must include things like beans, potatoes, bread, nuts etc. By skipping all of those you would have to get your daily intake of calories from things like tomatoes or lettuce and that would get extremely expensive.

Calories is the most important of the nutrients you eat, without it you die. So you got to get up to that calorie intake each day, that is highest priority, things like vegetables are just not cost efficient to do that.

My BMI is 22 now. When I was younger, I was borderline underweight (BMI of 18.1).

Um, measuring underweight using BMI is just as faulty as measuring obesity with it. If you are lean the most healthy place to be on that scale is roughly around "borderline underweight". The numbers where it starts to matter is around ~12-14 BMI, putting underweight that high is just to scare people and allows people to call all models underweight anorectic cases even though they are really not at all. I guess that you could find some cases which are really underweight at 18 though but it must be very rare.
As for this discussion, I think that the best way to fight it is to stop being so dandy with the issues. World smoking and such have dropped like a rock after all the campaigns, why not do the same thing for obesity? Well, I think the main issue is that people are like "Oh no, that can't be done! That would make all obese people feel bad about themselves!". But I don't really get that, why not show the kids how gross people can get who are not tending themselves? You need pictures and stories, not diagrams and health advice like we currently have since most people don't understand those things. Force the stores to mark up unhealthy food with skulls or something like that.

Maybe not all of that but something in that direction would help.

 

[Skyhunter]

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 ?

Yes.

The first step is to stop subsidizing commodity crops that are fed to livestock or processed into sweet empty calories to be sold back to unsuspecting consumers through the magic of marketing.

 

[Evo]

I don't know what more we expect the government to do. There are clear labels on every item of processed food that we buy. There is a ton of information available about nutrition. Anyone in the US that doesn't know that eating more calories than you burn, is living under a rock.

I think it's time that people take responsibility for the lifestyle they choose. No one is to blame but themselves.

It's American popular culture which favors anything sweet. It starts with infants with sweeteners added to their formulas, Gerber adds fruit sweeteners to their meat dishes for babies. No reason for it. We're training our children from birth to crave sweet foods.

You would be hard pressed to find any processed food that doesn't have sugar added, for no reason other than to make it taste sweet.

All of the cooking shows on tv are telling everyone "sweet is good". You see it all of the time "adding sugar gives the meat/vegetable/anything that sweet taste we crave". The tv cooks add sugar to everything, extoling the wonderful sweet flavor.

No wonder we have so many problems. The average American eats the equivalent of 22 teaspoons of sugar a day, with many eating over 50 teaspoons a day. It's in everything, pasta sauce, mustard, chips, salad dressing, even pickles, dill pickles, not the sweet pickles.

Here is a list of ingredients on my Hunt's Classic Italian spaghetti sauce "tomato puree, water, high fructose corn syrup, soybean oil, salt, corn syrup, carrot powder, sugar".

It only gives total grams of sugar, which comes to 1/3 of the calories. What I would like to see is the amount of unnecessary "added" sugar. It should be reported apart from natural sugar in the food, so I can tell how much added calories there are that shouldn't be there.

I just tend now to make everything from scratch because everything I buy lately tastes sickeningly sweet.

 

[MotoH]

I have a BMI of 19.0 and I am stunningly handsome. Any takers?

 

[mgb_phys]

All of the cooking shows on tv are telling everyone "sweet is good". You see it all of the time "adding sugar gives the meat/vegetable/anything that sweet taste we crave". The tv cooks add sugar to everything, extoling the wonderful sweet flavor.

Who uses sugar in cooking anything except cakes/cookies?

Here is a list of ingredients on my Hunt's Classic Italian spaghetti sauce "tomato puree, water, high fructose corn syrup, soybean oil, salt, corn syrup, carrot powder, sugar".

And HFCS is worse than sugar

 

[Agleh]

Yes, the addition of sugar, but especially of corn syrup, is very dangerous. they have been implicated in the development of heart diseases, high blood pressure, metabolic syndrome, and a host of other systemic illnesses, most of which are connected to overweight. Children in this culture stand almost no chance of having normal weight if they are raised on processed foods. There is a reason many commercial food products have long been known as "junk" food.

I guess we need more studies of the effects of these foods on the neurochemistry, for surely they must create cravings or even addictive effects. Could this be linked to the high rate of drug addictions (legal and illegal)? As well as obesity?

 

[TheStatutoryApe]

my Hunt's Classic Italian spaghetti sauce

Hunts?

Who uses sugar in cooking anything except cakes/cookies?

There are plenty of uses for sugar. Teriyaki sauce is made with sugar or Mirin, which is extremely sweetened sake. Sugar is added to tomato sauces and bases to cut the acid taste which is probably why there is so much in Evo's spaghetti sauce. They probably use cheap under ripe tomatoes and need to cut the acid, sour, and bitter tastes (probably also to mask the amount of salt they add). If they use good fully ripened tomatoes they probably wouldn't need the sugar, or only just a very small amount.

