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Overweight America
Image from the website of FOX's "More to Love" (fox.com/moretolove).

Image from the website of FOX's "More to Love" (fox.com/moretolove).

Americans are bigger than ever, by a long shot. Heavier. Fatter.

And maybe more culturally torn than ever over fat. A broad swath of the country has just accepted a heavier profile as the way it is. The way we are. In TV’s “More to Love” and plus-size model Glamour shots, heavy is fine.

But the backlash is fierce, too. Jessica Simpson pummeled for a few extra pounds. Fat disdain aplenty. And the health care debate highlighting the cost of obesity in health care budgets out of control.

This hour, On Point: Overweight America — accepted or rejected — and the cost of our pounds.

You can join the conversation. Tell us what you think — here on this page, on Twitter, and on Facebook.

Guests:

Joining us from New York is Kate Dailey, health and lifestyles editor for Newsweek and writer of Newsweek’s blog The Human Condition, where she’s been following the debate over American weight. She edited and wrote for Newsweek’s recent series “The Fat Wars.”

In our studio we’re joined by Lesley Kinzel. She runs the blog Fatshionista, “a heady mixture of social justice, fat-girl memoir, and popular culture.”  She has been engaging in fat activism and social justice politics for over a decade. When not blogging, she works in higher education in the Boston area.

And from Washington we’re joined by Kenneth E. Thorpe, executive director of Partnership to Fight Chronic Disease, executive director of the Emory Institute for Advanced Policy Solutions, and chairman of the department of health policy and management at Emory University’s Rollins School of Public Health. His Sept. 10 Newsweek commentary, “We Have the Power to Change Our Weight,” argues that obesity is a health and an economic crisis.

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  • Michael

    No more to love is not ok, being obese is not okay, not taking care of yourself is not okay and being heavily weight is not okay, your kids being 30% plus over weight is not okay,

    There is a difference when someone is exercising, or trying or keeping healthy and may be out of shape or a little over-weight its totally another when one doesn’t do either and nothing to keep themselves healthy who eats like a pig and expects people to think they are sexy or should be or people shouldn’t be disguised. Instead these people try to take a pill instead thinking it will solve bad eating and bad exercising or flaunt spandex or cloths lord knows noone wants to see .

    This reminds me of the movie wally where all the people are fat and could barely walk and used robots to do everything for them or idiocracy where everything is super sized.

    This is not cute or sexy

  • roger

    american “culture” can go to hell. that’s where it’s taking us anyway. there is no worthwhile “pro” argument on this topic. another wasted hour with tom ashbrook.

  • Cory

    I am overweight and would prefer not to be. For lots of reasons, I haven’t been able to get that done. I also work, go to school, and raise a family. I obey the laws, pay taxes, go to church, and work with the elderly. Please don’t tell me I’m a bad person because I have a “ring ding” at the end of the day. I’m sure the skinny guy down the street who judges or moralizes me for my gut has his own vices. Does he gamble, smoke, cheat on his wife or his taxes, or pick his nose? My vice is easy because you can see it. I’m not asking for sympathy either, I’d just prefer you mind your own damned business.

    I’m not here to be your whipping boy. Youv’e seen my personal vice… care to show me yours???

  • Folmkus

    Obesity has spread wildly in the past few decades in the US. I’m interested in knowing the cause of this, and what can be done about it, based scientifically and medically. We need to confront the issue, not dismiss it. I recommend the book “The End of Overeating” by David Kessler, who was on On Point a few months ago.

  • http://www.richardsnotes.org Richard

    Folmkus: The problem with David Kessler’s book and his interview on this show was that he blamed the food industry entirely for our addiction to salt, sugar, and fat. He did the same thing with tobacco companies. The problem with this view is that it takes the focus off of people attempting to take responsibility for and change their eating habits and lifestyles.

    I agree with Cory on this one: people like Kessler have turned smokers and folks who are overweight into victims. This is not the way to do social engineering.

    While I agree that obesity and smoking may drive up healthcare costs this is no reason to treat people who smoke or who are overweight the way we do. Americans can be an incredibly cruel people until we’re on the other side of a problem and unfortunately it takes being there for many people to get a clue.

  • Jim T in Boston

    I really hope someone mentions Gary Taubes’ “Good Calories, Bad Calories”. He completely exposes the alchemical nature of public health pronouncements concerning diet, illness and obesity. As a trained engineer, I was astounded by the power of “conventional wisdom” in determining dietary recommendations and policy.

    By the way, we are probably fat substantially because we eat too many carbohydrates. Read Taubes to find out why this is so. Unlike some, he cites his evidence.

  • Folmkus

    Don’t dismiss all of Kessler’s points just because you think he blames the food industry too much. He seems to understand we can’t solve this problem through regulation or government control. In fact all (or nearly all, I can’t think of an exception) of his tips and advice in the book focus on individual action. When looking for cause, he goes after the incredibly efficient food industry and our innate physiology. When looking for cures, he says it’s fundamentally a difficult personal journey of self control. This resonates with me since I am obese but have been taking steps to improve my diet and lifestyle over the past year.

    Sorry if this sounds like an ad for the book. I’ll listen to this show for an understanding of other viewpoints. I believe we do need a lot of dialogue about this sort of topic.

    Hypertension, heart disease, and diabetes run in both sides of my family. My father died from a heart attack at 40. The idea of someone telling me it’s OK to be obese like I am is horrifying, since it increases my risk with regard to those diseases.

  • BitterFan

    I notice from earlier comments that there seem to be a couple of assertions that are questionable.

    The first is that fitness is incompatible with overweight. This is certainly NOT true, since we all know heavy people who can run marathons or ride a bicycle 100 miles without undue effort. In other words, the notion of fat people being lazy or slovenly is clearly not a universal truth.

    The second is that the overweight are entitled to be overweight and should be left alone, thank you very much. Were there not public health costs associated with obesity, I would agree. However, the billions that will be spent treating totally preventable diseases such as type II diabetes that derive from overweight (or probably more likely, continuously elevated blood sugar levels) is a cost that will eventually show up in *my* insurance premiums. Thus, I lump this attitude in with that of smokers who feel they have no obligation to not burden our health care system with their eventual health problems, either. I don’t buy it, and I don’t care for it.

    Lastly, the insinuation that the obese are somehow weak-willed or lazy is not borne out in my experience. Many heavy people I know eat less than me, yet are fat (this includes relatives, whose eating habits I am very familiar with.) Does this make me somehow more “virtuous”? I think not. Nor does it imply that they are not, or that they lack willpower. Something else is going on, clearly, and blaming the “victim” is just plain lazy interpretation of the facts. For example, one disdainful comment basically dismissed heavy people with laughable generalities that would almost surely not be confirmed in the real world.

  • Brett

    I have always been thin with a high metabolism. I watch what I eat very carefully, too, because I have diabetes, but I also believe a good diet is healthy for many reasons. (Lots of whole grains–not all carbohydrates are created equal!!!, plenty of vegetables and some fruit, very little meat, care with fats and refined sugar, portion control, etc., are all part of a healthy diet.) That said, there are a lot of people who do not have a naturally fast metabolism or genetically are pre-dispositioned toward being overweight. I know people who are overweight who eat sensibly and get plenty of exercise; yet, unfortunately, they are viewed as being lazy, slovenly, lack impulse control, and so on.

    It is unfortunate that people who are overweight get treated differently than thin people. They often do not get ahead in the workplace as easily as people who are thin. In general, they often are not treated as respectfully as thin people.

    Obesity is a serious problem in the US. Culturally, eating junk/fast food are well promoted in the media. Portion size is distorted in the food products we buy. The choices we make are personal and private. Our health is our responsibility, however, but media and the corporate world also have some culpability.
    In our healthcare discussions, lifestyle has got to be part of that conversation. I believe there is a way to do that without people judging each other quickly and harshly.

    P.S.-I sometimes pick my nose when no one is looking! …I use a tissue, though!!!

  • http://www.somervillema.gov Tom C.

    Some of the most exciting work in reducing the incidence of childhood obesity is taking place right here in the Boston area. “Shape Up Somerville,” a partnership between Tufts University and the City of Somerville, has received national attention for its successful, community-wide effort to increase daily physical activity and healthy eating through programming, physical infrastructure improvements, and policy work. The campaign targets all segments of our community, including schools, city government, civic organizations, community groups, businesses, and other people who live, work, and play in Somerville. For more info, go here:
    http://www.somervillema.gov/Division.cfm?orgunit=SUS
    or here:
    http://nutrition.tufts.edu/1174562918285/Nutrition-Page-nl2w_1179115086248.html

  • http://www.richardsnotes.org Richard

    Folmkus: I agree with this statement:

    “When looking for cures, he says it’s fundamentally a difficult personal journey of self control.”

    I just didn’t hear him express it on onPoint where he sounded more like a professional victim to me.

    What triggers my anger is too much of “it’s all their fault” when some responsibility lies with individuals.

    No doubt some companies (food, tobacco, mortgage, etc.) are predatory and need regulation but individuals need regulation too and personally, I like it better when it comes from the individual.

  • Tim (Boston)

    By the numbers the overweight and obese have much greater health risks than those that are fit. The major issue is that not everyone that is overweight will necessarily cost more to the health system than someone that is fit. However, on the average those that are obese do cost more and probably would like to be healthier. So it makes sense to change the incentives whether through taxing health plans of those are that are overweight and/or taxing unhealthy foods. In many ways, American culture needs to re-define itself from the bigger is better to something more self-sustainable.

  • pw

    Though never really overweight, I’ve been fooling around for years trying to figure out what gets my weight down and keeps it that way. The answer is old and boring: exercise and eating well. When I got rid of my TV, my weight dropped. It made a huge difference in everything.

    Exercise is really important and is only a problem if you don’t make it a habit. Well, not so much a habit as a way of life. Not “go to a gym” exercise either, but simply moving more… and more and more! Walk, don’t ride.

    Eating till you’re no longer hungry rather than eating till you’re full makes a huge difference. Use smaller plates.

    When it comes to fixing good food and taking a walk rather than riding, don’t let lack of time become an excuse. (That’s where getting rid of TV helps even more — many people write off the 2-3 hrs a day TV as “normal.” Not.)

    Sum total? You get yourself back. You feel a whole lot better, are more fit, don’t drive up health care costs more than necessary. The self-respect factor goes up. Oh, and don’t go by the numbers. Everyone’s different: those charts about weight and calories are about some other species! Everyone reacts differently to carbs. I think people spend more time and effort on figuring out which is the best food for their pets than they do for themselves.

    In this country we feel “deprived” the moment we’re kept from going the limit. That’s gotta stop.

    Vices? Vice is nice!

  • http://www.theisogroup.com margret

    Americans have been mislead as to what is required to maintain their weight at a reasonable level. I am a 52 year old women of average height (5’4). According to standard tables, my calorie consumption should be between 1800-2000 cal.per day. The reality is that I expend only about 1300 calories per day, even when walking 2-4 miles per day. If I consumed the calories recommended by the FDA, I would accumulate about 500 calories per day… and certainly would be “overweight” by any standard in no time flat.

  • pw

    That’s it, Margret!

  • Todd

    Turning off the T.V. would be an excellent start to a weight-loss regime? Television has been scientifically linked to weight gain.

    Read “Remotely Controlled: How Television Is Damaging Our Lives,” by Dr. Aric Sigman.

    Excellent book, very digestible! ;)

  • http://witchchild.livejournal.com Soli

    Considering all the junk put in our food that our bodies cannot digest (soy, corn, sugar, HFSC, refined foods, synthetic sweeteners, etc.), is anyone really surprised about the health issues Americans have? At the same time, thin doesn’t mean someone is eating healthy, and BMI is junk science.

    Maybe if we stopped fearing food so much we wouldn’t have this problem.

  • aida sadr-kiani

    Dear Tom-
    I am infuriated that in your introduction to this segment just now, you mention the clothing size of the average woman in the US, but not of a man. So an average woman is a size 12, what about a man??? I found that offensive, degrading, and severely sexist. You are better than that.

