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Thursday, August 5. 2021

Overweight

Is Obesity A Lack Of Will, A Poor Lifestyle Choice, Or A Disease?


I term being overweight (aka fat) simply as a physical condition regardless of how it came to be. Many people seem to be quite content with being heavy even though it is not fashionable or entirely functional.


When people I see want to lose weight, I offer simple nutritional advice. Once in a while, they take it. 


Posted by Dr. Joy Bliss in Medical at 16:28 | Comments (31) | Trackbacks (0)

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When I joined the Marines I weighed 146. Discharged at 157.
Recently I weighed 229.

Went on a diet. Now eat two meals a day; one small mid-morning and one more substantial mid-afternoon. A lot more exercise.

No wine. One or two small Dickel's with water after 9pm. Very few sweets.
Now 161. Aiming for 150.
#1 oolioo on 2021-08-05 16:36 (Reply)
Just curious, what's your sex, age, and height?
#1.1 RJP on 2021-08-05 17:48 (Reply)
Male. 84 and 6'0"
Also curious - why did you want to know?
#1.1.1 oolioo on 2021-08-06 11:21 (Reply)
Because if you were a young, 5' 4" female, 150 pounds might be a reasonable weight, but if you were a 20-something, 6' 4" male, 150 would be woefully underweight. Even at age 84, 150 seems to me to be seriously underweight for someone who's 6' 0". Why do you want to be so skinny as you get older? There's tons of evidence that as we age, carrying a bit more weight is useful and healthy. Gives you something in reserve in case you come down with the flu or take a fall and are bedridden, for example. But hey, your body, your choice.
#1.1.1.1 RJP on 2021-08-06 13:23 (Reply)
It males exercise easier. I can climb Kennesaw mountain in about 15 minutes vs 30 minutes.
Food tastes better. George Dickel, too.

But, thanks for your concern.
#1.1.1.1.1 oolioo on 2021-08-06 16:09 (Reply)
I am pretty firmly in the camp that body weight is a matter of sub-conscious and conscious choice. I've seen developing countries absorb the introduction of the fast food franchise, and its result over a couple of decades. I've lived long enough to see obesity become the 'near norm' in this country, with overweight conditions being seen as the 'new norm'.

But it's not normal, nor is it healthy. My wife is dieting successfully right now, and it's all about the elimination of treats and strict portion control - and it works, I'm really proud of her. I say that most people, me included, carry around about 10-30 lb of 'treats indulgence'. Life is good, and I enjoy my food and love to cook - but I could stand to lose about 15 lb.
#2 Aggie on 2021-08-05 17:07 (Reply)
...but in response to the story, I think it's a big mistake to allow obesity to become defined as a 'disease'. It's not a disease, any more than drug addiction is (although I understand some describe drug addiction similarly). But both conditions in the extreme will almost guarantee the inevitable development of disease.

Allowing self-induced conditions that are wholly under the control of the afflicted allows the afflicted the handy denial that they are responsible - which is what gets them into trouble in the first place. Having that denial to fall back on removes and essential component of the cure: taking control of one's actions.

It's very important that we should be sympathetic and supportive of people going through tough times or life conditions. But that doesn't include effectively pretending someone else force-fed you and you had no choice in the matter.
#2.1 Aggie on 2021-08-05 17:17 (Reply)
And you're dead wrong. For most of us it's a result of a combination of underlying conditions, NOT a choice or "because you're just lazy gluttons".

I can't for example lose weight except when I go on a dangerous starvation diet where I consume so little total that I am essentially on a few glasses of water and a handful of supplement pills a day only, permanently.
I tried, anything more than 400 grams total food intake and 1 liter of water per day and I'd not lose weight.
Try keeping that up for the rest of your life and your life doesn't last long.

I've talked about it with doctors many a time, and they don't know what to suggest either apart from stomach reduction surgery which would effectively make it impossible for me to eat, not because it would do anything to my metabolism but "because it forces you to eat less" (which isn't the problem in the first place).

