Obesity As A Medical Condition

[Jingthing]

OK,

I started this new thread from the thyroid hormone thread, because I feel very strongly about this issue.

Here summarizes my viewpoint:

There are MANY causes of obesity. Only some cases of obesity are pure cases of people just eating too much.

Diets don't work. That is proven fact. Well over 90 percent of people who go on "diets" end up gaining back MORE weight every time.

Serial "dieting" is very unhealthy and is worse for the heart than not dieting.

Obesity has a strong GENETIC component. Children of obese parents usually become obese themselves. Your genetic makeup is a MEDICAL condition. And as a medical condition, it will be treatable in the future.

Processed foods in "advanced" societies do indeed lead to higher rates of obesity. A case where a sickness in society sickens its people.

It is destructive to tell all fat people to just "go on a diet, Fatty!" You are telling the fatty to do something that almost always results in more weight gain and more health risk.

Emotions and depression are a huge factor in obesity. Depression is a MEDICAL condition.

A huge percentage of obese people do NOT overeat. For them to "diet" would basically be starvation level eating and totally unsustainable.

There is new promise in medical research to provide real MEDICAL answers for obesity. INFECTOBESITY, a new MEDICAL field of research, could prove very promising. http://www.medscape.com/medline/abstract/1...+obesity+agents

The MEDICAL treatments for obesity are not very desirable. We have stimulant diet pills that are sometimes very unhealthy and not suitable for people with heart disease risk (the same obese patients). We have stomach stapling and banding, but these are radical treatments and only appropriate for the morbidly obese.

Medical research is working on this. There is great hope that better MEDICAL treatments are on the way. It is true that a TINY PERCENTAGE of obese people are successful at totally changing their life habits around healthy eating and exercise (NOT DIETS!) and manage to both lose the weight (easier) and KEEPING IT OFF (very rare statistically for obese people).

Given the extremely low success rate of diets, this is just not a very helpful or practical suggestion for obese people. They have enough problems with people thinking they are lazy, stupid, and morally lax.

QUOTE(Jingthing @ 2007-01-25 01:39:59) *

I am one of those people that think obesity is a medical condition, not a moral fault.

A medical condition limited to western world where people eat too much and live a too sedentary lifestyle?

If it's a medical condition, why does this condition affect nearly half the American population, increasing numbers of Brits and Germans and yet miraculously not seem to be such a common medical condition in Sudan, Cambodia and North Korea?

I'm confused.

If, as iwannateach says, this sub-forum is a mutual support and help group, surely the first part of the solution is understanding the problem, not hiding behind excuses.

Sure, abnormal thyroid levels can cause obesity but to make such blanket statements is very misleading and does more harm than good.

[bendix]

But, once again, you are failing to address the key refutation of your argument that it's a medical condition.

Why is obesity so much more prevalent (even epidemic) in countries where people have too much to eat, too much time on their hands to do too little exercise? Conversely, why is it virtually non-existent in countries like Sudan, North Korea and Cambodia.

How does this sit squarely with your contention that there is also a genetic aspect to it? Obese parents might be inclined to have obese kids, but that's nothing to do with genetics EXCEPT in the sense that the lifestyles and habits of those obese parents are likely to passed down to their children.

Obesity may lead to medical conditions like depression, and I don't deny there is a vicious cycle that would feed on itself (excuse the pun), but I cannot accept that people are 'born to be obese' due to something in their biological make-up.

Coincidentally, I accidentally caught a tv program last night called 'The biggest losers'. It was a reality show, following the fortunes of 'obese families' losing weight over a sustained period. Each family member (four in each) were obese. At the end of the 4-5 month period each family member had lost huge amounts of weight and were normal sized.

Did they genetically mutate, during that period? No, they underwent a complete lifestyle overhaul which meant a drastic change to their diet and an extensive exercise regime, all under the watchful and unforgiving eye of a TV audience. In other words, they took in less food, expended more energy and hey presto.

At the end of the show, the reported on each family member's progress since filming. All of them had continued their new regime. All of them had kept the weight off or reduced even further.

Bravo, I thought.

[Jingthing]

Check them in two years. Dollars to donuts, all the weight will be back AND MORE.

