Too Fat to Graduate

[sassafras]

I propose an experiment. Take a stroll down a middle grocery aisle, any middle grocery aisle (short of housewares and cleaning supplies, smartass) and find as many items as you can that don't boast some ludicrous amount of sodium or sugar intake or, better yet, do not contain an ounce of corn syrup. You certainly won't fill a shopping cart.

The problem is, not many people know how much are ludicrous amounts.

I certainly don't. Shit, I don't even know what fruit and vegetables contain that I'm supposed to be eating because I was never taught and can't find books on it. That's why I just dumped all processed or cooked foods in favour of a raw very varied diet.

Aw, come on. Even kids should know this stuff.

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[Quinlan]

The problem with obesity is that, once you are obese, it's becomes EXTREMELY hard to lose it. In fact, prevention really is the only real great strategy. Once a body produces fat cells, those cells never go away again. If someone who is obese wants to become healthy again, they must make CONSISTENT lifestyle and diet changes, and maintain them. That's hugely difficult. But that's what people need to understand; that's where the education would be. It's better to do that at a BMI closer to 30 than over that, because once you start getting much higher than that it gets more and more difficult.

I don't think there is any way that can actually prove that it is easier to never become obese than it is to become obese and lose it. How would you even test that? It seems as though that whoever is predisposed to obesity and has access to a positive energy balance (doesn't even have to be that many calories in the positive) becomes obese. I think either way, preventing obesity or preventy obesity relapse is walking a tight rope for the rest of you're life. If like you say that prevention is the most important thing, why is this class targeting those that have already succumbed to it? Shouldn't it actually be targeting the people in the "overweight" category?

As for the genetic side of it -- there'd have to be some sort of mass genetic mutation to create such a strong insurgence of obesity in only one generation. Genetics do play a part, but they are not an excuse. There are those that literally can't help it; that's not the majority, though, and people do need to take responsibility for that. Genetics is a factor; it is not often the cause.

There hasn't actually been a "strong insurgence", there has been a subtle shift to higher weights right across the distribution curve. So previously normal weight people are slightly bigger, previously overweight people are now slightly bigger, previously almost obese people are slightly bigger and have crossed the arbitrary line to obesity. People still look pretty much the same as their parents did except on average their slightly fatter. Genetics overwhelmingly determines who will be big and who won't be, the heritability of BMI is almost as high as that of height. That means that most of the variation between individuals in the population is genetic. So most of the difference between you and a very fat person is genetic, whereas most of the difference between that fat person and their twin or parents is environmental (do you see the subtle but important distinction?).

With good nutrition and nuture most children will grow slightly taller than they would have otherwise, however genetics is still the largest determinant of height. So good nutrition and nuture can optimise the height of a child, but it will still be genetics that determines who turns out like Michael Jordon and who turns out like Danny Devito.

Similarily, with good nutrition and nuture most children will grow slightly slimmer than they would have otherwise, however genetics is still the largest determinant of weight. So good nutrition and nuture can optimise the weight of a child, but it will still be genetics that determines who turns out like Kate Moss and who turns out like Oprah Winfrey.

Some articles about the heritability of obesity:

http://content.nejm.org/cgi/content/abstract/314/4/193
http://www.ncbi.nlm.nih.gov/pubmed/9481603
http://diabetes.diabetesjournals.org/content/57/11/2905.full

Genetics may not be an "excuse" but it would be foolish and ignorant to ignore the fact that genetics is a very (the most) powerful driver of obesity.

It is a choice. Lifestyle will be a choice before and after. However, if they are attending the university on their own free will, they are subject to its requirements. That, in itself, is a choice.

Well I think it's a stupid policy, but that is their choice to impose that requirement. Won't stop me from pointing out how I think it should be though.

The greatest causes of death of people in the United States are heart disease, cancer, stroke, and in place 6, diabetes. Obesity greatly increases the risk for all or most of these.

True, do you know what is a better predictor of those things than actual obesity? How fat you feel, rather than how fat you actually are. So by stigmatising and excluding these people it's likely they're making things worse not better. Chronic stress is not some benign thing, it is strongly physiologically damaging in the long term and being fat is very often a cause of chronic stress.

