The obesity epidemic

[sgeeeee]

. . .While I agree that correlation doesn't imply causality on the first occurrence, I wonder how many times or how many different places it needs to occur for statisticians to be convinced that there is causality. We already know that politicians are convinced on the first attempt!

We have to choose between statisticians and politicians?

That is not a comforting thought.

 

[wabmester]

Hollywood went from glamorizing to demonizing smoking.

Yes, I mentioned that there were other factors at play, but the evidence of price effects is strong. That's why I showed that when a state *decreased* cig taxes to address smuggling, cig consumption *increased.*

I didn't mention the Hollywood effect, since AFAIK, sloth and gluttony have never been considered to be very sexy. I think people understand that lack of exercise and overeating is bad for you. I don't think this is an issue of message or labeling or social pressure.

The issue here is how do we counter the effect or short-term rewards (food and sloth) for long-term benefits. I think one answer is short-term pain that directly offsets the short-term rewards.

How about this: BMI > 30 means we take away your car and TV set! Yeah, I didn't think you'd like that idea, so a junk-food tax disincentive combined with a healthy-food incentive might fly better.

I think we could combine that with other incentives as well. Rather than a tax break, just make gym membership free for anybody who is overweight. Maybe have a new version of the "special olympics" for overweight kids. We could do lots of things. We're currently doing nothing.

 

[Khan]

http://computer.howstuffworks.com/question658.htm

1. How much power does a computer or a TV consume?
2. Can a person generate that much power with a bicycle?

 

[wabmester]

1. How much power does a computer or a TV consume?
2. Can a person generate that much power with a bicycle?

I was hoping somebody would bring up the Soylent Green solution.

There's a lot of energy stored around the waists of Americans. This could fix our dependency on foreign oil.

 

[Nords]

1. How much power does a computer or a TV consume?
2. Can a person generate that much power with a bicycle?

No matter how articulate an engineer you may be, if you try this quite logical approach to energy conservation then your spouse will still call you a @$#%ing nuke. Even if you offer to buy the bikes for your spouse & kid out of your own paycheck.

But I don't want to tell you how I learned that.

 

[jclarksnakes]

....We do have a BIG problem in the US with obesity. It is getting worse and there is virtually NOTHING being done to solve it. Like Doctor Phil says "how's that working out for you". It seems to me that we should be trying lots of different things just to see if one or a combination of them will work. Wab's "fat tax" would certainly be worth trying. I would think that calling it an incentive plan rather than a "fat tax" might make it a little easier to promote and get legislated. Ideally it would be a combination of taxes on unhealthy high fat foods and incentives for eating healthy foods and losing weight. I think exercise is as much a factor as overeating in the problem and any plan should include incentives for exercising. Gyms have been mentioned in some posts here. I hate gyms. I am sure that exercising in gyms is right for some people but I would rather burn my calories outside seeing the world and doing exercise that is fun. It has to be a lifestyle of exercise and healthy eating rather than dieting and temporary exercise plans. BTW, I also hate running, blame it on 20 years of running in the army. Education is a big part of the problem. I would love to spend my nursing career educating people about healthy lifestyles rather than working in a hospital treating the symptoms of their unhealthy lifestyles. Unfortunately virtually all the money paid to nurses in the US is paid for treatment rather than education and health promotion.
....When I was flying army helicopters we always blamed the victims in accidents. It was the only way that we could go back out and fly after we had lost friends in accidents. I lost my closest friend in an accident where he was a passenger riding in the back of a Huey. For the longest time I actually did blame him for going along on a flight that he did not have to be on. The human mind works in very funny ways. When we were in Saudi Arabia before Desert Storm we had a lot of night accidents. True to form the chain of command actually blamed them each one after another on pilots cowboying and not paying attention to safety rules. I may only be half bright but after six or eight accidents were blamed on cowboying even this died in the wool cowboy took things real slow and easy at night. We still had accidents. Finally the chain of command admitted that perhaps we were having a problem with night vision goggles in the desert and that perhaps we did not "own the night" as we had been claiming for some time.
jc

 

[jeff2006]

We could do lots of things. We're currently doing nothing.

