Weight loss

[Moemg]

Sorry to hear about your late wife.

My wife worked in a hospital as an OR surgical nurse. She said that many surgeons refused to work with fat nurses in the OR during long surgical procedures because of their complaints about standing on their feet for long periods. One surgeon told a nurse to "get her fat ass out" and stop complaining and then got a harassment complaint against her. It's sad to see so many obese healthcare workers. .

I was an OR nurse for forty years and if any surgeon said that to one of the nurses every nurse in the department would be on strike .

 

[audreyh1]

Totally agreed. That's why in my post I specifically acknowledged "there but for the grace of God go I" conditions. Stuff happens. My uncle, a gloriously-built marathon runner who wouldn't permit white bread in the house, dropped dead of a heart attack at age 42. We all have similar examples. We still need to prevent what's preventable.

I understand folks getting frustrated with US obesity rates rising and impacts. But I really wonder whether that’s a major driver of the increasing costs of medical care. I suspect the impact is not as large as from expensive to treat diseases that are not obesity related. Plenty of normal weight people get heart attacks, heck half of the heart attacks occur in people with healthy cholesterol levels!

I feel bad for folks living with obesity, but I guess I don’t automatically think about what they might be costing me.

 

[Freedom56]

This is a huge problem IMHO.
I had to change primary doctors recently because of this. He was projecting all his own personal medical problems onto me (and probably many of his patients).

Basically it was "I take this pill, therefore you should take it too." And not just drugs, but all sorts of lifestyle things. I was considerably healthier than he was, despite being older, but that didn't seem to count.

And it wasn't a matter of time -- this was a concierge situation where he routinely gave me 45 minute appointments and loved to chat about all sorts of things.

My new doctor has been a nice change.

Good doctors are hard to find. It took me 5 years to find the doctor I have been seeing for the past 20 years. He is 69 years old now and eventually will retire. He is in very high demand especially after appearing on that crazy Doctor OZ show after they met by chance at a free clinic for uninsured people several years back. He only works on Wednesday and is backed up 4 months for appointments. I learned a long time ago that the best doctors and dentists are those that continue to teach at major universities and work at hospitals and clinics connected to those universities. They are not always motivated by money.

Don't feel bad about a lack of attention. My annual physicals have turned into discussion between the doctor and my wife on what tests to run. He reads the vitals taken by the nurse and just comments you're fine. The most important thing you can do is communicate any issues with your doctor. If he/she doesn't listen, find someone else. You have every right to ask for blood screening tests, ECGs, colon cancer screening, X-Rays, bone scans as you see fit. It's better if you walk into your appointment prepared to discuss any issues you may have.

Weight is a very sore point with a lot of doctors. Many feel that they are powerless to stop what their training says can be easily cured. Many don't understand eating disorders. Most medical schools don't train you to deal with those issues. Doctors also try very hard not to have any emotional attachment to their patients. Keep that in mind also.

 

[UnrealizedPotential]

I understand folks getting frustrated with US obesity rates rising and impacts. But I really wonder whether that’s a major driver of the increasing costs of medical care. I suspect the impact is not as large as from expensive to treat diseases that are not obesity related. Plenty of normal weight people get heart attacks, heck half of the heart attacks occur in people with healthy cholesterol levels!

I feel bad for folks living with obesity, but I guess I don’t automatically think about what they might be costing me.

Yes, cholesterol is what my doctor wants me to have checked next. So far everything else looks good, but we don't know about the cholesterol level yet. I didn't know that you can be at normal weight and still be at risk for heart attack. If you are normal weight you are at less risk for a heart attack I would think.

 

[MRG]

Yes, cholesterol is what my doctor wants me to have checked next. So far everything else looks good, but we don't know about the cholesterol level yet. I didn't know that you can be at normal weight and still be at risk for heart attack. If you are normal weight you are at less risk for a heart attack I would think.

Not long after I retired a 50 yo guy who was on my team dropped dead Sunday morning. He was ideal weight, frequent exerciser.

Heck back in 2000 the PCP I had replaced dropped dead from a heart attack. He was a 40 yo marathon runner and looked it. Healthy looks and healthy hearts are not related.

 

[athena53]

I feel bad for folks living with obesity, but I guess I don’t automatically think about what they might be costing me.

