Obesity is a choice

KK - as always you make a well thought out and structured post. While aspects of your analogy are accurate, I do disagree with the smuggling notion. I can see people smuggling in cheap cigarettes from Mexico, but I honestly don't see them doing the same with BigMacs.

I do agree with most of your comments on fat-food taxation. I just felt that was a possibility which didn't attack the individual, but did attack the mechanism by which they are harming their bodies. Personally I'd be more tempted to charge people who require medical assistance through their own doing (which I'd extend to include drunk teens who need their stomach pumped, extreme sports fantatics who break bones etc etc etc).

There were items on the news this week about a portion of the UK society who are on benefits because they are "too fat to work", which is a disgrace, and they should be ashamed. As I've pointed out in this thread, there's nothing stopping them losing the weight and getting back into society.

 

Well, thats insane that being too fat to work counts as a reason to be getting supported by the government.

Though, it also, I think, leads to the question of why should they bother to try to enter the workforce if they're getting benefits for not doing so? There's no incentive.

 

We can provide a floor of degredation in our society. There is no need for people to live on the streets or go without food. Providing the very basics of life is going to do nothing to the competetive system we need and have.

I find all this talk of statistics interesting. If it wasn't our society, and choices made by at the societal level, then shouldn't the rate of lazy fat people stay the same? If it is purely the product of individual choice, then what has created this vast new proportion of the population that has "chosen" to be fat? Perhaps you can claim that people who are capable of making decisions legally, ie adults, do so. However under our laws children are not capable of making legal decisions for themselves. How can a child "choose" to be fat when he can't choose to have sex or sign a contract? The younger the child is, the more control adults and society have over them. Hence when we see young children becoming very fat, I am not sure how you can place the blame on the child in most cases. They eat what their parents and schools give them to eat. You might try to place all the blame on the parent, but when there is just one of them that must work 40 hours a week, then you can't say that parent has control over what their child does most of the time.

And once these fat kids grow up into fat adults, it is much more difficult for them to choose to lose the weight than someone who made that "choice" as an adult.

As a society, we have made choices that have lead to increased numbers of both old and young becoming fat. Food can become an addiction. Like any other addiction, there are societal factors in play just as much as there are personal ones. A society without alcohol would have no alcoholics. Sure you can blame the alcoholic for choosing to get drunk, if he had never drank in the first place he would have never become addicted. That doesn't change the fact that his addiction has had a physiochemical change in his body that makes it much more difficult to not drink when compared with you or I. Placing all the blame on him and refusing to pay for the costs of any treatment might make you feel good about him getting what he deserves, but it's inhumane and ineffectual. The cost of not addressing the problem will likely be greater than the preventive efforts. At some level, society is also to blame for those few who can't handle the substance because it is not necessary, and if we never made it none of these people would have the problems they do. Perhaps prohibition isn't the solution because so many in society want the product, but if we changed our wants the problem wouldn't exist, hence the fact that we must share the blame for the side effects of our choices.

Now I realize this isn't a complete analogy, we always need food. My point is that because we allow a system in which surplus calories may be consumed as foods that increase obesity, the increase in levels of obesity cannot be solely blamed on the individuals who consume more. If we know that statistically speaking when 100 people are placed in a situation where unhealthy eating options are offered, and 30 of those people will choose them, we should stop worrying about wheither they have a choice in the matter, and figure out how to drop the number of people that will do it. Personal accountablity is great, but not when it comes at the expense of looking at the wider problems and solutions.

A tax on fat might be a good idea, if only if it is coupled with a subsidy on fruits and vegetables. An apple might taste just as good as a candybar, but generally fresh fruit costs a lot of money and doesn't last for very long. Food is the last great deal in this country.

 

So then maybe we should deny insurance coverage to Blacks because they are more likely to have heart disease, diabetes and sickle cell anemia?

My point is that if you are PAYING into the system, you should get the SAME benefits as anyone else.

 

ANOTHER DOCUMENTERY is coming out, this one is about the corn industry in the United States, and the Grants the Government provides.

Already stated in this thread is the fact that our portions are out of control in the United States.

When places like Circle K, and 7-Eleven started offering huge cokes, the Fast Food joints responded by adding their
own "Super Sized" drinks.
Liquid calories alone can add an easy extra 500 calories a day, or 3500 calories a week.

