Bound to be controversial

124

Replies

  • daniwilford
    daniwilford Posts: 1,030 Member
    edited July 2015
    In the US doctors use International Statistical Classification of Diseases and Related Health Problems codes for justification to insurance for tests, medical procedures and medications. There are codes for obesity and overweight. They are classified as Endocrine, nutritional and Metabolic disorders (E00-E90). Anything that is classified by the international medical community as a disorder, seems intuitively the opposite of healthy.
  • ElizabethAnne14
    ElizabethAnne14 Posts: 12 Member
    No, you cannot be Healthy At Every Size. Too little weight, your body cannot function as it was designed just as if you weigh too much. The too little and too much might seem like arbitrary numbers, but using charts like BMI give you a general guideline that will help determine where you fit in the best overall range for your body.

    Example, when I was 19 and 110 pounds I had none of the health issues that I currently have, because they have all been caused by weight gain. I am currently 114 lbs over my ideal weight range. It is no accident that those who stick closely to their ideal weight have less health issues in everything from cancer to heart problems.

    Being accepting and loving of each other is something that should be done. But going around saying that you can be Healthy At Every Size is just a big ol lie.
  • Kexessa
    Kexessa Posts: 346 Member
    Nay. It isn't just for those who are severely overweight. My Mom was 40 + pounds underweight at the age of 72. She was in the early stages of dementia and refused to eat. Her own doctor kept saying as long as she drank and Ensure a day she'd be fine, she was healthy enough. Because of being extremely underweight and medication she was taking she developed a perforated bowel. She survived surgery but because she was so underweight her body was unable to heal and recover. She subsequently died.

    She died as a result of being underweight ultimately. She was not healthy at her weight and was not healthy enough to heal. From an identical surgery an 86 year old had the same day and left the hospital 3 days later.
  • PaulaWallaDingDong
    PaulaWallaDingDong Posts: 4,641 Member
    I was technically healthy being obese (5'3" and 250 lbs put me just over the line into morbidly obese), but I don't think it was going to last forever, especially given my family history. Plus, there were some quality of life issues.
  • shank35l
    shank35l Posts: 102 Member
    One of the most exhaustive research papers on the subject, from the Ciccarone Center for the Prevention of Heart Disease, showed that obese people had elevated levels of troponin(cTnT).

    Increases in levels troponin T corresponded to increases in people's BMI in a 9,500 patient study. A direct relationship was found between obesity and subclinical heart damage. Obese people with elevated troponin levels were nine times more likely to develop heart failure than people with normal weight and undetectable troponin levels.

    People who were severely obese—those with a BMI above 35—had more than twice the risk of developing heart failure compared with people of normal weight. That risk rose incrementally with BMI, growing by 32 percent for every five-unit increase in BMI. For example, a 6-foot, 225-pound man with a BMI of 30 was 32 percent more likely to develop heart failure than a 6-foot, 188-pound man with a BMI of 25.

    Most importantly for this thread, the elevated risk persisted even when investigators accounted for other possible causes of heart damage, including diabetes, hypertension, and high cholesterol.

    So no, medical professionals are not wrong to weigh us, or focus on weight as a primary factor.
  • kshama2001
    kshama2001 Posts: 28,052 Member
    karyabc wrote: »
    Depends. I think if you're 150 lbs over your "normal" weight, there really isn't any way on earth you're healthy. But if you're a little over and exercise regularly, sure you can be healthy. When I was in high school, I was considered overweight by about 25/30 lbs. BUT I was on the track team (shot put and discus), was a 2nd degree black belt teaching 4 martial arts classes a week, and ran regularly. I was toned and athletic, but still felt insanely fat in my size 14 jeans. Looking back as an adult there's no doubt in my mind I was healthy despite being overweight, and this has helped me set realistic expectations for my weight loss this time around.

    I think the matters is ask our self is what is the definition of healthy. I see by your definition that i wasn't healthy in your book, but not so long ago i was 300 lbs/150 lbs over weight and i didn't have any medical health issues, likeeee nothing, blood test, hormones, metabolic panel perfect, joints working perfectly.etc

    So being healthy to you is define by the actual health condition of a person or by the potentially risk a person have to develop some medical health weight issue in the future?

