Obesity a disease?

For anyone interested, this is a full access article from American Journal of Clinical Nutrition that is worth a read. It discusses the link between poverty and obesity.

http://ajcn.nutrition.org/content/79/1/6.full

I certainly don't see a problem with heavy taxes on certain foods. I feel the same way about booze and cigs. User pays...

spoken like a true orthorexic^^^^

oh, were you gong to eat that? let me "clean " it for you

if u think i should have to pay more for ice cream, because some person is obese, thats just crazy...While were at it, how about we add additional taxes to gasoline since I dont drive and your exhaust is unhealthy. Yeah, pretty senseless isnt it? I loathe self centered individuals.

Exactly. That is ridiculous!! I should pay more because I can eat in moderation? Or if I want to have a drink after a long day? You have got to be kidding!

If fresh food was more affordable and available, and fast food was more expensive, perhaps it could made some difference in their choices.

I ALWAYS spend less when I cook from home, even when I buy steak then when I get fast food. It is cheaper, you just have to actually cook and shop sales.

Also, re the tax issues, lots of places already tax fast food more then grocery store. I think our grocery store food is taxed at 3% (except some stuff which isn’t, I’ve never figured out the rules on this) and fast food is taxed at 11 or 12 percent. It still makes no difference because it’s not about cost it’s about convenience.

That may be your experience but there is a strong correlation between lower income and higher consumption of fast food.

Fresh food can also be convenient, but it's expensive. When I'm in a rush, I can go to the supermarket and buy a prepared salad with a little tub of dressing and a rotisserie chicken but I won't have much change from $20. The same amount of money will buy a lot more food at Most fast food places.

OH MY !!! I am taking this one. There is a correlation between lower income and higher consumption of fast food not because of price but because of attitude and choices. Yes, ATTITUDE and CHOICES. There is also a correlation between the percentage of smokers in the lower income bracket versus middle income or them evil rich fat cats. What is the deal there? Again, attitude and choices.

Also, to your second point about getting more food at a fast food place for $20, you need to bounce your head on a table for a little while and re-think what you wrote. How about instead of buying a prepared salad, rotisserie chick and a little tub of dressing you buy a head of lettuce, then chop it up, buy a whole chicken or frozen chicken breasts and cook them ahead of time on the grill, then also buy a bottle of dressing. I can guarantee you that is a lot less than $20 and will feed a family of 4 for at least 2 meals if they are eating proper portions. It is all about preparedness and CHOICES!!!!

Time is money and effort to prepare is money though. It's the same with microwavable foods. When i buy healthy it is definitely cheaper but then I need to put in the time and effort to make the food (and the patience to wait) compared to fast food and microwavable food.

The way your argument would be valid is if you could just go shopping and put all the healthy foods you bought in a box and it came out prepared and tasty. Other than that, it is a matter of how much you value your time.

I guess what I'm saying is you both have good arguments but everything must be considered. It would be like you arguing it is cheaper to make your won chair than to buy one. Yes...the wood might be cheaper but the time and effort might not be worth your while. ...unless you enjoy woodshop...same with food. If you enjoy cooking then you might not even count it as a negative. I'm enjoying eating healthy but occasionally I do like to pop something in the microwave and come back at the next commercial break and eat.

If fresh food was more affordable and available, and fast food was more expensive, perhaps it could made some difference in their choices.

I ALWAYS spend less when I cook from home, even when I buy steak then when I get fast food. It is cheaper, you just have to actually cook and shop sales.

Also, re the tax issues, lots of places already tax fast food more then grocery store. I think our grocery store food is taxed at 3% (except some stuff which isn’t, I’ve never figured out the rules on this) and fast food is taxed at 11 or 12 percent. It still makes no difference because it’s not about cost it’s about convenience.

That may be your experience but there is a strong correlation between lower income and higher consumption of fast food.

Fresh food can also be convenient, but it's expensive. When I'm in a rush, I can go to the supermarket and buy a prepared salad with a little tub of dressing and a rotisserie chicken but I won't have much change from $20. The same amount of money will buy a lot more food at Most fast food places.