  • Suzanne

    The issue is health/fitness rather than actual size. Obesity and poor health go together in many, many instances but not all. Much of this boils down to our food system (cheap high fructose corn syrup, fast food, etc.) and the increasing norm of a sedentary life, starting in early childhood. A huge conversation!

  • Suzanne

    Women’s clothing is now labeled differently than 20 years ago. I now get a size 6 or 8 pants, whereas years ago I was a 10 or even a 12 (without any weight change). So some of this “inflation” is a marketing tool to help women put their heads in the sand about their weight gain. I think this is especially true with high end clothing (although that’s mostly out of my experience).

  • Erin in Salt Lake City

    As an actress and a recovered bulimic, I have always been perplexed by the way our culture polarizes body weight. How fascinating that no woman bigger than a size 2 can be considered “thin,” but plus-size clothiers imply that only overweight customers are “real women.”

    The way our media tell it, there is no happy medium. No wonder, then, that a 150-pound viewer who can’t whittle down might become so disillusioned that she just gives up.

  • Clinton

    There is a difference being obese and finding your natural weight. Promoting the idea that being obese as hip and cool is frankly frightening. There are so many co-morbidities, heart disease, diabetes, cancer, etc… associated with being obese that cost us millions of dollars a year, and promoting acceptance of unhealthy lifestyles as O.K. is wrong. But, once again natural weight is not the same thing as being obese.

    Someone who is at their natural weight eats well, exercises, and is probably not going to look like a model, and that’s a good thing!

  • Walker Bell

    We need to stop the political correctness.
    Ever increasing obesity is the new smoking, and if we had the courage to call a spade a spade there are NO benefits to being radically overweight.

    This will be the next health care crisis and we who do the work to eat better and stay healthy are paying for all the disease and premature deaths of those who choose rationalization, couches and clickers, failing to take personal responsibility for sedentary a lifestyle, to much TV, too much corn subsidized artificially low high glycemic index ‘foods’.

    Lets start rationalizing health care according to the BMI index – all these rationalizations will melt away.

  • Gerald Fnord

    The issue is complicated, because two things are true at once:

    1.) Our culture _does_ have unreasonable expectations implicit in its body-image ideals: weight, dental condition, skin colour, facial features, and (now that pr0n is so common) genital appearance and size. This usually is worse for women, though every attempt is being made to make men feel similarly (speaking as an hairy-backed man possessed neither of a ‘six-pack’ nor a ten-inch…pianist). This isn’t necessarily all that toxic, given that beauty ideals fail to match reality in all cultures, everywhere, but it has become so because image-based propaganda is now more ubiquitous than ever before, and because most of us are so alienated from our work that we get little real sense of importance from it.

    2.) You can’t fight physics, or in this wise, bio-mechanics: the human spine and knee, hip, and ankle joints, somewhat kludgy to begin-with, cannot work as well and for as long with someone very overweight than otherwise. Biochemically, diabetes seems intimately tied to overweight beyond some limit. Reality is the stuff that won’t go away when you disbelieve in’t, and one reality is that evolution didn’t provide us with the mechanisms to deal well with excess fat because every time we were able to reach that state in the past, we rapidly grew our numbers until we were lucky to get _enough_ to eat.

    The existence of a fake problem does not preclude the existence of a real one.

  • Chris Kealey from Newburyport MA

    We are a lazy nation. We want the quick fix. We have more gyms, more marathons, fitness bootcamps, etc etc and yet we get fatter and fatter.

    Fitness takes hard work and dedication. I am 42 and can run a 4:40 mile. I can not tell you how hard you have to work to maintain a high level of fitness.

    People think if you live in a cave you can become a geologist. You have to do the work! There is no magic pill.

    Cheers

    Posted by Chris

  • Tom

    Can someone please speak to the toll on the environment that results from all the cheap food being consumed?

    Thank you.

  • Marilyn

    Obesity and Health Costs
    If only it was as simple as taking care of one’s self but, aside from self-inflicted illness, we have industrial pollution, uncontrolled use by food companies of saturated fats, sodium and corn syrup, heredity, accidents and crimes that might require health care. Not to mention advertising by food companies and fast food restaurants which lead us to crave more and the increased obesity and diabetes rate that is a side effect. We also have insurance companies that drop you as soon as you get any of hundreds of illnesses and pressure employers to lay off employees that cost more.

  • Hank

    This is such a tired subject.

    Fat isn’t beautiful. It’s unhealthy. And no one wants to be fat. That’s BS.

    We need to stop coddling people. Fatties need to get their acts together and get in shape. I’m tired of paying for their big bums.

    Eat less, exercise more. No more excuses.

    Hank

  • Kathy

    I think that this is a class issue as much as anything else.

  • Sara

    After listening to the first bit of the program Overweight America, I cannot help but point out that while Mr. Ashbrook and his guests use the terms ‘everybody’ and ‘we’ it is women that are the most affected by these ‘Fat Wars’. The overweight models are in Glamour, the examples used were about the fat female coworker. It would be interesting to see the percentage of the male population who obsess about their weight and body image as opposed to the percentage of the female population. Just a thought.

  • Shane

    Obesity and the sedentary lifestyle may also be attributable to the way we design our cities/neighborhoods. Many people, especially children do not have safe access to trails and parks, cannot walk to school, and must drive to soccer games. Healthier communities will provide more opportunities for active lifestyles.

  • Jill M.

    Yes I agree with the above commenter, please discuss the environmental impact.

  • Mark

    I was pushing 260 a year ago, even with 2 miles of walking a day, and just got sick of it. Switched to sugarless sodas (which finally taste good), lost 20 lbs in 2 months, gave up breads and potatos in may, lost 12 more.. I’m down to 225 and feel so damn good!

    I’m still technically obese, but given my height I’m supposed to be a 180lb pipsqueak.. forget that. I’m almost certainly type-2 diabetic (years of excess had consequences) but I’m feeling wonderful.. and the wife likes it too. ;-)

    btw Cory: I smoke like a train, it’s next on the list.

  • http://www.executivenomad.com Eric

    There are two prongs to this discussion: 1) There is no “perfect” body and we should be accepting of a range of body types and sizes. You look best in the body you are most comfortable with. 2) There are enormous costs to obesity and other conditions related to personal choices around diet and exercise. Diabetes, hypertension, heart disease, joint wear-and-tear — these and more are affected by weight.

    Healthier eating, more exercise, and probably a bit less work would serve us well in terms of health, weight, and health care costs.

  • JaneM

    The explosion of obesity cannot be explained simply by stating that people are lazy, eat poorly, and don’t exercise. We have to look at the food we eat, the drugs we take, and the chemicals in our environment. People are being given medications the moment there is the slightest anomaly in their “numbers” and these drugs can actually contribute to overweight and diabetes (e.g., blood pressure meds, antidepressants, etc.). Preaching exercise and low fat food is not the answer. In fact, we are starving for fats in our diet, and also the fact that our food may be less nutritious and full of corn means that we are starving for nutrients.

  • Dan

    This woman defending fat people is a delusional idiot. Fat people should not be made fun of but they should also take some responsibility. Everyone doesn’t have to be skinny but there is a big difference between being a “healthy” weight and being a walking actuarial nightmare.

  • Laura

    For those who believe those who are overweight are simply making bad choices, not only are they unsympathetic – they must have the fortune of being easily thin.

    I’m 32 – run 1/2 marathons and marathons am in my mid-thirties (I run 25 – 35 miles a week) – eat an organic low fat high protein diet and still manage to weigh 160lbs at 5’6 and wear a size 10… all because of a slow metabolism, thyroid issues…

    There is a huge division between those who are lucky enough to do exactly what we are supposed to to stay healthy and for that to keep them thin…and those who aren’t that lucky.

    Those who would think that people like me, by sight, are driving their insurance up need to check themselves… how presumptuous!

  • Beatriz

    I think what we are forgetting in this conversation is the fundamental issue: Class

    It is VERY expensive to eat well in America. Think about how expensive veggies, organic products, meat are.

    Who are the fat people in America? I think “obese” people tend to poor and people of color. Could it be because they have less access to health, healthy food, gyms, and recreational areas?

    We must be educate ourselves about the the multiple causes of “fatness.” We should also talk about what it “costs” (in all senses of the word) to be healthy.

  • Hendrik

    I can’t help but think about all of the references to normal to larger women in popular music. There aren’t a lot of songs idolizing Twiggy. Music videos today seem to idolize the “athletic with a little jiggle” look of hip-hop dancers.

    The following are humorous, but also show desire for a little meat on the bones.

    “I like big butts and I can not lie…” Sir Mix a Lot

    “The bigger the cushion, the sweeter the pushin’” Spinal Tap

    “Fat bottom girls make the rockin’ world go ’round” Queen

  • Vlad

    Can someone please discuss the use of Body Mass Index (BMI)? The use of BMI seems almost arbitrary. Based on the BMI most of the players in the NBA are obese. Worse yet, the insurance companies seem to use this number to increase premiums regardless of how healthy an individual might be.

  • Jamie

    Tom,

    Nina’s call really highlights the predjudice and absolutism (if that is a word) of the attitudes of people who have never struggled with weight. Not everyone who is overweight is sedentary or puts as she put it “crap” in their mouths. What if Nina carries the gene for breast cancer, should she be charged more for health insurance? What about older or high risk women who chose to bear children, should they be held accountable? Any heritable trait that may result in illness and the associated costs? Why not just hammer out a complete list of people who deserve health care and those who don’t based on their choices?

  • http://wbur.org Janis

    An issue not addressed today is the increasing number of obese people who fly commercially with only one seat purchased. I have seen quite a few passengers spilling over into surrounding seats. Ask the people who have had other people’s fat in their lap if this is a beautiful thing.

    While I think obsessing over the so-called perfect and unrealistic body is unhealthy, convincing yourself that being grossly overweight is OK is unfair to oneself as well as others. I believe the majority of those who say “Fat is beautiful” are lying to themselves.

  • L

    We need to work on becoming more active and eating more healthfully, and stop focusing so much on how much we weigh and what we look like. We need to work on being positive, and focus on what is helpful, on what works. Hating fat people, besides being mean, hypocritical and wrong, isn’t helpful. Hate, fear and negativity don’t work. We need to try to be healthy — in ALL ways.

  • Rebecca

    I have struggled with weight for most of my life. Restrictive dieting at 12, bulimia for 16 years, and a decade of therapy have led me to a place where I can now eat when I am hungry, stop when I have had enough, and exercise regularly.

    Obesity is a complex problem, and we most often overlook the emotional aspect of overeating. Without proper mental health support for this issue, it is almost impossible to overcome.

    Societal pressure and discrimination only served to hurt and anger me to point where I would resist weight loss in protest. I developed a more mature response when I realized that my children needed a healthy role model.

    For many people, this is a MENTAL health problem, and it cannot be solved without addressing that aspect.

  • cameron sark

    There is an alarming overlay of “benevolent” soft fascism attendant to this debate. My body does not belong to the state or federal government. My health costs them nothing. I write a check to the doctor when I visit. My employer, the commonwealth of Massachusetts, does not provide me health insurance and penalizes me on my income tax for not having it. As the sixties’ philosopher Lesley Gore said: “You don’t own me.”

  • Chris

    Cheap fuel and cheap transportation have helped create this epidemic. Long commutes, inexpensive electronics, etc etc.

  • Amy P

    I am surprised that no one is pointing fingers at the food industry. What is the relationship between high fructose corn syrup and obesity? What ingredients create appetite? How is food manipulated (such as increasing salt content or msg) to make it more addictive?

  • George Styer

    I object the use of your speaker’s accusation that the weight data is a “fact”. Recommended weight definitions have changed over the decades. So comparisons to these sliding definitions cannot be called factual, when it is clear that they are fabricated comparison numbers.

    Before 1980, or so, the government did not choose the correct weight for Americans. Tables were available from actuarial data from insurance companies. Insurance companies were the first to calculate the life expectancy differences. They used normal curve relationships; therefore one half the population was always above average and one half was below normal weight. Since the DHHS has controlled these recommended weight numbers the numbers of overweight have grown every time the numbers are adjusted. Note: Obesity is a percentage definition of recommended weight. So both the term overweight and obesity are recommended numbers from the government.

