Author Topic: Economic Impact of Obesity = 2.1 Trillion  (Read 16757 times)

Ottawa

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Economic Impact of Obesity = 2.1 Trillion
« on: November 20, 2014, 07:52:06 AM »
We've already discussed why so many people are overweight and obese. 

Obesity is now being touted as a critical global issue.  Right up there with smoking, (armed violence/war/terrorism) and alcoholism.  Currently ~30% of the global population are overweight/obese.  This is expected to increase to ~50% within 15 years!

Whoah!  Why are people not more alarmed?  I mean, people are aware in a vague sense about the issue.  But, like alcoholism and smoking - the root cause of obesity/overweight is more complex than simple addiction.  Whereas smoking and alcoholism are still huge issues, I think their impact trajectory is relatively flat.  In general I also think that they have been more stigmatized as 'bad' relative to obesity/overweightness in my view.  So there has been some societal success in that regard. 

The global impact of obesity is measured (as a direct affect on global GDP) in the order of 2 trillion dollars - that is more than the GDP of Canada! 

By my way of thinking, speaking openly about obesity is still fairly taboo and its solutions largely in the theoretical realm.  That is, in theory plenty of people could lose weight and be healthy within a short period of time.  But, they don't. 

Why? There is more than just the addiction-to-food angle.  There has been:

- a whole shift in the food industry,
- a shift in the food delivery model,
- a belief that the 'get fit quick' schemes industry provides solutions (similar to the 'get rich quick' schemes)
- the public acceptance of being overweight. 
- loss of cooking skills
- perceived loss of time for making food
- when everyone gets larger at the same time - it becomes 'normal' and therefore acceptable
....etc.

Do you think that mitigation through the interventions mentioned in the article summary will work?  I can't imagine that many of them will 
Where does this leave us?

Edit: add forgotten link: "I can't imagine that many of them will"
« Last Edit: November 20, 2014, 08:08:52 AM by CDBDIs »

seanc0x0

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #1 on: November 20, 2014, 08:08:28 AM »
Whereas smoking and alcoholism are still huge issues, I think their impact trajectory is relatively flat.  In general I also think that they have been more stigmatized as 'bad' relative to obesity/overweightness in my view.  So there has been some societal success in that regard.

Surely you jest. There is a HUGE social stigma to being fat.  In my experience, you're better off being an alcoholic than a fat person, since at least people recognize it's a struggle rather than just being a lazy face-stuffing bum. Smokers are lower than dirt, though ;)

The issue is very complex, and many of the issues you've mentioned are factors. I don't think more fat-shaming is the answer. Smoking and drinking are something you do. Being fat is something you ARE. Making people who are already struggling feel bad (or more likey worse) for not succeeding won't make it better.

I don't have any answers, but my inclination is to work on diet modification. Far too much high-carb, high-fat, high-salt processed junk convenience foods is my leading suspect.

Ottawa

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #2 on: November 20, 2014, 08:12:14 AM »
Surely you jest. There is a HUGE social stigma to being fat.  In my experience, you're better off being an alcoholic than a fat person, since at least people recognize it's a struggle rather than just being a lazy face-stuffing bum. Smokers are lower than dirt, though ;)

Hah!  There is to being obese.  However, I don't think there is to being overweight.  The classic male spare tire is practically ubiquitous. 

I think there is a lot more sympathy for an alcoholic than a smoker.  Certainly more than an obese person...  So yeah, I agree with you...

GuitarStv

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #3 on: November 20, 2014, 08:34:19 AM »
Social stigma regarding obesity is an odd one.  On the one hand, there is a clear and demonstrable stigma attached to being fat . . . on the other hand, it's being fat is such a widespread condition that there's also a lot of acceptance of it as pretty normal.

odput

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #4 on: November 20, 2014, 09:19:34 AM »
I'm going to preface this with I haven't looked up the long term studies, so I don't know their parameters

BUT

Quote from: article
That raises another troubling question. If diets don't result in weight loss, what does? At this point the grim answer seems to be that there is no known cure for obesity, except perhaps surgically shrinking the stomach. Research suggests bariatric surgery can induce weight loss in the extremely obese, improving health and quality of life at the same time.

Isn't this saying that dieting does in fact work, we just have to be FORCED to do it?  It seems irresponsible to claim that obesity can't be "cured" when it obviously can, it just takes an amount of willpower that most people don't have.  I wonder how many of the 95% they say have regained the weight after two years have kept the habits that they established during their trials, or have just reverted back to how they used to live?  I suspect (again, I haven't looked up the studies, so I'm just postulating here) that the two year time frame is when people return to their previous weight because that is sufficient time to lose the good habits they built during the study.

Aside from the complicated issues related to obesity, I also wonder how they determined that $2 trillion figure...is that purely in medical costs?  Do they factor in the GDP produced by people overconsuming food and outsourcing physical labor?  Lots of questions that I don't really see answered.  Interesting stuff though

jka468

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #5 on: November 20, 2014, 09:31:10 AM »
Too much fat shaming ITT. It's not allowed anymore, stop it.

fallstoclimb

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #6 on: November 20, 2014, 09:34:19 AM »
I am so tired of the willpower argument on this board.  I think we have way too many people self-congratulating on everything their "willpower" and "hard work" has brought them, while ignoring their relative advantages.

