Seeking Fat Acceptance (Read 3394 times)

    Now people....I hope we aren't being a little elitest.

     

    It's easy to understand why civilisation is going the way it is. If we want to eat we go to the local supermarket or fast food outlet and consume anything and everything we want. Everything is there for us and we don't have to do a thing except part with a relatively small amount of money in exchange. Temptation is at every turn. Balance this with what we came from - having to run for a whole day with a spear in your hand to hunt for food - and it's easy to see where it all starts to go wrong. If Darwin were alive, he'd probably predict that we are destined to turn into big round blobs being serviced by machines.

     

    People are always going to take the easy option with everything in life and this will have varying consequences for different people. The human race was never designed for this type of existance and the planet is now struggling to cope with the way we consume every resource of any value. Fat people are just one of the by products of this. With the way we have constructed our world, I'm surprised there aren't more obese people.

     

    I guess that the difference between runners and the cavemen that we came from is that we carry ipods instead of spears and have a nice hot meal waiting for us when we get home. (I don't use an Ipod - I run on the road so need to listen out for cars)

     

    Mmmmmmm........bacon.

    GST



      LOL, too funny...


      Anyways, I'm not very patient with fat people, at all. To the point of having some problem with it. It's all about self control. It's hard to put the french fry down and pick up an apple, but good grief, it's not impossible. It's not that hard to go for a walk in the afternoon. From someone who has control issues and has overcome them, I KNOW fat people can overcome their fat obsession and become truly healthy. Just take a look in the "before and now" thread and tell me its impossible to lose weight!

       

      So this extreme reaction is partly what I was referring too...  Especially in the case over the overweight and not morbidly obese, someone "fat" can be physically active - moreso than just a walk even.... Also, you're assuming it's all binging on junk... Most people who gain weight don't gain mass amounts in a short period (unless there's something wrong) - they put on extra weight over a long time.  To gain 1 lb a month (12 extra lb a year... which is still pretty fast), it's less than 120 Calories a day over what you need to maintain your weight... That's a glass of milk, a banana, a can of soda... definitely not some gluttonous lack of control they have that the rest of us manage to restrain from.  This is where I agree there IS a bias.

      And let's not even get into all the disagreements on and lack of education on nutrition out there.

       

      I'm just saying this viewpoint is a little simplistic.


      Giant Flaming Dork

        It's not only strange to those from other countries.  Just spend some time in a place where most people are "normal" and it's shocking when you return to the US.  Flying from Shanghai to Chicago non-stop was a real eye opener - the difference is stark.


        It's so easy to get stuck where you are.  There's a lot of groupthink at work here.  Everybody is fat, therefore we should change the definition of normal.  The thing that gets me about this whole movement is that if there was a pill that would take them down to a normal weight, they would all take it.  

        http://xkcd.com/621/


        A Dance with Monkeys

          http://kateharding.net/bmi-illustrated/

           

           

          Yes. Joy is Obese.

           

          The (regurgitated) BMI rant (since BMI is [again] under attack):

           

          BMI is a simple calculation, height divided by weight squared using metric units.  The BMI categories are based on general statistica about the population at large (heh) and, as above, do not account for body fat percentage or musculature.  The BMI for somebody who is 5-10 and 145 lbs is 20.8, which is squarly in the "normal" range of 18.5-25.


          When most athletic folks complain about BMI, they are complaining because they are muscled and their muscle weighs a lot, giving them a calculated BMI category of "overweight" or "obese" when they are all-muscle.  These folks are misinterpreting the BMI, which is meant to serve as a screen for obesity.  A screening test is meant to find all cases of a disease, even though some of those it identifies may not have the disease.  Used as a screen, all people who are obese should be found by an elevated BMI, but some of those found with the elevated BMI will be football quarterbacks.  That is why there are follow up tests, such as whether the person looks fat, or the results of a body fat test.

          However, that is not how BMI is meant to be used.  BMI is a screening test to help identify folks with obesity, not a diagnostic test to calculate bodyfat.  Most 200 lb Americans are not Arnold Schwarzenegger and are not all-muscle.  That it happens not to be very accurate for a bunch of freaky runners does not mean the test is garbage.

          And also, how do YOU know your overweight body mass index is due to muscle and not fat?  Answer: unless you have had a body fat measurement, you don't.