    I think we need acceptance the American are growing larger, taller, and heavier! People are different at birth, learn to accept that we are not all the same.

    gws

  • http://www.louisabertman.com Louisa Bertman

    NO ONES MENTIONED the fact the the food industry should be held accountable for allowing the public so much PROCESSED foods! kids are given corn syrup and partially hydrogenated oils constantly in schools. Yes, excersize helps — but seriously why don’t we tax the food industry for making and giving processed foods to the public — similar to the TOBACCO industry! Make them pay for the premiums — not the public. Obviously the obesity level has risen — if you look at all the processed foods in country now it’s no wonder there is so much obesity!

  • Sheesh

    The fat blogger is being disingenuous. I commend her for eating healthy foods, but if she ate fewer calories than she expended, she would lose weight. Period. Being 300 pounds is not “natural”. It’s not healthy. At all.

  • http://craftmother.blogspot.com/ Nakia

    Personally, I’d prefer to lift a fork once too often than to be too weak to lift one at all. The only times in my life when I was at a “normal” weight was when I was quite ill. The numbers on your scale don’t tell half of your health story.

  • John

    Has anyone wondered if part of the increase in obesity is the result of ingredients in processed food? I refer to transfats and hydrogenated oils and high fructose corn syrup. How about parents starting their youngsters on sweets at very early ages? Could it be that some obese people are obese as a result of self image rather than the other way around?

  • http://www.makingpeacewithfoodandyourbody.com Barbara Holtzman

    Good program. But I was disappointed that no one mentioned the relationship between how we handle food in this country and obesity – for example, that high fructose corn syrup (which is clearly linked to obesity) is subsidized while fruit and vegetables are not.

  • Jessa

    I am disturbed by how often this framed in terms of WEIGHT and LOOKS. What about “Healthy is Beautiful”? Being anorexic is not healthy and neither is obesity, period. The fact is, we don’t have an epidemic of anorexia in this country, we have an obesity epidemic.

    Weight and height correlations to health are simply not comparable as the guest just suggested. Throwing out such ridiculous red herrings is misleading. Many of this guest’s points are based on the most marginal science out there (like the pre-determined weight “study”). I can find marginal science that says being a smoker is pre-determined too. Please!

    The fact is that being obese is often correlated with chronic disease, period. Most of us know that people like the speaker who is healthy and obese are in the minority, period. If we help everyone figure out what it takes for everyone to be healthy and have a culture that supports that, the problem will diminish drastically. If our culture emphasized health over, say, making $100,000 a year by working 100 hours a week, we’d be in a better place.

  • Helen

    There is too much talk of whether being overweight or obese and whether it’s okay and not enough of what is causing it. As usual, Americans tend to see it as a personal issue and therefore open to personal attack.

    Are we really more gluttonous and lazy than we were pre-1980? That is hard to believe. The answer is what we are eating and how we are getting around – these things have changed.

    The person who mentioned Gary Taubes’ “Good Calories/ Bad Calories” is on the the right track, though I have a somewhat different take. (People ate carbs before the obesity epidemic.)

    All calories are *not* created equal. Some of the things we eat cause us to store more fat in more unhealthy ways (belly fat), and even to cause us to overeat.

    I think there are a few simple answers:

    1) Enormous amounts of added sugar and fructose in foods. See Robert H. Lustig, MD, UCSF Professor of Pediatrics, Endocrinology’s riveting video: http://www.youtube.com/watch?v=dBnniua6-oM

    2) A shift from the kinds of fats humans have historically eaten to industrial vegetable oils like corn and soy, which also cause abnormal weight gain (and a lot of other bad stuff). http://wholehealthsource.blogspot.com/2008/12/vegetable-oil-and-weight-gain.html

    3) Sprawl and the lack of safe, walkable communities, which create a car-oriented society in which people don’t use their own energy to get from here to there, and kids don’t play outside.

    The food and physical environment’s affects do disproportionately affect the poor because they have less access to healthy foods (more expensive, sometimes not even available where they live) and walkable communities. There’s also a connection between stress, lack of sleep, and insulin resistance and weight gain. Again, this is the American lifestyle. Rather than being lazy, maybe we are all working too much, and that’s why we’re fat.

    At the same time, there’s a difference between being concerned about overweight from a public health standpoint and the obsession with thinness that leads people to attack women who are, by Hollywood’s standards, plump (like Jessica Simpson or Brittany in her postpartum belly dance), but really just are normal, like the “plus-sized” models in Glamour.

    If fat people are less healthy, *some* of it may be due to actually carrying those pounds. Some of it, though, may be the exposure to the unhealthy diet of processed foods that most Americans, fat or thin, consume.

  • Aliyya Demartino

    I feel that the issue is not so much how much people weigh, but the lifestyle they are leading. It’s more important to eat a healthy dietsuch as lots of whole foods, lots of fruit and veggies, and limit the sugar, chemicals, food coloring and refined foods. It’s also really important to exercise regularly.

  • Mari

    The prime causes of “epidemic” American obesity?
    Easy: Cars, TV, fast food. Too many excuses to sit around passively consuming entertainment and too much availability of cheap, fattening junk foods.

    I recently heard (on NPR, no doubt) that New Yorkers are leaner than mid-westerners. The lower body fat of New Yorkers was attributed to the fact that they walk more than they drive. The reverse must be true in the mid-west and the suburbs where driving is mandatory for survival.

    Self-discipline regarding one’s food intake and education about basic human physiology are pivotal to maintaining a healthy body weight. Short of gastric surgery, this is the only proven way to keep the fat from accumulating, especially as we age.

  • Glenn

    Everyone eats until they are satisfied. Thin people don’t deny themselves the cheesecake that they crave. They just don’t crave it. So I’m not impressed with the holier-than-thou attitudes of those that are genetically and psychologically easily satisfied. The easy access to huge quantities of greasy, high-calorie food makes it virtually certain that those who crave more will get more, and obesity is bound to increase. “Being thin” is a distant goal at the end of a long road. But there are a thousand cravings to deny in order to get there, constantly chipping away at one’s resolve. It’s no wonder diets don’t work.

  • Edward

    I’ve got two points:
    1. I make no apology for my bias against fat people. This, in my mind compares to the stance I took in the 80′s and early 90′s against smokers in public places. People don’t remember now all the smoking in malls, restaurants and workplaces. When I would rant about my freedom to breathe clean air, people thought I was crazy–even some non-smokers! Now it’s fat people that are taking up too much space—in the row behind me in the movie theater, pressing against my seat, in elevators, on sidewalks. They should pay more to fly on airplanes; it’s only fair.

    2. Even though there’s no doubt we have an obesity problem in this country, we also have a problem with the standard height/weight charts, as an earlier poster mentioned. I’m physically fit and not all that muscular at 5′ 10″ and 185 lbs, yet I come up as overweight on these charts.

  • cindy

    The discussion just aired has missed the point. It’s not about the individual, it’s about our American culture as a whole today. Food is omnipresent and we’re told by marketers that it’s okay to eat all the time, anywhere (in office meetings, in class, at the mall, at the ball game, etc). If, like other cultures, we only ate at mealtime as a nation we’d shed inches off our waist line and pounds off our bodies. And if we insisted that food manufacturers disclose to us exactly what we’re eating (the same way the drug industry has to disclose side effects), we as a culture would be more aware, more outraged and would seek out and demand better quality foods.

    Have David Kessler on to talk about the ideas in his new book: “The End of Overeating: Taking Control of the Insatiable American Appetite”.

  • Susan

    To the 300 pound woman, you may “think” you’re doing everything right, but you are NOT! It is impossible. Come live w/ me for a week and you’d see. It’s all about habits and environment. You are not exercising properly AND/OR not eating properly. Do you weight train, in addition to aerobic exercise? And is the right kind and proper amount of aerobic exercise? Do you eat processed foods? Do you eat poison: aspartame and other artificial sweeteners, corn syrup, sugar, white flour, soy products other than fermented, non-organic foods full of pesticides and toxins, non-grass fed beef which is full of saturated fat, fish from China, farm-raised salmon instead of wild? I could go on and on. Basically, if you want to be sure you eat right, do not shop at a grocery store, period. Buy all of your raw, organic food at a local farmers market. Don’t eat out – ever – especially fast food. If you do all these things, the weight will come off. Here are some sources for you: books: Fast Food America, Nourishing Traditions, You: the Owner’s Manual, websites: mercola.com, BreadBeckers.com.

  • pw

    As so often in discussions like this, we break down into a “change yourself” group and a “force the villains (environmental and marketing villains) to change” group. I’m in the first category. Why? Had a look at Congress lately? Noticed how long it takes to force change on corporations? Ever noticed how fast your or my spending habits change the people who market crud? So yeah, fast food makes us fat so don’t buy it. Don’t wait decades until Congress does something.

    I’m with Edward (@12:02)on the smoking parallel. We knew from the early ’60′s about what it could do to us. Some quit. Many didn’t. Notice (too) how long it took to get Congress to clamp down.

    Don’t wait! Do it yourself!

  • Matthew

    One problem that doesn’t receive enough attention is the fact that the dimension of the weight debate that is centered on self-esteem, sexiness, image, etc. is rather misleading and even off-topic.

    You don’t see TV shows featuring legions of smokers reclaiming their sexiness; you don’t see drunks walking down Paris runways; you don’t see anybody lauded for taking a stance and asserting their happiness about their driving without a seatbelt and speeding. Yet why do we have to accept obesity and reclaim fatness as sexy? It’s simply not healthy and it costs EVERYBODY (fat people included) staggering amounts of money each year.

    One’s self-esteem and self-image should not come at the expense of one’s physical health. When are people going to wake up and realize that THIS IS ABOUT MUCH MUCH MORE THAN SELF-ESTEEM???? It’s no more ok to be fat than it is to be a drunk, or a chain smoker, or anybody else who participates in risky and unhealthy behavior at the expense of society.

  • Edward

    pw, I remember the first victory against the smokers. I was working for the Postal Service at a sorting facility, and there was a large break room full of vending machines and lots of tables that was the “smoking” break room, and a tiny, poorly lit, no vending machine room for non-smokers. Though I had complained for many months about the inequity, I know that it had nothing to do with me when they suddenly reversed the labels on the rooms (must’ve been a national directive), but everyone blamed me! Even other non-smokers were mad at me, because they missed their smoker friends, and the new smoking room was less well ventilated and, again, less well appointed.

    hey, I’m also communicating with a pw on a runners forum! you?

  • Heather Hills

    Cameron Sark
    You can’t be more wrong!!

    I have to admit that when I watched “more to love”, it was almost nauseating to see some of the women go on these “sob fits” every, well, ten minutes. And honestly, big majority of these women are not just overweight but sickly so. I really believe that they should be soo much more concerned about whether they will live for another ten or twenty years. but what’s funny was that at leat for those last 5 or so, most of their family members weren’t nearly as overweight as they were.

  • DD

    Being overweight is a complex condition not necessarily explained by a person’s weakness, inactivity, and gluttony. For example:

    I am 54 years old, 5’6”, and 220 pounds – obviously obese. I am a lifetime Weight Watcher’s member (currently in poor standing), which means that I reached my goal weight and maintained it a certain amount of time.

    I have been overweight or obese all my life, except for one brief, excruciating period when my whole life revolved around being 125 pounds. I liked being 125 pounds, but I did like having my entire life revolve around being that weight.

    Throughout my life, my body size has defined who I am. Even when I was 125 pounds, my weight was constantly on my mind – and not in a positive way.

    I am not lazy, stupid, or inactive. I hike and walk regularly, swim as often as I can, and once rode my bicycle 1200 miles.

    I probably know more about nutrition than my doctor.

    When I was at my lowest weight I became pregnant. After my child was born I developed hypothyroidism, which makes it more difficult to lose weight. So does menopause.

    A couple of years ago, I decided I was tired of having my life and self-image revolve around food and weight. I gave up Weight Watchers. Instead, I try to eat as well as possible (failing about as often as my thin friends do). I continue to walk, hike, and swim.