Do we really think that since the ~1980s there has been a major shift in the willpower of Americans -- and not, perhaps, industry-wide shifts in food policy & production (and yes, too, lifestyle trends) -- causing the obesity crises?

Ottawa

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #7 on: November 20, 2014, 09:36:46 AM »
Too much fat shaming ITT. It's not allowed anymore, stop it.

Huh?  This is not fat shaming.  If you do feel shamed - you should ask why.

This thread is about exploring the economic impact and potential mitigation of a very real problem that impacts all of society.  I hope that the tone of this thread remains above board in this spirit.  Usually the forums on MMM maintain excellent decorum. 


Ottawa

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #8 on: November 20, 2014, 09:39:01 AM »
I am so tired of the willpower argument on this board.  I think we have way too many people self-congratulating on everything their "willpower" and "hard work" has brought them, while ignoring their relative advantages.

Do we really think that since the ~1980s there has been a major shift in the willpower of Americans -- and not, perhaps, industry-wide shifts in food policy & production (and yes, too, lifestyle trends) -- causing the obesity crises?

Agreed!  The argument of 'willpower' tends to simplify things to a single cause that is plainly not true. 

odput

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #9 on: November 20, 2014, 09:46:37 AM »
I agree that it is simplifying an extremely complex issue (which is why I prefaced that I didn't look into the studies), but they flat out state in the article that surgically shrinking stomachs works for keeping weight off.  If you boil it down, isn't that really just forcing lower calorie intake?  Thermodynamics can't be cheated

skunkfunk

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #10 on: November 20, 2014, 09:48:33 AM »
It is difficult to find healthy food to eat, relatively speaking. There's so much garbage out there that is cheap and easy to access. Admittedly, I eat more pre-made Schwans type stuff than is optimal.

There's just too much incentive for food providers to do a terrible job. I don't think there is a solution.

Ottawa

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #11 on: November 20, 2014, 09:57:37 AM »
I agree that it is simplifying an extremely complex issue (which is why I prefaced that I didn't look into the studies), but they flat out state in the article that surgically shrinking stomachs works for keeping weight off.  If you boil it down, isn't that really just forcing lower calorie intake?  Thermodynamics can't be cheated

I think just to make sure...it should just be done at birth.  To all people. 

But seriously, part of the problem at this time with this option is that the procedure is not covered by most insurers.  Even if it is, people are afraid to take this option.   I believe a laparoscopic procedure is in the neighbourhood of $20,000.  Ouch. 

Interestingly though, a study shows something that Mustachian-minded people might appreciation.  The pay back value on this bariatric investment was 2 years for laparascopic procedures and 4 years for open procedures!


GuitarStv

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #12 on: November 20, 2014, 10:00:24 AM »
It is difficult to find healthy food to eat, relatively speaking. There's so much garbage out there that is cheap and easy to access. Admittedly, I eat more pre-made Schwans type stuff than is optimal.

There's just too much incentive for food providers to do a terrible job. I don't think there is a solution.

Bullshit.

It is not difficult to find healthy food to eat.  I have yet to find a supermarket without produce, fresh meat, dairy, and eggs.  It's easier to open a processed package of food than cook a healthy meal though.  Processed food stores better, so you're more likely to have it laying around in teh back of your cupboard if you don't plan your meals/shopping well.

odput

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #13 on: November 20, 2014, 10:00:56 AM »

I think just to make sure...it should just be done at birth.  To all people. 


LOL!!

skunkfunk

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #14 on: November 20, 2014, 10:02:43 AM »
It is difficult to find healthy food to eat, relatively speaking. There's so much garbage out there that is cheap and easy to access. Admittedly, I eat more pre-made Schwans type stuff than is optimal.

There's just too much incentive for food providers to do a terrible job. I don't think there is a solution.

Bullshit.

It is not difficult to find healthy food to eat.  I have yet to find a supermarket without produce, fresh meat, dairy, and eggs.  It's easier to open a processed package of food than cook a healthy meal though.  Processed food stores better, so you're more likely to have it laying around in teh back of your cupboard if you don't plan your meals/shopping well.

Only relatively speaking. It is difficult compared to grabbing a pack of ramen noodles. It's no more difficult now than it ever was.

I for one only keep the prepackaged crap around because it is simple while I wait for my wife's broken foot to heal. But the point is the perception has changed and people buy it like crazy - one guy choosing not to buy it will not end the era.

Pigeon

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #15 on: November 20, 2014, 10:19:05 AM »
I think the automobile also has a lot to do with it. 

CommonCents

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #16 on: November 20, 2014, 10:23:12 AM »
Whoah!  Why are people not more alarmed?  I mean, people are aware in a vague sense about the issue.  But, like alcoholism and smoking - the root cause of obesity/overweight is more complex than simple addiction.  Whereas smoking and alcoholism are still huge issues, I think their impact trajectory is relatively flat.  In general I also think that they have been more stigmatized as 'bad' relative to obesity/overweightness in my view.  So there has been some societal success in that regard. 

Sure, this reasonable to me that smoking and alcohol is perceived as more "bad" than obesity, because they can negatively impact other people through secondhand smoke, drunk driving, abusive behaviors associated with living with many alcoholics, while obesity hurts primarily the individual.  (Effects on other people are far more attenuated, and health care costs of it to the population are not easily recognized by the average person.)