"Obese" just becomes a rough catch all term for poor, female, minority and low social status. The causal links between those diseases and obesity are actually very unclear and poorly understood.

How much of those deaths come about because fat people particularly women avoid seeking out medical treatment untill it's much too late because they fear the constant shaming and disregard from their doctors because of their weight?

How do you tease apart the effects of the actual adipose tissue from the effects of being a fat person living in a fat hating/shaming society?


Good article about this:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386473/

It's not common for someone who is eating well and exercising to become obese, unless there is a physiological disorder of some sort. If someone is a bit overweight or even moderately overweight, this might be the case. However, that is not normal for obese individuals, unless they started these programs after becoming obese. These things do increase the health of the individual, but risks are still present.

What are you basing this on aside from completely making it up? If you put a group of people on a standardised diet and exercise regime you will see a very wide difference in results right across the group because everyone's body responds differently to diet and exercise. Energy expenditure is largely managed unconciously. An error over perfect energy balance of less than 5% is enough to turn someone obese in a couple of years (note that calorie labels are often have an error of 10%). Perhaps you are defining "eating well" as "eating whatever it takes not to be fat", so when it comes to those many people that maintain an obese body after bariatric surgery, how low are you willing to expect them to go? They are already eating very small amounts, how close to starving do you suggest they go?

And most people do go down in size with such a surgery. Two of my aunts have done so successfully.

Did they drop to the "normal" weight range? Most obese people that have the surgery lose a lot of weight but still stay obese or overweight.

 

[Quinlan]

This basically sums up my view about obesity, I choose to believe the geneticists and obesity experts rather than the snake oil salesmen in the diet industry and media (and the general public that is high on their snakeoil propaganda).

This guy in particular (Jeffrey Friedman) is the one guy I admire and pay heed to because he is one of the very few people that have actualyL completely "cured" some people of obesity and he did that through genetics, not by telling them they're lazy and stupid.

I think that to the extent that increased weight has health
consequences, people should do their best. It certainly is a good thing
to be fit. And it is a good thing to eat a heart healthy diet. And it’s
probably a good thing to make one’s best efforts to keep one’s weight
under control. So that means not doing much different than what
Hippocrates would have recommended. But I think at the same time we
have to recognize that those measures are rather limited in their
efficacy and that to make the leap therefore that people who are not
successful at keeping their weight off are at fault is just wrong
headed. And there are all kinds of attributes about each of us that
might draw the next person to draw a conclusion about them. But to draw
conclusions about obese people, I think, is unenlightened to say the​

least about what their personal characteristics are.

http://www.rockefeller.edu/benchmarks/obesitytranscript.pdf

Check out the transcript if you're interested, I think it's very enlightening.

 

[VH]

Bench press is a poor indicator of health.

Yes, but it is a fairly good indicator of muscle capacity, and if someone is working out enough to perform at this level of performance, their growth hormones are going to activate and affect other muscle groups, and they're likely going to adopt other exercises while they're working out. It's a good motivational tool to suggest a cardio and bench press performance benchmark because it gets people off the bench and started on the path to a lifestyle that includes exercise.

Edit: And for the record, statistically, fat is not a factor in overall health. Athletic performance is. If a person can perform well but has a high BMI, they're statistically in the same risk groups as someone who has a very low BMI that performs at the same levels of athleticism. The opposite is equally true. Underweight people who poorly perform athletic activities are in the same risk groups as fat people who perform at those same levels. The body is a dynamic machine that reacts to stimulus. The more you use it, the better it operates. The less you use it, the worse it operates. ... just like the mind.

I'd support an athletic performance requirement before I'd begin to consider something as arbitrary as BMI. Every company, agency, or organization that has a fitness requirement bases their assessments on performance more heavily than BMI. The ones that even bother with BMI only use it as one of multiple criteria.

 

[gloomy-optimist]

Alright, I'm a little done with the go through each part thing, so I'm going to do an overall synopsis:

Genetic factors do determine much of weight. Some people gain very easily, others not at all. Any sort of weight-based program should take into account the individual's height, weight, body type, and genetic history.
HOWEVER, genetics do not often predict a person to be naturally obese.

