Obesity is a choice

No one is disagreeing with you about the efficacy of preventative measures. The concern is more practical.

1. For instance, an immediate switch to preventative measures does not help people who have already developed a disease as a result of several decades of previous poor lifestyle. That is, let's grant your (questionable) scenario that after funding support for preventative measures, no one should be covered for conditions related to their obesity, etc, since there would be proper support for eating and living healthy. Fine. What about all the people that didn't have that support before, and lived the entirety of their life with the McDonald's fast food dollar menu as the most economic way to feed themselves? Should be denied assistance in the same way as someone who had the nutritional counseling, medical support, healthy food subsidies, and convenient exercise centers that your new preventative programs would presumably provide?

2. Really, no one should be treated if they can be held even partly responsible for their condition? Because I'm fairly certain that every sports-related injury ever could be avoided by simply not playing the sport in question. And children wouldn't get sick so often if they would have better hygiene and be more cautious about sticking things in their mouth. Do neither of these two situations deserve any help?

3. How do you account for the fact that our knowledge of disease processes grows and changes over time. How long was it before the link between asbestos and mesothelioma was well known and established scientific fact? Smoking and lung cancer? If someone does something that seemed innocent at the time they did it, but was later discovered to be a major risk factor for causing a disease, are you still going to deny them coverage?

4. Because these are long term processes, changing your lifestyle can help (in terms of preventing things from getting worse) without really improving your condition. In that sense, do you think it's really sensible to consider it "encouraging poor lifestyles" to tell someone who stopped smoking cigarettes 20 years ago but still developed emphysema that they don't deserve any help?

Etc

The point being, you are grossly over-simplifying here. You are also making a false choice. Supporting preventative care programs does not mean we have to cut funding for acute care, nor vice versa. Your position is also unrealistic. While, yes, it would be more cost-effective for people to live better, that's not what they actually do. If your goal in healthcare reform is to reign in costs, you have to focus on things that actually change people's real behavior, not figure out which plan would work in an ideal world where people are already competent and responsible.

 

Well too bad for them. They should have considered what they were doing before they got diabetes or a heart attack. Either way, a shift in lifestyle from that point on would drastically improve their overall health almost instantly. Losing 10 pounds in a month for a guy who's 400 would be a drastic improvement because the guy is working out. As long as he continues like that, he would reduce the chance for a heart attack much better than any treatment.

What funding? I'm not suggesting that taxpayer's funding go into providing obese individuals with more resources that they don't need. If they have a heart attack because of their unhealthy lifestyle, they should be expected to pay more for health care than someone who took better care of themselves. (By that, I mean someone who is within the healthy height/weight ratio) The scenario is making healthcare benefits more restricted for people for exercise bad judgment.

This is America, not Angola. Such people aren't starving to death. And if they're living off McDonald's, then all they have to do is exercise some degree of self-restraint. Eat less, save more.

You don't need any of those to stay healthy. If a person can't lose weight, it's by his/her choices.

Those are one-time events. Obesity is a constant and habitual problem. If a person just ate a lot of spray paint on a routine basis, it would be the same thing.

This is nothing new. Obesity simply wasn't as common fifty years ago as it is now, but the knowledge was always there. Anyone who didn't know that getting fat was unhealthy must probably ate a lot of spray paint when they were kids.

Wrong. If a person allowed himself to reach ~400 Ibs, then nothing will improve his condition unless he changes his lifestyle. Dropping 20 pounds significantly improves that pers

 

What you aren't addressing is the time issue. Yes, losing 10 pounds a month would be an excellent way to reduce the risk of a heart attack. But sometimes, a person's risk of heart attack is so high that such an approach isn't good enough. By the time you they've lost enough weight to move into a more modest risk category, it may well be too late. For those individuals, a combination of drug treatment and lifestyle changes are the best way to ensure their safety. The lifestyle will help in the long term, and the drugs will help get them out of the extreme danger of having a heart attack that they suffer from presently. That's current medical practice. If you limit people's access to drugs--and, remember, given the correlation between poverty and obesity, changing how much treatment costs will have a major impact--the number of heart attacks will go up. Are you comfortable with that? Why?

If your focus is on helping people be healthy and avoid serious illness, you should do what best serves that end. In this case, that means giving medication sometimes. If your goal is to somehow punish people for being fat, then you've sort of missed the point of healthcare altogether.

 

So, really you're suggesting what health insurance companies ALREADY do, which is to charge people based on the risks they present and where some health insurance companies charge less for those that work out.