          To be crystal clear: BMI is the number.  Not the word.  The number is always accurate.  The word is an interpretation that has to do with population-based statistics.  The word "overweight" does not mean "fat", but rather something along the lines of "more weight than average".  I am sorry if that word offends you because you beleive it implies "fat".  The fact of the matter is that most people whose BMI falls into the category of "overweight" do have excess fat, even athletes.  And they have a higher risk of dropping dead at an early age or developing diabetes or other conditions related to excess fat.  This is a fact, supported by science.  AND, many athletes who are overweight due to muscle today remain overweight as their muscle inexorably becomes fat as they age.  Also a fact.

          I am sorry if the word "overweight" offends you.  If your BMI can be categorized as overweight, you might have excess fat, no matter how badly you want to believe otherwise (or how much you believe yourself to be an "athlete", whatever that means).  If your BMI can be categorized as overweight, go get your body fat measured.  Targeted data is better and safer than denial.

          From the CDC, paid for with your tax dollars:

          How is BMI used?

          BMI is used as a screening tool to identify possible weight problems for adults. However, BMI is not a diagnostic tool. For example, a person may have a high BMI. However, to determine if excess weight is a health risk, a healthcare provider would need to perform further assessments. These assessments might include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.

          Folks need to stop judging it as if it were a diagnostic tool.

           

          Here is a corpus of literature from different investigators and different patient/subject populations from around the world. The studies all test different hypotheses. The studies show consistently that high BMI and low BMI are independent predictors of death and disease and that these predictors remain when controlled for confounders such as comorbidiites, level of exercise, smoking, socioeconomic status. Most of these are in JAMA.

          http://www.ncbi.nlm.nih.gov/pubmed/18056904

          http://www.ncbi.nlm.nih.gov/pubmed/16505525

          http://www.ncbi.nlm.nih.gov/pubmed/17986696

          http://www.ncbi.nlm.nih.gov/pubmed/16551713

          http://www.ncbi.nlm.nih.gov/pubmed/16478900

          http://www.ncbi.nlm.nih.gov/pubmed/15840860

          http://www.ncbi.nlm.nih.gov/pubmed/17670912

          http://www.ncbi.nlm.nih.gov/pubmed/15353531

           

          The science is fairly consistent and clear. BMI > 30 (note, not >25) is associated with excess morbidity and early mortality, as is BMI < 18. This makes sense. Most folks with BMI > 30 have excess fat. Most folks with BMI < 18 are malnourished.

          Note. I said "most". I did not say "all".

           

          In summary, given the current science we have, excess fat is an independent risk for excess morbidity, early mortality and excess cost to society (in terms of lost productivity and increased healthcare costs).

           

          ---

           

          And as long as I am dragging out old posts, here is some more regurgitated BMI rant:

          The BMI is a very useful number in terms of guiding policy and services and for following an individual patient who you have already identified to be unhealthy due to being both overweight and fat. BMI is much easier to follow than body fat, which can be hard to test.

          BMI is a screening test. Body fat measurements and the mirror test (i.e., look into the mirror while nekkid and be honest) are individualized tests that have much greater cost and time associated with them. Screening tests are supposed to have high sensitivity and poor specificity, and be very inexpensive to perform. BMI is perfect in this regard. Diagnostic tests, by contrast, are supposed to have excellent positive predictive value and cost/time considerations are less relevant. So BMI is a great place to start.

           

          Anybody who tries to use BMI as a definitive tool, ask them to define the difference between screening and diagnosis. Tell them that you are patient and happy to wait...

          When faced with YOUR BMI, as with your weight, you should not rush to be defensive (e.g., "that stuff is just rubbish, it does not apply to us athletes"). Rather, you should supplement that information with a measure of your body fat, blood pressure and lipids. If any of these are out of the normal range, you stand a chance at improving your health and life by reducing them.

           

          Julia1971


             

             

            Not sure what she was trying to prove with that, but by and large the BMI index shows a pretty good indication of the pics. People who are obese per their BMI looked obese in their pics with few exceptions.

             

            The BMI as a metric has been discussed at length on these boards. Any reasonable person will agree that it's a single measurement that can give some good insight into a persons body comp. No reasonable person thinks it's the ultimate tool and gives a total picture of overall health.

             

            No reasonable person would, but BMI is usually what is used to determine obesity by those who seek to discriminate against people because of their weight.

             

            Although, it looks like this baby in Denver was denied coverage because of his height/weight ratio: http://www.denverpost.com/ci_13530098

            Run the mile you are in.


            A Dance with Monkeys

               

              No reasonable person would, but BMI is usually what is used to determine obesity by those who seek to discriminate against people because of their weight.

               

              So fight the misuse of BMI, not the misperception of the numbers.  You are a researcher.  You should be able to educate people on the difference between screening and diagnosis.