Let's take a quick minute to define obese as I am referring to it:
Obese: Well above ones normal weight. A person has traditionally been considered to be obese if they are more than 20 percent over their ideal weight. That ideal weight must take into account the person's height, age, sex, and build.
In BMI, this shows to be about 30 or higher. Now, BMI does not take muscle mass into account, so that is not always a good indicator. When I think of obese, I think of the above definition.

The above definition I retrieved from http://www.medterms.com/script/main/art.asp?articlekey=11760.
Other good points from that site:
"A BMI of 30 is about 30 pounds overweight."
"Accordingly, treatment of obesity usually requires more than just dietary changes. Exercise, counseling and support, and sometimes medication can supplement diet to help patients conquer weight problems. Extreme diets, on the other hand, can actually contribute to increased obesity. "

Why do we care?
"The prevalence of overweight and obesity has increased with alarming speed over the past twenty years. It has recently been described by the World Health Organisation as a 'global epidemic'. In the year 2000 more than 300 million people worldwide were obese and it is now projected that by 2025 up to half the population of the United States will be obese if current trends are maintained. The disease is now a major public health problem throughout Europe."
http://www.dohc.ie/publications/report_taskforce_on_obesity_es.html
Also, from 1990 to 2007, some states in the US have jumped up from 10%-14% obesity to over 30%. That can't be explained by genetics or predisposition alone.

Obesity is directly related to many diseases, and more than for just stress-related reasons. Heart disease is the biggest killer, although predisposition does play a large role as well; "Cardiovascular disease risk increases due to overweight elevating blood pressure, cholesterol, triglycerides, and increasing insulin resistance." "Over 50% of all cases of hypertension are simply due to being overweight" (http://www.drhoffman.com/page.cfm/193). Others include high blood pressure and diabetes ("Eating sweets or the wrong kind of food does not cause diabetes. However, it may cause obesity and this is associated with people developing Type 2 diabetes. Stress does not cause diabetes." -http://chinese-school.netfirms.com/diabetes-causes.html). "Diabetes is three times more likely in obese individuals with a BMI of 28 or greater." "Cancer risk can increase due to elevated hormones associated with obesity" (http://www.drhoffman.com/page.cfm/193).
Other rather indisputable, direct causes from obesity are back and joint problems, respiratory problems, and sleep apnea.

And what's causing it? Genetics does have some factors, but a lot of it is this:
http://www.cdc.gov/nccdphp/publications/factsheets/prevention/obesity.htm
"In 2005, few adults met the Healthy People 2010 objectives for fruit and vegetable consumption; only 33% consumed fruit two or more times per day and even fewer (27%) consumed vegetables three or more times per day."
"Despite the proven benefits of physical activity, less than half of American adults in 2007 engaged in enough physical activity to provide health benefits."
"The percentage of young people who are obese has approximately tripled since 1980. In 2003

 

[Quinlan]

That's quite a tangent, you've lost me a bit.

HOWEVER, genetics do not often predict a person to be naturally obese.

What does that even mean?

If you mean that by throwing a bunch of obese people into the wilderness they won't stay obese for long, you're probably right. But for practical purposes who is going to willfully root around the forest for grubs and run away from predators all day? In every population that has access to a reasonable amount of calories there will be obese people.

Let's take a quick minute to define obese as I am referring to it:
Obese: Well above ones normal weight.

The concept that the whole population can fit into a narrow range of "normal" BMI is just pure ideaology and there is no such population on earth anyway. Some of the things keeping us so beautifully slim 50-60 years ago were disease, illness, smoking and poverty.

Why do we care?
"The prevalence of overweight and obesity has increased with alarming speed over the past twenty years. It has recently been described by the World Health Organisation as a 'global epidemic'. In the year 2000 more than 300 million people worldwide were obese and it is now projected that by 2025 up to half the population of the United States will be obese if current trends are maintained. The disease is now a major public health problem throughout Europe."
http://www.dohc.ie/publications/report_taskforce_on_obesity_es.html
Also, from 1990 to 2007, some states in the US have jumped up from 10%-14% obesity to over 30%. That can't be explained by genetics or predisposition alone.