I am not interested in your comparing a country with famines with more advanced countries like Australia and Thailand. Doesn't prove a thing. No matter what the genes or underlying conditions, no food at all will cause starvation.

You are falling into the morality view of obesity, the Calvinist view. The people who undergo heroic deprivation and suffering are the good ones. The fatties are moral failures. But the reality is almost all dieters are spinning their wheels and making themselves sicker.

People pushing "dieting" are pushing a method that has a dismal success rate. Now, I must admit, I can't tell you a better method right now that doesn't have awful side effects. But to degrade the people who see that dieting is a sham, really more of money making industry than anything else, is just wrong.

[chuchok]

How does this sit squarely with your contention that there is also a genetic aspect to it? Obese parents might be inclined to have obese kids, but that's nothing to do with genetics EXCEPT in the sense that the lifestyles and habits of those obese parents are likely to passed down to their children.

What the would you know.Are you a doctor,or just mouthing off?

There are aspects of what you have said that are true IMO,but certainly not everything.,You don't strike me as being a person with medical training etc?

[Ijustwannateach]

Good idea for a thread, Jingthing. Bendix, I'll allow your skepticism and harping on about "eat less, exercise more" in this thread alone, as it is more of a philosophical discussion and needs to allow all points of view. If I see it in other threads (the ones for support and suggestion), it (and you) will be gone.

"Steven"

[Grover]

Medical Solutions are in the Pipeline

There is a medical solution for this problem, or rather a surgical solution. It works by shrinking the size of the stomach to the size of a fist. It works wonders apparently and is reserved for those who have not succeeded in other traditional approaches. :D

[Simmo]

There are MANY causes of obesity.

No there isn't. You put more energy input into the system than you take out , you gain weight. You use more energy than you put in , you lose weight.

There are many contributing factors that influence the above that you list but to claim there are other causes is violating simple high school physics/chemistry ie Conseravtion of Mass & Energy.

[bendix]

Check them in two years. Dollars to donuts, all the weight will be back AND MORE.

I am not interested in your comparing a country with famines with more advanced countries like Australia and Thailand. Doesn't prove a thing. No matter what the genes or underlying conditions, no food at all will cause starvation.

OK, let's put the starvation countries to one side.

Let's look at France, where there is a surfeit of food - where, in fact, eating is a way of life - yet their obesity rates are drastically lower than the US. Why? Because France's eating habits are drastically different - small portions of meat, rich sauces, seperate servings of vegetables etc. In other words, a balanced diet.

Let's go further - let's look at today's obese countries, but go back 30-40 years to ago when our parents were young. Sure they ate lots of fatty food, but this was counter-balanced by an active lifestyle of - in many cases - manual labour supplemented by physical housework, manual lawnmowers, walking rather than driving etc. Obesity rates then were drastically lower than they are now.

Let's look at China over the last 10 years. Before it was 'westernised' people tended to eat a balanced diet of rice, meat, fish and vegetables, again counterbalanced by manual labour. Today, the spoiled brat sector of society of the new rich has been introduced to a lifestyle of Coca Cola, Starbucks, McDonalds and being chauffered around in Daddy's car. The result - widely reported increasing rates of childhood obesity amongst the kids of Shanghai, Shenzen and Beijing.

If there is something genetic in all this, how could our genes have drastically altered so quickly?

This simple fact cannot be ignored. People in western and westernised society are increasingly suffering from obesity. That is a fact; it cannot be debated. the only question is why? And - putting aside the unfortunate minority who's obesity is a result of some thyroid condition or another medical complaint - there are only two options: It's something to do with something that is happening to us, or it's something to do with what we are doing to ourselves.

Now, unless there is some kind of weird genetic or medical thing I'm not aware of, that can only be put down to one thing - changing diets and changing lifestyles.

Both of which we have the luxury of being able to influence ourselves, if we choose to.

[solo siam]

Can't help thinking that the reason so many people in the US for example are fat, is because its OK for them to be, people make excuses for them - create special motorised chairs for them to be able to get around Disneyland etc... and they have campaigns to blame society and state that it is an illness for which no-ones to blame.