Guses

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #17 on: November 20, 2014, 10:29:50 AM »
Why are we not allowed to facepunch/flubberpunch this issue?

Is the overcomsumption of ressources not fundamentaly facepunch worthy?

Sure, there are systemic issues at play, but the solution lies at the individual level. 

Pigeon

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #18 on: November 20, 2014, 10:33:43 AM »
It's fine to say that the solution is at the individual level, but the reality, for whatever reason, is that most people who diet gain the weight back.  So, you can point to the individual and do all the fat-shaming you'd like, but that doesn't solve the problem in the long run, it just lets you feel holier than thou.

Guses

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #19 on: November 20, 2014, 10:35:16 AM »
Diet is not a solution to obesity. A change of habits at the individual level is.

Pigeon

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #20 on: November 20, 2014, 10:36:47 AM »
Semantics.  Dieting is changing one's habits.

odput

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #21 on: November 20, 2014, 10:42:08 AM »
Semantics.  Dieting is changing one's habits.

I would say that dieting is changing one's behavior and it is important to distinguish between the two.  Behaviors are short term, while habits are long term.  This is what I was alluding to upthread...while I have no evidence for this, my hypothesis is that diets don't work because after a significant timeframe (like the 2 years quoted in the article) people have reverted back to their old ways (habits).

Guses

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #22 on: November 20, 2014, 10:43:19 AM »
Well either they change their habits and lose weight permanently or they diet and gain back the weight after the diet ends.

Same thing with overspenders, either they change their habits and see the light or the diet (i.e., bankrupt) and get right on spending.

Breaker

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #23 on: November 20, 2014, 10:46:31 AM »
Couple of thoughts.

1.  Nutritionists/Drs. have been giving the same advice for years:  "Eat less, exercise more".  While this works, most people just can't stick with it for life.  This advice just isn't working for the majority of people.

2.  I thought that the stomach shrinking surgery also shortens the time food is in the digestive system.  So not only less capacity but less time to turn into fat. 

3.  There are a lot hidden sugars and salt in the food that we buy.  Even those of us who try to be careful.  The Companies that sell food want us to eat more so they spend a lot of effort making the food tasty.  That usually involves adding, salt, sugar and fat. 

4.  Sugar is one of the most addicting substances there is.  There have been studies where children were given candy.  Then the candy and their Mothers leave the room.  When both are brought back into the room.  The Toddlers head for the candy instead of their mothers.

5.  People get into the habit of eating certain foods at certain times or in certain places.  We all know how hard it is to break a habit.

6.  Many activities that I engaged in as a Child have been replaced by video games/cell phones/computers.  Drive thru your neighborhood, how many children do you see playing outside?  Part of the reason for this is that the parent is afraid to let their child play outside.  It still creates less active playtime for kids.

What can we do?  Make an effort to be more active ourselves and get our kids doing physical activities.  For adults just walking can make a BIG difference.  So take a walk around the neighborhood at night and invite neighbors to join you.  As it is always said on these forums  "Lead by example"



jka468

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #24 on: November 20, 2014, 11:53:17 AM »
Too much fat shaming ITT. It's not allowed anymore, stop it.

Huh?  This is not fat shaming.  If you do feel shamed - you should ask why.

This thread is about exploring the economic impact and potential mitigation of a very real problem that impacts all of society.  I hope that the tone of this thread remains above board in this spirit.  Usually the forums on MMM maintain excellent decorum.

I was just trolling for the lulz.

Anyways, many of the causes have been named, and nothing about this is going to change. Some of the main causes...

1) More sedentary lifestyles
2) Sugar
3) Less time for proper meal prep due to many reasons including a two person working household, sinlge parenthood, consumerism, job hour expectations, etc.
4) Greater acceptance of being fat.

It's only going to get worse from what I see.

GuitarStv

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #25 on: November 20, 2014, 12:19:43 PM »
I think that a lot of the patterns and habits that people fall into are ingrained when they're children.  Maybe part of the solution to the problem is better advice and food program-type assistance to new parents.  If you don't develop poor eating habits earlier on, then it won't be necessary to fight your way out of them later down the road.

Ottawa

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #26 on: November 20, 2014, 01:00:11 PM »
Some thoughts on some of your thoughts...

1.  Nutritionists/Drs. have been giving the same advice for years:  "Eat less, exercise more".  While this works, most people just can't stick with it for life.  This advice just isn't working for the majority of people.

Yes, the old advice is spot on.  It would certainly work.  Now, if only people could do it.  Hmm...seems that the professionals have missed something. 

2.  I thought that the stomach shrinking surgery also shortens the time food is in the digestive system.  So not only less capacity but less time to turn into fat. 

Yes, maybe...I don't know.  But, it does occur to me that bariatric surgery may not be a panacea.  It doesn't alter the behaviour of people.  They still won't exercise and they still continue to eat, albeit it smaller amounts, of crap food.  So, I would therefore infer that there will be other adverse health affects that lurk under the surface of an otherwise 'healthy' looking person.  Maybe not the best thing to do to everyone at birth...in retrospect.