You still don't understand that these are big changes at the population level are very subtle changes on the individual level. They don't explain the very large differences between individuals. You have been misled and are struggling to translate these broad population changes onto the individual level. If you had read some of the articles I posted many explain just how misleading the "obesity epidemic" is and how they only explain population changes not individual differences.

The claim that we are seeing an ‘epidemic’ of overweight and obesity implies an exponential pattern of growth typical of epidemics. The available data do not support this claim. Instead, what we have seen, in the US, is a relatively modest rightward skewing of average weight on the distribution curve, with people of lower weights gaining little or no weight, and the majority of people weighing

3–5 kg more than they did a generation ago.3 The average American's weight gain can be explained by 10 extra calories a day, or the equivalent of a Big Mac once every 2 months. Exercise equivalents would be a few minutes of walking every day. This is hardly the orgy of fast food binging and inactivity widely thought to be to blame for the supposed fat explosion.
While there has been significant weight gain among the heaviest individuals4 the vast majority of people in the ‘overweight’ and ‘obese’ categories are now at weight levels that are only slightly higher than those they or their predecessors were maintaining a generation ago. In other words we are seeing subtle shifts, rather than an alarming epidemic. Biologist Jeffery Friedman offers this analogy: ‘Imagine that the average IQ was 100 and that five percent of the population had an IQ of 140 and were considered to be geniuses. Now let's say that education improves and the average IQ increases to 107 and 10% of the population has an IQ of >140. You could present the data in two ways. You could say that average IQ is up seven points or you could say that because of improved education the number of geniuses has doubled. The whole obesity debate is equivalent to drawing conclusions about national education programmes by saying that the number of geniuses has doubled.’

Ok. So how does that analogize to weight? Over the time period that
you’ve heard that the obesity rates have quote “doubled” or gone up by
70 percent, the average weight gain is 7 to 10 pounds. Now I’m not here
to argue that that’s not important; it is important from a public
health point of view. But if we then say that’s what environment
contributes to differences in weight over that time frame, think about
the fact that 7 to 10 pounds is almost nothing compared to the hundreds
of pounds of difference in weight that you might see in any two people
walking around the street today, both of whom essentially have​

unlimited access to calories.

http://www.rockefeller.edu/benchmarks/obesitytranscript.pdf
http://ije.oxfordjournals.org/cgi/content/full/35/1/55

Obesity is directly related to many diseases, and more than for just stress-related reasons. Heart disease is the biggest killer, although predisposition does play a large role as well; "Cardiovascular disease risk increases due to overweight elevating blood pressure, cholesterol, triglycerides, and increasing insulin resistance." "Over 50% of all cases of hypertension are simply due to being overweight" (http://www.drhoffman.com/page.cfm/193). Others include high blood pressure and diabetes ("Eating sweets or the wrong kind of food does not cause diabetes. However, it may cause obesity and this is associated with people developing Type 2 diabetes. Stress does not cause diabetes." -http://chinese-school.netfirms.com/diabetes-causes.html). "Diabetes is three times more likely in obese individuals with a BMI of 28 or greater." "Cancer risk can increase due to elevated hormones associated with obesity" (http://www.drhoffman.com/page.cfm/193).

"Associated with" does not mean "caused by", y'know they old correlation does not imply causation bizzo. The actual cause of Type 2 diabetes is unknown, stress seems as good a theory as any (you would know that if you'd read my link) as one of the main causes.

Overly casual use of epidemiological correlations as definitive answers rather than using them for developing furthur questions to be studied with randomised controlled trials is what has made the study of things like obesity a mess (and why one week <insert food substance/activity> is the cure for cancer the next it's the cause).

Correlations do not provide answers they just provide more questions. Most of the hype about obesity comes from poorly controlled epidemiology (like the study that found obesity was "contagious" untill later it was shown that using the same method height and pimples were also contagious).

Other rather indisputable, direct causes from obesity are back and joint problems, respiratory problems, and sleep apnea.

But people aren't exactly dropping like flies because of this are they?

Even if there are health risks associated with it, that says nothing about how much we can conciously control it. Just like there are health risks with being short but there is not much we can do to conciously control that.