 

Answering Lobacca: The US is moving towards the universal healthcare system that EU countries and Canada practice. If this comes into being in the US, it would only act as positive feedback for people to not care whether they become obese.

Very well, then what is? Go on, I'm listening. If you can devise a better solution, then do so.

Drugs? How are these people going to pay for such treatments? The bold phrase alone would work, but if they can afford the treatment to give them some time to change, I wouldn't stand in the way.

Most of these people have been in extreme danger for a long time. Usually when they suffer a heart attack or something extreme do they act. If someone eats their heart out and dies because of it, I would have no sympathy for that person. I would be all for someone getting their stomach stapled if that's how they want to slim down.

Yes. If treatments are expensive, then it would force people to exercise self restraint and it would dissuade people from thinking there's another simple and easy solution to deal with their ravenous cravings for food and laziness.

Punished people for being fat? How? If fat people tend to live in poverty, then the best thing for them would be to encourage them to exercise more. If they can't afford to have a heart attack, then the logical thing would be for them NOT to have it in the first place. If they can afford the drug treatment, then I won't stop them. If they can't afford it, then they'll die.

And some people seem to underestimate a lifestyle change. It's not simply losing weight; it's improving your health. I have a friend who's about 50 Ib overweight. He was much heavier before at >100 IB, but he is much healthier now than he was in high school. In changing his lifestyle, he dramatically improved his wellness. It's not like he went from a high risk of heart attack to moderate; the risk was almost gone after a month of working out.

I however do NOT recommend or believe it's healthy to suddenly start pushing your cardiovascular system while morbidly obese. The whole reason for heart disease is associated with the heart being stressed to provide for the body. Gradually starting a workout regiment, such as walking, is the best way to start out. After a few weeks, the person should be able to increase the regiment safely. As the body's metabolism increases, s/he would burn off fat much faster and, ironically, burn less as they get smaller.

There's no fast or simple solution for someone who'd been at it for months/years with snacks.

 

By having insurance plans that cover them at an affordable price (whether that comes from the government, or private insurance). You know, that thing that you keep arguing against?

First, it's not appropriate to make gross generalizations about how people do or don't think, and how they will or will not act. Among other things, even if people realize that being fat isn't the best thing, they could very easily be unaware of exactly how much danger they are in. Once they learn, they might be motivated to do something about that.

Really, though, if you really meant what you say above, then I don't see how you are actually interested in reducing the number of heart attacks. You are interested in having less fat people. Period. That sort of Malthusian ethic isn't really reputable, and shouldn't be dressed up as concern for others. If people's lives and safety are your first concern, that should actually be your first concern. Instead, apparently, it's the number that comes up when they step on a scale.

Again, what about the increased risk to the patients? You keep trying to deal with this in terms of abstracts notions of personal motivation, and not at all as an issue of facts. Even people who are trying their best to lower their weight through better diet and exercise don't automatically get moved out of the high risk categories. There's a lag until they've actually lost enough weight. By your own rules, these are people you should "have sympathy" for. For the window between when they start changing their life and when they lose enough weight to stop being high risk, drugs can help protect them like nothing else can. Apologies if that offends your abstract moral reasoning, but you have to address that fact regardless.

 

Really? What's been going on in the US over the last year or so?

If one person practices this, it's not much of a problem. If hundreds of thousands do, then it's the taxpayer's problem.

I've taken macro economics and I can tell you that insurance can't be relied upon in this case. The majority of the costs will come from taxpayers.

Is there an echo in the room? Sounded like a preventive measure.

Do you know why you visit the doctor every few months? It's to evaluate your health and so he could tell the obese that they need to get off their butts and start working out. If they ignored their doctors, then who's at fault?

What I want is for fat people to start exercising. Period.

And that last statement was wrong. It's not a matter of weight, but how many health problems are associated with inactivity.

 

The fact that the government pays the expense doesn't change anything about my point there.

For the fourth time, what about people who don't ignore their doctor? Even if someone listens, and does everything they can to start losing weight, it will still take time to accomplish. If they've started exercising, they've done what you claim to want. So why would you still support making it difficult for them to get the medications that could drastically lower the likelihood that they will end up dead or crippled before they ever get a chance to benefit from the better health that comes with a more healthy lifestyle.

At the very least, your position makes no sense there.

 

And where does the government get its funding? (Aside from government bonds)

Ultimately as insurance provided from the government goes up, so will taxes. And so the costs ultimately increase the national deficit, or burden those who struggle just to get by with oppressive taxes.

Oh, I have nothing against those people... the ones who had enough sense not to gorge themselves and sit on the couch, watching 'Cops' every night. I have nothing against those people. It's those who did ignore their doctors that I speak of.