    I agree that there are very different definitions of "healthy". When I was 100 lbs overweight I didn't have any heart, blood pressure, joint, etc issues at all. On paper, other than my weight, I was "healthy". But I couldn't walk up 3 flights of stairs without being winded. I couldn't get up off the floor without using every limb of my body and holding on to something. I didn't have the energy to throw my kid up in the air and play for more than a minute at a time. So I considered myself unhealthy despite what blood tests showed.

    I think of the bolded as quality of life issues and think they are important to factor in as well as labs test results.

    Now that I'm under the weight at which I have knee "pain with activity" I'm pretty healthy, but my quality of life and overall health will continue to improve as I continue to lose weight and increase activity.

  • Kalikel
    Kalikel Posts: 9,603 Member
    hal1964 wrote: »
    My doctor told me about one of is other patients. This person was obese and had a poor diet. Yet when he sent them for a heart scan and looked at their cholesterol, the arteries were 100% clear of calcium and their cholesterol numbers were perfect.

    It happens. Some do everything wrong and get away with it. Some do everything right and drop dead at 45. It's uncommon, but it happens.

    Most people who dance will have to pay the piper. The smoking, salt and obesity...it catches up with most people in the end. You get decades of no penalties, but it doesn't last forever.
  • karyabc
    karyabc Posts: 830 Member
    SezxyStef wrote: »
    karyabc wrote: »
    Zedeff wrote: »
    karyabc wrote: »
    Ohhhh 1) i dont try to act , i actually went to med school , did my 5 years and graduate so yes that actually qualifys me to write that sort of opinion cause i have the same degree than the "smarts people"

    I'm not buying it.
    irti6m64928d.jpg

    Physicians serve the role of health advocates. In Canada the accreditation body for specialty medical training is the Royal College of Physicians and Surgeons and their model of residency training is summarized in the CanMEDS roles, one of which is "Health Advocate." As an advocate for health you are responsible for advising your patients to quit doing harmful things - wear their seatbelt when driving, wear a helmet while cycling, stop smoking or drinking to excess and, yes, lose some weight if obese.

    It is actually my JOB as a physician to encourage obese people to lose weight. Studies on smoking cessation prove beyond a doubt that a physician advising someone to quit smoking increases their likelihood of actually doing it. I've no reason to think that obesity is any different.

    what is it that your are not buying it? That i went to med school, and that my daily job is well work as a physician? Ok im cool with that

    About the other thing, Again i never said a physician should not advise, be concerned abouth their patients weight, encourage them to achieve their very best health, oh no you're wrong i fully agree with that, where i was going is how unfairly i've seing SOME overweight patients being take care of, and physicians gets so fixated in their weight issue that they miss other health issues, yes is my job to tell you to loose weight but yes is actually my.job to respect your decision and treat your illness if u decide to loose the weight or not.

    I don't buy it either...being from Canada and having family who are doctors...

    as for the bolded...I am just gonna say this...lose vs loose..i vs I, i've seen vs i've seeing...u vs you.

    Hey steff lets make something clear i've being here for years and never had the necesity to prove anything to anybody, i quite the opposite act very quietly and have learn a lot from many people here, i dont go with "oh i went to med school i know it all, never once have donne that, the only reason i talked about is because someone post something about how i dare to talk about this subect when the real smart people are the physicians or something like that and was trying to make him understand where my opinion came from.

    2) sorry if my ortography bothers you, you see i actually learn english by watching friends and everybody loves raymond, haven't got propper education,neither i consider my self bilingual but someone not so long ago, told me that it was agains the rules of mfp to make corrections in other people post about language mistakes, so thats why i take the adventure to post from time to time, but hey thanks! lesson learn on lose/ loose thing

    3) what is it that you need to give me a little credit and actually stop making me appear like a liar, pictures of me, working in the hospital or my medical degree, will that do? and also how do you want it, by private message or you need it to be here public, i've never posted a single gif or picture but just for you stef i would learn.. please tell me since you show so much interest
  • SezxyStef
    SezxyStef Posts: 15,267 Member
    karyabc wrote: »
    SezxyStef wrote: »
    karyabc wrote: »
    Zedeff wrote: »
    karyabc wrote: »
    Ohhhh 1) i dont try to act , i actually went to med school , did my 5 years and graduate so yes that actually qualifys me to write that sort of opinion cause i have the same degree than the "smarts people"

    I'm not buying it.
    irti6m64928d.jpg

    Physicians serve the role of health advocates. In Canada the accreditation body for specialty medical training is the Royal College of Physicians and Surgeons and their model of residency training is summarized in the CanMEDS roles, one of which is "Health Advocate." As an advocate for health you are responsible for advising your patients to quit doing harmful things - wear their seatbelt when driving, wear a helmet while cycling, stop smoking or drinking to excess and, yes, lose some weight if obese.