It is an illness, its called over-eating, you are predisposed to your parents general figures but that doesnt account for the fact that obesity is relatively new, look at black and white pictures of people in the olden days (even really rich people who could afford to eat whatever and whenever they wanted to) you will hardly ever see obese people. The odd portly gentleman maybe but still this kind of puts to bed the whole 'genetics' side of things.

Some of these really fat people just need everyone to stop making excuses for them really.

It would be greate if humans could create energy out of thin air, there would be no need for oil, coal, nuclear power etc... but its a simple case of diet and exercise, I struggle with my weight but sortingout my diet and exercising soon sorts that out.

[bendix]

you know.Are you a doctor,or just mouthing off?

There are aspects of what you have said that are true IMO,but certainly not everything.,You don't strike me as being a person with medical training etc?

No, i'm not a doctor. Neither, I would guess, is anyone contributing to this interesting discussion.

However, my mother was very big and my father was normal sized. As a teenager, I was heavily overweight too. Ironically, when I left home at 17 and started to fend for myself - choosing my own meals and lifestyle rather than having it chosen for me, I lost weight and am now 'regular sized'. I started to eat vegetables, not the frozen pizzas crap an uneducated and ultimately lazy mother foisted on her kids.

So i do have an interest in the subject, and the whole area of nature v nurture is important to me for reasons that aren't important here.

It's widely accepted that there are multiple causes of obesity - genetic, pyschological and environmental. Except in extreme cases like thyroid problems, conventional medical opinion is that it's a combination of all three. Interestingly enough, there are studies which show that the adopted children of obese parents are inclined towards being more like their natural parents (which kinda refutes my original point), but conventional wisdom is that this is only a GENETIC PREDISPOSITION to obesity and NOT a 100% death sentence.

If those with a genetic predisposition to obesity are placed in an ENVIRONMENT where the wrong diet and little exercise is being obtained; if they are of a psychological type which binge eats when depressed, then their chances are minimal.

If, on the other hand, they apply the right disciplines, then there are likely to be ok.

Oh, by the way, my sister (a year younger than me) stayed at home until she was 26. I left 10 years earlier. She moved out to the council house, three doors down. I ended up on the other side of the world. She spends most of her days, sitting watching Oprah Winfrey and daytime tv, and four nights a week she goes round to 'me mam's for tea'.

Guess how much she weighs?

[ashacat]

Guess how much she weighs?

75kg?

[bendix]

Good idea for a thread, Jingthing. Bendix, I'll allow your skepticism and harping on about "eat less, exercise more" in this thread alone, as it is more of a philosophical discussion and needs to allow all points of view. If I see it in other threads (the ones for support and suggestion), it (and you) will be gone.

"Steven"

Thank you Steven, although I am not harping on.

I'm expressing a perfectly valid opinion based on very personal experiences and not - as you suggested in other threads to which I can't reply - because of prejudice or snide ignorance.

Karl Popper once said that the greatest obstacle to the progress of the human condition and thought was our desire to listen only to opinions that backed our theories and preconceptions. It's much healthier, he says, to not only accept contrary arguments but to actively seek them.

I dunno. Perhaps I'm wrong.

If my views upset people, then I apologise unreservedly. I mean no offense.

[chuchok]

you know.Are you a doctor,or just mouthing off?

There are aspects of what you have said that are true IMO,but certainly not everything.,You don't strike me as being a person with medical training etc?

No, i'm not a doctor. Neither, I would guess, is anyone contributing to this interesting discussion.

However, my mother was very big and my father was normal sized. As a teenager, I was heavily overweight too. Ironically, when I left home at 17 and started to fend for myself - choosing my own meals and lifestyle rather than having it chosen for me, I lost weight and am now 'regular sized'. I started to eat vegetables, not the frozen pizzas crap an uneducated and ultimately lazy mother foisted on her kids.

So i do have an interest in the subject, and the whole area of nature v nurture is important to me for reasons that aren't important here.

It's widely accepted that there are multiple causes of obesity - genetic, pyschological and environmental. Except in extreme cases like thyroid problems, conventional medical opinion is that it's a combination of all three. Interestingly enough, there are studies which show that the adopted children of obese parents are inclined towards being more like their natural parents (which kinda refutes my original point), but conventional wisdom is that this is only a GENETIC PREDISPOSITION to obesity and NOT a 100% death sentence.