    I’m not thinner, but I am at peace. I no longer think of food every quiet moment of the day. I no longer eat a snack before I go to bed – just because I have “points” left over from my day’s allotment to spend. I try to eat when I’m hungry and stop when I’m not.

    In regard to the push back from overweight/obese people about the abuse we get for being fat, what many of us are saying is losing weight is harder for some than others. Don’t judge me because I’ve failed. It doesn’t mean I haven’t tried or that I’ve stopped trying.

    In my case, it’s just that I’m trying to find a balance that enables me to be a healthy weight and have some mental health too.

  • Bruno

    There is a deep and ugly Health Fascist sentiment out there.

    Being overweight is the result of heredity, environment, and individual effort, such that the forces that each of us faces can be very different. There are few, if any, weight reduction programs that work in the long run.

    It should be pointed out that overweight people might not in fact add to the cost of health care. I don’t think we know. When statistics were compiled for smokers vs. nonsmokers, it was found that smokers, over their shorter lifespans, cost the healthcare system less. I would not be surprised if a similar situation exists for overweight people. If this were true, would it mean that we should tax non-overweight citizens more? NO, OBVIOUSLY NOT. Better health and longer life is a positive goal, not necessarily minimization of health care costs in the spirit of “don’t get sick and if you do, die quickly”. Better, longer life for more people should be our primary goal as a society.

    We need better means of controlling weight. The NIH needs a kick in the pants to fund more innovative research in metabolism and metabolic disorders. We need to find out what works ASAP. In the meantime, we need to use carrots rather than sticks, and mandate preventative programs in our health insurance plans.

  • pw

    Right, Matthew! Might want to check and see who sponsors shows which promote fat=sexy or even fat=okay. Are their sponsors by any chance corporations one of whose divisions produces food? This isn’t about setting out to give people lung cancer or deliberately making people obese. It’s about profits overriding all other considerations.

    Which reminds me to counter the argument that good food is expensive. Nope. Been there, done that! Only if you “have to” have organic California lettuce in January following a severe drought or you shop at WF — and things like that — does “good” food become too expensive.

  • pw

    I have old knees, Edward. Walking, yes. Running? No more. So no, it’s not the same pw.

  • cameron sark

    Hi Heather,
    I don’t quite understand what you meant here. Never having been a woman, I feel unqualified to speak for them. As to size, I’m one of the little guys in the family.

  • pw

    Bruno, there’s a huge diff between overweight and obese. Obese is a health problem. Overweight is often the result of body type not fitting into procrustean NIH charts. I think it would be fair to up the premiums on someone who refuses to go from obese to overweight. They have a right to refuse; society has a right to refuse to pick up extra costs.

    I really like what DD said: “In my case, it’s just that I’m trying to find a balance that enables me to be a healthy weight and have some mental health too.”

  • Rachel

    Yeah…and hey, what’s up with all these bald guys now…? When I was a kid most people were thin and had hair…what’s next?

  • NWG

    Who would ever CHOOSE to be overweight? I have never met an overweight or obese person who chose to weigh what they weigh. I imagine that almost EVERYONE in this appearance obsessed culture would weigh less than they do. What they actually weigh is the best they can do.

    There are no successful weight loss treatments. The most successful treatments have a minuscule long term record.

    Nevertheless I have gone on countless diets, deprived myself of carbs, sugars, fats for years, exercised regularly and have had weight loss surgery. Still obese.

    I think that current science does not have a clue about how to treat obesity. Lay off those with the disease, and find an effective treatment. I’d love to work hard at something that worked long term!

    Great points by your guests Leslie and Kate.

  • DD

    Many obese people struggle to get their weight down. Many fail. (for whatever reason) Some say society should penalize them for failing.

    Fine. Let’s even out the playing field. Let’s also penalize people who choose to:

    – Drive like jerks and get into accidents

    – Not wear seat belts and get serious injuries in car accidents

    - Become roofers, farmers, fishermen, construction works, taxicab drivers, and so forth and expose themselves to serious injuries or death on the job

    - Get body piercings that get infected

    - Forgo proper dental hygiene, resulting in dental
    disease

    - Give birth to children and then fail nurture them properly through childhood – resulting in delinquency, mental illness, teenage pregnancy, etc.

    - Etc., etc., etc.

  • Brett

    pw has a good point. Yes, the food industry is corrupt; yes, the government is corrupt; yes, city planners are corrupt by being too fast to cater to individual developers needs who have money and do not create communities that promote “community” which includes the promotion of walking; yes, media is corrupting; yes, yes, yes, but it isn’t that difficult to alter one’s habits a bit. It is easy to forgo processed foods and replace them with whole foods. It’s not that difficult to increase aerobic activity to include more walking, and so on. I am amazed at how little many people participate in good food choice decisions. Even something as simple as instead of having a white potato have a sweet potato. Eat brown rice instead of white rice. Eat fresh vegetables instead of frozen or canned ones. Don’t use corn oils; don’t drink sodas as a staple; stay away from modified food starch, hydrogenated oils, saturated fats, high-fructose corn syrup, carbs that are really in the simple sugar category, and bleached anything! ETCETERA.

    Results from taking stock in our own habits may be different from person to person, with varying outcomes; and, as DD points out, not everyone who is considered overweight has a problem, but making good choices and having good habits can benefit everyone.

  • Ellen Dibble

    I’ve gone through this whole thread and don’t see anything about the deteriorating environment ruining the feedback loops that tell us what to eat and when. Don’t animals know enough to walk days to a salt lick, or even migrate for a certain plant? Here we have vitamin pills and — actually there are billions of dollars in profits going to tell people what to eat when their bodies no longer give accurate “readings.”
    How could a body be so defiled that it won’t tell you skip the white bread, skip the donuts? Such a body could very well be craving a proper diet, and since the proper diet is not on offer (at Starbucks or wherever), one just gobbles what’s there.
    How can a body give accurate readings? There are so many things that throw off all the signals. (I’m thinking of the statistics that tell us people don’t fall asleep “naturally” in many cases either.) It seems to me in a society with scarcer resources, there is more careful gearing to make sure what is necessary is provided. When we hear about how important certain spices are to good health, it does not surprise me that those spices are used in India to make that diet go further. If we really were starving we would not waste our lesser intake on lesser foods. Our bodies would be very precise about needs. Would a vitamin pill confuse such a body? Maybe.
    I think mothers used to be told that if left alone, a child would always go for the healthiest diet. Just make it available. This presupposed the child did not have undiagnosed allergies to most foods, which in my case I did. My poor mother. I remember a knock-down/drag-out battle over my eating the bun as well as the hotdog one sunny summer day at the roadside stand on Route 63. I was about 15. I now know I was allergic to the yeast in the bun; at the time I had no idea what was wrong. It took decades to get to that diagnosis — decades devastating to the relationship.
    The allergies were subsequent to antibiotics (they didn’t co-prescribe yogurt and acidophilus around 1950), and heavy metals to some extent. Immunities to proteins break down after a certain level of “insult.”
    My running hypothesis is therefore that though eating poorly can lead to derailing the healthy hunger feedback loop, the environmental stressors inside the body and around it go a long way to keeping our specific appetites dysfunctional.

  • Sam

    Loosing weight is no big deal (though I dont know about the Thyriod issue, so pardon me if anyone has that).

    I was balooning to be around 197 Lbs and was getting my Blood Sugar off the roof, then, in Feb 2008, I thought, enough is enough.. and got on to right eating and a very simple exercise:

    1. Eat around 1800 Cals/Day (roughly)
    2. Cut half of the portion of whatever meal I was getting (after checking the cals on the list)
    3. Substitute the half with Fruits (I dont like veggies a lot)
    4. Run 1 mile (yes, 1 mile only) on a treadmill everyday, thats about 15 mins ONLY!!
    5. Drink water, most of the times (when I get hunger cramps) and if its not satisfied, Plums are my best friends or any other fruits (except Grapes, Dates, and Nuts)

    Bingo!!

    I have been on my perfect weight since Aug 2008 and its constant ever since.

    Any comments?

  • DD

    Glad that worked for you.

  • Shannon

    NWG, I agree. No one I know that is overweight has chosen to be that way. But they also didn’t choose to limit their diet, get more exercise, or lose excess weight, either. It’s true that sometimes they have a harder time losing the weight due to genetics or thyroid issues, but as long as they are still exercising and eating healthy, they will feel better about themselves.

    I used to wait tables at a chain that (like all other restaurants) serves way too much food in one portion. People feel the need to eat every last bit on their plate. I promise you, this is not the case. Simply by reducing the portion sizes, and trying to swap certain unhealthy items for better, healthier items, you can help yourself lose weight.

    To Cory, one of the first posters here, there are simple things you can do to help yourself lose weight. I understand it’s tough with kids, school, and work. I’ve heard good things about the “raw food” diet, which requires you to eat a lot of raw fruits and vegetables. The benefit to this is that you get more nutrients and vitamins from your food, and your body will work harder to digest what you eat, thus burning more calories and losing weight. That’s something you can change without changing your schedule.

    To anyone overweight that isn’t trying to change that: stop blaming a busy schedule. Go without your tv for a week, and you’ll find all the time you need to exercise. Or if you really can’t live without your tv, buy an exercise bike (or treadmill or whatever) and park it in front of the tv. If you can’t afford to buy one, look on Craigslist. There’s plenty that aren’t being used there. Then, instead of sitting on the couch to watch TV, walk or bike. Again, no loss of TV viewing time, but added benefit of burning calories.

    Also, if you stop eating so much processed sugar, and start eating more natural sugars like those found in fruits, you stop craving so much processed sugar. Start drinking more water. It helps curb the appetite and prevents you from drinking fattening sodas.

    There’s so many things that people can do to change their condition, but they feel they are unable to do. There’s always a solution. Get creative.

    To those of you who are overweight but get regular exercise: Keep up the great work. You should be inspirations for everyone around you to get lots of exercise.

  • http://www.fatshionista.com Etana

    I have to respond to Susan in particular.

    Note that the discussion of health, weight and size is inherently a class and disability issue as much as a gender and race issue. Pointing out the “right” types of exercises and foods assumes that issues of body and body health aren’t coming in to place. There is no right diet or exercise program for any single one body.

    Taking the personal diatribe route, I am 240lbs and 5’5. I have fibromyalgia, rheumatoid arthritis and am blind. If I were to do the type of weight training you suggest I’d lost the use of my legs. Instead I do PT-approved strength exercises and no-impact cardiowork-outs on a stationary cycle. I also walk everywhere I go given that my guide dog isn’t allowed to drive a car. And while you have some very good points about foods, many of the foods you list would negatively impact my own chemical and food sensitivities.

    So when you prescribe your own “THIS WORKS BECAUSE IF YOU LIVED WITH ME YOU’D KNOW SO” routine, try going to med school first.

    Yes I’m fat. I’m also gorgeous. I’m also blind, disabled and paying taxes so that YOU can have the same access to health care that I do.

  • George Riveros

    I agreeg totally with Brett. I congratulate Tom for the program but it is essential to follow up in these topics. These tragedy is bigger. Started with the School of medicine, AMA are not telling the Truth abbout what we eat. Every can of soda pop contains average 10 tea spoons of white sugar (the worst) and also the amount of meat served by Junk food stores. When “Pres. Clinton called for a better meat inspection, the meat industry’s response, as reported in a newspaper clipping I saved, was instructive: “Plenty of people are calling for an increased inspection and microbial testing of meat and poultry before it goes to market” says Dr. Ruth Kava of the U.S. Department of Agriculture. “But such action would only add to the cost without promoting health. This is because no matter how much we spend, we cannot eliminate naturally ocurring pathogens [virus,bacteria, etc.] throug inspection. About 4% of meat contain E-coli bacteria. This hardy bacteria survives both refrigeration and freezing”. In my opinion People doesn’t want to listen The Truth. Remember the more sick people, the more more money doctors and drug companies make. There are plenty of warnings since ancient times, (the Bible contains many stories about the type of food we should eat.) This topic is very vast, I hope you can have again another program on diet and food (sooner than later)Tks. (Comments from a book I translated, if someone wants the book send me an E-mail)

  • Xavier Shelton

    Of all of the American neuroses, the one driving this thread seems to be best captured in the refrain of the theme song for the tv show Malcolm in the Middle. “You’re not the boss of me” may get the average person through adolescence, but not much more. I hate when my wife reminds me about my wheat allergy, I resent the effect bread has on me. But it gets me nowhere to stamp my foot and stuff my face with bread. I get a minute’s worth of false sense of independence and then the reaction begins. Maybe if you don’t have an instant allergic response, it becomes easier to rationalize “feeling good” or “feeling less” over eating healthy.