    It is actually my JOB as a physician to encourage obese people to lose weight. Studies on smoking cessation prove beyond a doubt that a physician advising someone to quit smoking increases their likelihood of actually doing it. I've no reason to think that obesity is any different.

    what is it that your are not buying it? That i went to med school, and that my daily job is well work as a physician? Ok im cool with that

    About the other thing, Again i never said a physician should not advise, be concerned abouth their patients weight, encourage them to achieve their very best health, oh no you're wrong i fully agree with that, where i was going is how unfairly i've seing SOME overweight patients being take care of, and physicians gets so fixated in their weight issue that they miss other health issues, yes is my job to tell you to loose weight but yes is actually my.job to respect your decision and treat your illness if u decide to loose the weight or not.

    I don't buy it either...being from Canada and having family who are doctors...

    as for the bolded...I am just gonna say this...lose vs loose..i vs I, i've seen vs i've seeing...u vs you.

    Hey steff lets make something clear i've being here for years and never had the necesity to prove anything to anybody, i quite the opposite act very quietly and have learn a lot from many people here, i dont go with "oh i went to med school i know it all, never once have donne that, the only reason i talked about is because someone post something about how i dare to talk about this subect when the real smart people are the physicians or something like that and was trying to make him understand where my opinion came from.

    2) sorry if my ortography bothers you, you see i actually learn english by watching friends and everybody loves raymond, haven't got propper education,neither i consider my self bilingual but someone not so long ago, told me that it was agains the rules of mfp to make corrections in other people post about language mistakes, so thats why i take the adventure to post from time to time, but hey thanks! lesson learn on lose/ loose thing

    3) what is it that you need to give me a little credit and actually stop making me appear like a liar, pictures of me, working in the hospital or my medical degree, will that do? and also how do you want it, by private message or you need it to be here public, i've never posted a single gif or picture but just for you stef i would learn.. please tell me since you show so much interest

    You can't prove it really so no reason even bring it up to be frank and no reason to be upset just pointing out a few things that make your claim a bit more dubious.

  • karyabc
    karyabc Posts: 830 Member
    SezxyStef wrote: »
    karyabc wrote: »
    SezxyStef wrote: »
    karyabc wrote: »
    Zedeff wrote: »
    karyabc wrote: »
    Ohhhh 1) i dont try to act , i actually went to med school , did my 5 years and graduate so yes that actually qualifys me to write that sort of opinion cause i have the same degree than the "smarts people"

    I'm not buying it.
    irti6m64928d.jpg

    Physicians serve the role of health advocates. In Canada the accreditation body for specialty medical training is the Royal College of Physicians and Surgeons and their model of residency training is summarized in the CanMEDS roles, one of which is "Health Advocate." As an advocate for health you are responsible for advising your patients to quit doing harmful things - wear their seatbelt when driving, wear a helmet while cycling, stop smoking or drinking to excess and, yes, lose some weight if obese.

    It is actually my JOB as a physician to encourage obese people to lose weight. Studies on smoking cessation prove beyond a doubt that a physician advising someone to quit smoking increases their likelihood of actually doing it. I've no reason to think that obesity is any different.

    what is it that your are not buying it? That i went to med school, and that my daily job is well work as a physician? Ok im cool with that

    About the other thing, Again i never said a physician should not advise, be concerned abouth their patients weight, encourage them to achieve their very best health, oh no you're wrong i fully agree with that, where i was going is how unfairly i've seing SOME overweight patients being take care of, and physicians gets so fixated in their weight issue that they miss other health issues, yes is my job to tell you to loose weight but yes is actually my.job to respect your decision and treat your illness if u decide to loose the weight or not.

    I don't buy it either...being from Canada and having family who are doctors...

    as for the bolded...I am just gonna say this...lose vs loose..i vs I, i've seen vs i've seeing...u vs you.