That's doesn't negate anything I said. There is a correlation, but I think it's more about culture, education (as in how to cook, what to buy, etc), perhaps in some cases people lack a kitchen (ie, homeless), but we're primarily hitting convenience and taste, imo.

Convenience is a whole nother ballgame. You always pay for it. That doesn't mean you can't shop and buy healthy foods for a reasonable amount. Rice and beans with a little meat and vegetables is quite cheap and will feed you many meals healthier than fast food. I think we do a disservice to people when we tell them that it's not possible to buy healthy food cheaply.

Well, Congress declared pizza a vegetable, so I don't know how much I care for nomenclature anymore. I think we are best left to our own interpretations.

Everything is a disease nowadays because people just can't take personal responsibility for anything.

... I certainly don't see a problem with heavy taxes on certain foods. I feel the same way about booze and cigs. User pays...

Be careful what power you give to govenment, remember someone has to choose which "vices" are taxed/regulated/outlawed, and YOUR favorite may be next. For me personal respnsibility is the way to go. As long as you're not hurting anyone else, do whatever you want.

I feel like people are really missing something important here. You already pay more for your vice, if your vice is healthier food. Think about what foods the government subsidizes, and think about what it doesn't. Think about what our schoolchildren eat. It's the food that was the cheapest to produce, and that is heavily subsidized. This fear that you may have to pay more than you should for your "junk food" (relative term, I know), it's already been happening, it's just happening in reverse.

I certainly don't see a problem with heavy taxes on certain foods. I feel the same way about booze and cigs. User pays...

spoken like a true orthorexic^^^^

oh, were you gong to eat that? let me "clean " it for you

if u think i should have to pay more for ice cream, because some person is obese, thats just crazy...While were at it, how about we add additional taxes to gasoline since I dont drive and your exhaust is unhealthy. Yeah, pretty senseless isnt it? I loathe self centered individuals.

Exactly. That is ridiculous!! I should pay more because I can eat in moderation? Or if I want to have a drink after a long day? You have got to be kidding!

Did you actually read what I posted in later threads or any of the links I posted?

Obviously not. Before you jump on the bandwagon, perhaps you could actually read what I'm suggesting. It's also been suggested by the World Health Organisation and other credible organisations.

Sigh......

Yes, there is some personal responsibility in every decision that we make, but to say that every disease can be linked to personal responsibility alone is ignorant. There are some people who have genetic predispositions to certain diseases and being armed with that information can not take away that fact. Yes, people have that right to make better decisions to decrease the chance of a diagnosis, but all the good choices in the world does not negate genetics. (I am not talking about obesity as a disease, just disease in general)

The answer to this question surely must include attention to the medial/physical, behavioral, psychological, economic, and social aspects of obesity,

Many physicians are reluctant to prescribe medication for problems which are not officially classifiable as a "disorder" or a "disease." I'm not bashing them for this. If there's a bad outcome for a patient who has been given a medication for something which is not a disease or condition, (off-label prescribing) and there is a lawsuit, the result can be that the physician will write the number "1" on a check and the court will tell him/her how many zeros to fill in after it. For this reason, physicians have become very risk averse. So, it will be less risky for them if they can to treat the "disease" of obesity with one of the many medications currently being developed. This is one of the reasons why the AMA has such interest in this classification. Bariatric surgery presents a huge problem if obesity is not a "disease". It has some bad outcomes for some, but it also saves many lives. Why are we doing such a major procedure on people if obesity is not a disease state?

When offered a choice between a behavioral/lifestyle change and "a pill", many people (not all) want the "easier" choice of a pill unless they are generally opposed to medications. Makes sense--just look at the ads on TV for pharmaceuticals--wouldn't YOU want to be as happy as those people, and have that just by taking a pill? We are told by the ads, "Ask your doctor"...

Health care professionals are under extremely tight schedules. Too few of them and too many patients. Logistics alone make it impossible for a health care provider to sit with a patient and go through all the education that is needed to help them with behavioral management. It takes seconds to write a prescription--many visits to coach someone through behavioral change. Our medical center had behavioral management specialists associated with Primary Care teams for this purpose. Even their visits were limited to 30 minutes, with no more than 3 -4 visits allowed. Ask yourself, if you could make weight issues go away with a pill or by months and sometimes years of hard work and multiple expensive sessions with a health care professional, what would you do? If you chose "hard work and expense", well, you're a better person than I am.