If those with a genetic predisposition to obesity are placed in an ENVIRONMENT where the wrong diet and little exercise is being obtained; if they are of a psychological type which binge eats when depressed, then their chances are minimal.

If, on the other hand, they apply the right disciplines, then there are likely to be ok.

Oh, by the way, my sister (a year younger than me) stayed at home until she was 26. I left 10 years earlier. She moved out to the council house, three doors down. I ended up on the other side of the world. She spends most of her days, sitting watching Oprah Winfrey and daytime tv, and four nights a week she goes round to 'me mam's for tea'.

Guess how much she weighs?

That's all fine and good,but before in another thread you said it was "just calories in vs calories out" or something to that effect.This, I have personally proved is wrong.So have other people.

I'll give you another example,my wife.She is not reallyfat,but has a bit of a puku.She is perhaps the healthiest eater that I have ever seen.No fat in her diet unless it's fish.(And that's healthy colestrol as she is alway reminding me!!)No sugar and tries not to fry her food where possible.She also exercises at least one hour every day....she wakes me up at 6AM when she goes for her bloody run for christsakes! And as for aerobics ...singing with the walkman in down stairs is one of the funnier, yet painfull experiences in my life.

Her mum was a porker and she does not want to get like that.I tend to think that she will find it harder and harder as she gets older.She is in her late thirties now.

No one ever said that it was just genetic or anything like that,but they do and can play a part.People are very different though.One bloke who has 5 beers every night and has double helpings of ice cream after every meal might stay as thin as a rake.Another person who also runs a mile a day and eats and drinks the same might put on 2 kg per week.

There is also enough evidence to suggest that our bodies can get "used" to the exercise that we do and will stop the body from losing weight unless you are always changing your exercise regime.This is not for all people,but it is for some.

BTW,I am not using the reasons above as an excuse either,just it is not cut and dried like what some people think.

At the end of the day it's what goes in that counts and it's not just calories either.For some people it is easy,others it is not.

[BangnaBound]

While there may be a medical reason for obesity in small minority of people’s cases, in general, even with genetic disposition, obesity is behavioral problem.

How ever:

Diets don't work. That is proven fact. Well over 90 percent of people who go on "diets" end up gaining back MORE weight every time.

Serial "dieting" is very unhealthy and is worse for the heart than not dieting.

I totally agree with this, diets alone don’t work, and in fact diets and lots of cardio are even worse. The reason why diets do not work is well known and is not even a controversial or a disputed fact.

Ok, so why don’t diets work?

1) It takes more energy to move a heavier body.

2) When calorie intake is cut, the body tends to loss weight in proportion to its composition. If you don’t know what body composition is, simply put it’s the percentage for body fat and lean mass in your body.

3) Muscle mass burns calories even when it is not being used, unlike fat that does not burn energy.

Using these three points, I’ll illustrate the basic flaw of ‘going on a diet’. Say a 100kg guy who is 35% bf (body fat) goes on a strict diet to “lose weight” and loses 20kg. This guy will still be 35% bf. “So what?” you ask. He went from 65kg of lean body mass to 52kg. This 13kg loss of lean mass is mostly muscle. So two things have happened to him. He is burning fewer calories with every step as he is now lighter than before, and he is burning fewer calories with every minute of the day because he has less muscle than before. In fact his 80kg body is probably burning 500 to 1500 fewer calorie per day that at 100kg with the same activity level. That’s why if he goes off the diet, he will gain all the weight back plus more. If he had added a lot of cardio to his calorie restricted diet, he would of lost even more muscle causing a bigger problem.

So now that you know why diets do not work, you will want to what does. I hate to say it, but the answer is good eating habits and proper exercise. However the secret is in the phase “proper exercise”. The secret is resistance training.

If our 100kg friend above have added a proper resistance training program to that diet, he would have lost a lot less muscle. If he is also makes sure he eating enough protein, he would have lost even less.

If he wants to maintain his 80kg body at similar calorie intakes of his old 100kg then not only does he have to keep his original 65kg of lean mass, he needs to add some extra muscle to make up for the fact that he isn’t burning as much carrying the extra 20kg of fat.