And that's often the case. Whatever caused the obesity to start (often hidden medical problems, maybe in combination with a suboptimal diet and sudden reduction in the ability to do physical exercise), "just eat less" isn't the solution to it for most people who suffer from it, and medical professionals tend to be as lost to find what works as the patients themselves.
#2.1.1 JTW on 2021-08-06 22:00 (Reply)
Who are you quoting?
#2.1.1.1 Aggie on 2021-08-06 23:28 (Reply)
hmm, not fashionable to be fat? Turn your tv on or go out to a mall.
#3 LibDIs on 2021-08-05 17:21 (Reply)
Spot on. I’m always shocked when I come back to the US from Spain…..DAMN these folks are fat AF.
#3.1 DblTap on 2021-08-06 08:54 (Reply)
Obesity Rates by Country
#3.1.1 Zachriel on 2021-08-06 11:03 (Reply)
Be sure you don’t have an underlying problem. Following the diet recommended by my doctor and the nutritionist she referred me to, I got up to 295 and had almost constant stomach pain. After seeing an ad on TV for an IBS medication, I put myself on the low fodmap diet. Tests from my allergist helped find allergies to dairy, eggs and wheat. After eliminating those foods, I able to be fully satisfied on small low fodmap meals. I’ve lost nearly 50-pounds since the beginning of the year.
#4 Juan Paxety (Link) on 2021-08-05 17:43 (Reply)
A couple of years ago I watched Apollo 11 (movie). Apart from the fascinating story itself, I was struck by a couple of things. The thousands of people who came to watch the launch in person were dressed far more formally, on average, than you would see today - many in dresses and suits, or at least business attire. The other thing that was striking was how few people were substantially overweight.
#5 Cleveland Watson on 2021-08-05 19:11 (Reply)
When I was a child in the 1960's a Coke was a rare treat, in a seven-ounce bottle. Now people guzzle soda all day from liter bottles. Food then was at meal time, few snacks, now convenience stores, vending machines, fast food stores, mind-boggling abundance at supermarkets, people eat all the time, in bigger portions.

It doesn't have to be that way, and it seems discipline disappeared at the same time food abundance appeared. It is quite possible to learn in a matter of weeks to have a revulsion to highly processed foods in any quantity, and to excessive quantities of any sort of food. You just have to more strongly desire good health and reasonable weight than you do instant gratification.

In my sixties I weigh the same as I did when I was a slender twenty year old. Eight or nine pounds of excess weight is the signal to reduce portions and avoid simple carbohydrates and sugars until back at target weight.
#6 Rollie on 2021-08-05 20:04 (Reply)
I lost 50+ lbs this year after getting tired of being overweight.

I switched from fads (Keri, etc) to make healthy eating a habit and it worked. The top habits I cultivated:

1- weighed foods - portion control
2- no snacks, between meals, etc unless I earned it with exercise
3- included bulky foods at every meal, eg low calorie high volume foods like leafy green salads. Always included something
4- leaner cuts of meat (ham instead of bacon at breakfast)
5- cut down on the fats (mustard instead of mayo)
6- retrain the palate - Early on I starved myself (2 meals a day) so I was hungry but made sure I eat the foods I should be. Because I was starving, they were delicious (for once). When I went back to 3, it was easy to eat the right stuff
7- variety, I put together a 4-week rotating plan of great recipes

Once I got rolling, it was sustainable because it wasn’t a diet. I wasn’t hungry, I wasn’t sacrificing, and it was a habit.

Exercise played a very small role in things, but I did make sure I was active (light yardwork for watching TV, etc - thanks pro sports for making it easy to stop watching)

Eat for life, Fit for life.
#7 Alan Crowther on 2021-08-05 20:11 (Reply)
I am 40 pounds from my high 20 years ago when I gained 15 after surgery for cancer, I went up to 220 and I am not a big person but, then I was. At 185 I am about ten pounds above where I would like to be however working on part of one kidney, had some cancer there, my numbers are better than they have been in years. I try to do a mile every day, I do all of my yard work, mowing, edging and stuff on a decent size lot along with watering my roses and peppers. At 76 years old I feel better than I have in years.

I don't eat sweet stuff, I limit my carbs and eat two eggs and two slices of bacon every morning, I have a light no carb lunch veggies and a small bit of meat and then at supper time I grill rotating between skinless chicken, small portion of beef or pork chop or fish. We also do boiled fresh gulf caught shrimp on Fridays. We don't eat any fast food or processed stuff, we steam fresh veggies rotating between carrots, broccoli, cauliflower, asparagus, artichokes and at times new potatoes and that seems to work for us. My wife shops for fresh food at our HEB here in the Texas Hill Country a couple of times each week and by purchasing nice cuts of meat and good fresh vegetables I can cook a better meal each evening for less than ten or twelve dollars for the two of us than we could purchase for anywhere less than $50 than would taste better than ours.

I am old, retired and have nothing better to do than look up new recipes on the interweb. We also have nice cheeses and decent wine and a little bit of good scotch for the evening meals. Both of us over the half way point of our 70's are feeling better than ever and we are going to enjoy our lives as long as they last and then water happens is all all right.
#8 OldTexan on 2021-08-05 21:02 (Reply)
Living the life. Enjoy Sir.
#8.1 DblTap on 2021-08-06 09:18 (Reply)
Whenever you bring up weight, you comment section will overflow with people who tell you it's all just a decision and a matter of willpower. Mostly, these will be people who recently lost weight and are proud of it, and frankly think those other people are deficient in willpower in some way. They will tell you what the eating rules are, which they are sure work for everyone if they would just do it. As with education mental health, or a dozen other topics,people know a lot of stuff that isn't true and takes effort to talk them out of.

