Its all in the process.”

I’m the same really, sedentary, crap foods, no veggies, tons of sugar and fat, fast food whenever there’s some (which is not that often when you’re poor). I manage to weight between 100 and 105 lbs for 5′6″, and I can’t seem to gain an ounce…

Note that my BMI’s always been underweight by a fair margin since childhood, this isn’t a new development. I was 4′0″ and 50 lbs at 9 years old, 5′0″ and 80 lbs at 15 years old, 5′6″ and 110 lbs at 20 years old. Then weight fluctuated 97~117 since then.

I am also down about 20 pounds from my highest weight. But my weight, historically, has vacillated from around 230 to 270, largely correlated with external factors beyond my immediate control: whether I had time and opportunity and energy to exercise and to cook good (healthy and tasty) meals. I have never counted calories or intentionally refrained from eating when I was hungry. I see this fluctuation as being very different from what happens when somebody goes on a long-term regimen of calorie-counting and not eating when they are hungry — so I don’t think what you are talking about, Ron, is relevant to the argument that diets don’t cause people to lose weight.

But I’m not clear whether people in the FA movement are seriously arguing that obesity is good/neutral, or whether they’re making the (probably accurate) point that the costs of trying to lose weight are not worth the benefits.

People in the FA movement obviously argue different things. Personally, I see fat as a negative only when it prevents me from doing things that I want to do, or has other clearly negative effects on my health. Usually, that is not the case.

*Note that weight does not equal fat. CHF for example causes retention of fluid so that a person who has access to water will still be “overweight” even if they have no food because their bodies will retain the water abnormally.

Good for you, assuming the weight loss was intentional and the lifestyle changes don’t make the additional social approval of your lower weight and any health benefits not worth it. However, your experience is very atypical. I’ve never seen a study of any weight loss method, not even those that advise permanent changes in lifestyle, that has led to substantial weight loss for more than a tiny fraction of those studied. Analogously, some people can quit smoking, permanently, on the first try with no pharmacological aid. But that is very rare.

Other thoughts on how to make the population thinner: People who don’t get enough sleep tend to gain weight. As do people under chronic stress of any sort. So, a higher minimum wage, so that people wouldn’t have to work 80 hours/week (resulting in chronic stress and lack of sleep) would probably do more to reduce the incidence of obesity than any program lecturing 12 year olds on the evil of weight gain.

It is difficult to lose weight. Once you’re obese, you’re likely to stay there. However, it is generally much easier–not always, but usually–to avoid gaining weight. If you’re 5′5″ and 160 pounds, and you want to weigh 110, you may never attain that weight. But if you’re 5′5″ and 160 pounds and you want to avoid becoming 5′5″ and 200 pounds, you can probably do so. It’s hard to lose 15 pounds; it’s a lot easier to avoid gaining 15 pounds.

This is one way in which the “you can’t lose weight!” rhetoric becomes problematic when applied across the board. Because not every debate about obesity, and not every concept that views obesity as something to be avoided, is aimed at losing weight. No, you may not be able to turn obese people into non-obese people. But if you can prevent people from becoming obese, then you don’t NEED to reverse the process.

And children–especially children who are not yet obese, who are growing, etc–are probably fairly good targets for this type of thing.

Now, this still depends on a view of obesity as a negative thing. But I’m not clear whether people in the FA movement are seriously arguing that obesity is good/neutral, or whether they’re making the (probably accurate) point that the costs of trying to lose weight are not worth the benefits.

Viewing it from a prevention aspect puts it in a better perspective. The risks of “no transition to obesity” are very different from the risks of “diet like hell.”

Not so fast Dianne. I have lost about 25 pounds from my highest weight and have kept it off for about 8 years now. I did this by making a permanent change in my diet and exercise routines. For the former, I stopped drinking any kind of pop and pretty much only drink water and beer, with a definite drop in the amount of the latter BTW (I partially compensate by drinking much better beer). I also cut way back on the amount of food I eat that contains large amounts of fat and/or simple sugars. For the latter, I established one, as I wasn’t exercising at all up to that point.

Now, whether/how that would work for various people is a separate debate. I bring this up solely to rebut the proposition you advanced. It is possible for at least some people to have a lifestyle that causes them to have a certain weight, and to adopt a permanent change that leads to a permanent drop in weight.