                <q">

                 

                "When people say fatties are driving up the healthcare costs, I want to point out how arbitrary that is that they would single out that group and not the people who talk on their cellphones while driving, or who don't wear helmets or seat belts, or who drive too fast, or who are stressed out all the time. Where's the hue and cry about them?"

                 

                Um.... in many areas, talking on cellphones while driving, not wearing helmets or seatbelts, and driving too fast are all illegal behaviors. I think we're beyond hue and cry there, in actually condeming them as against the good of society.

                2013 Goal: Make 3:00:16 go away - FAIL.

                2014 Goal: Make 3:00:16 go away.


                A Dance with Monkeys


                  Although, it looks like this baby in Denver was denied coverage because of his height/weight ratio: http://www.denverpost.com/ci_13530098

                   

                  Examples of anecdotes of stupid mistakes (such as made by computers that are inadequately programmed) do not well support points.  Better to support points with data.  Note: the plural of anecdote is not data.

                  Julia1971


                     

                    So fight the misuse of BMI, not the misperception of the numbers.  You are a researcher.  You should be able to educate people on the difference between screening and diagnosis.

                     

                    I'm actually against discriminating against fat people no matter what measure is used.  (And, I don't think I'm the kind of researcher you think I am.)

                    Run the mile you are in.


                    A Dance with Monkeys

                      Define: discrimination

                       

                      And, who should pay for the increased medical costs accrued by anybody who incurs them?

                        Reminds me of "Shark Tank" last night.  There was a woman there trying looking for money to open a high-end fashion store catering to wome in sizes 12-32.

                         

                        I dont know man, I am all for people being happy with themselves, but this thing about not choosing what you weigh and being that heavy being healthy?  I just dont buy it.  I watch "The Biggest Loser" every week and the medical facts they throw out about these people that thoguht they were "healthy" at those heavier weights are astonishing.  And the fact that the people on that show that actually "do" the exercise and watch what they eat are dropping the weight pretty much proves that anyone could do it if they really wanted to.

                        Scout7


                        CPT Curmudgeon

                          Define: discrimination

                           

                          And, who should pay for the increased medical costs accrued by anybody who incurs them?

                           Well, that depends on the system in place.  If we go for a government-backed plan, then we all do, as a society.  If we go with our current method, then those who are members of their groups will have to pay for the increased risk.  Unless they are uninsured, then it goes to everyone again when they use the ER for their medical issues.

                           

                          Or something like that.

                             

                            Yes. Joy is Obese.

                             

                            The (regurgitated) BMI rant (since BMI is [again] under attack):

                             

                            BMI is a simple calculation, height divided by weight squared using metric units.  The BMI categories are based on general statistica about the population at large (heh) and, as above, do not account for body fat percentage or musculature.  The BMI for somebody who is 5-10 and 145 lbs is 20.8, which is squarly in the "normal" range of 18.5-25.


                            When most athletic folks complain about BMI, they are complaining because they are muscled and their muscle weighs a lot, giving them a calculated BMI category of "overweight" or "obese" when they are all-muscle.  These folks are misinterpreting the BMI, which is meant to serve as a screen for obesity.  A screening test is meant to find all cases of a disease, even though some of those it identifies may not have the disease.  Used as a screen, all people who are obese should be found by an elevated BMI, but some of those found with the elevated BMI will be football quarterbacks.  That is why there are follow up tests, such as whether the person looks fat, or the results of a body fat test.

                            However, that is not how BMI is meant to be used.  BMI is a screening test to help identify folks with obesity, not a diagnostic test to calculate bodyfat.  Most 200 lb Americans are not Arnold Schwarzenegger and are not all-muscle.  That it happens not to be very accurate for a bunch of freaky runners does not mean the test is garbage.

                            And also, how do YOU know your overweight body mass index is due to muscle and not fat?  Answer: unless you have had a body fat measurement, you don't.

                            To be crystal clear: BMI is the number.  Not the word.  The number is always accurate.  The word is an interpretation that has to do with population-based statistics.  The word "overweight" does not mean "fat", but rather something along the lines of "more weight than average".  I am sorry if that word offends you because you beleive it implies "fat".  The fact of the matter is that most people whose BMI falls into the category of "overweight" do have excess fat, even athletes.  And they have a higher risk of dropping dead at an early age or developing diabetes or other conditions related to excess fat.  This is a fact, supported by science.  AND, many athletes who are overweight due to muscle today remain overweight as their muscle inexorably becomes fat as they age.  Also a fact.