  • Jmars

    My BMI is over 50. I get up at 4:30 three mornings a week so that I can get to the gym before I go to my job (at which I earn a 6 figure income, thank you). I go once on the weekend, too, but not until 8am, so I don’t have to get up quite so early. And on the other 3 days, I exercise at home. I eat about 1000 calories a day fewer than “the laws of thermodynamics” tell me I must eat to maintain my current weight. So the next time you go to get all judgy about that fat lady, remember, she might have been at the gym while you were still tucked in bed this morning. And she was eating a bowl of organic multi-grain cereal (no sugar) and a hard-boiled egg for breakfast while you were downing that coffee roll from Dunkin Donuts.

    To answer Bruno’s question, yes, a study has found that a lifetime of care for a fat person costs less than a lifetime of care for a slim person because nothing adds to lifetime health costs as much as being OLD. No one is suggesting that we stop providing medical care to people over a certain age or that we start making seniors pay HIGHER costs for their doctors visits and medications last time I checked.

    From my perspective, it’s the media and not most fat acceptance folks who have made this about sexual attractiveness. I don’t give a rat’s butt whether someone thinks I’m attractive or not (other than my husband … who does). It’s when you decide that it’s OK to unfairly discriminate against people because of their weight — to deny them jobs, housing, etc. — that you’ve got a problem. And you’ll find that most people agree with you. Fat people demanding “acceptance” of society aren’t looking for dates. We just want to be sure that we’re offered the same opportunities as our equally-educated, thin compatriots.

    As for paying more for health insurance because I’m fat: fine.

    My husband and I don’t have kids. Our school tax rate should be reduced to reflect that fact.

    Statistically, I’ll be dead of fat before I’m old enough to collect Social Security or use Medicare. Reduce my “premiums” for those programs, and let the thin folks who will apparently live forever pick up more of the freight.

    Make just those two changes, and I can guarantee I’ll have enough left over to more than cover my higher health insurance premiums. Fair is fair, after all.

  • Brett

    ‘many of the foods you [Susan] list would negatively impact my own chemical and food sensitivities.’ by Etana

    Etana-
    So because you have food allergies you have to eat in restaurants? Processed foods? Aspartame? Other artificial sweeteners? Sugar? Corn syrup? White flour? Non-grass-fed beef? Fish from China? Farm-raised salmon instead of wild? I’m not sure what you mean about the foods Susan listed as ‘negatively impact[ing]‘ your ‘own chemical and food sensitivities.’ The foods she listed as bad are for all to avoid; what she listed as good were non-specific, simply a general description of organic. You are allergic to organic foods?

    Perhaps you didn’t like Susan’s tone, who knows, but her general ideas are good ones. And, although there is not one diet that is right for everyone, there are guidelines for what is considered a good diet for humans. She also was not specific in describing the weight training suggestion…so? I believe her general point was diversity of exercise and a move toward whole foods and away from processed/contaminated foods. Is there something in there that is worthy of righteous indignation?

    The crack about medical school is also unwarranted. One doesn’t have to be a doctor to know about good nutrition. In fact, doctors are generally behind the curve; they only have to take very few nutrition courses in medical school, and those are very basic!

    Susan’s advice was so general, I find it interesting that you would find such fault with it and have such a strong reaction.

  • Ellen Dibble

    Etana (above) said: “Note that the discussion of health, weight and size is inherently a class and disability issue as much as a gender and race issue.
    Pointing out the ‘right’ types of exercises and foods assumes that issues of body and body health aren’t coming in to place.”
    I am trying to connect that up to Susan’s post, and I’m thinking Etana, who talks about how her guide dog doesn’t drive (oh, funny), must have been using one of those computer readers, wouldn’t be able to scan the way I do. I see her remark as particular but general, to those who say “just do this.”
    As to weight as “a class and diability issue” “as much as gender and race,” maybe someone could expound on that. Just as race is an easy way to categorize and prejudge, so is excess flesh (or frown lines etc), and not only by personal cut-offs but by statutory discrimination. If I were in story-tellng mode I could tell a few tales about prejudging by shape.

  • Tammy

    Tom- Whats with the average woman is a size 12 comment, I don’t see how that is relevant. What’s the average waist size of a man?

    Also, why talk about how fat everyone is, why not get some health experts on here to talk about how people can lose weight.

  • William P

    The rationalizations go on and on – its OK to be huge; Its me and I love ME, etc., etc.

    Science says fat is bad. It is associated with high blood pressure, diabetes, and many other diseases. Read the science.

    These fatties are lazy and just want to keep stuffing themselves and tell themselves BS like “its glandular, its heridary” and a lot more. Get real and put down those Cheezo snacks. Get on the treadmill, eat non-fat foods like wonderful vegetable. Yes, I know you like your rationalizations.

    To get your attention we are going to triple your health insurance cost until you get off your drugs – FOOD. YOU are costing all of us. You and NOT big and beautiful – you are a blimp and need to change. And YOU can change if you really wanted to.

  • milla

    this was probably the worse show i’ve ever listened to on this program. listening to fat girls talk about how obesity figures are merely the result of changing the goal posts or saying we have a sedentary problem and not an obesity problem… these are all arguments where you do nothing but chase your tail.

    the problem is lifestyle. the female participants kept talking about diets not working. well, it’s not about diets dumb dumbs. it’s about changing your lifestyle. it’s about cooking real food as opposed to stuffing your face with oreo cookies and mcdonald’s which is probably exactly what these two guests do. lol!

    plus, anybody who says they exercise a ton, eat right is probably totally exaggerated what they do or don’t do. people usually overestimate the caloric burn of their workouts and underestimate their total caloric intake.

    a totally pathetic, rubbish-filled show. you need a do-over show with a better, more balanced perspective on health and obesity. two fats girls and a weak so-called expert does not a good show make. they needed to be talked down with facts and common sense.

  • Andy

    I have three points:

    1. Hey, chica who lost weight, come back and talk to me in FIVE YEARS and lets see how much of that weight you’ve kept off. I’m guessing you’ll be where you were before or possibly bigger, unless you spend all your waking time policing your temporary weight loss.

    2. I feel sorry for the people so threatened with folks coming to some appreciation for their bodies, rather than beating themselves up. I’m not exactly sure how beating yourself is supposed to enable those who wish to lose weight to do so.

    3. Isn’t Shaq considered obese. You think he’s lying about what he eats and how much he works out? Maybe his body is just that. Of course you could just accuse him of lying about all the doughnuts he’s really eating and see how many teeth you have left when you’re done.

    It’s always amusing people who haven’t had issues with weight make the assumption it’s because of their lifestyle when maybe they are just lucky. I wonder if these same people are remembering to wear sunscreen/stay out of tanning beds at the gym, wear condoms/practice safe sex, stop driving sans seat belt and lose the booze/cigs. Cause, like i don’t want to be paying for your skin cancerous leather face because you didn’t wear sunscreen or your std treatments because you don’t understand the concept of safe sex.

    Yeah, it’s a personal responsibility.

  • Dennis Sanner

    What we’re seeing are people who do not exercise as children and stay fat as adults. Agreed diets don’t work. Eat more intelligently, in moderation, and work out a little. Our bodies are made for movement.

    I travel overseas frequently. I can tell when I hit the States, just by the girth of the people shuffling and hobbling along the airport aisles.

    People who do not fit in a seat – for example on an airplane – should pay for two seats.

    I run, workout, etc. and weigh under 160. Why should I pay the same for luggage as a 300 pounder?

  • Ellen Dibble

    Nobody mentions that our bodies demand exercise the same way appetite demands food. Doesn’t anybody notice? I don’t mean the body demands an exercise bike. I mean there is such a thing as can’t sit still, can’t really sit (must slouch or perch; must slump or jiggle). Restless body syndrome. One cure is several hours of errands upon a bike, but for me the swift next step is I eat more in the next few hours than the next two days. For me, this is true whenever I’ve out and about (biking). Lots of exercise is always followed by the bottomless pit of hunger. I eat not one yogurt but all four (etc). When I was younger I ate the whole head of lettuce, with a whole pint of cottage cheese for sauce. The best way to control this is to drink lots of fluid all evening; I use decaf in water with dry skim milk and stevia. It takes a few days for my aging body to normalize again. Too much exercise would make me fat.
    But serious exercise is not an appetite suppressant. Quite the opposite.

  • Gary

    OK, fist I was a bad human being for being a smoker. Now I am a bad human being because I’m fat. To bad. Excuse me while I eat a burger and then smoke some cigarettes.

  • Jean

    Of course you opened the show by stating that the average dress size for a women is now a size 12 and failed to mention a man’s pant size. Marilyn Monroe was a size 12.
    I suffered from cushings disease for years before getting an accurate diagnosis. People should be careful about judgmental comments when they don’t know what people are coping with.

  • Moritz Weibel

    What “backlash” against overweight people??? If over 50% of our population is overweight, than more likely less than 50% of the population “backlash”. Fat is unhealthy and inefficient. I guess it’s great if you are about to be left somewhere without access to food for a long period of time, but in the USA you can’t go too far without finding a quick-mart or a McDonalds or free samples at CostCo. Our society puts much more emphasis on what we put ON our body (clothes, jewelry, make up, lotions, cars, shoes, accessories) than what we put IN our body. If no cheap food existed(fattening food is cheap because it has a long shelf life due to preservatives), then people would spend their money on healthful food and spend more energy affording it versus now when we spend our money & energy buying crap that we’ll be tired of in a year or two. Imagine if people were motivated to work harder because they needed to eat versus needing a new big screen TV. If I want a big screen TV, I can cut back on food cost by eating at McDonalds. If McDonalds & the like didn’t exist, I might grow a garden or take on a second job to afford good food. Oops, that would mean more activity that might mean a stronger heart, oops: that might mean fewer health problems and less health costs.

  • Carmen

    Obesity in children scares me. It will be very difficult for them to correct the fat cells later.. They are condemned to a shorter and more painful life.

    Someone coined the word ‘eatertainment’ which I find very descriptive. Fat or thin, our children are being raised with really bad food, I’m amazed at how little my daughter -in-law knows about how to eat; she doesn’t know how to cook and eats out at fast food places. I don’t want to be an interfering mother-in-law but I’m afraid for my grandchild. Also, my son started eating badly and is now so overweight I actually fear for him. At 36 he looks like a heart attack waiting to happen. He was raised on a healthy diet and plenty of exercise but he has slipped into bad habits too.

    I have not allowed TV in my life for 30 years. At first I missed watching but I knew I needed to make the sacrifice. Of course, pretty soon it was no longer a ‘sacrifice’. Many of my younger friends with children don’t have TVs either. Their children are significantly more active and well behaved.

    Throw the darn TV out the window! And toss the WI-Fi after it!

  • Daniel

    I just find it sad that here we are discussing about weight issues when there are many people in the world who are facing starvation on a daily basis. See National Geographic Magazine’s June 2009 article “The Global Food Crisis” (
    http://ngm.nationalgeographic.com/2009/06/cheap-food/bourne-text )

  • DD

    To those who have never struggled to maintain a healthy weight and those who have struggled and succeeded, I say, “Good for you.” Many of the suggestions and tips you have for losing weight are good. I will try some of them.

    Do any of you have problems or issues in your life that you struggle with? Do you ever vow to change a behavior and then fail? Ever make a New Year’s resolution and break it? No? Wow. It must be great to be perfect!

    I once got very thin and my outsides met society’s criteria for healthy. However, I was obsessed with staying thin and was still obsessed with food. My mental health suffered tremendously. Society couldn’t see the continuing internal struggle and the toll it took on me.

