obesity

[yassie]

I was at the DMV and on several buses in Phila recently and it's so sad that there are so many obese people living here-why is that?

[Malloy]

Cheesesteaks.

[carloss]

The urban poor in the US have higher rates of obesity, poor people can't afford to move out of the city...and, oh yeah, we don't tax soda like we ought to.

[darthsinatra]

The urban poor in the US have higher rates of obesity, poor people can't afford to move out of the city...and, oh yeah, we don't tax soda like we ought to.

There is an argument too that poor people are less educated about food and nutrition generally, and lack understanding of calories and protein etc. They live in "food deserts" lacking in choice and healthy, unprocessed foods. I feel like Philadelphia is on the cutting-edge of implementing solutions to these problems, e.g. turning vacant lots into food co-ops.

Side note: in the 18th and 19th centuries, the poor were bone-thin and the rich were the "fat cats." Now more poor are fat and the rich have personal trainers and nutritionists. Ironic. Of course I am solidly middle class and solidly 20 lbs overweight

[Gladys]

also, purchasing healthy food is expensive. access is an issue.


but the reasons are much deeper than that as well as your own perception. you could have simply been around a lot of fat people. Finally fat people aren't necessarily unhealthy, some are some aren't, just like thin people. so it's not always a bad thing.

Health at Every Size

[BarryG]

The whole country is fat.

[borntochill]

Finally fat people aren't necessarily unhealthy, some are some aren't, just like thin people. so it's not always a bad thing.

No, not always, but obesity more often than not leads to health problems. Obesity is a leading cause of preventable chronic diseases including diabetes, heart disease, high blood pressure, metabolic synndrome, sleep apnea and reflux.

Obesity has become a public health crisis. According to the Philadelphia Department of Public Health, 64% of Phily's adults and 57% of its children 6-11-years-of-age are overweight or obese. Many already have or will develop obesity-related diseases and a significant number of ill, obese residents are uninsured and indigent meaning that their healthcare will ultimately be paid for by taxpayers. Treating preventable obesity-related illness already cost taxpayers billions, and these costs are expected to baloon.

[Gladys]

No, not always, but obesity more often than not leads to health problems. Obesity is a leading cause of preventable chronic diseases including diabetes, heart disease, high blood pressure, metabolic synndrome, sleep apnea and reflux.

Obesity has become a public health crisis. According to the Philadelphia Department of Public Health, 64% of Phily's adults and 57% of its children 6-11-years-of-age are overweight or obese. Many already have or will develop obesity-related diseases and a significant number of ill, obese residents are uninsured and indigent meaning that their healthcare will ultimately be paid for by taxpayers. Treating preventable obesity-related illness already cost taxpayers billions, and these costs are expected to baloon.

yeah - that's the witch hunt. i am a large and lovely lady who has always had low cholesterol, low blood pressure,my doc wants my blood. it's better than his. I don't have any sleep apnea and only have reflux when i am stupid enough to eat spicy food before bed time or have too much acidic food. Heck many of my thin friends deal with reflux there are people for which this is a health issue to be sure but the hype is overkill and just makes everything worse for most people. The bigotry and discrimination that accompanies being large is incredible, especially when you are growing up. This witch hunt just gives bullies justification for their actions. Which leads to many more forms of illness, psychological to be sure, which also lead to reliance on public health care.
http://www.haescommunity.org/

[Dayman]

One of the first things I've noticed about Philly after my trip to Italy is the amount of fat people.

[Gladys]

Above-normal weight alone does not necessarily increase short-term risk of death, U.S. data suggest


Science News
... from universities, journals, and other research organizations

Above-Normal Weight Alone Does Not Necessarily Increase Short-Term Risk of Death, U.S. Data Suggest

ScienceDaily (July 6, 2012) — "An evaluation of national data by UC Davis researchers has found that extra weight is not necessarily linked with a higher risk of death.

When compared to those with normal weight, people who were overweight or obese had no increased risk of death during a follow-up period of six years. People who were severely obese did have a higher risk, but only if they also had diabetes or hypertension.

The findings, which appear in the July-August issue of The Journal of American Board of Family Medicine, call into question previous studies -- using data collected when obesity was less common -- linking higher short-term mortality with any amount of extra weight.

"There is currently a widespread belief that any degree of overweight or obesity increases the risk of death, however our findings suggest this may not be the case," said Anthony Jerant, professor of family and community medicine and lead author of the study. "In the six-year timeframe of our evaluation, we found that only severe obesity was associated with an increased risk of death, due to co-occurring diabetes and hypertension."

