AMA declares obesity a disease

[kelpdiver 2]

Southern_Man

BMI is a great tool to assess populations. it is a lousy tool to assess individuals.

It's a simple tool that is more or less effective for a sedentary population, which happens to describe the vast majority of the country now.

Dave - and yes, they use BMI exclusively to make the determination. 27 = overweight (and catches most of the athletes), 30 - obese, 40 = morbidly obese.

[Skyrad 0]

kelpdiver

***
BMI is a great tool to assess populations. it is a lousy tool to assess individuals.

It's a simple tool that is more or less effective for a sedentary population, which happens to describe the vast majority of the country now.

Dave - and yes, they use BMI exclusively to make the determination. 27 = overweight (and catches most of the athletes), 30 - obese, 40 = morbidly obese.

You're right to a point but I would suggest that in a ethnically diverse nation such as the USA standard BMI classifications are not effective for all elements of even a sedentary population. For example Americans of Asian decent have a propensity for depositing adipose tissue in different parts of their body and primarily the abdomen. This has led the Indian medical association to reclassify downwards BMI for asians:

Below 18.4 - Underweight
18.5 - 22.9 - Normal
23 - 24.9 - Overweight
25> - Obese

As previously mentioned a far more effective diagnostic tool is BMI along with waist circumference.

When an author is too meticulous about his style, you may presume that his mind is frivolous and his content flimsy.
Lucius Annaeus Seneca

[skydiver604 0]

AggieDave wrote:
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Are they only using BMI as the indexing factor? My BMI is 39 (which is well within the "obesity" range) but I am far from obese when viewed from the aspect of bodyfat percentage and health.

Then again I like to "pick things up and put them down." (That's 545lbs, I pulled 560lbs after that).

BMI is a great tool to assess populations. it is a lousy tool to assess individuals.



The best gauge for an individual to gauge their level of obesity or lack of obesity is what you see in the mirror and how good you feel after light to moderate exertion.

If you stand in front of the mirror and see a spare tire where there shouldn't be one or you're huffing and puffing after climbing 2 or 3 flights of stairs and need to take a break it's time to re-evaluate your lifestyle.

"The greater danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it." - Michelangelo

[NWFlyer 2]

I clicked on this thread against my better judgment but I have to say it's pleasantly surprised me - usually any thread about this topic is filled with hateful "ew gross fatties" type of rhetoric. But this one's not so bad.

As someone who has always struggled (and probably will always struggle) with my weight, I'm actually pretty torn about this one, because I think that declaring it a disease will mean that we'll just continue to look for a medical fix (surgical, pharmaceutical, etc.) when I'm a believer that a big part of the increase in obesity (and a lot of other chronic disease) can be laid squarely at the hands of the food system.

I'm not a statistician (nor do I play one on TV), but I do know enough to know that correlation doesn't equal causation. However, it's really hard to ignore that as our food production system has become increasingly industrialized over recent decades, as fewer and fewer people know how to truly cook (as opposed to reheat or assemble), chronic disease and health conditions have spiked.

Our food costs a lot less overall - we spend way less on average on food than we used to even though we're eating much more, but we pay for it later. Even if you do avoid processed foods, the quality of the non-processed stuff has declined as well, unless you very carefully source your food.

My opinion (partly influenced by my sample size of one) is that all of this has contributed to a rise in the obesity rate in a number of ways.

1) The food we do eat (processed crap) is carefully designed and engineered to make us eat as much of it as possible (go read Salt Sugar Fat or The End of Overeating if you don't believe me). Or just bust open a bag of Oreos.

2) The food we eat messes up the hunger signals in our body. The lower the quality of the food we eat, the more our bodies say "Wait, wait, I still need nutrients. I need to eat MORE." I absolutely notice this with myself; if I eat a nutritionally-dense, home-prepared, whole foods based meal, I hit that satiety point a lot more quickly. More importantly, that meal will last me hours without getting hungry. Eat processed crap or empty calories (even if it's the same number of calories as the other meal) I'll want to eat more and/or I'll be hungry a lot faster.

At the same time, a whole "diet-industrial complex" has sprung up to help us "fix" the problem, which I actually think has made it worse (especially when you couple it with a trend towards extreme thinness in media images, especially of women). For one thing, it's convinced people who are a healthy weight that they can (and need to be) thinner. "Natural" body weights will vary quite a bit from person to person, yet we've created these "ideals" that people aspire to at the expense of their health, or we tell people they have to fit into a BMI range that may not make sense given their bone structure and muscle mass, rather than looking at multiple markers of health status, not just weight.

For another, said diet-industrial complex is largely influenced by the same food industry that has helped to create this problem. Don't believe me? Go look at the sponsor list for the Academy of Nutrition and Dietetics (formerly the American Dietetic Association). Big food and big pharma have a strong incentive to keep things the way they are or worse. Unfortunately a good portion of the medical establishment follows along with this advice as well.

There's other stuff that's contributing too - the shift to a largely car-oriented culture and less activity overall; I think that's part of it but probably a smaller contributing factor than the food system.

Me, I'm just doing my best to undo years of damage (from being 100 lbs more overweight than I am now), by doing high-intensity interval/strength training 4-5 mornings a week, walking regularly (I live in a pedestrian-friendly location and am able to walk to work and to do a lot of my daily errands, which makes it a lot easier to get that bonus movement because I accomplish other things in the process rather than having to schedule dedicated walk time), limiting alcohol, eating a pretty clean diet that has only whole or minimally processed foods, sourcing my food carefully (grass fed / pastured meats, organic/local/in-season produce), minimizing stress and getting good quality sleep.

Even doing all that, I still would like to lose weight, but weight loss is very slow because I believe that eating crap food for as long as I have, and yo-yo dieting for years did some irreparable damage to my underlying hormonal balance. Some of it shows up in tests (I'm hypothyroid, for example) and some of it doesn't, but it is what it is. I try my best to just focus on overall health, fitness, and nutrition and not to stress the weight as much, but that's hard sometimes. It's even harder when I know that there are people out there who look at the shape of my body and figure that I must be subsisting on a diet of KFC & pop tarts while driving the 2 blocks to the convenience store to get my pints of Ben & Jerry's. In their mind I must be lazy, eating too much, and just not trying hard enough.

It is what it is; I'm pretty strong, I move pretty well for someone with severely arthritic knees (see years of damage above), my other health markers (BP, cholesterol, blood sugars, etc.) are excellent, and my only medications are for the thyroid and for allergies.

I'm entirely positive, however, that calling my obesity a disease isn't going to make a damn bit of difference in my progress.

"There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." -P.J. O'Rourke