3.  There are a lot hidden sugars and salt in the food that we buy.  Even those of us who try to be careful.  The Companies that sell food want us to eat more so they spend a lot of effort making the food tasty.  That usually involves adding, salt, sugar and fat. 

Agreed.  Fortunately we (as GuitarStv points out) have the ability to choose unprocessed food and learn how to cook that shit!

4.  Sugar is one of the most addicting substances there is.  There have been studies where children were given candy.  Then the candy and their Mothers leave the room.  When both are brought back into the room.  The Toddlers head for the candy instead of their mothers.

Agreed.  (If the mothers didn't eat the candy first) ;-)

5.  People get into the habit of eating certain foods at certain times or in certain places.  We all know how hard it is to break a habit.

Yes, food as a medicine for pain, boredom, hurt, etc...

6.  Many activities that I engaged in as a Child have been replaced by video games/cell phones/computers.  Drive thru your neighborhood, how many children do you see playing outside?  Part of the reason for this is that the parent is afraid to let their child play outside.  It still creates less active playtime for kids.

Agree!  100%  This is one for the future playbooks.

deborah

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #27 on: November 22, 2014, 03:13:03 PM »
One problem that has not been mentioned is that the size of meal portions has changed. Plates are larger, and what is served on them tends to be larger. Drink cans are larger, coffees are larger...

wtjbatman

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #28 on: November 22, 2014, 04:42:02 PM »
I would outlaw any soft drink larger than 12 ounces.

horsepoor

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #29 on: November 22, 2014, 06:17:16 PM »
I think that a lot of the patterns and habits that people fall into are ingrained when they're children.  Maybe part of the solution to the problem is better advice and food program-type assistance to new parents.  If you don't develop poor eating habits earlier on, then it won't be necessary to fight your way out of them later down the road.

Part of the problem with this is that government nutritional guidelines are awful.  Eat lots of grains, potatoes count as a vegetable, be afraid of fat, etc.  The focus needs to be more on the micronutrients and type of macronutrients.  It's pretty easy to maintain a healthy weight when consuming a nutrient-dense diet, because it's going to be chock-full of low starch veggies.  Food programs would be pushing the gov't guidelines, and those certainly haven't resulted in stellar outcomes over the last 30 years.

Most people in the US have access to healthy food and the time and means to prepare it, but don't make it a priority.  It's unfortunate that cooking became villified as drudgery, with the TV dinner or the McD's drive-through being advertised as the ticket to freedom.  Unfortunately, there's still not equality between working spouses when it comes to cooking in the home, so it's hard to blame working mothers who don't put a scratch-made meal on the table each day.  Just look at SkunkFunk, who admits to eating junk because his wife is not up and around - dude, how about getting a recipe and making something you can both enjoy while she's not well?


Heather in Ottawa

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #30 on: November 22, 2014, 07:11:12 PM »
I'd say our built environment is a huge part of the problem. It's not just that cars are convenient and tempt us into driving, but that actually make active transportation unappealing. Cars are too intimidating for most people to bike around, and are such huge hogs of public space for roads and parking that it make for low-density sprawl where walking becomes inconvenient. It's a positive feedback loop of car dependency.

bacchi

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #31 on: November 22, 2014, 07:33:44 PM »
I'd say our built environment is a huge part of the problem. It's not just that cars are convenient and tempt us into driving, but that actually make active transportation unappealing. Cars are too intimidating for most people to bike around, and are such huge hogs of public space for roads and parking that it make for low-density sprawl where walking becomes inconvenient. It's a positive feedback loop of car dependency.

Agreed. It's too intimidating and far to walk to the movies in the 'burbs. In a walkable city? A 1.5 mile walk to the movies is a pleasant stroll and is just built into the time allocated for the activity.

When exercising becomes another thing to schedule, it can be pushed aside until next week. Eventually, it becomes a New Year's resolution.

Gray Matter

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #32 on: November 23, 2014, 05:42:11 AM »
First, I want to thank everyone for keeping this conversation civil.  I usually avoid these kinds of threads, because they derail pretty quickly into fat shaming, but I'm glad I stopped by this one.  There's been some thoughtful discourse.

I think it's really unfortunate that it has come to be that weight=health.  They are NOT the same thing.  There are correlated, but it is not a 1:1 correlation, and weight is difficult to change in the long-term, so why do we keep harping on that?  It just increases the stigma associated with body size and encourages people to make all kinds of judgements by looking at a person that they cannot possibly know to be true.

We know that poverty is associated with poorer health outcomes.  Telling people to stop being fat in order to improve their health is a lot like telling people to just stop being poor to improve their health.  While a few individuals may be able to lose weight and keep it off, and a few individuals may be able to claw their way out of poverty, it's not a realistic solution for most people.

Research has shown that an overweight, active person has greater longevity than a thin, inactive person.  So why are we focusing so much energy (and venom) on the "weight" part?  Let's focus on the things that people actually have more influence over (notice I didn't say "control," because I believe there are many factors at play), things like:  activity, nutrition, sleep, coping skills. And find ways to systemically support them, while continuing to learn as much as we can about the many variables and what we can do about them.