                            I am sorry if the word "overweight" offends you.  If your BMI can be categorized as overweight, you might have excess fat, no matter how badly you want to believe otherwise (or how much you believe yourself to be an "athlete", whatever that means).  If your BMI can be categorized as overweight, go get your body fat measured.  Targeted data is better and safer than denial.

                            From the CDC, paid for with your tax dollars:


                            Folks need to stop judging it as if it were a diagnostic tool.

                             

                            Here is a corpus of literature from different investigators and different patient/subject populations from around the world. The studies all test different hypotheses. The studies show consistently that high BMI and low BMI are independent predictors of death and disease and that these predictors remain when controlled for confounders such as comorbidiites, level of exercise, smoking, socioeconomic status. Most of these are in JAMA.

                            http://www.ncbi.nlm.nih.gov/pubmed/18056904

                            http://www.ncbi.nlm.nih.gov/pubmed/16505525

                            http://www.ncbi.nlm.nih.gov/pubmed/17986696

                            http://www.ncbi.nlm.nih.gov/pubmed/16551713

                            http://www.ncbi.nlm.nih.gov/pubmed/16478900

                            http://www.ncbi.nlm.nih.gov/pubmed/15840860

                            http://www.ncbi.nlm.nih.gov/pubmed/17670912

                            http://www.ncbi.nlm.nih.gov/pubmed/15353531

                             

                            The science is fairly consistent and clear. BMI > 30 (note, not >25) is associated with excess morbidity and early mortality, as is BMI < 18. This makes sense. Most folks with BMI > 30 have excess fat. Most folks with BMI < 18 are malnourished.

                            Note. I said "most". I did not say "all".

                             

                            In summary, given the current science we have, excess fat is an independent risk for excess morbidity, early mortality and excess cost to society (in terms of lost productivity and increased healthcare costs).

                             

                            ---

                             

                            And as long as I am dragging out old posts, here is some more regurgitated BMI rant:

                            The BMI is a very useful number in terms of guiding policy and services and for following an individual patient who you have already identified to be unhealthy due to being both overweight and fat. BMI is much easier to follow than body fat, which can be hard to test.

                            BMI is a screening test. Body fat measurements and the mirror test (i.e., look into the mirror while nekkid and be honest) are individualized tests that have much greater cost and time associated with them. Screening tests are supposed to have high sensitivity and poor specificity, and be very inexpensive to perform. BMI is perfect in this regard. Diagnostic tests, by contrast, are supposed to have excellent positive predictive value and cost/time considerations are less relevant. So BMI is a great place to start.

                             

                            Anybody who tries to use BMI as a definitive tool, ask them to define the difference between screening and diagnosis. Tell them that you are patient and happy to wait...

                            When faced with YOUR BMI, as with your weight, you should not rush to be defensive (e.g., "that stuff is just rubbish, it does not apply to us athletes"). Rather, you should supplement that information with a measure of your body fat, blood pressure and lipids. If any of these are out of the normal range, you stand a chance at improving your health and life by reducing them.

                             

                             

                            goodness Trent - just transpose this into a few powerpoint slides, and you have a lecture!

                            Julia1971


                              Define: discrimination

                               

                              And, who should pay for the increased medical costs accrued by anybody who incurs them?

                               

                              Discriminate: to make a distinction in favor of or against a person or thing on a categorical basis rather than according to actual merit.

                               

                              I don't think someone should be denied a job because they're fat.  And, I don't think someone should be denied insurance because they're fat.  If someone can't do the job because they're fat, then fine - don't give them the job.  If someone actually has diabetes, then fine - don't insure them or charge them more.  But, I don't like the idea of saying they don't get these things based solely on the fact that they're fat.

                               

                              And, I'm fine paying for it.  My taxes and insurance premium pay for a lot of things I don't use or condone.  But, clearly, other taxpayers and people with insurance disagree.

                               

                              Off to work.  Have a great day!

                              Run the mile you are in.


                              A Dance with Monkeys

                                 Well, that depends on the system in place.  If we go for a government-backed plan, then we all do, as a society.  If we go with our current method, then those who are members of their groups will have to pay for the increased risk.  Unless they are uninsured, then it goes to everyone again when they use the ER for their medical issues.

                                 

                                Or something like that.

                                 

                                Yep.

                                 

                                But the insurance plans are incented by the high costs of taking care of folks who cost more to shift their care out of the group.  Ultimately, the care goes uncovered and folks are effectively uninsured or underinsured.  And then we all pay.