    Hey steff lets make something clear i've being here for years and never had the necesity to prove anything to anybody, i quite the opposite act very quietly and have learn a lot from many people here, i dont go with "oh i went to med school i know it all, never once have donne that, the only reason i talked about is because someone post something about how i dare to talk about this subect when the real smart people are the physicians or something like that and was trying to make him understand where my opinion came from.

    2) sorry if my ortography bothers you, you see i actually learn english by watching friends and everybody loves raymond, haven't got propper education,neither i consider my self bilingual but someone not so long ago, told me that it was agains the rules of mfp to make corrections in other people post about language mistakes, so thats why i take the adventure to post from time to time, but hey thanks! lesson learn on lose/ loose thing

    3) what is it that you need to give me a little credit and actually stop making me appear like a liar, pictures of me, working in the hospital or my medical degree, will that do? and also how do you want it, by private message or you need it to be here public, i've never posted a single gif or picture but just for you stef i would learn.. please tell me since you show so much interest

    You can't prove it really so no reason even bring it up to be frank and no reason to be upset just pointing out a few things that make your claim a bit more dubious.

    I was not upset at all stef, have a nice rest of the day .
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    karyabc wrote: »
    Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.

    like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot

    Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.

    Not so fast there...

    http://annals.org/article.aspx?articleid=1784291&ct=40009
    Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).

    Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.

    Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.
  • FrostAyy
    FrostAyy Posts: 23 Member
    karyabc wrote: »
    I was not upset at all stef, have a nice rest of the day .

    You sound incredibly upset lmao

  • tomatoey
    tomatoey Posts: 5,446 Member
    edited July 2015
    karyabc wrote: »
    Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.

    like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot

    Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.

    Not so fast there...

    http://annals.org/article.aspx?articleid=1784291&ct=40009
    Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).

    Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.

    Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.

    there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.

    now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)

    i think it was this one
    http://www.medscape.com/viewarticle/791407
  • Mr_Knight
    Mr_Knight Posts: 9,532 Member
    Merkavar wrote: »
    I keep hearing and seeing people talk about being healthy while being fat, overweight or obese.

    They're deluding themselves.
  • MamaBirdBoss
    MamaBirdBoss Posts: 1,516 Member
    Merkavar wrote: »
    So... Healthy at every size

    I keep hearing and seeing people talk about being healthy while being fat, overweight or obese.

    I can inderstand being healthy while a bit fat but it seems fat and health have a negative correlation.

    So am I wrong in thinking that you can't be healthy while very over weight? It just seems logical to me that more fat equal less healthy.

    But healthy at every size people seem to be common. Maybe my thinking is outdated.

    So healthy at any size... Yay or nay?

    It's like saying that you can be a healthy smoker. Weeeeeeell, by some measures, yes, you can be very healthy while also being a smoker. But you're completely delusional if you think that the smoking isn't impacting your health now and might have dire consequences later.
  • tomatoey
    tomatoey Posts: 5,446 Member
    edited July 2015
    nvsmomketo wrote: »
    I agree with those who say age is a HUGE factor. An obese, active person who is 25 is going to be healthier than an obese, active 45 year old almost every time. Young people, (I would define as about age 30 or younger) haven't had enough time being fat for their health problems (caused by what they eat) to catch up to them yet. It most likely will.

    It's like smoking. The smoker who has been doing it for 10 years probably doesn't have obvious health problems from that activity YET, but the 50 year smoker is the one who is more likely to have issues from their addiction.

    I think some overweight poeple can be healthy, mostly those who are working on reducing their weight. If you eat like a thin person, your blood and body will reflect it before you get thin. If an overweight (or thin person) is eating like a fat pesron, their blood won't stay healthy for many years.

    I do agree that exercise at any weight will make you healthier. Note that I said healthier and not healthy. My 72 year old mother goes to the gym 3 days a week. I am sure she has better muscle tone than many 60 year olds, but she is 100lbs overweight - there is only so much going to the gym will do for her. It helps, but it isn't enough.

    yeah, i think that it's likely to show up sooner or later, for most.

    my top bmi was 30. i had no health problems at that time (in my 20s). what i've read though is that having been obese can still put you at risk of metabolic disorders even after you lose weight, i.e. that some of the hormonal / metabolic markers are more or less permanent.

    i am now at a bmi of 22 (but of course older) and now have borderline high cholesterol. i wonder how much having been obese made a difference. (but then i also have genetic risk).

    i also wonder how much body fat percentage plays into health, given that fat is endocrinologically active. bc have also had low vit d and low creatinine levels (reflecting what is very probably an obese-range body fat %, although i'm bmi 22 - classically skinny fat). vit d is fat soluble - wonder if high bf % means less of the vit d is getting where it needs to go.