Who are "WE" in this discussion? Some kind of modern-day Ku Klux Klan or Nazi Youth movement?

 

[Mr._johngalt]

I was hoping somebody would bring up the Soylent Green solution.

There's a lot of energy stored around the waists of Americans. This could fix our dependency on foreign oil.

I like this idea but most folks would think it's a kroc.

JG

 

[Mr._johngalt]

We could do lots of things. We're currently doing nothing.

I agree, as long as we doln't end up with the government forcing people
into lifestyle changes, which I'm afraid is coming. Actually, I see no end to it. Today it's smokers and fat people. Tomorrow?..........
use your imagination.

JG

 

[jeff2006]

I agree, as long as we doln't end up with the government forcing people
into lifestyle changes, which I'm afraid is coming. Actually, I see no end to it. Today it's smokers and fat people. Tomorrow?..........
use your imagination.

JG

JG is exactly on point here. Exactly!!! Who is "we" if it is not the govt? Heaven forbid . . . yearly weigh-ins ultimately at the point of a gun?

 

[lets-retire]

Gumby I disagree with the first part of your statement, a semantic really. It's not that the person chooses to be overweight it's that they chose not to do the things necessary to be fit. If you ask a group of overweight people I'd guess most want to lose the weight, but when they are told exactly what to do they fall of the wagon fairly quickly. Eating whatever you want and not exercising is much easier than monitoring your food intake and calories expended. No amount of tax is going to replace that unwillingness to take action.

I think I would agree with your first statement if the only people overweight had some medical problem preventing them from losing weight. Unfortunately that is not the case. Many people don't see their weight is a problem and until they do nothing will motivate them to lose the weight, others see the problem but lack the desire to do anything about it.

The problem with a junk food tax is all junk food is made from healthy food. What is to prevent a person from making potato chips in their home with out paying the tax? Are they going to tax jail because they made the chips? I can see it now, sorry little Johnny you can't have a birthday cake this year we don't have the $40 to pay for the ingredients. All junk food is not bad. The over eating of junk food is bad so taxing it is rather useless. The overeating of any food is bad, so let's tax it all.

The second part about starting in school I agree with. The last school my son attended had no recess and only had P.E. on Friday. Now that's really teaching a kid the value of fitness. Something I remember from being in school was P.E. seemed to be basically an organized recess. Maybe if actual healthy living was taught in physical education it would serve a better purpose.

 

[bpp]

Who are "WE" in this discussion? Some kind of modern-day Ku Klux Klan or Nazi Youth movement?

Oops, I do believe the fat lady has sung. As it were.

 

[Martha]

Bottom-line: we've done nothing to address the problem so far. Try something. If a tax doesn't work, repeal the tax and try something else.

I'll go back to what I said when this thread started (and before I had the meltdown): Let us have a national initiative to fight obesity and addictive disorders. Tax cigarettes even more and use that money to help finance free nicotine substitutes. I am OK with some sort of bad food tax. One easy target would be trans fats, which is unequivocally bad for you. Tax those McDonald's fries. Tax those candy bars. But earmark money into subsidies for good for you food, the fresh fruit and vegetables. This won't be enough, because you can get fat even eating foods that are good for you and that you prepare at home. So, we need to help people find ways to motivate themselves. Exercise once started can be a good motivator. With the government initiative, doctors would be encouraged to prescribe weight loss programs and exercise programs for the obese. One problem is shame--people won't much want to exercise with a bunch of gym rats. Start gyms specifically for people who are more than a certain BMI. My town has a hospital with a very fancy health club. Have hours just for people who are obese. Have hours just for women and just for men. Subsidize through tax deductions and sliding fees.