Cut the corn grants, price of Corn syrup goes up, price of Coke goes up, waist sizes go down!

 

And every presidential candidate has their head on a platter in Iowa. 12 years ago my family drove through the corner of that state, and I really don't think I saw anything except corn fields and grain elevators.

 

I can't comment on your specific examples, but in principle it already happens. You complete family history questions when applying for health insurance, and if your family has a history of cancer (etc) then your premium goes up. However, the example you gave of sickle cell anemia and diabetes (in certain cases) cannot be avoided, ie it is not the fault of the individual, it is purely their genes. In the case of obesity it is 100% avoidable, and 100% reversible - that is undeniable biological fact - sickle cell anemia etc is not.

Nonsense. Those who drain the system should be forced to foot the bill. Why should I (as a member of society who is fit, healthy and makes effort to nuture their body) pay the same as someone who treats their body like crap and needs constant medical attention?

The people who are the biggest burden should pay the largest proportion of the costs.

 

I believe, and chibiangi can correct if i misinterpretted, that what was being discussed was health care policy in universal health care. Where, if you're going to create a system everyone is forced to pay into, then everyone should get taken care of with it.
Not how it should work with private insurance, where you can basically pick the company and plan you're insured with.

 

They shouldn't be denied coverage, but they should have to pay a rate for coverage that corresponds to the actual risk associated with their developing those (and other diseases). Race has nothing to do with it, though. It's simply a matter of statistics.

My family has a history of heart disease and cholesterol problems (which is why I focus heavily on preventative care for myself), on both sides of the family. That makes me more likely to have heart disease. There is a history of diabetes in my family (again, on both sides), including my father. Again, that makes me more likely to develop diabetes (according to some sources, I have about a 1:4 chance). Those things should be taken into account when I get health insurance, and I should then pay a rate corresponding to the level of risk that I present. Why should someone else who has a similar level of risk to me have to pay less because of the color of their skin?

Paying into which system? Health insurance? In that case, you should receive the level of service promised in your policy (it is, after all, a contract).

Health care in general? Why should anyone have to pay into that system at all? That is a big reason that I oppose government-run health care. A healthy person who chooses not to get preventative care should not have to pay into the health care system at all. Why should the healthy be forced to pay for the sick?

Kimball Kinnison

 

Its two years old, but here is an interesting article about the effects of cigarette taxes:

http://money.cnn.com/2005/07/12/pf/taxes/cigarette_excise/index.htm

 

Exactly. If we are being taxed at the same rate, paying into the system the same, then EVERYONE should receive the same benefits. I do not believe in eugenics, so my feeling is that everyone, regardless of race, size, gender, crappy genetics has the right to live and have adequate health care.

And if you are already paying for health insurance, as stated above, it is part of your contract. They should pay out.

I find it disturbing people would actually deny care to people based on their size and race. As if your (faulty) genetics determine your worth to soceity.

I also do not believe that overweight/obesity is 100% the individuals fault. Of course, I am not going to take the time to go round it again other than to say it has been shown time and again that body size is a heritable trait and not 100% influenced by environment.

Dr. Stunkard also pointed out the implications: ?Current efforts to prevent obesity are directed toward all children (and their parents) almost indiscriminately. Yet if family environment alone has no role in obesity, efforts now directed toward persons with little genetic risk of the disorder could be refocused on the smaller number who are more vulnerable. Such persons can already be identified with some assurance: 80 percent of the offspring of two obese parents become obese, as compared with no more than 14 percent of the offspring of two parents of normal weight.?

A few years later, in 1990, Dr. Stunkard published another study in The New England Journal of Medicine, using another classic method of geneticists: investigating twins. This time, he used the Swedish Twin Registry, studying its 93 pairs of identical twins who were reared apart, 154 pairs of identical twins who were reared together, 218 pairs of fraternal twins who were reared apart, and 208 pairs of fraternal twins who were reared together.

The identical twins had nearly identical body mass indexes, whether they had been reared apart or together. There was more variation in the body mass indexes of the fraternal twins, who, like any siblings, share some, but not all, genes.