People have brought up lots of potential contributing factors, like access to food, quality of food, walkability, technology, etc.  I think they all likely play into things, as does general pace-of-life and stress (stress hormones drive people to eat particular kinds of food and store fat), and even potentially things like plastics and antibiotics.  My family has been involved in university studies (as subjects) looking at plastics and scents and how they mimic hormones in the body.  Also, the correlation between gut microbes and obesity is interesting. 

And, unfortunately, the well-intentioned advice to diet and the diet industry have likely contributed to the problem.  One study I read showed that if you took two people of the same weight, and one of them went on a diet, and you tracked them for five years, the one most likely to weigh more in the future was the one who went on a diet--it's a cruel twist.

BZB

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #33 on: November 23, 2014, 06:31:23 AM »
Do we really think that since the ~1980s there has been a major shift in the willpower of Americans -- and not, perhaps, industry-wide shifts in food policy & production (and yes, too, lifestyle trends) -- causing the obesity crises?
+1
Check out The Portion Teller by Dr. Lisa Young. The book is based on her dissertation work about the changes in serving sizes in the U.S. over the years. For example, look at the size of a dinner plate from the 1950's compared to a dinner plate today. Even coffee cups are much larger.

MoneyCat

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #34 on: November 23, 2014, 06:52:50 AM »
Food is indeed an addiction like alcohol or drugs.  That's part of the reasons why it is so difficult for people to lose weight.  I used to be pretty overweight, but I made a conscious choice to change my life forever by taking up three day a week exercise sessions and doing more outdoors.  Bicycling makes a massive difference.  I don't think we should shame overweight people, because that just forces them deeper into denial and can act as a trigger for problems like binge-eating.  I just think we need to use a lot more encouragement and demonstrate to people how beneficial it is to take up a more active lifestyle.


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horsepoor

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #35 on: November 23, 2014, 08:28:11 AM »
Food is indeed an addiction like alcohol or drugs.  That's part of the reasons why it is so difficult for people to lose weight.  I used to be pretty overweight, but I made a conscious choice to change my life forever by taking up three day a week exercise sessions and doing more outdoors.  Bicycling makes a massive difference. I don't think we should shame overweight people, because that just forces them deeper into denial and can act as a trigger for problems like binge-eating.  I just think we need to use a lot more encouragement and demonstrate to people how beneficial it is to take up a more active lifestyle.


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Ahh... that is another thing that makes this issue so complex.  Different people are fat for different emotional/psychological reasons.  I was venturing into the obesity category, and was kind of in denial about it.  The overly accepting culture of "big is beautiful", "everyone's great in all sizes", "you can be healthy even if you're heavy" ideas really just enabled me to stay that way for a few years.  I didn't need someone telling me I was a worthless POS, but I think I would have probably never gotten past the overweight category, at most, if there'd been more societal pressure for being thin and active.  The message that may have worked for me would probably be damaging for others.

mcneally

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #36 on: November 23, 2014, 12:57:20 PM »
Obviously some people make better food choices than others, but set point theory is not an unsupported hypothesis. If you are/once were fat, your body wants to be fat. Your body gets more efficient at using calories (not a good thing) and you will feel hungrier sooner. Someone in this BBC doc argues that someone who loses even 10% of their body, say 200 to 180 lbs, would have to consume 20% fewer calories to maintain the same weight compared to someone who  always weighed 180 lbs (but will still be as hungry as the other person would be if that person ate 20% fewer calories).

I don't remember which it was discussed in (maybe both- they're both very interesting):
The men who made us fat:
https://www.youtube.com/watch?v=RoVlU7-ojM0

The men who made us thin:
https://www.youtube.com/watch?v=RoVlU7-ojM0

edit: The most relevant one- Why thin people are not fat
https://www.youtube.com/watch?v=dAQr77QMJiw
« Last Edit: November 23, 2014, 09:54:37 PM by mcneally »

Silverwood

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #37 on: November 23, 2014, 02:00:12 PM »
whoops posted in an old thread instead of here

has anyone checked out the freakonomics podcast 100 ways to fight obesity?

http://feeds.feedburner.com/freakonomicsradio

southern granny

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #38 on: November 23, 2014, 04:36:37 PM »

Why? There is more than just the addiction-to-food angle.  There has been:

- a whole shift in the food industry,
- a shift in the food delivery model,
- a belief that the 'get fit quick' schemes industry provides solutions (similar to the 'get rich quick' schemes)
- the public acceptance of being overweight. 
- loss of cooking skills
- perceived loss of time for making food
- when everyone gets larger at the same time - it becomes 'normal' and therefore acceptable
....etc.

Do you think that mitigation through the interventions mentioned in the article summary will work?  I can't imagine that many of them will 
Where does this leave us?

Edit: add forgotten link: "I can't imagine that many of them will"

I think the lost cooking skills is a big one.  A coworker just showed me her latest lab work.  Her cholesterol last year was 277, this year it was 197.  She said the only difference was that they had cut way back on fast food and were cooking at home more. 

OzzieandHarriet

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #39 on: November 23, 2014, 05:22:52 PM »
The whole "fat people are costing us trillions of dollars" is a load of bullshit. It's based on questionable extrapolation from made-up data. If anyone wants to read a rant about this, I'd be happy to oblige.

Also, what Gray Matter said.