    ***

    http://www.nature.com/ijo/journal/v24/n1/full/0801082a.html
    Mortality associated with body fat, fat-free mass and body mass index among 60-year-old Swedish men¾a 22-year follow-up. The study of men born in 1913

    RESULTS: The risk of dying was a linear function of percentage fat and fat-free mass, and increased from a relative risk of 1.00 in men belonging to the lowest fifth to 1.4 (95% confidence interval 1.11-1.99) in men in the highest fifth of percentage fat mass. For BMI the lowest risk was observed for men belonging to the middle fifth of BMI. When the relative risk was set at 1.00 for subjects belonging to the middle fifth of BMI the risk associated with the low BMI fifth was 1.3 (95% confidence interval 0.94-1.68) and that with the highest fifth was 1.5 (95% confidence interval 1.09-1.96). Analyses including both body fat and fat-free mass showed that total mortality was a linear increasing function of high fat and low fat-free mass.

    ****

    which arghalsdkfjaskdfj sucks because i cannot lift heavy weights right now :(:(:(:(
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    I don't know that having been obese is a factor in cholesterol issues. I've been obese a while, still am hovering on the cusp of obesity/overweight, have a genetic predisposition to high cholesterol, and just from losing the weight I've already lost, I've managed to drop mine down to normal range. I think I'm older than you too.
  • PAV8888
    PAV8888 Posts: 14,254 Member
    edited July 2015
    Can a few outliers be obese and healthy?
    YES. One or two very athletic people, assuming they didn't take steroids to get there, can!
    YES. A lot of younger or recently obese people can.
    YES. A still obese person who just lost a lot of weight and has been exercising, can!
    YES. In some rare cases an obese person who is athletic and exercises and hasn't lost weight, can, maybe (athletic+obese+haven't lost any weight? How often?)!

    However, most obese people, after a few decades of being so, and with the weight increasing as time goes on... just can't--not as healthy as they would have been at a lower weight!

    This does not mean that they should be denied health care.
    This does not mean that health care should be disproportionately rationed when it comes to them.

    The things one HEARS about say the rationing of health care in the British public health care system... disturb me.
    Then again the things one HEARS about the US health care system from people who have some money but not enough for health care coverage also disturb me.

    It is one thing to encourage the patient to follow a path towards a more favourable outcome.
    It is another thing to deny care pending patient compliance (even if such compliance would result in slightly more favourable odds)
  • MelissaPhippsFeagins
    MelissaPhippsFeagins Posts: 8,063 Member
    Mostly, I think there's a range of Healthy weights. However, my sweet sister-in-law is overweight, but has perfect lab values, normal blood pressure, no health issues beyond a broken arm from a fall last year. She's an exception.

    LeBron James has a morbidly obese BMI, but I wouldn't call him fat and I would presume his cardiovascular heath is good. OTOH, I would find it surprising if he doesn't have joint damage already that will make his later years very uncomfortable. Is that healthy or not?
  • Mr_Knight
    Mr_Knight Posts: 9,532 Member
    edited July 2015
    The "healthiest" obese people we have are probably NFL linemen. They can easily scale out at 325-350 pounds, and yet they are strong, mobile and fast.

    Until they hit their 30s - and then it all goes to **** in a hurry.

    Medical problems in 40+ year old ex-linemen are legendary...
  • Mr_Knight
    Mr_Knight Posts: 9,532 Member
    It's not just about being fat - even if you're carrying an extra 100 pounds of PED-enhanced muscle, you're going to have problems, because you're carrying a **** ton more weight than your frame and connective tissue evolved to carry.
  • fishshark
    fishshark Posts: 1,886 Member
    well there is a few of you using the term "being fat". I am at a healthy BMI for my heigh smack dab in the perfect zone.. but I have 33% body fat.. so... I am.. fat, but you know not fat. I also have an auto immune disease that will never go away so I guess I'm not healthy either. The word healthy is so relative to the person talking about it. I was a marathon swimmer with just about no body fat and my blood work always had something wrong with it. Does all of this correlate to weight? hell no it doesn't. being "fat" means your fat... being "unhealthy" can happen at any weight.
  • PAV8888
    PAV8888 Posts: 14,254 Member
    fishshark wrote: »
    well there is a few of you using the term "being fat". I am at a healthy BMI for my heigh smack dab in the perfect zone.. but I have 33% body fat.. so... I am.. fat, but you know not fat. I also have an auto immune disease that will never go away so I guess I'm not healthy either. The word healthy is so relative to the person talking about it. I was a marathon swimmer with just about no body fat and my blood work always had something wrong with it. Does all of this correlate to weight? hell no it doesn't. being "fat" means your fat... being "unhealthy" can happen at any weight.
    How are you arriving at that %? Bioimpedance scale? Even if true, you are not that far from the % for a healthy female.

