Obesity

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  • #110540
    MomMDMomMD
    Participant

    CNN: Report: Fat Americans getting even fatter
    Extreme obesity is ballooning in U.S. adults
    Tuesday, October 14, 2003 Posted: 9:11 AM EDT (1311 GMT)
    It’s no secret that Americans are getting fatter, but the biggest Americans are gaining weight faster than ever, a new study shows. CNN’s Christy Feig has more.

    •CHICAGO, Illinois (AP) — Americans are not just getting fatter, they are ballooning to extremely obese proportions at an alarming rate.

    The number of extremely obese American adults — those who are at least 100 pounds overweight — has quadrupled since the 1980s to about 4 million. That works out to about 1 in every 50 adults.

    Extreme obesity once was thought to be a rare, distinct condition whose prevalence remained relatively steady over time. The new study contradicts that thinking and suggests that it is at least partly due to the same kinds of behavior — overeating and under-activity — that have contributed to the epidemic number of Americans with less severe weight problems.

    In fact, the findings by a RAND Corp. researcher show that the number of extremely obese adults has surged twice as fast as the number of less severely obese adults.

    On the scale of obesity, “as the whole population shifts to the right, the extreme categories grow the fastest,” said RAND economist Roland Sturm. He added: “These people have the highest health care costs.”

    http://www.cnn.com/2003/HEALTH/diet.fitness/10/13/extreme.obesity.ap/

    Thoughts of the epidemic of obesity? SOlutions? Reasons? Comments…

    #110542
    MTaylorMTaylor
    Participant

    I think that we as Americans have deemphasized the importance of physical fitness. Our children play outdoors less (for multiple reasons) thereby become obese; PE has been cut back so far in our schools that it’s not the same class we took as teens. The cafeterias serve fattening food. And even as adults, with more money and more options, it’s not easy to find healthy alternatives for lunch or breakfast on the go. Micky D’s doesn’t serve fresh fruit, or granola. Burger King doesn’t have tofu on their menu – And, it’s difficult to find places that do. Not to mention the added “expense” of eating healthy. A .50 cent bag of chips, or a $2.00 salad? Hum…if I eat a salad I’ll be hungry in an hour; the chips will hold me until dinner.

    Also, I hear about the increasing amount of “steroids” in food, and that may contribute to “bigger, rounder” people as well.

    #110544
    amykamyk
    Participant

    The answer is as simple as it ever was.

    Too much food.
    Too little exercise.
    Fear of numbers.
    Unwillingness to self-educate about nutrition.
    The unpleasantness of being hungry while losing weight.

    The cost of fresh produce is still a serious problem for the poorest people, but for most Americans it’s not. That $4 pizza and $5 half-gallon of ice cream buys lots of bananas, apples, scallions, etc.

    And there are some other exceptions: Lots of popular meds, including antidepressants, can cause serious and uncontrollable weight gain. So, maybe, can changes in metabolism caused by morbid obesity.

    But the fact that we’ve got grossly unrealistic ideas of how much food people need doesn’t help. Nor does the fact that we’ve essentially given up. It’s getting hard to find a pair of pants that doesn’t involve spandex or elastic, even for teens. Just a couple hours ago my (significantly overweight) husband and I were laughing about “invisible” copy in the Eddie Bauer catalogue. Example: “elastic side panels for extra ‘give’…for your extra ‘fat’.”

    Mya’s answer is actually a pretty good example of general lack of nutrition education. Looking for “healthy” foods at McD’s, she wants granola. Granola’s not particularly healthful stuff, high in sugar, highish in calories — the medium-density fiberboard of whole grains, with syrup for glue. It just has good marketing. As does tofu, though tofu can be quite high in fat and calories, even if it’s not fried. Other “good marketing” foods: salads (with dressing, cheeses, egg yolks, fatty meats, in gigantic bread bowls), grilled chicken sandwiches (2-3 portions’ worth of meat, with mayo, on heavily buttered buns), “egg beaters” omelettes (cooked on a greasy grill, with 3 oz. cheese and 3 servings’ worth of pancakes), all-fruit ice pops (made of frozen fruit syrups), etc….I eat all this stuff, btw. But I have a general sense of how much food I’m eating & how many calories are going in v. out. If my accounting’s off, I gain weight, and that’s a tipoff to fix it. Works every time.