MayDay

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #40 on: November 23, 2014, 06:01:25 PM »
I agree with the PP's who said you have to address childhood eating habits.  If any of you have elementary aged kids, you know what I am talking about.  I do a recycling program at the school at lunch, and I see a lot of what the kids eat.  It is HORRIFYING.  The saddest part is that the packed lunches are considerably less healthy overall.  A typical packed lunch is a juice pouch (Capri sun, so not even juice, just sugar water and dye) a squeeze applesauce pouch, fruit snacks, and a white bread sandwich.  Maybe throw in some pretzels or crackers (all white flour of course!) I'm not kidding.  The school lunches in our district are very good, but even a bad school lunch has a canned vegetable which is more than a typical packed lunch!  And this is an affluent district with parents who can afford better and should know better.  But it's quicker and easier to throw in a bunch of prepackaged junk.

My mother gained quite a lot of weight in her late 20's/30's and later lost it all with weight watchers.  She has kept it off for ten plus years now.  The key is she hasn't kept it up by just continuing the good habits she learned at WW.  She still has to actively attend WW meetings and follow the program to keep the weight off.  So even the "success stories" of weight loss are putting in a ton of work. 


Abe

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #41 on: November 23, 2014, 06:49:29 PM »
Regarding bariatric (weight loss) surgery - it is only effective in combination with significant diet changes. People who continue to eat as they did prior to the operation will ultimately re-gain almost all of their excess body weight. This is well established. Most hospitals do not perform bariatric surgery unless they have a well-established support infrastructure regarding psychologic and dietary counseling. We have patients attend several sessions, demonstrate ability to comply with dietary changes, and continue to follow-up every 3-6 months for life. Most people we evaluate are eventually declined due to inability to comply with the dietary changes or other psycho-social issues that significantly decrease their chance of success after the operation. It is definitely not a panacea.

OzzieandHarriet

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #42 on: November 23, 2014, 10:04:58 PM »
This video is a short TED talk about why dieting doesn't usually work:

http://www.ted.com/talks/sandra_aamodt_why_dieting_doesn_t_usually_work?language=en#t-750236

And if you think weight loss surgery is the answer, think again; it has a very poor success rate long term, along with much higher health risks than just staying fat.

In fact, it has not been proven that being overweight or obese has a causal relationship with any illness, despite what the medical profession is telling us. For one thing, many thin people get all the same illnesses -- and many fat people do not. Not all fat people eat too much or eat badly. It is much more complicated than calories in calories out. (Watch the video.)

And one reason the official obesity rate has risen dramatically since the 1980s is because in 1998, the cutoff points of the metric that is used to calculate weight (the body mass index) were lowered. The BMI itself is problematic, and this made it worse.

bugbaby

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #43 on: November 24, 2014, 03:44:56 AM »
1. The data OP and others cite too often lump overweight and obesity together. Overweight ie BMI 25-30 is more optimal than thinner bodies (lowest overall morbidity and mortality). See JAMA 2013:301 p.71-82 ; a systematic analysis of 7000 studies shows that:

 BMI 25-30 (overweight) had a 6% lower mortality than BMI <25 (normal weight) and 30-34 (grade 1 obesity) (which are both about equal and are the baseline).  BMI 35+ (grade 2-3 obesity) had greatest mortality which was 29% (18-41%) higher than baseline.  This is about the most comprehensive recent systematic review of this issue.

2. The issue therefore is not the regular overweight people, its the obese.  Problem us these facts are just not as profitable to the weight loss industry, whose biggest customers are in the overweight (and thus healthiest!) group -- you gotta make them feel bad about that extra 30lbs ie shove into their face images of emaciated ideals, so they can buy your new diet, book, gym membership etc.

3. Granted, the real problem of grade 2-3 obesity is growing crazily and needs to be addressed. I'm in healthcare and no question these are the real drains on resources . Unfortunately few are really motivated and they are probably not the peeps on this forum .  I believe that battle had already been lost. The only way to turn this ship around would be to make an individual truly responsible for his/her own healthcare cost. It won't happen. , unless the ER could turn away a guy with a heart attack or insurance premium were truly risk stratified.

OzzieandHarriet

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #44 on: November 24, 2014, 07:35:43 AM »
I agree with most of what you say, but I argue with your last point here:



3. Granted, the real problem of grade 2-3 obesity is growing crazily and needs to be addressed. I'm in healthcare and no question these are the real drains on resources . Unfortunately few are really motivated and they are probably not the peeps on this forum .  I believe that battle had already been lost. The only way to turn this ship around would be to make an individual truly responsible for his/her own healthcare cost. It won't happen. , unless the ER could turn away a guy with a heart attack or insurance premium were truly risk stratified.

Of course if you are in health care (as … what? doctor? nurse? other?) you see mostly sick people, both large and small. The actual numbers (i.e., the "drains on resources") don't bear you out. What uses the most resources in health care is living a long time. The 2 trillion dollar figure in the title of this thread is not valid in any way.

If you go down the road of charging people more money for things they do to themselves, how about people who engage in ill-advised sports activities, are bad drivers, drink/take drugs to excess, smoke? And how are you going to monitor this, exactly? You cannot tell by someone's size whether they are taking care of their health, how much they eat, how much they exercise, and so on. Body size is generally not within someone's control.

Insurance companies are already collecting patients' BMI. If they can use it to make more money, they will. This is not something we should be hoping for. "First they came for the obese people … then they came for the overweight … then they came for me."