And what's causing it? Genetics does have some factors, but a lot of it is this:
http://www.cdc.gov/nccdphp/publications/factsheets/prevention/obesity.htm
"In 2005, few adults met the Healthy People 2010 objectives for fruit and vegetable consumption; only 33% consumed fruit two or more times per day and even fewer (27%) consumed vegetables three or more times per day."

Unproven hypothesis, there are plenty of fat vegetarians.

"Despite the proven benefits of physical activity, less than half of American adults in 2007 engaged in enough physical activity to provide health benefits."
"The percentage of young people who are obese has approximately tripled since 1980. In 2003–2006, 16.3% of children and adolescents aged 2–19 years had a body mass index greater than or equal to the 95th percentile for age and sex on the CDC growth charts." Which may be because "In 2007, 65% of young people in grades 9–12 did not get the recommended amount of physical activity; 35% watched television for 3 or more hours on the average school day."

Obesity rates have levelled off and even decreased in some groups for the last ten years.

http://www.time.com/time/health/article/0,8599,1809829,00.html

Percentage rates can "triple" without any change to the bell curve, so fatties are still fatties, skinnies are still skinnies etc.

How much part do genetics play?
According to http://www.cdc.gov/genomics/resources/diseases/obesity/index.htm:
"Although population genetic changes are too slow to be blamed for the rapid rise in obesity in the United States and many other countries, genes do play a role in the development of obesity."
The main theory behind genetics that are not involved in body size is this: "the same genes that helped our ancestors survive occasional famines are now being challenged by environments in which food is plentiful year round. "
This can be backed up in a more complex analysis with http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1642700/:
"The evidence we have to date suggests that the major impact of genes on human obesity is just as likely (or perhaps more likely) to directly impact on hunger, satiety and food intake rather than metabolic rate or nutrient partitioning. At the risk of oversimplification, it seems that from an aetiological/genetic standpoint, human obesity appears less a metabolic than a neuro-behavioural disease."
In other words, people have difficulty noticing when they are full, and thus they eat too much.

It is obviously a combination of both metabolism and neuro-behaviour systems (among many other things). Most obese people are resistent to leptin so there is a breakdown in the feedback system, we don't know why it breaks down. I personally think obesity is much more of a problem of the brain than the "mind". Either way genes are driving the desire to eat.

This does show that genetics do take a part. But genetics do not often PREDISPOSE people to be obese; they predispose someone to how psychologically able they are to notice whether or not they are properly sated.

Not just that, their metabolisms also slow right down when they try and lose weight at much higher levels than other people, there are many other ways obese people are biologically different to others. Either way the predisposition is so powerful and is so often failed to be reversed that for practical purposes and in terms of making judgements about people's character and lifestyles it may as well be predestined. We have to recognise that these people are climbing a genetic mountain while we are standing proudly atop a genetic molehill. Ignoring the extraordinarlily powerful biological drives and differences that they face helps no one. That's why after 50 years of prescribing diet and exercise we're still fatter than ever. Willpower has it's natural limits.

In the current environments that breed high obesity rates, it becomes more difficult for a person to notice that they are over eating, and with the high-stress environments, they are more likely to eat through stress, eat quickly without having the time to really notice their bodies, eat more without feeling full, and get less physical exercise due to their more packed schedules. With proper education, this can come to the attention of these people, and they can take the steps they need to understand this.

Sure they could fix all that and maybe even lose 10-20lbs which might even reverse the obesity stats but they'll still be fat, fat, fatties, just a bit less fat.

The only time it becomes really uncontrollable is when the body has a mutation in the regulation of the hormone leptin; for those people, it becomes almost impossible for them to tell at all whether or not they are full or hungry. However, there have been cases even then where some people have realized they have this problem and have done much to regulate their diet so as not to become severely obese.

Some people (rare) can't produce leptin other people (most obese people) are resistent to it, so they basically experience exactly the same thing. It is a breakdown in exactly the same feedback system just at different points. Jeffrey Friedman is the geneticist that discovered leptin, he thinks obesity is largely genetic and that we should have compassion and understanding for the obese.

I don't think obesity is destiny, but in all practical senses it is pretty damn close and we should understand and recognise just how hard it is to reverse or prevent and not get too bogged down in idealogy.