Based on the study, Jerant recommends that doctors' conversations with patients who are overweight or obese, but not severely obese, focus on the known negative effects of these conditions on mental and physical functioning, rather than on an increased short-term risk of death.

By contrast, Jerant added that it is important for doctors to talk with severely obese patients who also have diabetes or hypertension about their increased short-term mortality risk and treatment, including weight loss.

"Our results do not mean that being overweight or obese is not a threat to individual or public health," said Jerant. "These conditions can have a significant impact on quality of life, and for this reason alone weight loss may be advisable."

In conducting the study, Jerant used nationwide data from 2000 to 2005 of nearly 51,000 adults aged 18 to 90 years who participated in the Medical Expenditure Panel Surveys on health-care utilization and costs. The surveys include information on health conditions such as diabetes and hypertension.

Body mass index (BMI), or weight adjusted for height, was calculated for each respondent. The study categorized people as underweight (BMI < 20), normal weight (BMI 20 to < 25), overweight (BMI 25 to < 30), obese (BMI 30 to 35) or severely obese (BMI > 35).

Mortality was assessed using the National Death Index. Of the 50,994 people included in the UC Davis analysis, just over 3 percent (1,683) died during the six years of follow-up.

The investigators found that severely obese people were 1.26 times more likely to die during follow-up than people in the normal weight group. However, if people with diabetes or hypertension were eliminated from the data, those who were overweight, obese or even severely obese had similar or even lower death rates than people of normal weight. Consistent with a number of prior studies, underweight people were nearly twice as likely to die than people with normal weight, regardless of whether diabetes or hypertension was present.

The prevalence of overweight and obesity has increased dramatically in recent decades. An estimated one-third of all U.S. adults over age 20 are obese and another one-third are overweight. In addition to diabetes and hypertension, health problems associated with these conditions include heart disease, osteoarthritis and sleep apnea.

The relationship between weight and mortality is a controversial topic in public health. Although studies based on data collected 30 years ago showed that mortality risk rose as weight increased, analyses of more recently collected data, including the current one, call this assumption into question."

[borntochill]

yeah - that's the witch hunt. i am a large and lovely lady who has always had low cholesterol, low blood pressure,my doc wants my blood. it's better than his. I don't have any sleep apnea and only have reflux when i am stupid enough to eat spicy food before bed time or have too much acidic food. Heck many of my thin friends deal with reflux there are people for which this is a health issue to be sure but the hype is overkill and just makes everything worse for most people. The bigotry and discrimination that accompanies being large is incredible, especially when you are growing up. This witch hunt just gives bullies justification for their actions. Which leads to many more forms of illness, psychological to be sure, which also lead to reliance on public health care.
Health at Every Size

Gladys, congratulations on your excellent health. I have no doubt you are a very, very lovely woman.

However, I disagree with you that there's a "witch hunt" on regarding obesity. Using your own experience to generalize about obesity and chronic disease is like the guy who says that smoking is perfectly healthy because he had an uncle with a 2 pack a day habit who lived to be 95. The exception doesn't change the epidemiology. And the epidemiology is clear. Just as smoking greatly increases the likelihood of a person getting lung cancer or emphysema, obesity greatly increases one's risk of becoming insulin resistant, developing heart disease, high blood pressure, sleep apnea and/or several other chronic health conditions. Far more clinically obese individuals become seriously ill than those with a normal BMI. Average health care expenditures are much higher for obese people. In 2006, average U.S. health care expenditure for people who were obese was $5,148, compared to $3,636 for those who were overweight and $3,315 for people who were normal weight:

Trends in Health Care Expenditures by Body Mass Index (BMI)

Above-normal weight alone does not necessarily increase short-term risk of death, U.S. data suggest

I made no remarks about the relationship between obesity and death rates, only on the comorbidity of obesity and chronic disease, and the concomitant health care expenditures due to that comorbidity. On that, the data is unequivocal.

[Gladys]

Gladys, congratulations on your excellent health. I have no doubt you are a very, very lovely woman.