The researchers concluded that 70 percent of the variation in peoples? weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease.

 

Hold it right there. The only person bringing race into this discussion is you. Don't pull out the "race card" in order to paint those who disagree with you with the tar of racism. That's nothing more than a cheap shot.

It is not about race, but risk. As I said before, I have a higher risk of heart disease based on family history. You mentioned that blacks statistically also have a higher risk of heart disease. Now, if I should have to pay a higher premium because of my higher risk, why shouldn't a black person also have to pay a higher premium if they have the same level of risk?

Or should everyone just have to pay the same, regardless of risk? Do you realize what sort of financial disaster that would be? It would do nothing to get people to reduce at-risk behaviors (or even cause an increase), which would in turn lead to an increase in those requiring care, and increase the cost of that care.

Kimball Kinnison

 

It would do nothing to get people to reduce at-risk behaviors (or even cause an increase), which would in turn lead to an increase in those requiring care, and increase the cost of that care.

PPOR. You are slippery sloping, KK, and ignoring important variables like cost containment, improved third-party payment, etc. The current spiraling costs of health care are the product of a vicious circle of existing costs, multi-tier coverage, cost inflation due to pennies-on-the-dollar payments by third-party entities with subsequent reliance on overbilling, etc. The health care system is *a lot* more complex than your linear and simplistic presentation of equal payment --> cats and dogs living together.

I would like to get back to malkie's original question for a second, however (i.e., the idea of obesity being a choice). I am mesomorphic (linebacker-shaped; 6' 1" with a muscular build), so I put on both fat and muscle easily. My weight has plateaued at 240 lbs, despite my efforts to reduce it. I exercise 5x/week (2-3 mile walk + 60-90 minutes on the elliptical (total of about 1400 calories burned/workout), and weight-lifting 3x/week) and have reduced my caloric intake to <2000/day and eat balanced meals (low-fat proteins, fruits/vegetables, reduced carbohydrate intake). I've been doing this specific program for the past three months, but have followed similar regimes for nearly two years (substitute cycling or additional walking for the elliptical), with little overall change (there was dramatic weight loss initially, but it's been basically a maintenance program since then, much to my chagrin). I am still considered overweight by clinical definitions, but how is this a choice? How is this not taking care of my body? Does it stand to reason that I should pay more for insurance?

 

Well, malkie will tell you that you need to eat 500 calories a day and starve your body into submission, but we both know that your so-called "extra" pounds are by no means unhealthful and your lifestyle is far better than the average person--thick or thin. Which is why basing health insurance benefits solely on weight is absolute garbage. Some people are bigger people. They are also just as healthy as thin people. In fact, as far mortality rates are concerned, people in the so-called "overweight" category of BMI 25-30 have the LOWEST mortality rates of all. The highest? Underweight people. Obese individuals do not meet the same level of mortality "risk" as underweight people until they are in the highest ranges (BMI 40+)

So according to KK's assertion health benefits should be tiered to risk, than our very thin brothers and sisters should be paying the highest rates. But no one mentions that because well, frankly, there are more fat people to price gouge.

As for your claim that I am playing the race card, KK, no I am not. Whether one wishes to deny coverage or to increase rates to effectively deny coverage the end result is the same--an uninsured individual with no access to health care. You want to say it is based on "risks" and not race, well sickle cell anemia is pretty much unheard of in Caucasians and Asians so pretty much the only people with that risk are going to be Black. Heart disease and diabetes are found in higher rates in Blacks. Blacks are also at the highest risk of being obese (Hispanics are pretty close.) So when you say, sorry your risk is too high due to heart disease, diabetes, and obesity, yes, you are in effect denying health care to people who are also the most likely to need it the most--poor, working class Blacks. And that is pretty much where this argument that obesity=huge health risk ends up--The wholesale discrimination against people based on their body size and in all likelyhood their socioeconomic status and race.

 

Actually, mortality rate in and of itself is a poor measure of who would require the most health benefits. After all, someone who lives longer with a chronic disease will likely cost a lot more than someone who dies younger. And those who are overweight have a much higher risk of developing many chronic conditions, such as diabetes.

Remember, when it comes to insurance, the question isn't how soon will they die, but how much will their overall treatment be likely to cost.