    My weight is ONLY PART of what I am working to change. My goal is to be a healthy weight AND have a healthy attitude and appropriate behaviors with regard to food and exercise.

    I refuse to be a pariah because struggle with my weight. I refuse to hate myself because I struggle with my weight. Society’s condemnation and my own is no help whatsoever in solving this problem. Trust me. Been there and done that.

  • Sam

    Just a thought,

    Reebok Shoes in India had launched a campaign/commercial over the billboards, around 2003 all it said was

    “I Live Life, I Workout”

    Isnt that true to some extent, atleast?

  • Folmkus

    To those who thought this show was terrible, there were some good points made if you chose to hear them.

    For someone struggling with too much weight, it’s better for them to have a positive outlook than to be

    depressed. A depressed person may give up on any hope of being able to improve their eating and exercise habits.

    A positive outlook doesn’t mean giving up on their weight, but I think it means being able to shift the focus to

    eating better and exercising, with weight as a secondary concern. Look toward incremental improvements, rather

    than hating who you are and how other people look at you.

    We do have an inactivity problem that overlaps with the obesity problem. If people could be encouraged to be

    more active, this would absolutely improve health, and also help most with weight loss (though it won’t make

    everyone equally thin). It would also help peoples’ self esteem.

    Nutrition is also important. Temporary diets fail, this should be well known by now, and was said during the

    program. It’s better to make sustainable changes that leave us satisfied.

    If you truly do exercise 3-4 times a week, and eat well, have good blood pressure and other diagnostic

    measurements, but are still obese (like one of the guests on the show), then that should be sufficient for her

    and for us all. But always be willing to improve, in ways that are sustainable and increase your happiness.

    Torturing yourself to try to lose weight is a bad idea and won’t work long term.

    I’m obese, but have been building incremental changes into my lifestyle over the past year which are paying off

    now. I’ve lost 40 lbs and have 30ish more to go — though I emphasize that I’m trying to keep weight loss a

    secondary goal. Primary goals are to eat better and be more active – which give me more energy and improve my

    self esteem – and also to do this long-term. I tell myself every day that most people who lose weight gain it

    back, and am making sure that I’m not over-exercising or over-dieting in a way that leaves me unsatisfied and

    which would lead to a lapse. A slow successful journey to better living is preferable to a shortcut that fails.

  • http://wbur.org Kathy

    I have been overweight (222 lbs, 5’8″). I lost weight on weight watchers and have kept it off (below goal at all times) since April 2002. No, this is not a ‘good for me’ or ‘in your face’ comment. It is to point out that it *is* possible to take off weight and keep it off. Sadly, most people are not successful at this effort.

    I monitor what I eat. I exercise daily. I slip up/indulge on occassion. As others have noted, it is a lifestyle, not a diet. I do not deprive myself. Nor do I eat to excess. To the body, food = fuel, just like to the car, gas = fuel. You need enough to keep it going but don’t overfill. And you cannot run it on empty.

    I do not walk the shoes of others though. I cannot judge others. There are people who try mightily to lose weight and cannot find sucess. Just as there are people who claim they do everything ‘right’ and are lying through their teeth.

    In an interview with Kessler in Nutrition Action, Kessler did reference some physiological aspects of why people eat that I found fascinating – parts of the brain that make heavier people, for simplicity reasons, act like pavlov, just continually reaching for food despite lack of hunger.

    I attribute the obesity to society’s recent attractions to things like McMansions, SUV’s an so on. The bigger the better. Those who could afford to live a large lifestyle did. Articles have been written that, with corporate lunches decreasing, folks have dropped many pounds.

    Add busy lifestyles, computer games & TV to the need for ‘quick’ and ‘convenient’.

    One other aspect, as some have reference, is the high fructose corn syrup. Huge. It is what is contributing to the bulging bellies of younger women.

    I do not agree that menopause slows metabolism. I’m in perimenopause currently. Hang me if you will, but IMHO, that’s another ‘excuse’ we use to justify poundage.

    In addition to looking at BMI, body composition is part & parcel. There are thinner people who’s body comp may play a part in overall health. This is never mentioned. My body fat % was 40% when I started. It’s now down in the low 20% range. (It’s thought that body fat, being less dense, gives cancer-causing free radicals, room to move in the body)

    I’m about to turn 45. My weight is in the mid 140′s. My vice is diet coke.

  • http://www.energystories.org Glenn Koenig

    I think there is very little advice that applies to “everybody.” The most exciting thing to me was breaking the ‘thin’ stereotype put forth by the fashion industry, simply because clothing “looks better” on thin models. It’s all for appreciation of the fabric, the design, etc. Finally, we’re talking about loving your body first! If anything, I think that’s the most important thing to do, regardless of diet, exercise, etc. Because if you accept your body and yourself as a good person, intrinsically, then taking good care of it is the next step. And taking good care of it starts with finding your body’s natural weight, whatever it is. And we all know there are many factors in that, but blame doesn’t do any good. Yes, the food industry has put profits at a higher priority than feeding us well. And many of us have taken the bait and bought their products. But emotions are also a huge part of this. Stress in life, from the economy, from home life & relationships, from the workplace, from the pace of life, from lack of access to nature, are all factors driving up stress (including anger, fear, grief, etc.). And many people use food for the only thing that’s handy to relieve that stress. But our society has such a tendency toward isolation among us, that many people never get support around what’s truly bothering them, so the cycle continues. Stress, more ‘recreational eating’ (eating for reasons other than basic nourishment), more weight gain, then even more stress.
    And, I’m completely left out of this discussion. I’m underweight. I end up not eating when I’m stressed and that makes my problem worse. I actually have to gain 5 pounds right now to reach my normal body weight. And yes, I’m male, so dress sizes don’t make much difference to me. And, yes, I’m attracted to ‘full figure’ women as much as thinner women. No, genuine obesity doesn’t appeal to me, but I wish to celebrate all women’s efforts to love their own bodies and feel loved in the world by everyone.

  • DD

    This show and discussion has been so enlightening (no pun intended).

    I had no idea there were so many perfect people out there. No wonder they’re so ticked off at us fat people. They’re the only ones doing everything right!

    I bet they have all the answers for people who struggle with alcoholism, depression, obsessive-compulsive disorders, anorexia, and losing socks in the wash.

    If only they ran the zoo…

  • http://www.pnart.com Peter Nelson

    Some fat people say they have a “slow metabolism”, but you can’t escape the laws of thermodynamics. Every calorie must be accounted for – It’s either converted into kinetic energy (movement), thermal energy (heat) or it’s stored as fat or glycogen.

    So anyone with a slow metabolism MUST move less or have a low body temperature – there’s no way to get around the numbers – physiology still has to follow the laws of physics.

    There ARE real medical conditions that cause a slow metabolism – thyroid deficiency is a good example. But people with these conditions are tired, have very little energy, and abnormally low body temperatures. (i.e., they produce less kinetic energy and less thermal energy) These conditions are serious and require medical treatment.

    But you CANNOT have a normal body temperature and normal (or high) levels of activity and have a “slow metabolism” because that would violate the laws of thermodynamics.

  • Jean

    This conversation is just bizarre. Leave America for a few days — to Europe, but even better, to South America or Africa — and you will see just how overweight Americans are. We won’t need a “realistic view” of what it is to be healthy. Fat people need to eat less and eat healthier food.

  • Amy

    The note from Glenn struck a chord with me. He mentioned being thin (in fact underweight) and, therefore, left out of the discussion. I am a thin woman (around 100 lbs.), but I am also just under five feet tall. I am not underweight, yet, because of “vanity sizing” in women’s clothing stores, I do not typically fit into adult clothing. What used to be labeled a size 4 is now labeled a size 0.

    A much more important issue is that I see/hear a similar kind of hatred directed at thin people. It has been said to my face, “No adult should weigh that little. Eat something,” and “Real women have weight on them.” When my mom was a teenager, people felt it appropriate to give her nicknames related to her being “skinny.” Why is it considered socially acceptable and even appropriate to comment about someone being thin?

    I really think that conversations about the need to lose OR gain weight should be conducted between a person and his or her medical professional. Issues with weight beyond those that are health-related really are irrelevant.

  • Cajun

    To the obese people who claim that everyone who is thin, who works out, who has a high metabolism and who you claim is “perfect,” and who say calls you lazy and fat and disgusting, and who you say judges you — you do the same thing to us. I work hard to stay healthy and enjoy working out, but cannot tell you how many times I’ve gotten a judgmental look or snide comments from an obese person. It is assumed I must be anorexic. That I have no life outside of a gym. That I can’t be passed a piece of cake because I’m not allowed to eat it. Judgment goes both ways so think before you tell us we’re the only ones judging when we “judge” you.

  • http://www.onpointradio.org/2009/10/overweight-america#comments Seasons

    I find it interesting to observe reactions to my yo-yo body weight. Some people look in amazement. “What happened!” has been said. Is it laziness, too much junk food, too much alcohol, thyroid or maybe depression?

    Actually, it’s none of the above. Very simply, after spending years exercising away an average of 600 calories/workout, 6 times/week, my body is full of chronic injuries; even after persistent re-adaption to the injury du jour. Trying so hard to maintain a healthy weight has made me unhealthy. A lot of time and energy went in to maintain my 160 female pounds.

    Do you think negative assumptions and comments are helpful as I try to adapt again? Running a marathon was easier than trying withstand the jury.

    Layers do not change the human being that lives within.

  • Rob L

    Stop talking and start walking. Seriously. When I’m at the airport, I can tell the departure city by how fat the passengers are. Anywhere in the South is the worst. Why? It’s too hot to go outside and walk, so people stay in the A.C. and eat.

  • http://n/a Andrea Kiener

    I do not think that our eating habits, psychology and life style have changed that dramatically since the late 80′s. I am wondering if changes in the formulation of food – genetic engineering in key grain crops, growth hormones in animal-based foods and corn-based micro-ingredients are making it easier for us to eat empty calories and put on and keep on weight. The impact of growth enhancements in animal food is especially intriguing.

  • Brett

    That is an interesting point, Andrea! And one that also could be part of today’s discussion of genetically engineered food from the show with Stewart Brand

  • Britta

    As someone who was brought up on fast food and babysat by T.V. it is really hard to change those habits as an adult.

    And it really, really doesn’t help with the 20 T.V.’s all over the gym with nothing but commercial after commercial of delicious fatening food, and people eating fatening food for every meal on every show, and that damn Food Network. It is driving me nuts!

  • Peter Nelson

    I am wondering if changes in the formulation of food – genetic engineering in key grain crops, growth hormones in animal-based foods and corn-based micro-ingredients are making it easier for us to eat empty calories and put on and keep on weight. The impact of growth enhancements in animal food is especially intriguing.

    But no matter WHAT they put in they still can’t get around basic chemistry and physics. Carbs are 4 kcal/g, lipids are 9, and you eat a certain amount. If you don’t turn them into movement or heat they get stored. Any drug that makes you gain or lose weight can ONLY do so within those parameters.

  • peter nelson

    And it really, really doesn’t help with the 20 T.V.’s all over the gym with nothing but commercial after commercial of delicious fatening food

    Since I don’t watch TV at home I find TV annoying and irritating in other environments. Luckily I’m nearsighted, so in the gym I just take off my glasses (so I can’t see the TV), put in my earbuds and listen to my iPod. I have no advertisements in my little sonic world.

  • Dan, Boston

    It’s difficult for me to listen to this broadcast/see this discussion when over 1 billion billion in our world are hungry:

    http://www.nytimes.com/2009/10/22/world/22food.html?_r=1&hp

  • folmkus

    Dan,

    Interestingly, obesity is becoming an issue in Africa too, sometimes in the same villages where malnutrition and being underweight are problems. Heard about it on the NPR a while back.

    Over 1 billion hungry in the world is bad news, but there’s a lot of good news. More women are getting educated, and a lot of people are being lifted out of poverty in developing nations. Aid and charity only go so far– education and opportunity for people seem to be the way to go to really defeat poor circumstance.

  • Richard Jay

    Overweight is not bad in the moral sense, but severe overweight ( obesity ) poses a huge risk for the affected person, imposes huge costs on our medical care system and impacts our family members as well.