    The low-carb diets aren’t genius either, since they’re just another way of avoiding learning basic nutrition and doing the arithmetic. My FIL’s idea of following that diet was to walk around eating spoonsful of PB, and he wondered why he couldn’t lose more weight….My MIL actually bought him pork rinds to eat while he was on that diet.

    Losing weight is not complicated for most people, if you’re disciplined enough to mind the numbers, and you’re willing to live in a way where your body can get enough exercise. That means reasonably low stress, lots of freedom to move around and exercise during the day (I mean sweaty exercise, not go-for-a-stroll exercise), minimal time sitting, using feet more than car for transportation, refusing to eat for entertainment, and eating much less than adults are expected to eat now. That’s not easy in this society, and it’s harder if you have trouble conceiving of lifestyles different from the ones handed you. But I think that’s what it takes.

    amy

    #110546
    PremedRNPremedRN
    Participant

    I must talke about this while we are on the subject of obesity:

    I know fat is on the rise, for reasons that have already been posted, nintendo games, instead of climbing a tree, we are a face passed society, and many cant seem to find the time, or have enough energy to prepare healthy food. Every thing is becoming soo high tech. I mean really, way back when people washed their clothes by hind, hunted their own food which meant running and dragging their prey through the woods, the women were at home to prepare the food and tend to children,(most parents are both working and have to today in this age) there was no television and late came the radio. People used brooms and not a sweeper. Yes, even washed their dished by hand. There are remote controls for darn near everything. Heck, we even have cruise control on the cars for heaven’s sake, not to mention automatic redial!!!!!! Okay, enough on that.

    I was reading my new letter that I get from the ANA (American Nurse Association). In one article, I had gotten the impression, they accepted ridicule for having had an obese nurse on the front issue of a previous cover. Basically saying they were sending a the wrong message, and how nurses and what they stand for should not be examplified by an overweight nurse. I was uphauled, and this is coming from me, a person who is not overweight!

    First off, many obese people have psychological issues. Others have an inheritied trait, or has been found in some cases (genetically linked or not) to be deficient in a signaler for feeling satiety. Instead of ridculing these people we should treat the reason why they are this way. And let’s remeber that there are many young women with eating disorders (anorexia, bullemia) because of the message sent through magazines like Cosmopolitan, and Glamour. And I will be damned as a nurse, if I will support the ANA to send, although be it inadvertantly, the same message. I see many dieticians, nurses, docs, etc. who are overweight. And have other bad habits. It would be unrealistic to broadcast such people across the US as just thin people. And for those people who for instance are obese because of an inherited trait—well that’s not quite fair. After all, that thin nurse on the cover could have bullemia, or even anorexic, and appear as such—is anyone gonna whine and complain about that?

    #110548
    amykamyk
    Participant

    First off, many obese people have psychological issues. Others have an inheritied trait, or has been found in some cases (genetically linked or not) to be deficient in a signaler for feeling satiety. Instead of ridculing these people we should treat the reason why they are this way.

    Unfortunately, for most of them there’s nothing to treat except environment. Most overweight people are not victims of genetics — if they were, we’d have seen this problem long ago. If you can’t make it easy for most people to lose weight — and that means having food less available and exercise less avoidable — they’re not going to muster the necessary discipline. You can throw the whole pharmacopaeia at them, but it really won’t do as well as less food, more exercise. And for that, the food industries, working conditions, and neighborhood setups will have to change. I don’t see it happening anytime soon.

    amy

    #110549
    SAHM of 3/ MDSAHM of 3/ MD
    Participant

    Amy, I agree wholeheartedly with your good, old-fashioned common sense. Sethina, thanks for bringing up this topic. I am currently applying to preventive medicine residency with the hopes of making a difference in public health efforts to combat modifiable risk factors for our biggest killers–heart disease and cancer.

    And for that, the food industries, working conditions, and neighborhood setups will have to change.