Increase the number of public health nurses or have public nutrition classes that can be prescribed by physicians. Employers can send their employees. Nothing should emphasis shame, but instead emphasize that this is a public health initiative to improve American's lives. Encourage employers to let employees take time from work to exercise. People waste about a third of their work time anyway.

There is a woman who wrote a book on improving school lunch programs and what they have done in Berkeley California to have healthier lunches that kids will eat. Follow her program.

Physical education in the schools should be changed dramatically. Again, the emphasis should not be shame but success. Spend time and ask a kid what do you want to do. Ride an exercise bike? Run the track? Get them moving and competing against themselves instead of others.

Many people don't see their weight is a problem and until they do nothing will motivate them to lose the weight, others see the problem but lack the desire to do anything about it.

I think most overweight people know their weight is a problem and desire to do something about it, but feel hopeless. If we removed some of the shame from the process and focused on holding someone's hand and walking them to the nutritionist and the gym, we might help people find motivation in themselves. A taste of success can go a long way in building new habits. Much like the AA model, we can enlist people who used to be too heavy or used to be out of shape as sponsors.

I am not in the health business, yet I can think of many ideas to promote public health. There is much positive we can do if we just do it. Crisis of motivation for us all.

 

[Martha]

Who are "WE" in this discussion? Some kind of modern-day Ku Klux Klan or Nazi Youth movement?

Jeff, I have read your posts on this thread and they are very inflammatory and don't do anything to advance the discussion. I can't even tell where you are coming from. You just seem upset. What's the deal?

I strongly disagree with Lets Retire and what he has said on this thread. But at least he articulates his position and you get an idea of why he thinks the way he does.

 

[lets-retire]

Martha--The BMI thing won't work. It doesn't take into consideration body make up. A 300lbs bodybuilder can have a higher BMI than a 150 obese short person. However, If you are going to have to go to a doctor then have them do a water displacement test to determine fat content. People over a certain fat percentage would be eligible for your gym.

P.S. I still disagree with most of your plan, but just trying to be constructive.

 

[Martha]

Fair enough on the BMI. Though when someone is obese, the doctor knows it and most often the obese person knows it, so I don't think we have to get too fancy.

 

[Rich_by_the_Bay]

FWIW, a simple measurement of abdominal circumferenceis almost as good a predictor as BMI regarding adverse health outcomes. You measure at the narrowest part of the abdomen from a frontal view.

40"/35" (male, female; non-Asian[lower for them]) are high risk markers for diabetes, hypertension, etc., with a less steep risk at lower numbers. For heart attack risk, waist-to-hip ratio is an even better predictor.

 

[jclarksnakes]

...As an ultraconservative "pull yourself up by your bootstraps" self reliant old curmugeon I actually find myself strongly agreeing with much of what Lets Retire AND Wab AND Martha have to say. If people would exercise more and eat less and fundamentally change to a lifestyle of healthy living rather than fad diet and exercise programs Americans would lose weight and keep it off. I am also a very pragmatic person. If what we are doing is not working then we need to be doing something different. Wab's "fat tax" and the different things that Martha mentions sound like excellent ideas to me.
...I am going to stoop to answer Jeff2006's inane post about who are we. We are Americans. A group of people who have often in the past worked together to solve OUR problems. I am the last person who would advocate the government intruding into people's personal lives and forcing them to do anything. I am strongly in favor of giving Americans incentives to live healthy lifestyles. Financial incentives work in lots of interesting ways. Just look at the tax code and the US economy for a whole bunch of examples. And like Martha says, what are you so angry about?
jc

 

[azanon]

If holding people accoutable doesn't work and is morally wrong, then maybe you should consider a different religion besides christainity, because the bible is literally filled with this sort of guidance.



you forget the ..... "in my opinion." We don't agree.


Yes they do. I could choose to be fat in 2 years if i all of a sudden became apathetic about what i ate and quit exercising. Very few things are not within my control.

Disclaimer: If you know of someone who has excessive amounts of food forced down their mouth against their will, then i will concede that they dont have a choice.

...........