    Some persons who are severely overweight primarily get this way because of continually eating too much and/or eating the wrong foods, e.g. high fat foods, high calorie foods, high sugar foods.

    Some other severely overweight persons do not overeat, but are genetically predisposed to be fat. This predisposition exists because of abnormal functioning of the endocrine system or an excessively large stomach and upper intestine ( the organs ), causing what is known as having a “bad metabolism”.

    Most severely overweight persons, however, live with both of the above conditions! They eat too much or the wrong foods, and they also are metabolically predisposed to put on fat. This is the worst of all worlds.

    Whatever the reason for one being fat, it is important to get professional help, early. Early in life, I think, physical changes occur in the size of our GI tract that progressively convert more of the food we intake into sugars that enter the bloodstream and also transfer more of the fats we ingest into the bloodstream. The consequences are not only weight gain, but the start of diabetes and circulatory disease.

    If one sees signs of abnormal weight gain, things can often be done that help minimize the process. Important actions are to do physical exercises that keep the size of the gut ( the “belly” ) small by keeping the supporting muscles tight. In women, after pregnancy, it is particularly important to regain muscle tone in the abdomen that is thought to be aided by breast nursing your baby. Another action that can be important is not to ingest too much liquid of any kind, especially if your belly is soft and saggy; the heavy weight of the liquid can stretch the GI tract and make it larger. For guys, the caution about excess liquid also applies, and this refers to all kinds of liquids: sodas, beer, juices, and even water. Drinking more than a little alcoholic beverage is a large contributor for guys and for gals. Note that if your muscle tone is good and you perform regular aerobic exercise, drinking lots of healthy fluids should pose no problem.

    The foregoing thoughts are the result of observations, not medical studies. Much still remains to be learned about all the causes of severe overweight. Even a lot of physicians I think are not well educated about the complexity of this disease, its prevention, and treatment.

  • peter nelson

    Early in life, I think, physical changes occur in the size of our GI tract that progressively convert more of the food we intake into sugars that enter the bloodstream and also transfer more of the fats we ingest into the bloodstream. The consequences are not only weight gain, but the start of diabetes and circulatory disease.

    Where did you learn your physiology? The foods you eat are what they are. If the food is a mono-, di-, or polysaccharide then it HAS to be absorbed as a sugar – what else would it be? And lipids are lipids – what else would they be? The size of your intestine has nothing to do with it. If you’re a healthy person and you eat 100g of a polysaccharide (i.e., starch) it will be broken down by amylase enzymes and you will absorb 100g of sugar in the form of monosaccharides. Likewise with fats – the fat you eat will become fatty acids in the bloodstream. Where else would the fat go? If it comes out ‘the other end’ the symptom is a very loose stool or watery diarrhea. The only people who DON’T absorb sugars and fats from the intestines have malabsorption syndrome, and they are very sick and need hospitalization before long.

    As I said earlier, metabolic disorders exist but they are serious illnesses requiring medical attention. It is not possible to eat the same calories as your thin neighbor AND maintain the same activity/temperature level and get fat, because that would violate the laws of thermodynamics – essentially doing the same amount of work (where work = expenditure of kinetic or thermal energy) on fewer calories. I say fewer because if you’re getting fat while your neighbor isn’t then you are left with a surplus to store.

  • Ellen Dibble

    Peter, I think malabsorption might be a bigger problem nationwide in terms of numbers affected than is documented.
    Food allergies, for example, cause malabsorption. As I understand it, the allergic gut lets toxic undigested radicals (sorry, I’m not a doctor) go into the bloodstream (think of skin with hives, raw and swollen), but along with that, the gut gets dysfunctional and needed nutrients pass right through. I have seen leaves of lettuce go right through, along with whole vitamin tablets. Sorry about that. But you can imagine. Asthma has gotten a lot of publicity, how it rages among the children where fumes abound. A choking child gets instant attention. But malabsorption requires testing to see what the nutritional status of the blood is, and the person may not be in the hospital, just not very healthy. People could be eating with that kind of problem, sugars get digested quickly and easily, but not more complex nutrients.
    As to the “size of the stomach” debate, I tend to agree with Richard Jay. He is citing the well-known “beer belly.” A person who drinks liquid to satiate the stomach rather than satisfy thirst is asking for a stretched stomach.

  • Richard Jay

    Sources of sugars entering the bloodstream come not only as ingested sugars, but as other carbohydrates that are converted in the GI tract into sugars.

    I suspect that some persons genetics and the flora and fauna in their GI tracts cause them to be much more effcient at converting carbohydrates into sugars and to be much better at transporting high molecular weight lipids ( some of them fats ) into the bloodstream.

    I know of active people who eat nearly the same diet, one eating less in quantity than the other, but the one who eats less puts on weight puts on weight, while the other adds no weight. If there is a source of information that comprehensively and clearly explains such differences to the layperson, I have yet to read it but would appreciate learning the citations in the medical literature.

    Perhaps we need some chemical engineers to study the problem of obesity as some of those engineers are experts in bioreactors and digestion of carbohydrates and fats. Nutritionists don’t seem to have produced the answer.

  • Brett

    The conversion of carbs into glucose for the bloodstream to carry said glucose through said bloodstream to enable the body to function (the brain, for example, will not function without glucose), is assisted by the pancreas (a gland) which secretes enzymes into the duodenum (small intestine) to turn carbs into glucose.
    The proper functioning of the pancreas in concert with all of the above systems and, as Richard Jay points out, a proper functioning GI tract with all of the good and bad fauna balanced to efficiently absorb (Ellen’s mention) nutrients, is key to metabolism and nutrient benefit.

    Many factors can affect these systems, e.g., type II diabetes (type I even more so, but insulin injections can compensate for a nonfunctioning pancreas); diverticulitis; a poorly functioning gall bladder (secretes bile into stomach to assist in digestion); a high-fat diet with too many inferior carbs and low fiber, undiagnosed food allergies, etc.

    Too many liquids can interfere with the optimum functioning of the aforementioned systems, although it would take a lot of water, say, to cause a problem. That said, there have been cases of people becoming ill and even dying from excessive ingestion of water.

    People who eat very rapidly often overeat before the brain gets the message that they are full causing the aforementioned systems to function improperly . Additionally, they bypass an important function of chewing small amounts and swallowing small amounts at a time. This is the first part of the digestive process. Also acids move farther up the upper GI tract with the habit of rapid eating which contribute to all kinds of problems, e.g., acid reflux, hiatal herniation, esophageal cancers, etc.

  • Ellen Dibble

    More on death by water (waterboarding aside). I think I know whereof I speak since there was a decade of chemical toxic exposures that caused in me allergies to all foods except green peppers and sweet potatoes, and anything else tested for: my body swelled to protect itself and even bled to try to excrete toxins. I drank so much water that the bottled water provider refused to haul any more up to the third floor. Mostly I drank tea with powdered skim milk (there was a soy product I put in during the decade I was allergic to milk, and the soy allergy wasn’t as bad), a drink that is still my comfort drink. I needed the caffeine badly. Blood pressure goes way down and temperature goes down in this situation. Also stomach acid isn’t secreted, leading to the nondigestion.
    Anyway, that much tea doesn’t make one fat, but it does what Brett suggests, causes jitteriness (from not enough substantial food, so the stomach seems to swell to make room for real food as well). A demitasse of coffee is better for the waistline and the digestion.
    Anyone who has health issues along with overweight (other than diabetes and circulatory) — headaches, depression, skin disorders — environmental issues could be causing in said person the leading edge of full-blown MCS (multiple chemical sensitivities). If you are not careful ASAP (by protecting yourself from fumes etc.), you could end up having to take extreme and costly measures to restore yourself, and I’m not talking about “just” weight, over or under.

  • Peter Nelson

    Sources of sugars entering the bloodstream come not only as ingested sugars, but as other carbohydrates that are converted in the GI tract into sugars.

    Yes, that’s why I mentioned polysaccharides. If you eat an unsalted plain cracker or some potato and chew on it long enough without swallowing it will start to taste sweet because amylase is release in saliva so it starts to get broken down right on the spot.

    I suspect that some persons genetics and the flora and fauna in their GI tracts cause them to be much more effcient at converting carbohydrates into sugars and to be much better at transporting high molecular weight lipids ( some of them fats ) into the bloodstream.

    You seem to be positing that thin people have some kind of malabsorption syndrome so they’re not getting access to the calories they’re ingesting and, instead, it’s all coming out the other end. Or to put it another way, we’re all naturally fat but the thin people are suffering some sort of digestive disease. It’s an interesting thesis but I’ve never heard anyone else suggest it.

  • Peter Nelson

    There are certainly cases where people have died from excessive water consumption (hyponatremia) but the mechanism is simple and well understood. The kidneys try to maintain electrolyte balance by excreting water to increase the concentration of the remaining ions. Unfortunately some ions are lost in this process. But as the water is lost the person feels thirsty and drinks more water. This sets up a vicious cycle in which the kidneys can’t keep up, so the ion balance gets so out of wack up that heart rhythm can’t be maintained and/or cerebral edema sets in.

    A few years ago I was doing a photo shoot in Tuscany (see http://www.pnArt.com) on a hot day in August. The photographers and models were well-supplied with cases of bottled water. But I was sweating bullets and feeling worse and worse. Every time I drank some water it went right through me and within minutes I would pee great quantities of clear (not amber) urine. Meanwhile I was getting a splitting headache and feeling weaker and weaker. Luckily it dawned on me what was happening and I went down to the kitchen in Castle Bibbiano where we were shooting and mixed myself several glasses of water with as much salt as I could stand without vomiting. Within 20 minutes I was completely back to normal and finished the shoot with no problems.

  • Ellen Dibble

    Peter is citing Brett, which is another angle than my experience, but I would say fat people would be the ones with malabsorption, and they eat and eat and still crave, because they are truly not getting the nutrients they need. Thin people would be the ones with very efficient digestive systems. Good food gets right where it’s needed. I mean, the alternative is to succumb to the feeling of perpetual hunger. (I am speaking from the perspective of allergies, probably IBS — irritable bowel syndrome, that set of dysfunctions.)

  • Ellen Dibble

    Peter, very interesting about electrolyte balance. (I’ll have to check that Tuscany site; lucky you.)
    I have thought my allergy-ridden body was trying to dissipate the toxins, swell my body to make the density of troublesome substances weaker per cubic centimeter. So I added water.
    Anyway, I always craved salt those years. And I’d get headaches which I cured (when possible) by taking potassium tablets. (Potassium is the opposite, balances salt, NA2 for salt, K1 for potassium.) I think my kidneys were fine, but — let me think about this.
    I still take potassium for headaches, which the specialists who treat MCS aren’t too keen on, worrying about me precipitating heart problems. Not a chance.

  • Ellen Dibble

    I think the headaches (those cured by potassium) are from cerebral edema, the aftermath thereof, edema from allergic swelling. Very similar to a classic hangover, I understand, where dehydration is at the root.

  • Peter Nelson

    but I would say fat people would be the ones with malabsorption, and they eat and eat and still crave, because they are truly not getting the nutrients they need.

    But you’ve gone off on a different angle now, because if what you say is true, then fat people really ARE eating more calories, to satisfy those cravings.

    What I and several other people here were discussing is different: the claim that some fat people make that they eat the same calories as their thin neighbors and maintain the same activity levels but gain weight anyway because of some metabolic problem. That’s what I’m skeptical about because the numbers don’t make sense. Calories are units of energy (1 cal = the amount of energy it takes to raise 1g of water 1 degree C, and a “food calorie” is a kcal = 1000 calories). And that energy has to be accounted for.

    The only ways a fat person could gain weight with the same caloric intake and same activity level as a thin person are:

    1. Have a much lower body temperature.
    –or–
    2. Be more efficient in that energy’s use – e.g., the fat person would have to be able to walk around the block consuming less energy that the thin person. Or if they both had a 2000 kcal diet the fat person would have to be able to do everything the thin one does on, say, 1700 kcal. If anything I’d expect the opposite since they have to lug around all that extra mass.