I am only interested in five-year followups, thanks, because the short-term numbers do not sustain. I say this as a person who has lost and sustained it over a few years (not yet five). It's not what you think.

For the actual neuroscience behind weight gain, weight loss, and obesity, I recommend The Hungry Brain, and know that the loss of significantly more than 10% of your body weight - 20%, just for fun - sustained for five years is rare. And there are reasons for that. I think Dr Bliss has touched on some this in the past.
#9 Assistant Village Idiot on 2021-08-05 22:27 (Reply)
Then why are “American Fat” people so rare outside of the US,UK and Pac Islands?
#9.1 DblTap on 2021-08-06 09:14 (Reply)
Hyperpalatable foods, which humans are programmed to eat, and have to control their environments not their willpower, to overcome. When people come to the West, especially America, from those places, they put on weight.

Food marketing here is very efficient, so we have high-reward - also high-calorie fat/carb/sugar foods easily available, requiring very little preparation. Once you hit a weight, your body "defends" that weight, regarding any loss as the beginnings of starvation. Our neurochemistry evolved to always regard weight loss as a bad thing.

It's not recommended to assume other people haven't thought of the obvious when discussing things with them.
#9.1.1 Assistant Village Idiot on 2021-08-06 10:48 (Reply)
Assistant Village Idiot: Hyperpalatable foods

Potato chips: salt, fat, and carbs. All the major food groups!
#9.1.1.1 Zachriel on 2021-08-06 11:23 (Reply)
Aw, common, Zach, you forgot sugar and alcohol ;-)
#9.1.1.1.1 Frances on 2021-08-07 00:49 (Reply)
C’mon man….you recommend “The Hungry Brain” and don’t expect mild kidding?
#9.1.1.2 DblTap on 2021-08-06 13:21 (Reply)
Sorry if I was harsh. I did, however, approach the issue seriously - hence the book. Is there something about its science that is faulty that I should know about? It wouldn't be the first time. He seemed solid on the research to me.
#9.1.1.2.1 Assistant Village Idiot on 2021-08-06 19:03 (Reply)
I think he really underplays culture. He’s a neuroscientist of course the answer will be somehow brain related. I spend 90% of my time in Spain, there is zero shortage of fast/junk food in Spain, but “American fat” people are literally a “daaamn” moment on the street. My office is in a very poor area the local stores are full of crap food, not a diet drink to be found, buuuuuut no fat people. Perhaps part of the issue is that if you are fat here people will shamelessly mock you for it. If I gain even slight weight colleagues and friends will, loudly and brutally, let me know.
#9.1.1.2.1.1 DblTap on 2021-08-07 05:52 (Reply)
At least for me, being overweight was due to addiction to sugars and carbs. Now that I live alone, those foods are not around to tempt me. As far as I can tell, the "obesity epidemic" is an issue of addiction.
#10 Igy on 2021-08-06 10:53 (Reply)
There's clearly a evolutionary purpose. The portion of the population that has the ability to store fat better than others will compete with more agile members of the population during times of plenty, but will have an advantage during times of want. Sexual selection can enhance the effect, as fat people are considered more worthy when food is a scarce resource. Selection will reach a dynamic equilibrium, which depends on the frequency and depth of famines.

That doesn't mean people are fated by their genes. Human intelligence and perseverance is quite remarkable. But the availability of high calorie food stuffs makes good decision-making more difficult. Developing countries are now experiencing the obesity epidemic.
#11 Zachriel on 2021-08-06 11:14 (Reply)
(Quaeso ignoscas per typos)
#11.1 Zachriel on 2021-08-06 11:28 (Reply)
I'm 6'2", 75 yr old male whose only exercise was light resistance training two times a week. I was getting ready to order 42 waist jeans & decided that I wasn't going to be that big.

So, I went low carb on 12-18-20 weighing 232 lbs. Today I weigh 185 lbs. and am not starving. I did NOT count one calorie only carbohydrates & for first 6 mos kept them in 20-25 grams per day range. Today I keep carbs
#12 Formerly Big Bob on 2021-08-06 22:58 (Reply)
Cut myself off... Anyway, today I keep carbs
#12.1 Fat Fingered Big Bob on 2021-08-06 23:04 (Reply)

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