People overeat and become obese for lots of reasons--life stresses are paramount among these. Many jobs are mostly sedentary. I believe that mostly, people do the best they can given their particular set of circumstances.

Diagnostic classifications come and go as science and research evolve and social thinking changes. In the mental health field, we are seeing a huge change in diagnostic decision making with the soon to be released DSM-V. Yet, the same symptom pictures have been around for a long time. For example, we used to diagnose and classify people with mental retardation as "idiots" and "imbiciles" in an effort to target treatments to them more specifically based on their level of developmental problems. Of course, these classifications no longer exist (thankfully), but the conditions that they represent do. What would you think of alcoholism? Is that a disease or just a person who can't control him/herself? Does classifying it as a disease matter? It does to the person suffering from it--having poor self control will not bring any treatment, will it? Is overeating different from a substance-related disorder?

So, it's not a simple problem. I honestly think that AMA tries to do the best it can in supporting physicians who are struggling to care for their patients who are suffering. The first adage of the medical profession is "Do no harm." What are the benefits/risks of calling obesity a disease?

There are many more questions about this than answers, I believe. Most of medicine is like that. There are very few things that are straightforward in medical practice. You can be sure that there will be lots of discussion about thing among medical professionals and that the treatment of obesity will continue to evolve, no matter what it is called. Some treatments will be helpful, others will carry more risk than benefit. As for me, I can't answer this question yet. There's so much that we simply don't know.

The answer to this question surely must include attention to the medial/physical, behavioral, psychological, economic, and social aspects of obesity,

Many physicians are reluctant to prescribe medication for problems which are not officially classifiable as a "disorder" or a "disease." I'm not bashing them for this. If there's a bad outcome for a patient who has been given a medication for something which is not a disease or condition, (off-label prescribing) and there is a lawsuit, the result can be that the physician will write the number "1" on a check and the court will tell him/her how many zeros to fill in after it. For this reason, physicians have become very risk averse. So, it will be less risky for them if they can to treat the "disease" of obesity with one of the many medications currently being developed. This is one of the reasons why the AMA has such interest in this classification. Bariatric surgery presents a huge problem if obesity is not a "disease". It has some bad outcomes for some, but it also saves many lives. Why are we doing such a major procedure on people if obesity is not a disease state?

When offered a choice between a behavioral/lifestyle change and "a pill", many people (not all) want the "easier" choice of a pill unless they are generally opposed to medications. Makes sense--just look at the ads on TV for pharmaceuticals--wouldn't YOU want to be as happy as those people, and have that just by taking a pill? We are told by the ads, "Ask your doctor"...

Health care professionals are under extremely tight schedules. Too few of them and too many patients. Logistics alone make it impossible for a health care provider to sit with a patient and go through all the education that is needed to help them with behavioral management. It takes seconds to write a prescription--many visits to coach someone through behavioral change. Our medical center had behavioral management specialists associated with Primary Care teams for this purpose. Even their visits were limited to 30 minutes, with no more than 3 -4 visits allowed. Ask yourself, if you could make weight issues go away with a pill or by months and sometimes years of hard work and multiple expensive sessions with a health care professional, what would you do? If you chose "hard work and expense", well, you're a better person than I am.

People overeat and become obese for lots of reasons--life stresses are paramount among these. Many jobs are mostly sedentary. I believe that mostly, people do the best they can given their particular set of circumstances.

Diagnostic classifications come and go as science and research evolve and social thinking changes. In the mental health field, we are seeing a huge change in diagnostic decision making with the soon to be released DSM-V. Yet, the same symptom pictures have been around for a long time. For example, we used to diagnose and classify people with mental retardation as "idiots" and "imbiciles" in an effort to target treatments to them more specifically based on their level of developmental problems. Of course, these classifications no longer exist (thankfully), but the conditions that they represent do. What would you think of alcoholism? Is that a disease or just a person who can't control him/herself? Does classifying it as a disease matter? It does to the person suffering from it--having poor self control will not bring any treatment, will it? Is overeating different from a substance-related disorder?