Yes, you did play the race card. You said that people who disagreed with you were willing to "deny care to people based on their size and race". That is a direct accusation of racism, among other things.

Yes, people of different races can have different levels of risk for different diseases in part because of their racial ancestry. However, that doesn't mean that they are being denied coverage based on their race. It is based on the risk level that they present as a total package, not just any one specific disease.

I mentioned earlier that my father has diabetes. Because of that, he cannot get any new life insurance policies, even though his diabetes is completely under control through diet, exercise and minimal medication. Why? Because his diabetes makes his risk level too high. That's how insurance works. The insurance company determines the probability that it will have to pay out within a certain period of time, and sets premium rates at a corresponding level. If they determine that the risk of payout is too high, they refuse coverage.

Race might play a factor in a person's risk for a few diseases (like sickle cell), but health insurance is based on the aggregate of all of the risks, not just any one disease. Someone's race is a matter of genetics, and it is the genetics that help determine your risk for certain diseases, not your race. There was no reason for you to bring race into the discussion at all, because race does not cause any diseases.

If you want to participate in risky activities, I shouldn'

 

? But family history is something you can't control. Last I heard we weren't punished according to our ancestor's transgressions.

I can see where chibiangi comes from. In the end basing costs on genetic risks seems to tend to disadvantage blacks more than other racial groups, and while perhaps not intentional, the end result of this policy results in discrimination against the worst off in society. However I would say that class is a much bigger factor than race. The rich are the most educated and most able to avoid risky behavior. When your socio-economic group is already adequately educated and taught from childhood certain risk adversion skills, to say that government shouldn't do anything in both preventive and corrective measures seems to me to be pure selfishness.

Like I said, this is society's problem, which means until we all work together to fix it, you cannot absolve yourself of the shared risk. By your same logic, as a young person who is not really in need of much health care, I should pay nothing into the system. All the old people can rot for all I care. Better for them to die and decrease the surplus population.

 

Then why were there no obese people in Nazi concentration camps? An extreme example, but it proves that your body is 100% a product of what goes into it.

You "won't go round it again", because you have no biological leg to stand on. Your size is entirely controlled by what goes into your mouth. It is absolutely 100% as simple as that.


To make excuses about genetic influences on metabolism or body fat handling is a joke. If no fat is going into your mouth then there will be no fat accumulation. I'm very happy to conceed that starving yourself can be equally as unhealthy as stuffing your face with McDonalds, but thats not the point I'm making. All I am trying to say is that your size is simply a product of what goes into your body.

 

"All I am trying to say is that your size is simply a product of what goes into your body."
That is an oversimplification beyond the point of usefullness. Diet is a part of it, but not the only part. Two people eating the same foods are not neccessarily going to have the same weight as there are other factors. To say that because all people can be starved and therefore being overweight is a choice seems to be akin to saying that asthma is a choice because all people can be asphyxiated so clearly its a choice how much air they breathe.

 

That is an oversimplification beyond the point of usefullness.

No, it really isn't. Are you honestly trying to argue that your body isn't a product of what goes into it? Where else does the fat come from if it isn't your diet?

seems to be akin to saying that asthma is a choice because all people can be asphyxiated so clearly its a choice how much air they breathe.

Why do people insist on making crap analogies when they can't argue their point clearly. All that happens is that the thread gets derailed while I point out the obvious flaws in your analogy, then you counter argue the flaws I point out, and the original thrust of the thread is lost.

Food into body is a 100% controlled choice. Air into body is not. An obese person can control their food intake, an asthmatic cannot control their air intake (or rather their inability to exhale).

 

Perhaps I can help with another personal example here.

My family has a strong genetic predisposition towards chemical additions. On both sides of my family, there have been many alcoholics, compulsive smokers, and even some drug users. But, it is not deterministic. None of them were born addicted to anything. However, because of our genetics, even one try of alcohol, drugs, or any other addictive substance can be enough for someone in my family to become addicted.

You know what? I'll never be an alcoholic, nor a drug addict, because I recognize my body's limits and have chosen to control what I put into my body. Alcohol and drugs are not on that list.

My genetics might make it easier for me to become addicted, but I am still in control, and I refuse to take the steps that would lead to addiction.