    I would love to hear anyone else’s opinions about solutions to the obesity problem.

    #110551
    M -AM-A
    Participant

    I think that the way suburbia is set up is a recipe for weight gain. Everyone drives, there are fast food joints everywhere, and generally not too many parks to go to. I live in a metropolis where you can get anywhere by walking or riding your bike.

    I also find that if you work long hours or shift work, it’s very difficult to maintain a balanced diet. Often you have to squeeze in a meal, and sometimes the only thing available is fast food or a candy machine!

    I myself am not overweight, but I have to make a conscious effort to watch what I eat. Cooking at home is a good solution, as long as you buy healthy groceries. Finding a form of exercise that you can enjoy is another key to losing weight.

    I also think that weather plays a part in obesity. If you live in a place that has cold winters, it’s hard to stay active. You tend to want to stay indoors and crave sugar and carbohydrates.

    Just my :twocents: !
    M-A

    #110553
    amykamyk
    Participant

    I also think that weather plays a part in obesity. If you live in a place that has cold winters, it’s hard to stay active. You tend to want to stay indoors and crave sugar and carbohydrates.

    I live in the upper Midwest, where it gets very cold and windy. -30F with wind chill isn’t unusual here. But again, it’s all about how serious people are when it comes to staying at a reasonable weight. Despite the queerly fascist tones of the instructors, the FIRM videos are very effective workouts, assuming you don’t have musculoskeletal problems. I shoved the coffee table out of the way this morning at 6:30 and did a strenuous 1-hr aerobics workout. Equipment: Floor, TV/DVD, set of 3-lb weights, small weighted ball, kid’s plastic stepstool. I vary morning exercise so I don’t get bored (aerobics, sculpting/weights, Nordictrak, Pilates, yoga), but it still adds up to about an hour each morning. Back when I was in jr. hi, before the exercise boom, I used to just put on a tape of music I’d got off the radio and run in place, do calisthenics, etc. All indoors.

    If you don’t have kids keeping you from exercising outside, good outdoor-exercise equipment in January here includes Mad Bomber hat, down coat, insulated pants, wool sox, thick scarf, good boots, heavy-duty gloves, walkman, boss headphones (I like Grados, they’re like taking the club with you and they keep your ears warm too). That’s for walking; for running, a thick turtleneck, thick sweatshirt, thick tights, pants with some kind of wind resistance, lightweight Thinsulate gloves, and a fleece hat with earflaps will do you just fine, no need for expensive performance materials unless you’re running 1/2-marathon or more distances. When it gets below 10 degrees F, I like to add a lightweight, non-fiber-waving face mask, something the air has to go through before it gets to my mouth. Stops mild cold-induced asthma.

    If you can’t stand cold and have an infant, you can strap him/her on and go for a walk in the mall, a treadmill, an indoor track…you see where I’m going. If you really want to get the exercise in, cold weather won’t stop you.

    As for carbs…=) Do the exercise and stay reasonable with the calories, and you’ll be pretty OK, carbs or not. If you want to be neurotic about it, you can get a drugstore glucometer and see how well exercise keeps your blood sugar in check.

    amy

    #110555
    DONOTDELETE ****DONOTDELETE**
    Participant

    I hate to even weigh in on this discussion because I am overweight, but since I didn’t shy away from the other debate I guess I will go ahead and add my :twocents:

    I was always very thin and very consientious about my weight. My mother, on the other hand, has been obese throughout my entire life. I never understood why she didn’t just “get some control” and exercise more/eat less. I was very unforgiving in my opinions. I also grew up with a father that monitored my food intake and made fun of fat people….if he saw an overweight woman jogging, he’d scream out at her “too late, honey” :twocents:

    kris

    #110557
    mommd2bmommd2b
    Participant

    First, let me apologize for being a tad defensive in my response…I’d change it if it wasn’t for the fact that I hadn’t logged on and so I can’t access it….can you tell weight is a huge issue for me? Sorry for offending anyone.