So, it's not a simple problem. I honestly think that AMA tries to do the best it can in supporting physicians who are struggling to care for their patients who are suffering. The first adage of the medical profession is "Do no harm." What are the benefits/risks of calling obesity a disease?

There are many more questions about this than answers, I believe. Most of medicine is like that. There are very few things that are straightforward in medical practice. You can be sure that there will be lots of discussion about thing among medical professionals and that the treatment of obesity will continue to evolve, no matter what it is called. Some treatments will be helpful, others will carry more risk than benefit. As for me, I can't answer this question yet. There's so much that we simply don't know.

like

The answer to this question surely must include attention to the medial/physical, behavioral, psychological, economic, and social aspects of obesity,

Many physicians are reluctant to prescribe medication for problems which are not officially classifiable as a "disorder" or a "disease." I'm not bashing them for this. If there's a bad outcome for a patient who has been given a medication for something which is not a disease or condition, (off-label prescribing) and there is a lawsuit, the result can be that the physician will write the number "1" on a check and the court will tell him/her how many zeros to fill in after it. For this reason, physicians have become very risk averse. So, it will be less risky for them if they can to treat the "disease" of obesity with one of the many medications currently being developed. This is one of the reasons why the AMA has such interest in this classification. Bariatric surgery presents a huge problem if obesity is not a "disease". It has some bad outcomes for some, but it also saves many lives. Why are we doing such a major procedure on people if obesity is not a disease state?

When offered a choice between a behavioral/lifestyle change and "a pill", many people (not all) want the "easier" choice of a pill unless they are generally opposed to medications. Makes sense--just look at the ads on TV for pharmaceuticals--wouldn't YOU want to be as happy as those people, and have that just by taking a pill? We are told by the ads, "Ask your doctor"...

Health care professionals are under extremely tight schedules. Too few of them and too many patients. Logistics alone make it impossible for a health care provider to sit with a patient and go through all the education that is needed to help them with behavioral management. It takes seconds to write a prescription--many visits to coach someone through behavioral change. Our medical center had behavioral management specialists associated with Primary Care teams for this purpose. Even their visits were limited to 30 minutes, with no more than 3 -4 visits allowed. Ask yourself, if you could make weight issues go away with a pill or by months and sometimes years of hard work and multiple expensive sessions with a health care professional, what would you do? If you chose "hard work and expense", well, you're a better person than I am.

People overeat and become obese for lots of reasons--life stresses are paramount among these. Many jobs are mostly sedentary. I believe that mostly, people do the best they can given their particular set of circumstances.

Diagnostic classifications come and go as science and research evolve and social thinking changes. In the mental health field, we are seeing a huge change in diagnostic decision making with the soon to be released DSM-V. Yet, the same symptom pictures have been around for a long time. For example, we used to diagnose and classify people with mental retardation as "idiots" and "imbiciles" in an effort to target treatments to them more specifically based on their level of developmental problems. Of course, these classifications no longer exist (thankfully), but the conditions that they represent do. What would you think of alcoholism? Is that a disease or just a person who can't control him/herself? Does classifying it as a disease matter? It does to the person suffering from it--having poor self control will not bring any treatment, will it? Is overeating different from a substance-related disorder?

So, it's not a simple problem. I honestly think that AMA tries to do the best it can in supporting physicians who are struggling to care for their patients who are suffering. The first adage of the medical profession is "Do no harm." What are the benefits/risks of calling obesity a disease?

There are many more questions about this than answers, I believe. Most of medicine is like that. There are very few things that are straightforward in medical practice. You can be sure that there will be lots of discussion about thing among medical professionals and that the treatment of obesity will continue to evolve, no matter what it is called. Some treatments will be helpful, others will carry more risk than benefit. As for me, I can't answer this question yet. There's so much that we simply don't know.

What's next? Smoking a disease? Drinking.....wait that's already classed as one.


What about this....... IT IS YOUR OWN fault you are fat......


Take some responsibility for YOUR own actions....regardless of what it is.

AGREED! and it is also your own fault if you smoke, have a drinking problem and drug problem. If you got yourself into the mess then you need to get yourself out whether it is on your own or by getting help. People need to stop blaming others when their health go's to **** because they don't look after themselves.