LalsConstant

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #45 on: November 24, 2014, 07:39:58 AM »
Oh boy is this on my mind lately.  According to my scale, I'm down 56 pounds.  Got a lot more to go but we're off to the races.

I could say a lot but I'll try to keep it short and direct:

- We are, as humans, maladaptive because we were designed by nature, evolution, God, and/or random chance (and I believe it's a combination of all of the above personally but it really doesn't matter) to survive some pretty harsh conditions without the aid of technology. 

For most of human history, it was vital to eat every last little bit of food you could find, because you probably weren't eating very much at all. 

It's very instructive to try to hunt and gather for a short time, say a day or three, and realize how sparse food in the natural world actually is.

We have now in many (but not all) countries solved the problem of not enough food, but we have not adapted to the environment of food being plentiful. 

To put it simply, we descend from the people who ate a lot (relatively speaking).

- The culture we're in gives us terrible ideas about food, what we should eat, how much, we equate eating with socializing, etc.

- I personally think, and this is really summarizing it here, that we live in a society that gives us material abundance (relatively speaking), but doesn't fundamentally address individual happiness in a meaningful way.

When someone isn't starving to death, they start thinking about their self-realization needs, need for acceptance, etc. and we live in a society which fundamentally isolates people.

I don't think people were meant to live like this in nature, in societies with millions and even billions of people under one banner, I think we were meant to live in small societies of a most a couple hundred people (Dunbar's number) that we were fundamentally very similar to.

When you have such a large population, you do get a much economically and culturally richer and more robust society.  However you also create a plurality of people who, on various axes, are not suited to the dominant culture.

The problem is, if I am pro-skub and so is 33% of the population, we're not allowed to live a life of skub because 67% of the population is anti-skub and forces their views on us. 

"Skub" can be any political wedge issue.  The more minorities you are in "skub" wise, the less this society suits you.  If you're only pro skub in one or two areas, you probably get along okay but are fundamentally unhappy about certain things, now imagine if it's a dozen or more skubs...

The point is, the larger the scale a society operates on, the less it conforms to the values and needs of individuals, and the more unhappiness it must create.

- I don't think we should "normalize" being fat to the point it's not acceptable to call someone out for it, we don't want people to be delusional for the sake of always sparing their feelings. 

There's plenty of reasonable ways to tell someone they're fat that gets the point across without vitriol, such as "You are overweight and I am concerned for you".

Shaming tactics aren't going to motivate anyone.  It's okay to call me "fatso", because this is unfortunate but true, but stop with the "You're fat because you're a stupid person" that comes with it.

That leap of non logic takes it too far, and if anything this kind of negative discussion just makes people more unhappy creating another barrier between an obese person and better health.

- Willpower is a tricksy thing.  It is ultimately the answer, but you have to understand where your willpower comes from and that it is a limited resource.

I could for example go on an explosive rage of fitness madness, drinking nothing but vegetable juice and doing 2 cross fit sessions a day.

That would last... hardly any time at all.  1 day, maybe 2?

For someone else, that sounds ridiculous.  "I do that every day and then run a marathon every weekend, what is wrong with you, you fat stupid lazy idiot?"

And I can tell you that this does not motivate one to lose weight either.  It's a classic apex fallacy.

Even in my current streak of success, I hate discussing my workout because it's very simple and pathetic sounding:

I do body weight exercises for about 8-10 minutes three days a week.
I do a kettlebell circuit for about 10 minutes three days a week.
I walk until a full hour has passed regardless of whether today was bodyweight/kettlebell day.

Now is this going to be my daily workout forever?  I hope not, even now I keep making it a little more intense here and there after all (I am doing more reps, I upgraded to a heavier kettebell, etc.).  I hope eventually to start packing on more lean muscle, I do have goals, but for now this is all I can handle.

But to someone who can do 15 pull ups in their workout and who does 9 different kinds of deadlifts, who compares their snapshot in time to mine, yes that workout is pathetic. 

Fitness is pretty much the only arena I've ever seen where it's okay for anyone, even if they are not super athletic themselves, trash anything that's less than Olympic level intensity.

It'd be like someone who saves 70% of their income mocking someone who "only" saves 20% of their income.  The perfect is the enemy of the good, and this is the approach you have to take to improve your willpower.

It's the classic lesson of, you can't compare yourself to other people, but we live in a society where we constantly compare ourselves to other people!

You don't jump from "Dorito eating couch potato trainwreck" to "Crossfit loving triathlete" in one go (nor do either of those things sound like fun in the least to me), it's not a willpower switch you can just flip, there's a lot of steps in between, and you have to make little changes that you can live with.

It's better to make a small change that will be permanent going forward, forever, than to make a big change for some 12 week boot camp gimmick program.

I can't tell you how many "beginner" workouts I've seen that involve 12-20 different exercises.  Nutrition is even worse, I don't need a 300 page dissertation on what the best kind of antioxidant is.

Simple.  Small.  Understandable.  Plug the big holes: too much sugar, too many calories, too much salt, too many carbs, too much fat (I put it in that order because solving sugar solved calories for me, etc.)

Don't try to be a Navy SEAL, just learn how to make time every day for yourself because your health is important and you deserve some time for care and maintenance.