    As to solutions….I would agree that we have a distorted idea of what people ‘should’ eat today. I’m shocked by the fact that burger king and McDonalds now have those ‘big kids’ meals now, for example. I ate a ‘happy meal’ on the occasions that we ate out until I went to college and it was more than enough….it seems to me that we are training our children at younger and younger ages to eat more.

    Our children’s school cafeteria now even allows children to get two meals instead of one 😮 They actually sent home permission slips at the beginning of the year. We declined to sign.

    Also, when you go out to a restaurant the portion sizes are HUGE…It’s like getting three meals at one time.

    I recently ate at Fridays with my husband and since I’m actively watching my weight I ordered a Cobb Salad with the dressing on the side. They brought me out what could be considered a platter full of salad…not a plate. I immediately had them bring me a to-go box and put 1/2 of it away before I even started eating…because I knew that if it was sitting on my plaste I’d probably eat it all…not out of hunger, but just because it was there.

    I think a lot could be done to limit portion sizes in restaurant and provide healthier options in fast-food establishments. Also, you are right that healthy foods are more expensive. It is cheaper for me to buy a box of those $1.19 twinkies for the kid’s snack than to buy a bag of carrots. The catch-22 though is that the farmer has to be compensated.

    kris

    #110558
    LaramisaLaramisa
    Participant

    I don’t think you were being overly defensive mommd2b. If it was as easy as just having a disciplined personality/character, I don’t think there would be so many otherwise hard working and high achieving people with weight problems. I was an athlete and a dancer when I was younger and always skinny, but after kids and quitting smoking and working crazy schedules, I really struggle to keep the weight under control. I know how to get it off – it’s just that in order to keep it off I seem to have to be obsessed with keeping up my exercise routine and then I don’t have time for anything else. And I don’t even live in the states where you are confronted with giant portions, fast food and disappearing sidewalks.
    I think it’s also a problem of modern city layouts that don’t encourage or allow walking to work, school, shopping.
    (Since I’ve given up on making it to the gym or out for running regularly enough to make a difference, I replaced my old sofa with a treadmill 3 days ago, which is my favorite equipment from the gym. I also walk my daughter to school and myself to work most days and to do the shopping – but it probably doesn’t help much since I’m so close anyway.)

    #110560
    PremedRNPremedRN
    Participant

    Limiting portion size with a walk or run (treadmill when too cold) seems more realistic than buying a whole wardrobe for exercising in the cold. And most people cant seem to set aside time to do that.

    My exercise is doing housework, chasing kids, and going up and down my stairs. Working on my feet 9 hours. I am not going to get up at 5-6am at this point to exercise, it is unrealistic for me. I am not overweight. Not that my metabolism wont slow down someday.

    Yes, for a lot of people their lifestyles are the reason they are obese. But there are some with genetic inheritances that was noticed long ago, for example, the PIMA indians.

    #110562
    TexasRoseTexasRose
    Participant

    I think that we can easily talk about how to manage weight when we’re referring to the usual 5-50 lbs that the average American needs to lose. I think that it’s a different issue when we’re talking about someone who is morbidly obese.

    When someone is 100+ pounds overweight, it’s not just a matter of walking 3 days a week or choosing grilled chicken over beef. It’s not a simple matter of self-control. I don’t think we can put the 2 issues in the same place.

    I would also suggest that it is more than a matter of restaurant portion sizes. My kids naturally stop eating when they are full, no matter how much food you put in front of them. They will turn down dessert if they ate their fill of chicken. But we as adults (I’m generalizing) eat past the point of saiety. Why is that?

    I know I eat to soothe stress. Maybe the culprit in America has more to do with the amount of pressure that we are under than the portions that McD’s gives us. Afterall, they wouldn’t make it if we didn’t buy it. Why do we buy it??? Are we greedy as a culture? (the more I get for my money the happier I am?) Are we so sure we can’t live up to our Hollywood ideals that we don’t even try, but swing in the opposite direction? Is our culture so repressed and miserable that we substitute food for emotional/physical intimacy or satisfaction in other forms?

    My grandma once said that what was wrong with america was that “with all this television, everyone got to see what they didn’t have and it made everyone unhappy!”