    Someone might be tempted to point out that there could be BMR differences, but that doesn’t help because BMR is expressed in either kj/kg or total heat production / m^2 and since fat people have more m^2 and more kg, their total energy consumption at rest tends to still be higher than thin people, even if their ratios are lower. See, for example: http://www.fao.org/DOCREP/MEETING/004/M2845E/M2845E05.gif

  • Ellen Dibble

    I am definitely going at a different angle. In terms of calories, you and I agree, and indeed the discussion that Tom led was about metabolism and calories. Thermodynamics, exactly, with certain esoteric exceptions that physicians understand but not me.
    I’m saying that hunger is not for calories (apparently, or we would not have obesity issues among humans), but hunger is about nutrients. A person could be eating thousands and thousands of calories and extracting the calories but not the nutrients. See what I’m saying? The capacity to get the sugar and the capacity to get the lipids into the bloodstream and into fat deposits remains undiminished, but the capacity to extract other things stops. So one continues to be hungry. So one continues to eat, not because one needs calories but because one needs enzymes (not present in processed foods) or vitamins (wasted by alcoholism or by the kind of digestive dysfunction I described), other things not yet identified. (Once upon a time businesses didn’t want to think clean air and water were important to offer; some day they’ll look back and say why didn’t we suspect, when we saw all those fat bodies, that the environment was compromising their absorption. I wonder.)
    They say the allergies started back in Egypt (probably back in the days or Arbi), when intestinal parasites were a problem, and the body learned to seize up and guard against such intestinal insults (the advent of the allergic response). I’m thinking the same response kicks in when the chemical environmental insults of this day and age assault us.
    The disruption I have in mind could be a precursor to diabetes in many people, more than precursor to allergic-type problems. I don’t think insurers want to evaluate — they won’t pay for some of the kind of testing (or treatment) that I have had to pursue. I mean, it’s an insurance nightmare, a nightmare for industry. I don’t blame fat Americans, that’s for sure. Many are probably victims, IMHO.

  • ruralcounsel

    Bottom line is this…

    People should be however they want (or can manage) to be. But then they need to accept the consequences of that choice.

    Healthy people should not have to subsidize the health insurance of unhealthy people, if the “unhealth” is due to controllable lifestyle choices. It doesn’t matter whether that is obesity, smoking, drinking, drug use, risky activities.

    That is the basic flaw of national health insurance reform…it’s designed to make the individualized costs of health care even less transparent or apparent to the individual consumer. It’s all about spreading the pain, not realizing the consequences.

    Our goals should be to make health care choices more informed, more transparent, more competitive. Not less.

  • Peter Nelson

    I’m saying that hunger is not for calories (apparently, or we would not have obesity issues among humans), but hunger is about nutrients.

    That’s certainly a factor and everyone should occasionally have a blood test to make sure their nutrients aren’t out of whack. My wife, who is active and a perfectly healthy weight, was shocked to discover recently that all of her vitamin and mineral levels were perfect except that her vitamin D was about 1/3 what it should be! Who woulda thunk it?

    Years ago I was involved in research at UMass studying appetitive behavior in rats. We would give them a diet that deliberately omitted some specific nutrient. Not only would they eat more, but if given a choice they were usually able to choose the food that had the missing nutrient.

    The first part might be the same with humans, although probably not the second part, else I would expect the average couch potato to suffer from cravings for salad 8-)

  • Peter Nelson

    That is the basic flaw of national health insurance reform…it’s designed to make the individualized costs of health care even less transparent or apparent to the individual consumer. It’s all about spreading the pain, not realizing the consequences.

    Our goals should be to make health care choices more informed, more transparent, more competitive. Not less.

    But what’s the alternative? As an AAAS member and general science geek I read the peer-reviewed literature regularly and, contrary to public perceptions, dietary and lifestyle choices have only a marginal effect on the risk of many specific diseases. Type II diabetes has a clear relationship to diet and exercise, but no one has been able to show conclusively that breast and prostate cancer do – small studies which suggested they might could not be replicated. Current evidence is that colon cancer risk can only be modified by about 30% with common lifestyle changes – earlier suggestions that dietary fiber might reduce colon cancer risk have not been borne out by later studies. Half of all heart disease happens to people with no specific serological risk factors. About 70% of hypertension is ideopathic. No one has shown any clear relationship between Alzheimers and diet or exercise although several current studies might alter that.

    Bottom line: despite the pronouncements of some popular “health gurus”, diseases like Type II diabetes or emphysemia are the exception rather than the rule. Get on to NIH/PubMed and do some literature surveys (i.e., look at a few hundred research papers for any given disease and not just 1 or 2), and you’ll see that for most major disease the best science suggests that you can modulate risk by somewhere between 0 and a few 10′s of percent. So how would you apply that to insurance or health-care costs?

    Part of the problem is that the general public has an abysmal grasp of science, and the press likes to grab dramatic stories. So if someone does a little study with 50 subjects that seems to show that a diet high in selenium reduces prostate cancer risk by 70% it makes the headlines. When larger studies with broader subject selection show no such result it doesn’t get reported because it’s not dramatic.

    I follow prostate cancer because my father died of it. There was a study some years ago that showed that elderly Harvard alums who did regular physical exercise had about half the risk of prostate cancer of everyone else. Everybody got excited about this, but subsequent studies with broader demographics have failed to reproduce such dramatic findings although they seem to show some benefit to exercise. But even that’s being called into question because people who exercise are different in OTHER ways from people who don’t. Epidemiological research is extremely hard to do reliably.

    The other flaw in your proposal is that it assumes that financial incentives are stronger than health incentives. In other words that someone is more likely to be motivated by having to pay a higher insurance premium, than by avoiding the fate of an early death from cancer after years of chemotherapy, surgery, and radiation!

    And so far we’re only talking about disease here – a huge part of healthcare cost is caused by trauma – car accidents, work accidents, sports injuries, home accidents, violence, etc. ( having an abusive spouse is a “preexisting condition” in many states ). If you wanted to individualize insurance costs how would you account for all these variables?

    I think we need to disabuse ourselves that capitalist, free-market behavior is the balm for health-care costs. For all of our regulations the US STILL has more competition and “free market” components than almost any other industrialized nation. So why do we pay 60% MORE than the “socialized” systems? (especially considering that we have shorter lifespans, higher infant mortality and less consumer satisfaction than many of those “socialized” systems?)

  • Richard Jay

    I hypothesize that a major cause of obesity is that ingesting excessive liquids stretches the diameter of the upper ( small ) intestine: this stretching considerably expands the interior surface area of the intestine thereby increasing the caloric transfer of nutrients into the blood stream. When the duration and extent of the stretching is very large, the stetching probably becomes permanent, evidencing itself as “pot belly” and making it very difficult to lose weight unless one attempts to follow a starvation diet.

    Ingesting too much water can severeley stretch the small intestine just like too much beer, diet soda, orange juice or milk, noting that high calorie or high fat fluids just means more nutrients will be up taken by the bloodstream. Also, solid foods, particularly high glycemic index foods like breads, in a stretched intestine containing a lot of fluid will much more completely be converted into simple sugars that subsequently transferred more efficiently, too.

    It is also possible many persons are born with small intestines that are large in relation to their intact (pre-obese) height and frame size. Just like some normal size people have large noses, feet, etc., why shouldn’t some people have abnormally small intestine size? A big sized small intestine could result in undesirably efficient transfer of nutrients due to greater intestine surface area, greater residence time of digesting foods, and better mixing of the contents.

    It would be interesting to have nutritional researchers and biological engineers study if the following hypothesis are correct:
    1. Excessive liquid intake positively correlates to obesity
    2. Excessive high calorie containing liquid intake coorelates very strongly to obesity.
    3. Small intestine dimensions ( lengths, diameters, and even more interestingly surface areas ) vary widely in pre-obese persons with the consequence that later in life those persons with larger surface areas are much more likely to become obese.
    4. Excessive intake of high calorie fluids in persons with larger-than-average small intestine size in relation to pre-obese body size, where the same persons perform minimal abdominal exercise ( allowing greater intestinal stretching ), are highly certain to become obese.

  • ruralcounsel

    Peter writes:
    “I think we need to disabuse ourselves that capitalist, free-market behavior is the balm for health-care costs. For all of our regulations the US STILL has more competition and “free market” components than almost any other industrialized nation. So why do we pay 60% MORE than the “socialized” systems? (especially considering that we have shorter lifespans, higher infant mortality and less consumer satisfaction than many of those “socialized” systems?)”

    The fundamental facts behind your statistics (e.g higher infant mortaility”) are that countries measure infant mortality differently. Life span, more a function of genetics and lifestyle than medical care. The US performs much better than you suggest. You need to do a little research so you can compare things properly.

    I never said free market was the “balm”, though that is a highly ambiguous term. I happen to think health care insurance should be prohibited, or at least not be tax-deductible to employers, and everyone carry their own costs. That would be the most fair. Pay for what you use. I don’t want you, the government, or anyone else, telling me what I spend my income on. We, as a nation, spend a lot on health care because we chose to. Health insurance (though insurance is surely a misnomer) has just proven itself to be another corrupting influence, which is now getting in bed with the government in order to assure itself of one last period of profitability.

    And yes, I think financial incentives, being immediate, are much more effective than health incentives. Too many health incentives (or disincentives) are delayed and diffuse. If people knew the immediate health impact of smoking, versus waiting for 30 years, no one would start.

    I think we need to disabuse ourselves of the notion that spreading costs across the entire population will ever change costs. It might change your price, but not the cost. And it puts society’s nose under the tent even further; once the state thinks it pays for something, it thinks it has the right to dictate everything around it. Even when it pays for it with your own money.

    Government reform threatens to destroy a very good medical care system and infrastructure and people’s freedom to contract for their own care, in order to socialize the cost. If it comes to pass, I think we’ll learn to regret that path.

  • Dan

    From Daniel Engbers article, “The Fat Premium” http://www.slate.com/id/2234003

    Yes, obesity is correlated with higher rates of cardiovascular disease, diabetes, and other ailments—but that doesn’t mean that everyone who’s fat is going to get sick. A 2008 study from the Archives of Internal Medicine found that a full one-third of all obese patients were “metabolically healthy” in terms of their blood pressure, cholesterol levels, and other measures. Meanwhile, one-fourth of the patients whose BMI was in the normal range showed abnormal metabolic signs. So a policy that varies its premiums as a function of body size is guaranteed to punish a bunch of people who are perfectly healthy and reward a bunch of people who are at risk.

  • loeb_cari@bentley.edu

    Hello. Exercise is such a productive tool to fight obesity. But for a lot of people, sticking to an exercise plan is a real challenge. I’m a graduate student doing research on exercise and motivation. Please take 5 minutes to give me some feedback on your gym habits. If you’re feeling especially generous, I am also looking for people to participate in focus groups on what motivates them to go to the gym. Please check out my survey and tell me what you think:

    https://www.surveymonkey.com/s/gymUsageStudy
    Thank you.

  • Annonymous

     I loose the most weight when I increase my water consumption.  Drinking water when I am hungry helps to avoid cravings.  I would estimate that I drink 3-4 liters of liquid per day.  The mater of fact about weight is your calorie balance (consumption versus exhaustion).  The biggest problem we have is that people don’t realize just how many calries they are consuming, or else they jsut don’t care.

    When I decided to loose weight, I used fitday.com to track every single item I ate for two weeks.  I think went back and looked at what I ate that made up the most calories.  With that, I stopped eating french fries (maybe allowed once a month), cut back on pizza (again maybe once a month), and switched as much as I can put up with from soda to water/tea/juice.

    After that, I didn’t need to track what I ate.  I just made sure I didn’t stuff myself and I stuck to those rules.  Without excercise I dropped from 280 to 250, and with excercise from 250 to 220.  220 is reasonable for my height.

    Also, if you are ever giving advice to an overweight person, DO NOT tell them to go exercise.  Most people that are significantly overweight have very limited excercise options.  For example jogging can hurt their knees or other joints.  In general it can just plain be uncomfortable which is a big demotivator.  It depends on the person, but odds are that for most people in bad shape, modifying diet as described above is the best way to get started (then they should push excercise when in better shape and more motivated by their past progress).

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