I'd cheer on those kind of people who do that.

It's called common sense... I know I'm really being annoying with this kind of thing. Common sense dictates that you must eat less than you work off in order to lose weight. Those that don't follow this aren't practicing common sense.

Jarred, the Subway guy. Richard Simmons, the body builder. These people were morbidly obese and turned their lives around with self-guided, but strict diet and exercise regiments. Losing weight is not easy. I'll admit that right now, as I'd lost 80 pounds myself. But staying healthy... improving one's health depends upon maintaining a level of discipline. For those who'd allowed themselves to become obese, there's no simple solution. But it must depend on maintaining a strict level of self discipline. That doesn't require drugs. It may require a doctor to advise you, but beyond that, it's cheap.

 

I'm not saying it requires drugs to lose weight. for the fifth time, I'm saying the drugs can help you survive long enough to successfully lose the weight. Address this point.

 

I will... after you address yours. You say obesity and poverty are closely related. If they can't afford those drugs, then they can't count on such treatments. 'Surviving long enough to lose weight' really doesn't account for much if the person never does it.

Like the 'God created the universe' theory requiring the proven existence of God, the 'drug survival' theory can't stand without the 'changing their lifestyle' component. Yes, drugs make it easier for such people to turn their lives around, but it depends on them actively changing their lifestyle... for the sixth time.

It always comes down to lifestyle, which is why the rate of heart disease, diabetes, and other weight-related ailments are on the rise. If Americans don't change their lifestyle, then drugs don't matter.

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And I'm getting tired of addressing the same thing again and again. I'm not going to respond again unless a new topic emerges here.

 

If obesity is ALWAYS lifestyle choices, what proof do you have that the article I posted was based on flawed science, because the weight loss in mice actually was because the skinny mice were just running around a lot more.

And I'm getting tired of addressing the same thing again and again. I'm not going to respond again unless a new topic emerges here

You mean you got tired of addressing the question he kept asking and you got tired not answering it? I can see that.

As for the increase in obesity in this nation: You really expect me to believe that it is all because people just decided to be lazier? When it is as widespread a trend as it is, I just don't think it makes any sense to enact policies based on individual bad choices. Americans work just as hard as skinnier countries, and unhealthy eating says more about the options available and culture of food than the choices those individuals make. A smoker today has all sorts of messages and signals not to smoke. They don't get to watch commercials selling tobacco, but we think nothing of plastering wall to wall advertisements of unhealthy food that claims to make us feel better. If you actually interested in lowering obesity rates rather than punishing people who are not deserving, there are plenty of things we can do as a society, while still helping the obese.

 

Yes...? Were you opposing my point?

When did exercise suddenly stop being accounted for in lifestyle?

If you see 'that,' then it's a delusion. I see here that I'm continuing to address the same subject, but at least I've got someone different this time. I see that I've answered the issue and if someone simply doesn't like it, their desire is irrelevant.

Do you have alternate theories? I'm listening.

No, I don't mean someone simply decided 'Hey, why bother with walking, I'll just drive my car.' or 'You know, exercise sucks. I'll just skip it from now on.' It's habitual.

An auto-dependent, fast-food nation? Americans don't do as much physical activity as Europeans. And they have much more meat/grease/sugar/fastfood crap per capita than any other nation in the world. Yes, it's a society problem, but that's no excuse. No one forced the obese to do anything. Reread the title of the thread and realize it's exactly that.

It's called self-restraint. You cannot help those who won't help themselves. A smoker doesn't become one because of society. Fat people don't become fat because there's a Mcdonald's on every corner. No one forced any of that crap on those people.

 

Preventitive measures are the best, but of course that won't help those who already suffer from obseity.

It's nationwide education that is needed and what money should be going into. Banning advertising for fast food and promoting healthier eating at a younger age.
If a child is raised on unhealthy food from a young age they are likely to grow up preffering that to healtheir alternatives.

I was given vegetables and fruit right from the start, and brown bread. I was never given fizzy drink until I was much older and I never got taken to fast food places or given any at home.

Healthy living will prevent obesity, the problem is getting people to do that.

 

When did exercise suddenly stop being accounted for in lifestyle?

I'm not saying exercise doesn't have a place, but it doesn't really matter how much you exercise if you are just talking about weight as you could run a marathon and barely use up enough calories to cover a Big Mac. Exercise more has just good effects on health than on actual weight loss.