    If we’re going to help people tackle the obesity problem, we’re going to have to do better than sell them another diet plan or aerobics video.

    I’m fortunate not to have a weight problem, but I am close to people who do and I have listened to their struggles. I just don’t want to belittle their difficulties or make it a matter of waking up one morning and “just do it.”

    #110564
    amykamyk
    Participant

    But we as adults (I’m generalizing) eat past the point of saiety. Why is that?

    Because it tastes good and we’re used to the discomfort of overeating. We don’t stop to think about the relative value of 69 cents v. our own health, so we eat it all rather than throw some away (or buy less in the first place).

    I don’t mean to belittle anyone by saying weight loss, for the vast majority of people, is a matter of calorie control. But like I said, you have to be prepared to live against the American grain if you want a fairly easy road to fitness and a healthy weight. We chose our town and our house in part because this area’s safe and walkable, we’re in bike distance to most places we want to go, and in walking distance to grocery/cafe/parks/etc. We could have gotten a huge, gorgeous Victorian an hour away for the same money we’ve spent on a small suburban insta-box, but independence from cars is that important to us. We essentially have a spare car, because my husband uses his about twice a month. I didn’t have a car until about two years ago, and I’m 35. If you’re used to using your feet as transportation, you eventually collect foul-weather gear. Saves on frozen toes.

    One of my top requirements for a job is that it not involve hours at a stretch sitting or being fairly still, and that it allow me time for strenuous exercise and moving around. About two hours of exercise and walking a day is about right for me. Sure, that limits the job opportunities and the income; it’s a matter of priorities. Living against the grain, again. If someone’s priorities involve sitting at a desk for long hours, long commutes, living on an American scale, and committing to the point of not having time for exercise, then yes, it’s going to be very hard to find time for exercise. But I can tell you, I’ve lived in loud apartments in bad neighborhoods while being dirt-poor and working 70h/wk at min-wage jobs that leave you with bone-tired feet and legs, and I still managed to exercise regularly.

    I live in this body 24/7 and it mediates my experience in this world. After taking care of my daughter, it’s what I take care of first. Frankly, it’s part of why I’ve got no intention of having more than two children. Living this way also ensures time to remember who you are; walking home from work ensures a pressure-valve no car commute does.

    I never did say it was easy, psychologically or situationally. But simple, for most people, yes. As noted, there are exceptions. High levels of stress can make weight loss difficult, as can certain drugs (steroid and antidepressants, for example). And yes, there are populations that are famous for obesity. For the vast majority of people, though, enough exercise (more than most people think) and avoiding overeating (less than most people think) does an excellent job of warding off obesity. If that weren’t true, fat as a norm would be old, old news.

    amy

    #110566
    amykamyk
    Participant

    If we’re going to help people tackle the obesity problem, we’re going to have to do better than sell them another diet plan or aerobics video.

    Unfortunately, the things that will work run smack into vested interests. The food industry has a vested interest in your overeating. The housing industry has a vested interest in your living in a giant house fifty minutes by car from where you work, which ideally is far from dense and aging multiuse city zoning. The auto industry wants to sell every adult an SUV. The video-game industry wants your kids to sit still, and so does the tutoring industry; the toy industry wants you to pay extra for a motor on the scooter or play-car. The clothing industry wants you to get fatter; that’s what sells men’s clothes, anyway. (I’m not joking.) There’s no diet industry without fat people. And your employer doesn’t want you taking a two-hour lunch/gym break or leaving early because you’ve done enough sitting today.

    Helping people tackle the problem will require political courage on a reforming-Social-Security scale. Until it happens, I think all we can do is encourage people to resist what comes easiest and privately provide ways to help them do that. Donate gym memberships. Volunteer to help sedentary girls play sports. Teach nutrition and cooking in community centers for free. Publicize nutrition info. Organize community “weight-watchers” groups. Provide sliding-scale therapy so people can learn to deal with their problems in ways other than eating. Support and donate to rails-to-trails projects. Buy poor women sports bras and good sneakers. Raise money so schools don’t have to go begging to Coca-Cola.

    I think stuff like this will still miss the majority of people; it can help the motivated, though.

    amy

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