So if you want to be thinner, you need to figure out how much fat you want to lose, then figure out much muscle you need to add in order to easily maintain your lower weight.

As for:

It is true that a TINY PERCENTAGE of obese people are successful at totally changing their life habits around healthy eating and exercise (NOT DIETS!) and manage to both lose the weight (easier) and KEEPING IT OFF (very rare statistically for obese people).

As a member the tiny percentage, he’s got it backwards. Getting to your idea weight and body composition is the tough part, maintaining it is relatively easy. This is because you will have developed a number of good habits along the way, and you will have build the extra muscle so you can burn the food that you love.

This link does a better job at explaining this than I do:

http://healthfitness.com.au/articles/weights/weightloss.html

[Ijustwannateach]

I think, Bendix, that questioning the purpose of this forum and the need for alternative forms of support on 3 different threads (out of 5-6 so far in the forum) qualifies as "harping." In any case, no one disputes your right to have an opinion; it's just expression of that opinion will be restricted in this subforum as I've so far stipulated.

Care to share some of these "very personal experiences" of having been overweight? Any of them involve moderate exercise and traditional forms of diet having not worked, after multiple attempts?

"Steven"

[Ijustwannateach]

Let's keep discussion on the causes of obesity in the one thread reserved for it please.

Threads merged.

I'm also altering the title of this thread slightly to make its purpose clear.

"Steven"

[Grover]

bendix you bring up a point about the psychological factor in obesity. Deep down some obese people need the psychological security of feeling physically 'big'. Thus any attempt to lose weight etc will not work because the unconscious structures in their mind will not support this change. If this is the case, they probably need to address some of these issues before doing the diet/exercise thing.

[bendix]

Care to share some of these "very personal experiences" of having been overweight? Any of them involve moderate exercise and traditional forms of diet having not worked, after multiple attempts?

"Steven"

I think I already explained it Steven. I moved out of an environment where fish & chips, burgers, chocolate biscuits, cakes and frozen pizza was the norm, where sitting on my chuff each night watching Coronation Street was considered a family activity.

I moved from there to university where that was no longer the norm, where I could control - and take responsibility - of what I ate.

It wasnt rocket science. My diet changed, my weight fell. Less energy went in, more energy came out. I've kept it off ever since because I control what I eat and I control how much energy I expend. Frankly, it's easy for me because food isn't that important to me - I often go for a day or two and eat no more than a couple of pieces of fruit because I don't feel like anything else, or because I forget to eat, or don't have time. No big deal.

When i see obese parents sitting in MacDonalds 'treating' their fat kids, effectively condemning them to a life of illhealth and unhappiness, it sickens me. What they are doing is tantamount to child abuse.

[Ijustwannateach]

^Ok, and so you never had trouble losing weight. What's your theory on how your "easy" model helps those for whom it does seem to be trouble to lose weight? Do you exercise? When you did exercise while still overweight, did the weight come off steadily and easily, or do you just put on muscle in addition to the flab? When you were overweight, was it evenly distributed or did you have pockets of flab around your abdomen?

I think your answers to the above questions will be very different from mine, and from others. I don't think that in weight loss (or in weight gain) "one size fits all." Everyone's medical makeup has individual factors, and causes of and solutions for obesity will not be the same for every person. That's why I'm happy to have all the alternative viewpoints made available on this forum, and I will discourage (this thread excepted) an attitude of "you're wrong, my idea solves it all" hijacking most of the threads.

From a physics point of view, Bendix, you're right- but from a biological point of view, the *place* that the energy comes from in the body and the *type* of energy coming in as food matter a great deal. The inputs and outputs are much more complex, leading to the experience of persons who have difficulty, given cultural and dietary options, losing weight.

"Steven"

[astral]

Biology may come into it for a "very small" number of people.

Look at Thai's 20-25 years ago.

The majority were slim and small in stature.

Now many 20 year olds are 1.80M (6ft) tall and heavy built.

The same change took place in Europe, but it was 50 years ago.

You cannot blame that in biology, genetics or whatever label you choose to use.

It is:

1. What we eat,

2. How much at each meal

3. How often we eat.

Let's forget the excuses and concentrate on the real issues.