The point is, tiny little changes that are indefinitely sustainable, piled up over time, is the method, and how you get to this mindset where you're able to do that is a whole other rant.

Those are the lessons I have learned that very few fitness gurus teach.  It's not their fault, they market mostly to people who are already very healthy who are trying to be superhuman.

You have to stretch and strengthen your willpower as much as any muscle, if you over exert it, you'll fail.

Really it's the getting into the mindset where you accept small, sustainable, improvements being made indefinitely going forward that's the hard part.  Incrementing your nutrition and exercise is easy in comparison.

Honestly it's very similar to when I made a decision to manage myself better financially, it's not something I did overnight, and I'm not where I want to be, but I choose to consciously monitor and incrementally improve as circumstances allow.  That kind of change is hard and takes time, and the support for it is a bit sparse.
« Last Edit: November 24, 2014, 07:44:58 AM by LalsConstant »

GuitarStv

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #46 on: November 24, 2014, 07:40:16 AM »
I think that a lot of the patterns and habits that people fall into are ingrained when they're children.  Maybe part of the solution to the problem is better advice and food program-type assistance to new parents.  If you don't develop poor eating habits earlier on, then it won't be necessary to fight your way out of them later down the road.

Part of the problem with this is that government nutritional guidelines are awful.  Eat lots of grains, potatoes count as a vegetable, be afraid of fat, etc.  The focus needs to be more on the micronutrients and type of macronutrients.  It's pretty easy to maintain a healthy weight when consuming a nutrient-dense diet, because it's going to be chock-full of low starch veggies.  Food programs would be pushing the gov't guidelines, and those certainly haven't resulted in stellar outcomes over the last 30 years.

Government guidelines (by and large) have followed the advice of nutritionists.  They have changed over time as our understanding of food has changed.  The current guidelines (http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf) are quite reasonable and have addressed pretty much all of your complaints.

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #47 on: November 24, 2014, 07:51:43 AM »
Honestly, the #1 thing for me that's contributed to gaining 30 pounds in the 5 years since college is a sedentary lifestyle brought on by working in an office environment.

I was, and still consider myself to be, an athlete. I've played soccer for over 20 years all through my childhood. I was an extremely healthy kid, only missed 3 days of school from K-12. In college, I played soccer on the weekends, walked a lot, played club sports whenever I could, ate like crap, and drank a lot. I graduated college at 165lb with maybe 12% body fat.

Ever since taking an office job that takes up 9-10 hours a day with commute time included, I'm up to 195lbs with 25% body fat. I still play soccer on the weekends, but instead of starting I'm a rotation player. I've tried working out at work, in the morning before work, after work, and sometimes twice a day- I just can't seem to find something that works.

I did lose 20 lbs one summer while following WW strictly, but honestly it was miserable eating crappy 99% fat free turkey burgers on wheat sandwich thins. I fully acknowledge that I don't have much willpower, but I ate like total crap growing up (tube of Oreos almost daily), but because I was active, it didn't matter much. One of the biggest reasons why I want to be FI is to get some time back in my day to exercise again.

horsepoor

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #48 on: November 24, 2014, 08:10:02 AM »
I think that a lot of the patterns and habits that people fall into are ingrained when they're children.  Maybe part of the solution to the problem is better advice and food program-type assistance to new parents.  If you don't develop poor eating habits earlier on, then it won't be necessary to fight your way out of them later down the road.

Part of the problem with this is that government nutritional guidelines are awful.  Eat lots of grains, potatoes count as a vegetable, be afraid of fat, etc.  The focus needs to be more on the micronutrients and type of macronutrients.  It's pretty easy to maintain a healthy weight when consuming a nutrient-dense diet, because it's going to be chock-full of low starch veggies.  Food programs would be pushing the gov't guidelines, and those certainly haven't resulted in stellar outcomes over the last 30 years.

Government guidelines (by and large) have followed the advice of nutritionists.  They have changed over time as our understanding of food has changed.  The current guidelines (http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf) are quite reasonable and have addressed pretty much all of your complaints.

The discussion of nutrients there is extremely limited and cursory and promotes eating fortified foods.  The recommendations may stave off say, scurvy, rickets and goiters, but that doesn't mean they're optimal, and the human body is smart enough that hunger is triggered by lack of micronutrition, even when caloric/macronutrient requirements have been met and surpassed.

I think that recommendations have improved, but the government is a slow-turning ship tied to farm subsidies and lots of lobbying and political pressure.  The latest science takes quite a while to get rolled in, and when it does, likely not in its purest form.

GuitarStv

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Re: Economic Impact of Obesity = 2.1 Trillion
« Reply #49 on: November 24, 2014, 08:51:08 AM »
Where do you get the impression that hunger is triggered by lack of micronutrients?  Were this actually the case, taking a multivitamin each day would lead to reduced hunger and therefore weight loss.

Quote from: comment
It's pretty easy to maintain a healthy weight when consuming a nutrient-dense diet, because it's going to be chock-full of low starch veggies.

The guidelines specifically say that you should consume a nutrient dense diet.  There's an entire chapter (chapter four) that explains exactly what foods should be selected to achieve this.
« Last Edit: November 24, 2014, 08:56:56 AM by GuitarStv »

 

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