Plenty of studies out there (and junk science, I'm sure) but one study done at Cornell concluded that obesity-related conditions accounted for 8% of overall healthcare costs.

https://www.sciencedaily.com/releases/2018/02/180208180356.htm

Ignore the headline which is a very good example of bad math: the SHARE of obesity-related costs went from 6.13% of total to 7.1% of total between 2001 and 2015 so that percentage increased by 29.1%. The headline reads: Obesity Drives Healthcare Costs up by 29%..."

But, taking that 7.91%, dividing by .85 (minimum loss ratio, so this is an approximation of the impact on healthcare premiums when the insurer's profit and expenses are built in) gets 9.3% of premiums attributable to obesity. That's a chunk of money I wouldn't mind having back in my pocket and it excludes indirect costs when people can't work due to obesity-related hip pains, knee pains, etc.

 

[UnrealizedPotential]

Not long after I retired a 50 yo guy who was on my team dropped dead Sunday morning. He was ideal weight, frequent exerciser.

Heck back in 2000 the PCP I had replaced dropped dead from a heart attack. He was a 40 yo marathon runner and looked it. Healthy looks and healthy hearts are not related.

I guess you just never know. No guarantee of a tomorrow.

 

[Chuckanut]

And we all pay for this- it drives me crazy. There are the "there-but-for-the-grace-of-God-go-I" medical issues that come from bad genes or bad luck or both, and then there are the ones that come from smoking, fatty foods, Caramel Macchiato Frappucinos, Denny's Big Slam breakfasts and lack of exercise. I live in an area with mixed demographics and it kills me to watch people buying cases and cases of pop and Little Debbie snack cakes. No wonder many of those on scooters have an empty sock where a foot used to be.

People should really read the book Salt-Sugar-Fat.

https://www.amazon.com/Salt-Sugar-Fat-Giants-Hooked/dp/0812982193

It tells a story about how Big Food Industry makes these factory foods so they 'light up' the pleasure centers of the brain. It's hard do lose weight when the food that we see around us is designed to make us over eat, and then quickly funnels those extra calories right to the fat cells.

Knowledge is power. Know your enemy. And the enemy for many of us is cheap, highly processed, factory made foods, IMHO.

I am not condoning people who just dont' care enough to eat right, and especially those who stuff their already overweight children with sweets, sugary drinks and chips. But people must realize that the modern processed food industry is not on their side when it comes to weight and health. And, yes, I include things like protein bars, low-fat yogurt, low-carb bars, glutton free muffins and cookies, and other such stuff in that category.

I remember my childhood when eating fast food and/or highly processed foods bought in a store was more expensive than real food. My mother would see the price of TV dinners, for example, and tell us that for the price of four TV dinners she could make a roast or chicken meal that would provide two good dinners and probably a lunch for our entire family. Today, cheap junky factory food is very cheap compared to real food. Cheap, that is, until one figures the potential future medical costs into the equation.

 

[Freedom56]

Yes, cholesterol is what my doctor wants me to have checked next. So far everything else looks good, but we don't know about the cholesterol level yet. I didn't know that you can be at normal weight and still be at risk for heart attack. If you are normal weight you are at less risk for a heart attack I would think.

You should have a C-Reactive Protein test done in addition to the normal lipid panel test.

As for healthy people dropping dead, my doctor says that over 60% of males over 20 don't visit their doctors for their annual check-up and blood work. So that may explain what's going on. I have seen many examples of this. My former boss was slim but smoked and hadn't seen a doctor for over 25 years until the age of 60 when he was diagnosed with stage 3 colon cancer after complaining of abdominal pains. I have a friend from school who "looked" healthy but ended up in a hospital with a stroke. His last visit to a doctor was at the age of 22. He had high blood pressure for many years. When he was admitted to the hospital, he had malignant hypertension. Many of these conditions could have been treated with regular screenings a long time ago. The body is extremely complex. Some people respond to medication, some don't. Some people recover from illnesses without medication or treatment, some don't. However, if you follow some common sense guidelines for annual screening and keep your weight under control, you can improve your quality of life and longevity.