[Ijustwannateach]

Beg to disagree. All of us know people who can "eat anything" and stay slim, others can just look at something with sugar and gain weight. Metabolism and body type depend heavily on genetics AS WELL AS behavior. I'm not saying that people with a weight problem shouldn't diet and exercise, but that results will be highly individual- in some case, results which apply to one person will not apply equally or at all to others. For some people (and I think that includes myself) carbohydrates may play a large role in the problem, even if we're not eating overly much compared to other persons. That's why specific discussion of which types of foods to eat and what types of exercise to do and WHAT TYPE OF PERSON they work for is important. It's also why simply repeating a mantra of "eat less, exercise more" will not be enough for every person (though it will work for some).

One size does not fit all.

[jumnien]

In 1953, the American Medical Association recognised "Alcoholism" as a disease. Like obese people, alcoholics, have a hard time dealing with their disease on their own. The alcoholic metabolises alcohol in a different manner than a non-alcoholic, so perhaps this "metabolism" thing has some credence in obesity as well. Likewise, wholistic treatments that address psychological and spiritual factors are probably the most successful for obesity as they are for alcoholism. Drug treatments will probably be found to be less successful.

[sbk]

Thats interesting esp when considering these two recent discoveries:

Obese mice lacking protein and

Damage to a spot in the brain removes smoking addiction

[Ijustwannateach]

Thanks for those, SBK! And thanks to you I also need to add to the guidelines- news article links should still be allowed in the threads, for the obvious reasons.

[sbk]

Oops, breaking forum rules already

[Ijustwannateach]

Nah, you just rewrote them (or rather I did, but you were my inspiration... )

[Jingthing]

I don't think obesity is a desirable condition. It is definitely unhealthy and for most people unattractive. However, given that the conventional "diet" suggestion has a failure rate well over 90 percent over time, I don't think it is a good enough answer. Since almost everyone is destined to fail at it, you have all these fat people not only feeling badly about their bodies but also about their moral worth. I don't think its helpful. For some people who have dieted and lost 10 times in their lives, and yet always gain the weight back, I honestly think the most humane answer is just accept that they are fat. I do expect some really effective medical solutions not as radical as surgery within 10 years, and this will be revolutionary.

[Ulysses G.]

Care to share some of these "very personal experiences" of having been overweight? Any of them involve moderate exercise and traditional forms of diet having not worked, after multiple attempts?

"Steven"

When I was 15 years old I was mildly overweight. In the next year or so I moved up to obese and then I started exercising fanatically and dieting when I was 17 years old and kept it up until I moved to Thailand in 1991 when I was 35 years old.

I had come down with Rhumatoid Arthriris when I was 25 and it had become VERY painful to do any kind of excercise, but I kept it up until I couldn't take it more.

Since I stopped exercising all day, every day, I have steadily gained weight and a regular diet and moderate exercise have no effect on my weight at all. The only thing that works is starving myself or ONLY eating salads and fruits with very low calorie dressings.

However, if I start eating cooked food again after losing weight with salads, I put on a few kilos a week even on a very low calorie diet with all whole grains and no meat, sugar or dairy!

[Ijustwannateach]

Sounds like you and I are in the same boat... some people seem to put on more weight from the same amount of the same type of food.

[FranklyNoMore]

Personally those with weight problems have underlying psychological problems that they are unwilling to accept and look at. Yes people have different metabolisms and some can eat cakes without gaining weight but those who do eat cakes and gain weight shouldnt be eating them in the first place. Cakes are not good for you whether you are thin or fat. Eating healthy food is considered boring. The sensation just isnt there. So you eat foods for the sensation and not for health and life. Dressing it up with medical excuses doesnt hide the fact that overweight people just eat too much of the wrong foods, lack exercise and have underlying problems they refuse to look at. This combination leads to obesity. Once you start to gain weight it's very difficult to get of that path. What starts you on that path is an emotional problem. Continuing to become obese means you refused to look at your problems. Stopping the need for the sensation of food isnt easy but looking at your life and asking why you feel the need to eat destructive foods will certainly help more than any diet which only cover over the cracks short term. Find the problem change to a healthy diet and exercise will give results. Making excuses like genetics wont help a jot. Thats just another comfort word to stop you looking at the real problem