 

[gloomy-optimist]

I have to say, Quinlan, that I'm a little done with this debate. I don't agree with you; I do agree that genetics plays a part, but I disagree that it is the main or only determinate. I'm not quite sure what you mean by analyzing it on an "individual" level -- you're doing a pretty similar thing yourself. According to you, obesity is genetic; I've been saying that it's partially genetic, but much of it is also environmental. If you want to expand on your idea of how to analyze it individually, I wouldn't mind hearing it.

You're not looking at my main picture; yes, vegetarians may be fat. But here's how I see that: vegetarians may eat greater amounts of veggies and fruits, but that's not assuming that they eat necessarily better. A vegetarian can drink pop, eat lots of high-carb foods, and may have difficulty reaching full nutritional health. Thus, a vegetarian can be easily just as unhealthy -- it's not saying that veggies and fruits are the end-all to health, but rather that diets are not balanced without a certain amount of fruits and vegetables.
People don't die from joint problems or sleep apnea. But both of those prevent weight loss -- without enough sleep, the body is more likely to have problems metabolizing. Joint problems, especially in the hips, knees, etc. make it difficult to exercise. Both of those problems are extremely significant to those with excess weight.

And obesity is genetic. It runs in my family. So does high blood pressure and heart problems and diabetes. However, I've seen the way my family eats; large proportions, huge amounts of pop every day, almost no exercise, etc. Those are the people in my family that become obese. The rest do gain weight more easily; however, they are not obese. And the obese ones are the ones that have the biggest heart problems and diabetes.

I've taken enough health classes and have enough history with it to know that people are, in fact, somewhat responsible for the state of their own health in this case.

 

[Quinlan]

I have to say, Quinlan, that I'm a little done with this debate.

No worries, thanks for engaging my ramblings for a while

 

[GaiaGraha]

THAT'S FUCKED UP!!!

And who GIVES a shit about what makes you fat anyway.
The point is that those people pay to go to that college and it doesn't MATTER how fat they are, they should be able to graduate anyway!
The college should NOT be allowed to control their personal lives.

 

[ec3khrl]

So are they telling the fat people not to receive education?


What about a too-black-to-graduate rule?
Too-yellow-to-graduate rule?
Too-white-to-graduate rule? They all start to make sense now.


Get white, yellow, red or any color before you graduate, or don't.

 

[poshlost]

Ahaha.

 

[enfp can be shy]

It's a free country. If you so badly want education, get half of your fingers cut off. Too many fingers to graduate! It's your life, your responsibility, the choice and the truth is within you...

P (jk, btw )

 

[bijo]

lol, thats funny.

 

[Skoffin]

So are they telling the fat people not to receive education?


What about a too-black-to-graduate rule?
Too-yellow-to-graduate rule?
Too-white-to-graduate rule? They all start to make sense now.


Get white, yellow, red or any color before you graduate, or don't.

Generally if you want to give a counter example to something it is best to give an example roughly on the same level, instead you have taken something you see as ridiculous and given extra ridiculous examples against it.

First is that weight is something changeable, skin colour is not.
Second this was just an idea put into place as their method, whether misguided or not, to tackle the increasing obesity problems the country is facing.
Whether you agree with them or not or whether this was even a good plan to begin with, this was their honest attempt at trying to find a way to curb obesity problems. It is not on par with weeding out nationalities and it is silly to suggest such.

 

[Quinlan]

First is that weight is something changeable, skin colour is not.

You can get a tan or bleach your skin.

 

[Skoffin]

I thought of that but didn't bother covering it as the various methods are either not lasting, dangerous or beyond ludicrous.

 

[Quinlan]

I thought of that but didn't bother covering it as the various methods are either not lasting, dangerous or beyond ludicrous.

Just like weight loss treatment!

 

[Reon]

Just like weight loss treatment!

Your opinion seems to disagree with the people, in general, who have lost weight.

 

[Barnabas]

I don't think he disagrees with wieght loss through activity and proper diet but instead the crazy health diets and weight loss pills.

 

[Quinlan]

Your opinion seems to disagree with the people, in general, who have lost weight.

I'm sure there are people that would claim the same for skin tanning/bleaching.