    Did someone say that not being obese is a guarantee of health?

    The question is whether MOST obese people can be BOTH obese AND healthy. The obvious, to me, reference being as to whether obesity BY ITSELF brings about health complications... which... well... it DOES when you consider obesity over time.

    Now, whether that is true or not (that obesity has health consequences over time), so do thousands of other things that people do. From driving a car, to drinking alcohol, to smoking cigarettes, to going out for a run in the forest when there is a wind storm.

    Should this affect how they receive health care?

    Is the obese person less worthy of health care than the BMX biker who face planted after a 9ft jump in the forest?
  • atypicalsmith
    atypicalsmith Posts: 2,742 Member
    PAV8888 wrote: »
    It is one thing to encourage the patient to follow a path towards a more favourable outcome.
    It is another thing to deny care pending patient compliance (even if such compliance would result in slightly more favourable odds)

    When I was 30, I had an ectopic pregnancy which nearly killed me in 1980. My doctor let me talk him out of checking further into it because I was in no pain and had a major project at work. When I blacked out, I was rushed to the hospital and BP was 0/0 and it was amazing that I lived. Later, my friend Debbie, who went to my doctor at my referral, had cramping. He told her to go the hospital RIGHT NOW. She said but she was on her lunch hour. He said he didn't care, to call her office and go to the hospital RIGHT NOW. She argued and he said, "Do you remember your friend Sherry? I will never have a patient nearly die again. If you don't go to the hospital RIGHT NOW, I won't be your doctor any more." She went and her life was saved.
  • fishshark
    fishshark Posts: 1,886 Member
    PAV8888 wrote: »
    fishshark wrote: »
    well there is a few of you using the term "being fat". I am at a healthy BMI for my heigh smack dab in the perfect zone.. but I have 33% body fat.. so... I am.. fat, but you know not fat. I also have an auto immune disease that will never go away so I guess I'm not healthy either. The word healthy is so relative to the person talking about it. I was a marathon swimmer with just about no body fat and my blood work always had something wrong with it. Does all of this correlate to weight? hell no it doesn't. being "fat" means your fat... being "unhealthy" can happen at any weight.
    How are you arriving at that %? Bioimpedance scale? Even if true, you are not that far from the % for a healthy female.

    Did someone say that not being obese is a guarantee of health?

    The question is whether MOST obese people can be BOTH obese AND healthy. The obvious, to me, reference being as to whether obesity BY ITSELF brings about health complications... which... well... it DOES when you consider obesity over time.

    Now, whether that is true or not (that obesity has health consequences over time), so do thousands of other things that people do. From driving a car, to drinking alcohol, to smoking cigarettes, to going out for a run in the forest when there is a wind storm.

    Should this affect how they receive health care?

    Is the obese person less worthy of health care than the BMX biker who face planted after a 9ft jump in the forest?

    Well funny you mention that because my hubby rides BMX for a living riding for big companies and he doesn't get health care so he has to pay out of pocket and his premiums are triple mine because of his career. so yea lol
  • Isabelle_1929
    Isabelle_1929 Posts: 233 Member
    Bshmerlie wrote: »
    Something I have noticed as I've gotten older is life catches up to you. Things you could get away with when you were younger seem to come back and haunt you as you get older. Eating crap, being stressed out, being obese, staying up until dawn and going to work the next day is something you can get away with in your 20's. It gets a little harder in your 30's. By the time you hit 40 you're starting to feel it. Just like a car. It's great when it's new but when it hits that 10 yr mark you're gonna be able to tell if a car has had proper maintenance over the years. Human bodies need maintenance. Being overweight puts strain on joints and tendons. Puts strain on the heart and lungs. Not a big deal when you're young but increasingly becomes a problem the older you get.

