Obesity is now a Disease...

[Relic]

I think it's a grey area (leaning towards disease). Obesity pretty much fits the literal definition as a disease despite the fact that it's a symptom because it tends to have plenty of symptoms itself.

from Marksdailyapple...

http://www.marksdailyapple.com/is-obesity-a-disease/#axzz2XMGLqdhh

the Obesity Action Coalition, a non-profit, spearheaded the initiative in order to “change the way the medical community tackles this complex issue that affects approximately one in three Americans.†Sounds nice, doesn’t it? Until you learn that the OAC board is made up of bariatric surgeons and the coalition is funded by pharmaceutical companies with big stakes in weight loss drugs and surgical supply manufacturers with big stakes in weight loss surgery. In other words, the very people who stand to make a ton of money from medicalizing obesity are responsible for medicalizing obesity.

*facepalm*

[wideeyed]

I suppose one's take on this would depend, in large part, on your take on addiction as a disease.  I've been sober for 20 years.  It was one of the hardest things I've ever done.  But it doesn't COMPARE to trying to keep weight off.  I used to go to both AA meetings and OA (Overeaters Anonymous) meetings.  The AA meetings were inspiring, uplifting, and I left feeling empowered.  The OA meetings were depressing.  When you quit booze or a  drug, you QUIT.  You simply abstain.  All done.  But you cannot quit eating.  Instead, you have to make changes.  You have to make these changes in a world that isn't friendly to those changes, among people who are sometimes supportive, sometimes indifferent, sometimes sabatoging.  OA meetings were all about the "slips."  For those of you who haven't experienced addiction first hand, it's really as simple as this:  you walk into a doctors office.  The doctor says quit or die.  You don't quit.  You can't quit.  You know it will kill you, and you STILL can't quit.  Until one day you get sick and tired of being sick and tired.  That doesn't happen for everyone.  Some people die.  Because they just can't quit.

 

My family would make an interesting case study.  Three sisters, none of us biologically related (two adopted, one biological).  All three of us have been (or still are) morbidly obese.  I am the oldest.  The pediatrician took me off the bottle at 6 months because I was "too fat."  For me, the beginning of a life of eating too fast, eating secretly, because whatever went into my mouth was watched and noted.  My parents put me on legal speed when I was 12 to lose weight (I might mention here that my mother has her own issues with food).  Two younger sisters were both very thin and active as kids.  Both really picky eaters.  Both later became obese.  Youngest had gastric bypass and is now "normal."  Middle one had Lap Band, managed to gain more weight, had all kinds of complications, and eventually had part of her stomach removed.  I have lost hundreds of pounds over my life time.  I can yo-yo with the best of them.  I am an AMAZING dieter - I just can't stay with it.  My sisters?  They are now smaller, but they still eat like crap.  So.  Nature and nurture both at play here.   I refuse to have surgery to correct something I CAN correct if I just manage my food better.  After 15 years of random neurological bullshit, I was finally diagnosed with fibromyalgia.  I decided to go Paleo because there is significant anecdotal evidence that it mitigates the symptoms.  Physical pain is an awesome motivator.  By the way, I met my biological mom and half-sister a couple of years ago.  Neither is obese.  My bio mom has put on weight since developing COPD as a result of losing mobility and boredom eating, but she's not obese. None of my cousins are, either.

 

I wish, as Denis Leary said, that it really was as simple as "putting the fucking fork down."  There are eating disorders.  There is a herediary component.  Finally, there is a food pyramid and medical system that is disparaging, inaccurate (and that's being kind), and shaming.  I recently watched a TED talk where the physician asked the question, "What if we have it wrong?  What if obesity doesn't cause insulin resistance, but that insuliln resistance causes obesity?"  There is high fructose corn syrup in everything.  Poor people have higher rates of obesity because there is a lack of healthy food available in their neighborhoods, and I can tell you honestly that my grocery bills are half again as much since going Paleo, and I'm not even doing totally organic. As long as highly processed foods and fast foods are cheaper and more readily available, the epidemic will grow.  I sometimes wonder that if we spent even a portion of the money we pay in corn and soy subsidies on ensuring access to better nutrition and nutritional education what the impact would be on the obesity epidemic.