 

[audreyh1]

Yes, cholesterol is what my doctor wants me to have checked next. So far everything else looks good, but we don't know about the cholesterol level yet. I didn't know that you can be at normal weight and still be at risk for heart attack. If you are normal weight you are at less risk for a heart attack I would think.

Sure you can have a heart attack at normal weight and normal cholesterol levels. Sure being overweight can increase the risk, but don’t mean that’s the only cause.

 

[redduck]

But people must realize that the modern processed food industry is not on their side when it comes to weight and health. And, yes, I include things like protein bars, low-fat yogurt, low-carb bars...

Oh, heck.. Do we need to include low-fat strawberry yogurt in the processed food category? Why is it considered a processed food?

And, as long as you are ruining my day: Is the Boars-Head Roast beef I buy at the deli counter also considered as being a processed food?

 

[PatrickA5]

Sure you can have a heart attack at normal weight and normal cholesterol levels. Sure being overweight can increase the risk, but don’t mean that’s the only cause.

Being overweight doesn't in itself cause heart attacks, but it does increase the risk of high blood pressure, diabetes, coronary artery disease, etc. which in turn increases the odds of a heart attack.

I have mild coronary artery disease in 3 arteries. I asked my cardiologist yesterday what my odds are of having a heart attack given my CAD, age (60) and weight. I have a 20% chance of a heart attack over the next decade (or 2% per year). He said a 60 year old at normal weight and no CAD has a 5% chance. So, I'm 4 times more likely to have a heart attack. Sounds really bad, but there's still an 80% chance that I won't and I should be able to improve those odds.

I've had enough tests to know where I stand on most health issues. In addition to a heart cath, I've had echocardiograms, stress test, CAT Scans, blood tests, chest xray, lung function test, etc. It's nice to know where I stand. I could die tomorrow or live to 97 like my dad.

 

[harley]

I just hope I finish the pizza and ice cream before I keel over. I hate waste.

 

[bjorn2bwild]

Oh, heck.. Do we need to include low-fat strawberry yogurt in the processed food category? Why is it considered a processed food?

And, as long as you are ruining my day: Is the Boars-Head Roast beef I buy at the deli counter also considered as being a processed food?

Hmmm....good question. 8 ball says you will get different answers depending on whether or not hedonic adjustments are fully accounted for at the end point.

 

[Freedom56]

Oh, heck.. Do we need to include low-fat strawberry yogurt in the processed food category? Why is it considered a processed food?

And, as long as you are ruining my day: Is the Boars-Head Roast beef I buy at the deli counter also considered as being a processed food?

If you just buy zero fat greet or plain yogurt and slice some fresh strawberries and mix it, you can get better results. You can also buy your own rib roast or tri-tip and roast it yourself and slice it on your own and make the best tasting sandwiches ever.

 

[JPatrick]

Yep, eat less junk, lose weight.

Tossed out the bad stuff (junk food, snacks, more than one beer) and poof---12 pounds gone in 2 weeks. The next 10 pounds is not going nearly as well...

 

[braumeister]

Tossed out the bad stuff (junk food, snacks, more than one beer) and poof---12 pounds gone in 2 weeks. The next 10 pounds is not going nearly as well...

Yes, the beginning stage of weight loss is largely water, so it's easier.

People generally don't realize it, but when your body stores fat, there are several water molecules bound up with each fat molecule.

 

[aja8888]

Oh, heck.. Do we need to include low-fat strawberry yogurt in the processed food category? Why is it considered a processed food?

Just eat the blueberry yogurt like I do. I hear there is something good about those blueberries that strawberries don't have.

 

[googily]

Oh, heck.. Do we need to include low-fat strawberry yogurt in the processed food category? Why is it considered a processed food?

And, as long as you are ruining my day: Is the Boars-Head Roast beef I buy at the deli counter also considered as being a processed food?

Lots of sugar in low-fat and nonfat yogurt.

I eat full fat Fage and mix in Splenda. And it's glorious.

 

[Amethyst]

Thin white women are most at risk, but anyone can lose bone; my dad did. We can only do our best to help the odds.

At one point in my life I weighed 261 pounds at 5'9" (female), but I lost 110, so I'm still not a small person. At 261 I had osteoporosis in a few places and still have it at my current weight (although rounds of medication keep it at bay for a year or two). If all the medical information is correct, I should never have osteoporosis. But every body is an experiment of N=1, I guess.