However, I disagree with you that there's a "witch hunt" on regarding obesity. Using your own experience to generalize about obesity and chronic disease is like the guy who says that smoking is perfectly healthy because he had an uncle with a 2 pack a day habit who lived to be 95. The exception doesn't change the epidemiology. And the epidemiology is clear. Just as smoking greatly increases the likelihood of a person getting lung cancer or emphysema, obesity greatly increases one's risk of becoming insulin resistant, developing heart disease, high blood pressure, sleep apnea and/or several other chronic health conditions. Far more clinically obese individuals become seriously ill than those with a normal BMI. Average health care expenditures are much higher for obese people. In 2006, average U.S. health care expenditure for people who were obese was $5,148, compared to $3,636 for those who were overweight and $3,315 for people who were normal weight:

Trends in Health Care Expenditures by Body Mass Index (BMI)

I made no remarks about the relationship between obesity and death rates, only on the comorbidity of obesity and chronic disease, and the concomitant health care expenditures due to that comorbidity. On that, the data is unequivocal.

It depends on who's study you are reading. eating well and exercise is really key to great health, the rest is genetics. but that's my opinion.

again i refer you to this site for more info about studies with different results.

Health at Every Size

and thank you.

[RittenhouseGirl]

There aren't a lot of heavy people living in Center City. In fact, I rarely see them. But I have seen a lot of them in other neighborhoods. In addition to inner city folks, if you ever visit small town or rural midwest, you will see that there is an incredibly high rate of obese people amongst the citizens.

Their reasons for being heavy? Farming jobs are mostly automated now, manual factory jobs are mostly gone, there are few sidewalks for walking, and fastfood places are everywhere.

Philly has at least the "walkable city" thing going for them. I know people who walk two hours a day between work, home, and errands. On the other hand, if your neighborhood is dangerous, you aren't apt to walk it, even during the daytime. Add to that the fastfood element.

Another funny thing -- I rarely see obese people in Canada. And they are just north of us. on the same piece of land.

[BarryG]

There aren't a lot of heavy people living in Center City. In fact, I rarely see them. But I have seen a lot of them in other neighborhoods. In addition to inner city folks, if you ever visit small town or rural midwest, you will see that there is an incredibly high rate of obese people amongst the citizens.

Their reasons for being heavy? Farming jobs are mostly automated now, manual factory jobs are mostly gone, there are few sidewalks for walking, and fastfood places are everywhere.

Philly has at least the "walkable city" thing going for them. I know people who walk two hours a day between work, home, and errands. On the other hand, if your neighborhood is dangerous, you aren't apt to walk it, even during the daytime. Add to that the fastfood element.

Another funny thing -- I rarely see obese people in Canada. And they are just north of us. on the same piece of land.

I think it has a lot more to do with the demographic in CC vs the neighborhoods: single people under 35. Philly shook "fattest city" a while ago due to the growth of this demographic. The record enrollment in the Broad St Run shows this plainly.

[rjj]

Gladys
also, purchasing healthy food is expensive. access is an issue.

There is an argument too that poor people are less educated about food and nutrition generally, and lack understanding of calories and protein etc. They live in "food deserts" lacking in choice and healthy, unprocessed foods

this is such BS. why cant people be accountable for their actions? the fast food joints have all the nutritional information on the MENU!!!
how much longer will it be acceptable to claim ignorance when the information is right in front of you?

oh, and the concept of fast food being cheaper than fresh/healthy food:

http://www.nytimes.com/2011/09/25/op...aper.html?_r=1

a typical order for a family of four — for example, two Big Macs, a cheeseburger, six chicken McNuggets, two medium and two small fries, and two medium and two small sodas — costs, at the McDonald’s a hundred steps from where I write, about $28. (Judicious ordering of “Happy Meals” can reduce that to about $23 — and you get a few apple slices in addition to the fries!)

In general, despite extensive government subsidies, hyperprocessed food remains more expensive than food cooked at home. You can serve a roasted chicken with vegetables along with a simple salad and milk for about $14, and feed four or even six people. If that’s too much money, substitute a meal of rice and canned beans with bacon, green peppers and onions; it’s easily enough for four people and costs about $9.

[RittenhouseGirl]

this is such BS. why cant people be accountable for their actions? the fast food joints have all the nutritional information on the MENU!!!
how much longer will it be acceptable to claim ignorance when the information is right in front of you?

I totally agree with you. People who have little money are still going to supermarkets at some point for their weekly food. So why don't they just grab some more veggies and lowfat meats? It still comes down to a matter of choice.

[borntochill]

this is such BS. why cant people be accountable for their actions? the fast food joints have all the nutritional information on the MENU!!!
how much longer will it be acceptable to claim ignorance when the information is right in front of you?

oh, and the concept of fast food being cheaper than fresh/healthy food:

http://www.nytimes.com/2011/09/25/op...aper.html?_r=1

That's a good article, although I wonder if you read the whole thing. We can rant and rail about "accountability" and "personal responsibility" until we're blue in the face, but it won't accomplish anything. The second page of the article delves into the cultural piece of the problem, and changing that is key.