 

It making it a disease and mandating insurance coverage for it means that people can get prescriptions for fresh produce and meaths and physical fitness education, I'm all for it. 

[MrsAMcGrath]

True that the ACA law will help obese people get insurance, but by declaring that obesity is a disease obligates doctors to work with and treat their patients. Which means that they should be versed on treatment options and be able to recommend nutritionists and physiotherapists for consults. 

 

I think it is a decent step in the right direction getting doctors and medical staff into more a preventative mind set rather than fix it mind set.  

 

I completely agree with the above statement - part of the problem though (this comes from personal experience working in a family practice doctors office) is the amound of diet suggestions our patients actually accept. And I literally mean accept. I have Type II diabetes patients that could solve nearly all their problems JUST but aligning their diet more to the Paleo diet - the problem is I see patiently who are regularly unwilling to make that change. I am not going to assume it is because they don't want to, are financially unable to, or have psychological issues keeping them from doing so - I can only correlate the information they give me in a healthcare setting with information I currently have. I'm not one to say I have all the answers, but I will say, that until we are able to assist the group of people who are most affected by these issues to understand how truly dire of a situation this (diet, exercise, healthy living, etc.) really is, we're kind of speaking to the deaf.

[~Jaguar]

Obesity is not a disease, it's a symptom...

 

As a few other people have said, Obesity comes from poor lifestyle and diet choices. I'm sitting here, just under 140kg with a BMI of just under 40 - and I know, 100% that it's my own choices, my own lack of discipline, my own actions (or lack of) that have got me to this position. Classifying obesity as a disease just allows me to put the blame somewhere else.

 

It also means, that - as our society likes to do these days - we end up treating the symptom rather than the disease. This is already happening with things like lap-band surgery and the like. Instead of actually sitting down with an obese person and saying, "What can we do to improve your lifestyle?" It's just a band-aid fix. 

 

For me, there's a lot of mental issues - my own insecurity and battles with depression and the like led me to emotional overeating, which have just spiralled - the fatter I got, the worse I felt, the more I ate, and so on! Treating my obesity does not actually fix what the real issue is, which is self-confidence. Thank God I'm in the process now of actually 'fixing' the problems in my head, rather than in my stomach.

 

We need to be treating causes, not symptoms. Find out what causes a person to become obese, and that's where we need to start.

 

I do, however, agree with the idea of removing government subsidies for sodas, sugars, all that kind of thing. 

[Raikas]

 

 

But I lack sympathy for "not knowing"  or just it is what it is- or any other excuse. I get it you have an issue that makes you want to eat- but I don't get how you can just not see it.  10 lbs- sure- maybe even 20- but there is a point where it's not "sneaking up on you"  

 

 

I used to think that way too, but recently I was talking to a couple of friends who mentioned their weights and plugging that into those BMI calculators they're both in that 29/30 mark between high overweight and low obese.  I mean, I could see that they were a little chubbier than when we were younger, but they just don't look huge at all.   One is 154cm/70kg (5' 1"/155lbs) and the other is 157cm/75kg (5' 2"/165lbs) - so all that talk about knowing that you're 300lbs just doesn't apply when you're short.  And surely people like that make up a huge percentage of the overweight/obese population (although I'm not American, and maybe things are different there).

 

 

Obesity is not a disease, it's a symptom...

 

As a few other people have said, Obesity comes from poor lifestyle and diet choices.

 

This actually reminds me of another anecdote - I used to work with a woman who was always trying to drop weight (and she was big, but she was tall, so it didn't actually look bad on her).  She went for some fancy metabolic testing and was told that with her system, she'd need to eat 800 calories/day to lose a few pounds a month, and then could look forward to upping it to 1100 calories to maintain. 