I just think we live in a society now where everyone can blame someone or something else about their problems; basically anything but themselves. You want to talk about morals, explain to me what is morallly right about absolving ourselves from all of these responsibilities; including this subject matter?


Trust me, i'm still working towards it.

 

[donheff]

I'm conflicted about this one. My liberal, use government intervention to fix problems streak says incentives to eat well or a tax on junk food might be sensible if the problem with childhood obesity is serious enough (e.g. comparable in danger to teens and smoking). My libertarian streak tells me to oppose government stepping into our personal business like what we choose to eat. I guess I would need to see good evidence of serious food-business abuse akin to the tobacco companies and good evidence that interventions would be both useful and fairly unobtrusive before I would come down on the intervention side.

Back to the "they could do it themselves if they only chose to" willpower argument, while technically true it is still a lousy argument. Many of the self satisfied skinny folks who raise it have problems of their own -- e.g. a propensity to cancer or heart disease. I bet many of you are on Lipitor to keep cholesterol down. I could say to you that if you would only exhibit a bit of willpower and adopt a draconian diet you too could have low cholesterol. In the meantime your irresponsible behavior results in the need for massive spending on heart research programs that drive up my (cholesterol free) health care costs -- shame on you.

 

[F M All]

FWIW:-

http://news.bbc.co.uk/2/hi/health/5399762.stm

 

[azanon]

I'm currently fighting an addiction to coffee (and the caffeine it contains), but would i even consider blaming someone besides myself? How ludacrious would that be? Its my fault, i'm harming myself by doing it (urology issues), and I'm the one that needs to stop.

Addiction it may be, but it is still my fault and my problem to fix; not societies.

 

[youbet]

I'm currently fighting an addiction to coffee (and the caffeine it contains), but would i even consider blaming someone besides myself?

Of course not and most obese folks don't blame other people or society either. But, like you, they have a problem they can't seem to get under control.

BTW, I beat the caffine habit by using discipline, will power and self control. It was no problem. If you're having a problem, there must be something wrong with you. But, thanks for not blaming me.

 

[Martha]

My libertarian streak tells me to oppose government stepping into our personal business like what we choose to eat. I guess I would need to see good evidence of serious food-business abuse akin to the tobacco companies and good evidence that interventions would be both useful and fairly unobtrusive before I would come down on the intervention side.

This is why I lean more towards positive incentives, like tax deductions and subsidized programs to encourage healthy eating and exercise. I think one fat we could tax fairly freely is hydrogenated fats, or trans fats as they are unequivacally unhealthy. Though they make food taste good. McDonalds pledged a few years ago to move towards removing transfats from cooking oil. They haven't because the french fries don't taste as good. Well, tax them fries.

Oh, and let's get those commercials off the air where some company claims you can lose weight by taking one supplement or another. Where is the FTC? This stuff is bunk. I think people have a lot of misleading ideas on weight loss that don't help solve the problem. Like reliance on goofy supplements. Like ideas that certain foods burn fat. A deficit of 3500 calories a week is required to burn one pound of weight. You can eat 500 calories a day less, exercise 500 calories more, or some combination, but no matter what you need a calorie deficit to lose weight.

 

[cube_rat]

Oh, and let's get those commercials off the air where some company claims you can lose weight by taking one supplement or another. Where is the FTC? This stuff is bunk. I think people have a lot of misleading ideas on weight loss that don't help solve the problem. Like reliance on goofy supplements. Like ideas that certain foods burn fat. A deficit of 3500 calories a week is required to burn one pound of weight. You can eat 500 calories a day less, exercise 500 calories more, or some combination, but no matter what you need a calorie deficit to lose weight.

Or how about NuriSystem's commercials with the woman stating she was a *fat* size 10 and now she's a 4. Or NurtiSystem's rib sticking *man* meals that elude to fact that weight loss makes you more manly/sexually desireable. I want to throw my shoe at the TV any time I see NutriSystem ads. What kind of bozo's think up this crap?