 

[DanP]

I don't know what more we expect the government to do. There are clear labels on every item of processed food that we buy. There is a ton of information available about nutrition. Anyone in the US that doesn't know that eating more calories than you burn, is living under a rock.

I think it's time that people take responsibility for the lifestyle they choose. No one is to blame but themselves.

Evo, what I expect governments to do is education. An aggressive education towards healthy lifestyle.

Sure, no one is to blame but themselves for the lifestyles they have. However, lack of education is a major part of the issue IMO. In a word full of deceiving marketing, companies
which would do anything for profit, including killing millions (it may seem like an exaggeration, but take the case of smoking. I believe it accounts for killing a very big number of ppl yearly, and even the government benefits indirectly from this, because of the very large taxes on tobacco products), a minimal education would enable to end user to see through deception.

It's not the intelligent and rich who are most exposed to those issues, but the poor and uneducated .

 

[DanP]

Today I fell below 29 BMI. As we near the quarter pole, I am in the lead.

Awesome. Remember to always correlate your waist circumference with your BMI, though, for a better picture. For a male that would be the widest part of your abdomen.

 

[Jimmy Snyder]

Awesome. Remember to always correlate your waist circumference with your BMI, though, for a better picture. For a male that would be the widest part of your abdomen.

Just this morning my wife said there was visible improvement there. She said I no longer look pregnant.

 

[AverageJoe]

Just grazing (lol) over the posts in this thread I haven't seen much about the addictiveness of fast food.
Time and time again from all the lower income people I've met, they all eat fast food and don't know why.
It's a combination of convenience and natural urge which I've found to be the primary reason that many people are overweight.
There was this one guy that I met when I was in welding school, he was addicted to cocaine, pot, cigarettes, alcohol and other stuff and managed to kick all of that, but he said that no matter how hard he's tried he can't kick fast food. The access is just far too overwhelming, "everywhere you go" he said "it's like cheap, legal crack shoved in your face, it's relentless."

I know personally that it feels addicting. But once I was able to control myself from going there and started eating healthier, then going back because of xyz, it just tasted awful...can't even finish the stuff.

 

[TheStatutoryApe]

The only drive I have ever had to eat fast food is that it is easy. I have never really cared for the taste much it was always about being able to just stop somewhere for five minutes and have my meal ready for me when I get home so I can just relax. When I make food myself it always tastes better and I enjoy it more. I still like to go out for chinese, thai, or hawaiian food occasionally though.

 

[Evo]

For me, fast food was a non-healthy "treat". I love the taste of fast food, but rarely eat it.

 

[MissSilvy]

I have little sympathy for people who say they 'don't have time to cook and eat healthily'. What the HELL are you cooking every day that takes more than 20 minutes to prepare? I'm in classes from dawn till dusk, work out 4x a week, and work a job on top of that and I manage to cobble together a stir-fry, salad, wrap, or whatnot everyday. Sure, it takes more time than ripping open a box of mac and cheese but it's not like it's incredibly prohibitive.

If you keep eating too much, you will gain weight. Fact. Boohoo, you have a tendency to put on weight or you 'really don't eat that much'. Calories don't come from the air so it ultimately comes down to what you stick in your craw, no matter what people protest.

Sorry for the mean tone but jesus, I am tired of silly excuses!

 

[TheStatutoryApe]

I have little sympathy for people who say they 'don't have time to cook and eat healthily'. What the HELL are you cooking every day that takes more than 20 minutes to prepare? I'm in classes from dawn till dusk, work out 4x a week, and work a job on top of that and I manage to cobble together a stir-fry, salad, wrap, or whatnot everyday. Sure, it takes more time than ripping open a box of mac and cheese but it's not like it's incredibly prohibitive.

If you keep eating too much, you will gain weight. Fact. Boohoo, you have a tendency to put on weight or you 'really don't eat that much'. Calories don't come from the air so it ultimately comes down to what you stick in your craw, no matter what people protest.

Sorry for the mean tone but jesus, I am tired of silly excuses!

Three days out of the week I work 12 hour shifts. Currently my car is dead and I need to get a new one so I have to take the bus for now. On these particular days I wake up three hours before work and have about half an hour to get ready before I need to get out to the bus stop. It takes a minimum of two hours to get to work, I work a 12 hour shift, it takes another 2 hours to get home. So by the time I get home I have less than eight hours before I have to wake up and get ready to do it all over again. Fortunately for me I don't have kids. I usually make a big pot of spaghetti and portion it out for lunches on those three days before hand but it does get tiresome eating the same thing and that does not take care of the rest of my meals. I usually just have cereal when I get home or maybe some cottage cheese and celery sticks with peanut butter because its quick and easy. But that gets tiresome too.