 

While that's possible in theory, how miserable would it be to eat that little for the rest of your life?  I'm all for personal responsibility, but 800 calories is tiny!  I can't imagine forcing soemone to live with that kind of restriction.

[wideeyed]

I'll still maintain that there are thin peoplle who are not fit, who are insulin resistant and have metabolic X syndrome.  They aren't obese YET, mainly due to genetics.  Yet they still face ALL of the medical risks associated with obesity, and because they aren't overweight, and because insulin resistance isn't part of a routine blood workup, they will likely be treated for high blood pressure or high choleserol, and given the advice to get more exercise and cut fat and salt out of their diets. 

 

What if insulin resistance (which, by the way, is not an EXCUSE for overeating, but is legitimate cause of constant hunger and cravings for more carbs, because you're trying to feed all that extra insulin running around in your system), IS a primary factor of obesity?  What if you've gone to the doctor (and thank God my GP is enlightened and recommends a "nothing white" diet), and been handed a standard "healthy diet" sheet and followed it and it left you feeling horrible, and tired, and depressed, and HUNGRY?  This is NerdFitness, folks.  We read.  We research.  The majority of the population doesn't.  I  have fought this battle my whole life.  I have gone through stages where I just don't give a shit any more about being fat, I don't CARE what I look like.  This go around, it's about my health, for real.  It's not about diabetes or high blood pressure or anything else there is a pill or medication for.  It's about chronic and constant PAIN.  That is what it took to get me to be drastic. 

 

Yes, I make choices about what I put in my body.  I'm just pointing out that those choices are much more varied for me than for people of low income, for example.  I have students who are morbidly obese because they are actually malnourished.  We partnered up with Fresh and Easy this year to start a food bank, and we have an organic garden at our school to help the families eat better.  Next year, we're taking to the city streets with community service and planting vegetable gardens in medians in areas with limited access to grocery stores.  Why is there so little "convenience" food available that is not full of chemicals and other garbage? 

 

 

I completely agree with the above statement - part of the problem though (this comes from personal experience working in a family practice doctors office) is the amound of diet suggestions our patients actually accept. And I literally mean accept. I have Type II diabetes patients that could solve nearly all their problems JUST but aligning their diet more to the Paleo diet - the problem is I see patiently who are regularly unwilling to make that change. I am not going to assume it is because they don't want to, are financially unable to, or have psychological issues keeping them from doing so - I can only correlate the information they give me in a healthcare setting with information I currently have. I'm not one to say I have all the answers, but I will say, that until we are able to assist the group of people who are most affected by these issues to understand how truly dire of a situation this (diet, exercise, healthy living, etc.) really is, we're kind of speaking to the deaf.

 

Again - some medical practices are instituting "group" appointments, which are sort of acting as support groups for patients like this.  It's a lot to take in, and people want the quick fix of a pill or even a shot.  I don't think they DO listen to where diabetes will take them.  And the power of compulsive eating is mind numbing.  My middle sister, who is to be the guardian of my children, had the lap band surgery and STILL gained weight because of her food choices.  She has Type II diabetes.  She has severe neuropathy.  She KNEW she was killing herself slowly.  I literally BEGGED her to get some help (post surgery) because my kids need her in their lives and THAT didn't matter.  Ultimately, she wound up having a large portion of her stomach removed.  Guess what?  SHE STILL EATS SUGAR.  She's losing weight, but not really dealing with the issue.

 

One thing for sure is that it is a complex issue.  There is no easy fix.  There is a simple fix, if you know about it, and are in a position to do it, but there needs to be more support than an online group for many people.  Ongoing and consistent education about reading labels, preparing food properly, making better food choices whatever your budget, growing your own food when possible, psychological assistance for those people whose eating disorders are emotionally based, etc.  would be a necessary part of the treatment plan. 

 

I may be an intellectual elitist, but I'm also a teacher in a low-income school.  I have learned that it is not fair to attribute the same level of interest/ability/knowledge to everyone around me.  Part of the Rebellion's manifesto is to educate people about how simple the fix is.