 

[aja8888]

Thin white women are most at risk, but anyone can lose bone; my dad did. We can only do our best to help the odds.

My DW lost 4" in height during 2017. Severe osteoporosis onset caused by over prescribed steroid (prednisone) due to COPD treatment.

 

[Freedom56]

Thin white women are most at risk, but anyone can lose bone; my dad did. We can only do our best to help the odds.

Women have an elevated risk of bone loss after menopause. My wife uses bio-identical hormones to keep her system normal. She uses several topical creams with doses customized for her according to her blood tests results. The doctor she visited in Santa Monica who pioneered this treatment was one of the best around. My wife was seeing him as a primary care physician for over 20 years. He was considered one of the best sports medicine doctors in the country. Unfortunately, he just retired last November and my wife is trying to find someone to continue to write the prescriptions for her.

 

[Dogman]

I have tried them all! Most fail due to human failure. The best is intermitten fasting. Look it up Jason Fung - Fasting, Intermittent fasting "reverse diabetes naturally". It works and it not that hard. Just start with a low carb diet first to turn off your hunger. 20 grams of carbs or less. It works unless you have a wife that will not help you, or a wife that eats all the time.

 

[MRG]

Thin white women are most at risk, but anyone can lose bone; my dad did. We can only do our best to help the odds.

FIL lost at least 5". I remember him complaining his lower ribs hurt from hitting his hips while boating.

 

[EastWest Gal]

What astonishes me is that diet is one thing - and THE most important thing - that has been looked at more or less scientifically for 2,500 years. It was virtually the only tool the ancients had for medical treatments and evaluations. And they did look at diet carefully. It was something they could observe, measure, record. And medical people did so throughout recorded history. And they WERE scientists. They didn't have all the instruments we have (and we have many fewer than we will have in the future), but they knew how to observe and analyze.

And still they couldn't get diet figured out. Nor can we moderns. Carbs vs. fats, round 827, anyone? The most recent findings show no great difference: https://www.washingtonpost.com/life...arch-says-it-doesnt-really-matter/2017/07/13/ Sugar? The new villain? To the point that it has to be treated as poison? I have my doubts about that extreme treatment.

I find it kind of comforting that nobody really knows! There can't really be diet police, not yet, thankfully. I like the idea that we don't really know that much more than the Greeks. We have to ask ourselves what makes sense for us. Cutting a food group out? Cutting a meal out? Cutting hours where we consume food? Counting calories? Listening to our own fullness cues? Ditching restaurants and take-out?

There are a variety of approaches depending on one's own sense of what works.

Packaged and highly processed foods have not been around for 2,500 years. Our global diet has significantly changed in a very short period of time. Mass produced packaged foods did not exist 200 years ago. OTOH, neither did the germ theory of disease. People figured out how to create foods that were spoilage resistant, by salting, drying, curing, and other methods such as making pemmican and cheese.

I'm not sure most medical people were scientists, either. We like to think we are. Unfortunately, the primary focus of many medical practitioners (and now the huge medical industry) is, and has been through history, profits, not healing.

This is one of many articles that discuss medical fallacies:

http://www.mnwelldir.org/docs/history/history03.htm

Even as late as the 1980s (after I finished medical school!) there were places that performed major surgery on infants with only paralytics, not anesthesia. The physiologic stress alone killed infants undergoing surgery.

Don't give us doctors more credit than we are due.

What has happened, IMO, is that the low fat diet believers worked the food companies and with the governments and pushed one particular agenda. Eating fat makes you fat is their motto. George McGovern spearheaded this in Congress and held hearings on the American diet in the 60s and 70s. Remember the four food groups? The food pyramid? All of that is gub'mint created.

This is a lengthy paper, and College honors thesis out of U. Conn. It is very well written, and pretty interesting if you're into this subject.

https://opencommons.uconn.edu/cgi/viewcontent.cgi?article=1482&context=srhonors_theses

There is still a lot to learn. I'm glad that many are still trying to learn. I think lower carbs and moderate protein helps a lot. Higher fat, especially MCT and healthy oils like olive oil, helps with satiety, in my case especially. Tracking total intake is important as well. I'm not the best at tracking constantly, unfortunately.