The fact is that it mostly depends on what you eat, and the choices people make on what to eat are limited by what is available and what your body does with the food it does eat. Some people have bacteria that makes them more efficient eaters, so they could make the same food choices as others yet be obese where another would not. Our bodies aren't X amount of calories - X amount of exercise = Persons weight. It just isn't that simple. And even if it was, you are completely ignoring the social and cultural practices.

Americans don't do as much physical activity as Europeans. And they have much more meat/grease/sugar/fastfood crap per capita than any other nation in the world. Yes, it's a society problem, but that's no excuse. No one forced the obese to do anything. Reread the title of the thread and realize it's exactly that.

How is that not an excuse? If society is the one that has the problem, like it or not that does in some ways absolve individuals of personal responsiblity when designing social solutions to the problems. If society helped create the problem, then shouldn't society help those people it lead into bad decisions via drugs that prevent them from dying? Do you even care why they don't do physical activity and eat more crap food? It seems pretty clear you don't, and just want to punish them for it.

You know what? Good tasting healthy food costs a lot more than fast food. Sure you can say a can of peas is technically healthy and cheap, but not even people who are health nuts just sit around eating cans of peas. They are going to want farm fresh vegies that actually have a good taste.

People live in places where it is impossible to walk. Even a bike isn't practical most of the time. So unless they move to Europe, they don't live in a place where natural daily exercise isn't so much a choice as a necessity.

 

I agree with Espy that the infrastructural layout of the U.S. doesn't help to create thin people. Where European kids go to school on bikes or on foot because it's close enough, the American kids are brought in the car or they have their own car.

 

Surely not everyone in the whole of the US lives miles from anywhere, and you do have sidewalks to walk on.

And where do people shop that sells good food at a higher price then bad food?
I can buy great big double packs of lettuce for less then £1, which is far cheaper then I can buy something in McDonalds. It's also easier to go to the Supermarket the a fast food outlet.

And if you must east fast food, why not go to Subway?
They aren't that expensive.

 

I'm not disputing any of that. The benefits of exercise actually come after you've done the workout. Increasing your body's metabolism, regenerating muscle tissue, and improved mental health all have little to do with weight.

The fact is that it mostly depends on how much you consume and how much of it you burn off. A person who eats 4000 calories a day and burns off 3900 calories actually would be very healthy in the long run. As long as his appetite doesn't change, his weight set point would shift and his body will eventually burn 4000 a day when he puts on more weight. Such a person would be VERY healthy in a number of ways due to the physical activity. The problem with obesity is that people don't maintain the same diet, but eats more calories as they get larger. If someone maintained a diet where they put on 200 calories a day, there would be a point where they stop putting on weight, as their body would adapt and reach a set point. The problem is that people's diets change as well.

How is that an excuse? People are bombarded everyday with messages of what to do and what to buy. Individuals learn to say 'no.' Absolving individuals of personal responsibility only encourages them to shift responsibility away from themselves.

And you're wrong. I know exactly why it happens. Suburban development makes auto dependent societies, where walking is essentially gone. People in New York, Sao Paulo, and Tokyo tend to be much more fit and healthy because they use public transportation. With that comes the need to walk to and fro.

Mcdonald's: Fast Food is more prominent because people are stressed after a hard day's work and don't want to bother with cooking when they get home. Fast food is cheap and convenient. And there aren't that many healthy fast food chains I know of. Still it comes down to personal choice.

And how exactly would 'society' organize such a feat as you describe? Remember that a society isn't made up of thoughtless drones. It's a collection of individuals all seeking their own agenda.

 

I said they cannot afford the drugs without insurance covering them. Which is why I disagree with you that government plans to cover things like drugs and acute care are not "crap."

I never disagreed with you there. In fact, I explicitly agreed at least three separate times. At issue was not whether lifestyle changes helped, but whether it was worthwhile investing in anything else.

 

This is going nowhere... yeah, I'm still going to continue on it.

The most cost-effective 'cure' for obesity-related problems is prevention. Studies have shown that the obese 'age' faster than those who are at a healthy weight. That means the lifespan for such people are about 5-10 years shorter on average. That is not just in regards to heart disease or early deaths, but that an obese person who had trimmed down at age 50 would be about as physically conditioned as one who's almost ten years older.

Obesity is defined as being at an unhealthy weight, but there are really not that many who would fall into this category in the United States as might be suggested. The majority of the population are above the healthy weight to height ratio. This is not the only thing you judge a person's health by, but it can be assumed that the excess body weight isn't muscle. And the majority of those who are overweight tend not to exercise as much as they should. Even if they were to consume more calories than they burn off, just doing three 30-minute sessions to exercise their cardiovascular system would greatly reduce the chance of heart disease. The whole point of the exercise is to push your heart beyond what it normally would be subjected to, strengthening it to handle expected and unexpected demands.