    Yes it's good to love yourself at any weight. But you also need to respect your body. Treat it right and don't assume the health you enjoy when you're 20 will continue into your 40's or 50's.

    Oh that made me feel better to read this. I was reading this thread, and was amazed that (almost) no one mentioned the age factor and long-term health damages.

    Because what, you are full of energy at 20 years-old? You can run without having a heart attack at 25? Get out of here !

    ;-)

    Now seriously: I am waiting to see a 60 + years-old person who has been overweight /obese most or all of his life, come and tell us that he has no health problems related to his weight or nutrition.

    Also, speaking of running ... am all for running and exercise, but being able to run does not in any way indicates that one is healthy. In fact, someone who is not certain to be reasonably healthy should not participate in a long distance or high intensity run.
  • MamaBirdBoss
    MamaBirdBoss Posts: 1,516 Member
    edited July 2015
    tomatoey wrote: »
    karyabc wrote: »
    Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.

    like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot

    Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.

    Not so fast there...

    http://annals.org/article.aspx?articleid=1784291&ct=40009
    Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).

    Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.

    Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.

    there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.

    now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)

    i think it was this one
    http://www.medscape.com/viewarticle/791407

    Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.

    You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.

    Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.
  • MamaBirdBoss
    MamaBirdBoss Posts: 1,516 Member
    edited July 2015
    Mr_Knight wrote: »
    The "healthiest" obese people we have are probably NFL linemen. They can easily scale out at 325-350 pounds, and yet they are strong, mobile and fast.

    Until they hit their 30s - and then it all goes to **** in a hurry.

    Medical problems in 40+ year old ex-linemen are legendary...

    A lot of that has to do with the type of sport.

    That's another thing...we assume that athletes are healthy, but a number do things that are either bad for them now (like some powerlifters who are obese to make their bases more stable...or some gymnasts who deliberately drop pounds below healthy levels to fly higher) and some are doing stuff that's likely to cripple them later.

    "XYZ is a great athlete, so clearly he must be healthy"--that's actually a pretty terrible argument. Just lock at all the football players with neurogenerative diseases and replacement joints at 40-50!

    There is virtually NO evidence in ANY direction about the long-term health consequences of having a healthy fat mass and a very high fat free mass (in absences of steroid use--the problems with that are well-documents). I'd be REALLY interested in studies into that! But the population would be hard to find. Not many people who lift like crazy at 20 are doing it at 50, much less 60.
  • tomatoey
    tomatoey Posts: 5,446 Member
    edited July 2015
    tomatoey wrote: »
    karyabc wrote: »
    Nah i think you are seeing things to black and white and there is a lot of shades of gray in it.

    like for example ,Are u familiar with the term metabolically healthy obesity? The american society of endocrinologist have refer about it a lot

    Normal bmi= healthy 100%? , as someone who works in a health enviroment you"ll be suprise how that doesnt always works that way.

    Not so fast there...

    http://annals.org/article.aspx?articleid=1784291&ct=40009
    Data Synthesis: Eight studies (n = 61 386; 3988 events) evaluated participants for all-cause mortality and/or cardiovascular events. Metabolically healthy obese individuals (relative risk [RR], 1.24; 95% CI, 1.02 to 1.55) had increased risk for events compared with metabolically healthy normal-weight individuals when only studies with 10 or more years of follow-up were considered. All metabolically unhealthy groups had a similarly elevated risk: normal weight (RR, 3.14; CI, 2.36 to 3.93), overweight (RR, 2.70; CI, 2.08 to 3.30), and obese (RR, 2.65; CI, 2.18 to 3.12).

    Limitation: Duration of exposure to the metabolic–BMI phenotypes was not described in the studies and could partially affect the estimates.

    Conclusion: Compared with metabolically healthy normal-weight individuals, obese persons are at increased risk for adverse long-term outcomes even in the absence of metabolic abnormalities, suggesting that there is no healthy pattern of increased weight.

    there was another study, maybe someone else will have the link handy?? - that found that mortality rates were lowest among people in the *overweight* BMI category, followed by normal weight, then i can't remember which of obese and underweight went to 3rd and 4th place.

    now whether the people in the overweight category lived well, as well as just lived more often, i don't know. (i can't remember if they also lived LONGER. i think it was a cross-sectional study. just that the mortality rates among overweight people were lowest.)

    i think it was this one
    http://www.medscape.com/viewarticle/791407

    Most very young people die of accident. People who are overweight are less active and undertake fewer risks, so they are less likely to die of accident at all ages. This becomes statistically significant when you're less than...45, I think it was, because NO ONE who's overweight is yet dying of illnesses caused by weight at that level.