The core problem is that cooking is defined as work, and fast food is both a pleasure and a crutch. “People really are stressed out with all that they have to do, and they don’t want to cook. Their reaction is, ‘Let me enjoy what I want to eat, and stop telling me what to do.’ And it’s one of the few things that less well-off people have: they don’t have to cook.”

...

Real cultural changes are needed to turn this around. Somehow, no-nonsense cooking and eating — roasting a chicken, making a grilled cheese sandwich, scrambling an egg, tossing a salad — must become popular again, and valued not just by hipsters in Brooklyn or locavores in Berkeley. The smart campaign is not to get McDonald’s to serve better food but to get people to see cooking as a joy rather than a burden, or at least as part of a normal life.

We all want indulgences. Families of little means, unable to afford nice meals out at fancy restaurants and vacations to nice places (or other such pleasures that people with more income have) may find small kicks in fast food. At the supermarket, I often see people with Access cards loading their shopping carts with junk food and cases of soda: also pleasurable, if unhealthy in these quantities. Sure, I could look down my nose at them. Or instead, I could recognize that their lives are probably stressful and they have fewer options for indulgences, and that these are among them. As a society, we need to figure out how to make delicious, healthy meals an indulgence that is valued and enjoyed not just by the middle class, but by everyone.

And, yeah, as suggested upthread, we should tax soda. If drank as an occasional indulgence, a tax will have a negligible impact on a family's pocketbook. Soda purchased by the case will probably lead to health problems and should be disincentivized. Food stamps/SNAP/Access should not pay for soda and candy and other nutritionally vacant foods. I'm amazed that it is allowed.

[discoprincess]

Food stamps/SNAP/Access should not pay for soda and candy and other nutritionally vacant foods. I'm amazed that it is allowed.

Then you will have people complaining about the government overstepping boundaries by telling people what they can and cannot eat.

Wouldn't a change like that need to be done on the federal level?

[borntochill]

Then you will have people complaining about the government overstepping boundaries by telling people what they can and cannot eat.

People can eat whatever they choose. I'm just objecting to using my tax dollars going to buy people food which has no nutritional value, and which consumed in excess (as it frequently is) will harm their health.

Wouldn't a change like that need to be done on the federal level?

Probably, yes. And lobbyists from industries profiting from selling sugary products will pour money into the coffers of politicians in an attempt to prevent the change from ever happening.

[rjj]

That's a good article, although I wonder if you read the whole thing. We can rant and rail about "accountability" and "personal responsibility" until we're blue in the face, but it won't accomplish anything. The second page of the article delves into the cultural piece of the problem, and changing that is key.



We all want indulgences. Families of little means, unable to afford nice meals out at fancy restaurants and vacations to nice places (or other such pleasures that people with more income have) may find small kicks in fast food. At the supermarket, I often see people with Access cards loading their shopping carts with junk food and cases of soda: also pleasurable, if unhealthy in these quantities. Sure, I could look down my nose at them. Or instead, I could recognize that their lives are probably stressful and they have fewer options for indulgences, and that these are among them. As a society, we need to figure out how to make delicious, healthy meals an indulgence that is valued and enjoyed not just by the middle class, but by everyone.

And, yeah, as suggested upthread, we should tax soda. If drank as an occasional indulgence, a tax will have a negligible impact on a family's pocketbook. Soda purchased by the case will probably lead to health problems and should be disincentivized. Food stamps/SNAP/Access should not pay for soda and candy and other nutritionally vacant foods. I'm amazed that it is allowed.

I did read the whole thing.

Its the same problem across the board, you cant legislate home. keeping a house and cooking meals used to be a central part of being a mother/father of a family. my mother taught us all how to cook, she made it family time and made sure we were all engaged. not once did it ever feel like a chore. we didnt have alot of indulgences and my father made sure we knew what it took to put food on the table. family time was very important to my parents, maybe thats old fashion? we didnt have much $, but that didnt mean we couldnt learn to cook together. even if it was just veggies from our garden, beans in a can and clearance aisle pork butt!!

it all starts at home: its not society, rap, rock, violent movies, greedy corporations, video games, tenured teachers, school boards, drugs or whatever smoking mirror you want to use to blame societal decay. its about a home with adults around that give a F about you, your well being and your future.

for the record- as much as i hate some liberties being taken away, if I'm paying for some/all of your healthcare - I want the right to say what you can/cant consume.

you live life much different when you actually have some skin in the game!!