Similarly, someone's genetics might make it easier for them to become obese, but that doesn't change the fact that they still have control over what they eat.

Kimball Kinnison

 

ta da! point made perfectly in a single sentence

 

Can I call Godwin now?

As for Nazi concentration camps, that is a garbage argument considering people were starving. Of course when people are starving they will lose weight that is what the body is designed to do. Of course, in such circumstances, you would want to be fat because you have the highest chance of survival.

However, saying that fat people should starve themselves in order to lose weight will only produce two results: lowering of metabolism and temporarily reduced weight with significant rebound weight gain. Not to mention the fact that when the body goes into starvation mode, it cannibalizes muscle and not fat, which is one of the reasons why anorexics and bulemics die of heart attacks (loss of heart muscle and electrolyte imbalance.) Aditionally, other bodily systems are effected such as the galbladder.


I have quoted two references stating that weight is a heritable trait (70) and that when fat people are forced to lose weight they can't keep it off, they have a host of psychiatric symptoms, regain the weight, and then the resultant lowering of metabolism. Conversely, when they tried to get thin people to gain significant weight, they only did with excessive calories and once they went back to their normal routine, the weight came off.

I do not think weight in itself is an indicator of health. I think lifestyle is and firmly believe in health at every size. If someone changes their habits and are able to lose weight and keep it off (chances are it will only be a max of 20%) then that means they were living unhealthily. If they do all of those things and still cannot lose weight, I am not going to tell someone like the poster above that he is unhealthy. He isn't. His lifestyle and athletic ability likely surpasses the average "normal" weight person. He has no need to starve his body into weight submission because of the misguided thought that falling into a certain BMI range makes him healthier, especially when such an act will likely produce the opposite results.

On a side note, I find it ironic that people will readily accept that a very thin person has a fast metabolism and can't gain weight but will in turn blast a fat person for being unable to lose it.

 

As for Nazi concentration camps, that is a garbage argument considering people were starving.

Not at all - it makes my point perfectly that anyone can lose weight. Those who don't do it purely out of choice.

it cannibalizes muscle and not fat,

Incorrect. The body will use fat first, then muscle as a last resort. You get more energy from breakdown of your own fat than your own muscle, so a starving body always takes fat first.

I have quoted two references stating that weight is a heritable trait

Totally irrelevant, and you are completely missing the point. One persons genes might allow them to eat as much fat as they like without gaining any, whereas another will constantly battle with weight despite avoiding fat wherever possible. However, this does not in any way alter what goes into someones mouth.

when fat people are forced to lose weight they can't keep it off,

because they have no will power - it is their choice to eat, and no-one elses

On a side note, I find it ironic that people will readily accept that a very thin person has a fast metabolism and can't gain weight but will in turn blast a fat person for being unable to lose it.

Sorry, but why is that ironic? (or are you just using the term "ironic" completely incorrectly?) A 400pound man with the nickname "Slim" would be ironic though.

 

Some people can drink pint after pint of beer without being noticeably drunk. Other people are plastered after on pint (or less). Does that make it inappropriate to criticize the latter for their excessive drinking?

It becomes excessive when you partake of more than your body can handle, and that limit varies from person to person. Just like if Bob can't handle more than one beer he shouldn't drink more than one beer, a person whose metabolism cannot handle more than 2000 calories (as an example) without becoming fat should not eat more than 2000 calories.

Kimball Kinnison

 

okay as for the concentration camp reference

I have 3 vehicles
a Hyosung Scooter
a Mazda 626
and
a Nissan Murano

to test the gas milage I could place zero gallons of gas in each, then record that each will be able to travel zero miles.
Thus all three of the vehicles i own get the exact same miles per gallon.


Using the concentration camps as an example is just plain wrong.
Let's instead use an example of program where people are fed 3 "square" meals a day, given medical care, and get lots of exercise, how about Marine Corps Recruit Training.
As someone who has graduated from this program I can say that, yes anyone could, lose the weight,BUT (and its a big but)this is not always practical in our day to day life, as it is not the same for everyone.

Anyone who has taken an economics glass has seen a Guns vs. Butter curve. It may be possible to lose the weight, but at what cost? What each person has to give up in order to work out more and eat healthy is going to be different.