Leptin resistance. Look it up. Someone already mentioned it in this thread but everyone is too caught up fat shaming to pay any attention.

There is a physiological basis for obsesity. Our eating habits are not as simple as "eat/don't eat". That is simple ignorance.

This.

Are you really trying to say that overeating, junk food and a sedentary lifestyle arent the main reasons why so many people are obese? Yes, there are valid medical conditions that can cause someone to gain weight or have issues losing weight but can we get REAL here???? 99% of the time personal responsibility has to be taken for the state we have let ourselves get to.

Have you ever met a person who seems to be able to eat whatever they want and still remains skinny. My roommate is that way. She eats lucky charms for breakfast every single day. I grew up on oatmeal and with a ban on all sugary cereals. I've never been obese and at max maybe 15 lbs overweight, but I am nowhere near as thin as she is.

There is definitely genetic predisposition. And obesity rates increase as our environment becomes increasingly obesogenic- sedentary lifestyles with big advertisement of cheap and easily accessible junk food. So yes, while those things create the environment that leads to obesity, it does not account for why some individuals are obese and some aren't. You cannot place all blame on individuals. It's silly and ignorant to say that we without any reference to culture, socio-economic status, and individual physiology decide whether or not we are fat.

For frak's sake we stigmatize the hell out of fat people and make their lives pretty miserable and yet call them lazy and blame it on them. It's pretty easily relatable to homophobia. If being gay was a choice don't you think that people would CHOOSE to not be shunned by their families and communities? If being fat was a simple matter of willpower don't you think everyone would be thin!!?

I know very strong people who are successful in every aspects of their lives but still struggle with weight. My mother worked her way out of poverty and through grad school with no one's help but her own. She is extremely successful in her work and has managed to raise 2 children. Is she lazy because she's obese? Yeah....I don't think so.

There are environmental hurdles that make it hard but like I said before I think there needs to be accountability on the individual. I will never agree that a person isn't more then SOMEWHAT responsible for their bodies. I think THAT is ignorant. They need to be aware of the harm that they are in and they need to try and figure out what they can do to take care of themselves. Even if all they can do are small steps at first at least it's a START.

I live in a community where many people are under the poverty line. I have lived there all my life. I know these people. I know the culture. They are my friends and family. And I can tell you that yes there are issues out of their control, but the reason why there are SO many obese people in my community is because they overeat and they are sendentary. HUGE plates of food. No water. Would rather take the bus a block then walk it. and they get bigger. and they see they are getting bigger and they KNOW why but they continue to lead the same lifestyle. and none of them take responsiblity.

Of course strong successful people struggle with weight. I am a living breathing example of it. So is your mother. That's not in dispute. The word lazy was not thrown around by me either. Is there a genetic pre-disposition to being able to gain fat more easily? Of course. They're called endomorphs. Is there a socia-economic impact on individuals that cause they to be bigger? Sure. It is more acceptable is certain cultures to overeat. Those who are poor tend to weigh more.

But the number of calories a person has every single day IS about willpower. Plain and simple. At the end of the day, in my opinion, it is about calories in and calories out. People keep saying its cheaper to eat junk food and too expensive to buy and eat fresh foods? Guess what? You do NOT HAVE TO EAT CLEAN to lose weight. You just have to eat less. All you have are poptarts bc they were the cheapest thing to get? Eat one. Not two. You had to buy a burger from the dollar menu? Eat ONE burger not three. In many cases that is the solution to the obesity problem. Not in all cases, but in many cases. Many times, when someone is 300, 400, 500 pounds, the sheer AMOUNT of food they have to eat every single day to stay that way and get bigger is astounding. I know this from EXPERIENCE. Guess what is going to happen for most of these people if they start eating less? They'll lose weight.

It's a miracle.

I know all about poverty and cultures who tell you it is acceptable to be bigger. I know about the hurdles. I lived through some of them. At the end of the day I took responsiblity for eating too much and being obese and I found out what I needed to do to help myself. It wasn't easy but I educated myself and did it. There are hurdles but there are ways to get over those hurdles. The question becomes how important is it to them and how bad do they want it?