The whole thing with drugs is that they are no solution on their own. It all relates to lifestyle, which is a solution on its own. It's for that reason that I'm so adamant about drugs, as they can act as positive feedback to the obese. If they think they can be kept alive on drugs, they may be less willing to change their lives. That might not be so, but it would be far better to discourage such people from taking an easy solution.

 

You keep making that point, which everyone agrees with, and ignoring everything else. Your logic is foolish and would destroy millions of lives. Yes, long-term solutions are the best thing, but sometimes you need to implement short and medium term solutions too keep things from getting worse (or collapsing completely). Your concern about incentivizing people to be lazy is overblown and unrealistic. Think about applying that logic elsewhere:

• By the same rule, we should deny anti-biotics and anti-retrovirals to all people with sexually transmitted diseases, since helping them could "encourage them to be sexually irresponsible." The death toll from HIV alone would be easily in the tens of millions. Let alone the return of deaths from syphilis, etc


• No treatment for people who overdose on alcohol or drugs--even presribed drugs where they were following medical instructions--because helping them would encourage people to be irresponsible about using pharmacologically active substances.


• No treatment for people who suffer sports-related injuries, because that will encourage them to play recklessly/irresponsibly and get injured.


• No treatment for people who get any infectious illness, as they could avoid it by practicing better hygeine, and treating it will encourage people not to do so.


Etc

What you are advocating is not a plan for helping people. The things you are recommending would lead to dramatic increase in deaths. Therefore, it's little more than a window-dressed attempt to punish people. That's not morally or ethically supportable. Everyone agrees that more attention needs to be given to prevention. But you aren't a god to decide that someone deserves no second chance, or that they have no "right" to treatments which could help save their lives. As I said before, that's not what healthcare is about. At all.

 

That's very different. HIV is a disease often caught by people who were not aware the person they slept with was a carrier. The point of drug trials for HIV is to try and find a cure.
Obesity is not a disease, it comes from poor diet & lifestyle. Most people know what they do is bad for them but they still do it, if you don't know you'll get HIV it's hardly your fault.

If people overdosed then they weren't following instructions, because then they wouldn't take the wrong amount of pills. People who don't read labels are stupid, but they are being affected by a drug and should be treated. But if someone is desperate to overcome an illness they could be forgiven for going too far. Addicts should be treated.
Those who consume too much alcohol are idiots and deserve any jail time or accidents that befall them. They know exactly what will happen if they overdo it, but they do it anyway.

Most sport injuries are caused by other people participating in the game.

There is no cure for the Common Cold, and no matter what you do you can still get it.

 

I suppose the counter argument will be that such people knew the risks and are just as culpable as the obese. I'll admit that people who sleep around are more at risk of the disease. People who do that have options for safe sex. If they're not treated, they'll infect others... or have infected others and should be alerted to it.

The thing with addicts is that they often are more prone to crime and violence. That's why they should be treated. I agree with this.

And it's not an imminent kind of thing... you don't really intentionally get yourself injured unless you disregard what your coaches teach you. They do teach football players how to avoid getting injured.

The biggest issue I have with obesity is that it makes people more prone to a variety of ailments. It's when someone gets a disease that the obese are more prone to, then it's possible for a fairly healthy person to suddenly die of a heart attack. It's when someone needs health care and the disease may have been inevitable, or it might have had nothing to do with obesity. Statistics show that the obese are more prone to many illnesses... that's pretty much the bottom line.

 

No, obesity is NOT a choice. There are so many things that lead to obesity--not just poor diet. Some people do not have a thyroid gland that is working properly, so they gain weight.

It's so easy to say "Just cut calories and you'll lose weight." Well, that advice comes from observing a closed, mechanical system where if you cut the fuel, the machine slows down or stops.

A human being is a living organism with built-in metabolic responses.

For example, when a person goes on a calorie-cutting diet, guess what, their metabolism slows down to compensate for not getting enough calories. Yes, exercise helps, but if the person gets shin splints or a bad sprain, they're not going to be able to continue their exercise program, and the weight comes right back.

Not every one has access to a swimming pool or a gym, either.

And there are people who have gotten HIV or Hep C from a blood transfusion given years and years ago. Unless their doctor is aware of the blood transfusion, they might not be diagnosed for several years and may be sick without knowing it.

Did you know you can get Hep C from using an infected person's toothbrush or razor, even just ONCE?

 

That would be due to extraordinary circumstances. I would not object to a person getting treatment for something that is beyond their ability to control.