    You also need to make sure in the elderly that you separate people who have a low body weight AND fat free mass from those who had a low fat mass and a healthy fat free mass. Many elderly people suffer from malabsorption which causes malnutrition. A risk factor for this is obesity when you're younger. If you don't die directly from a heart attack or cancer due to your elevated risks from being obese, many eventually end up a so-called healthy weight because their body is literally wasting away--fat-free mass included. Low fat-free mass causes you to be extremely unlikely to recover from all sorts of things, from pneumonia to a broken hip. Higher fat-free mass AND lower fat mass is one of the strongest correlations for health among the elderly.

    Finally, there are other things that you eventually die from thin that you're more likely to get when you're obese. For example, cancer causes most people to lose a lot of weight. The bad study you're referring to looked at weight AT DEATH and extrapolated from there--which assigns tons of people to normal or below-normal weight who got sick because they were obese.

    They later adjusted for things like smoking and age and found no difference

    "In a subsequent analysis that excluded 34 studies that were considered possibly overadjusted (ie, adjusted for factors such as hypertension that are considered to be part of the causal pathway between obesity and mortality) and 10 studies that were considered possibly underadjusted (ie, neglected to adjust for factors such as age, sex, or smoking), results for the remaining 53 adequately adjusted studies did not significantly alter the results. "

    (no idea if they excluded car accidents etc)

    though it seems they were more careful than you assume.
  • PAV8888
    PAV8888 Posts: 14,254 Member
    PAV8888 wrote: »
    It is one thing to encourage the patient to follow a path towards a more favourable outcome.
    It is another thing to deny care pending patient compliance (even if such compliance would result in slightly more favourable odds)

    When I was 30, I had an ectopic pregnancy which nearly killed me in 1980. My doctor let me talk him out of checking further into it because I was in no pain and had a major project at work. When I blacked out, I was rushed to the hospital and BP was 0/0 and it was amazing that I lived. Later, my friend Debbie, who went to my doctor at my referral, had cramping. He told her to go the hospital RIGHT NOW. She said but she was on her lunch hour. He said he didn't care, to call her office and go to the hospital RIGHT NOW. She argued and he said, "Do you remember your friend Sherry? I will never have a patient nearly die again. If you don't go to the hospital RIGHT NOW, I won't be your doctor any more." She went and her life was saved.
    fishshark wrote: »
    PAV8888 wrote: »
    fishshark wrote: »
    well there is a few of you using the term "being fat". I am at a healthy BMI for my heigh smack dab in the perfect zone.. but I have 33% body fat.. so... I am.. fat, but you know not fat. I also have an auto immune disease that will never go away so I guess I'm not healthy either. The word healthy is so relative to the person talking about it. I was a marathon swimmer with just about no body fat and my blood work always had something wrong with it. Does all of this correlate to weight? hell no it doesn't. being "fat" means your fat... being "unhealthy" can happen at any weight.
    How are you arriving at that %? Bioimpedance scale? Even if true, you are not that far from the % for a healthy female.

    Did someone say that not being obese is a guarantee of health?

    The question is whether MOST obese people can be BOTH obese AND healthy. The obvious, to me, reference being as to whether obesity BY ITSELF brings about health complications... which... well... it DOES when you consider obesity over time.

    Now, whether that is true or not (that obesity has health consequences over time), so do thousands of other things that people do. From driving a car, to drinking alcohol, to smoking cigarettes, to going out for a run in the forest when there is a wind storm.

    Should this affect how they receive health care?

    Is the obese person less worthy of health care than the BMX biker who face planted after a 9ft jump in the forest?

    Well funny you mention that because my hubby rides BMX for a living riding for big companies and he doesn't get health care so he has to pay out of pocket and his premiums are triple mine because of his career. so yea lol

    In Canada, where I am, he is just as well covered as an obese person would be! Actually better, because no one would deny him surgery pending losing some weight!
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