Wow — I really like this paragraph. This would make a great T-shirt.

Increase the number of parents who will let their kids play at those parks and playgrounds without constant adult supervision and interference (absent security issues).

Increase the number of local municipal entities that will let a bunch of kids organize their own games without shooing them off because it’s not a sanctioned activity.

Increase the number of parents who will make their kids play in those parks and playgrounds instead of sitting indoors.

But for the large majority, we are simply in that range of being 20-40 pound over the “ideal” weight. And this is where some of the medical data is controversial. Is it healthier, for example, to stay around 30 lbs. over the “ideal” on a consistent basis or go yo-yoing up and down every year, which screws with your matabolism. Also, there is a point off having too much exercise. (Most of us aren’t there, I’m sure) but there is a balance between healthy exercise and overuse injuries. So if doing so much exercise to cause injury or chronic pain is the only thing that will get you to your “ideal” weight, is it really the healthiest option? I think the controversy about weight is that if it is not vastly affecting your functioning (like you are not stuck in bed because of it, or unable to walk a short distance, etc.) is it really that unhealthy long-term? If not, then the definition of ideal weight or BMI needs to be expanded and people need not feel like failures if they are not supermodel skinny. If so, then yes, some of the measures described above may come into play.

But back to OP, none of this requires that 12 year olds be measured by middle school gym teachers.

Realistically, the only people who have a reasonable chance of losing weight permanently (barring the chronically ill) are those who undergo bariatric surgery. Which is only done for moderate to morbid obesity. Bariatric surgery can have health benefits for the severely obese, but it is clearly not worth the risk for people who are overweight or mildly obese. So people in the 25-35 BMI range are just out of luck: unending social pressure to lose weight and no means of doing so.

Like amp, I’m not at all convinced that the “obesity epidemic” is the threat it’s claimed to be, but if we really want people to lose weight on a society wide level (as opposed to the occasional “miracle cure” successful diet), we’re doing it all wrong. People aren’t going to lose weight because they’re told that they’re fat any more than they’ll stop smoking if you tell them they’re smelly and leave it at that. If we really want a thinner country, we’d have to make society wide changes similar to those that were undertaken for smoking. Some ideas I have, not necessarily all good, but to stir up thought:

1. Fewer cars, more public transportation, bike paths, and sidewalks. Walking uses energy and even the minor amounts of walking (and stair climbing) involved in the use of public transportation are enough to make the average person who is now driving lose a couple of pounds per year (assuming no compensatory increase in eating) and exercise, regardless of weight, is healthy.

2. Stop advertising high calorie low nutrient foods. By “advertising” I also include things like attractive packaging. Make all food come in neutral containers labelled only with the name of the product, ingredients, and nutritional information.

3. Increase the number of parks, swimming pools, playgrounds, etc available to kids of all socioeconomic groups so that those that wish to can have a chance to play outdoors.

4. Get serious about researching the mechanisms of hunger and weight control. As in, a NIH sub-institution dedicated to it. Pharma research is all very well, but too immediate term oriented to make the basic breakthroughs that will have to happen if we really want a decent pharmacologic method of appetite or weight control to become available. (And pharmacologic aids were critical in improving the number of people who quit smoking successfully: without any pharma, the successful quit rate is something like 6%, with wellbutrin, nicotine replacement and counseling, the success rate goes up to something like 30-35% per attempt.)

In short, stop blaming people for not accomplishing the impossible and make it possible. Assuming, for the sake of argument, that the goal is worth accomplishing.

We teach children the dangers of smoking even though we all hear stories of the occasional smoker living to a ripe old age. […] How is the obesity thing any different?

Well, first of all, there is universal agreement that smoking is incredibly unhealthy in legitimate, peer-reviewed journals. That’s simply not the case when it comes to overweight and obesity at all but the most severe levels. Conflicting peer-reviewed studies and journal articles aren’t at all the same as “the occasional smoker living to a ripe old age”; the former is evidence, the latter is anecdote.

There’s also the fact that smoking is, even according to the studies cited by the “fat is dangerous” crowd, far more dangerous than being obese. For instance, the study I wrote about here found that being obese carried risk ratios that rarely rose above 1.9 (1.0 is no difference at all), and in many areas the “normal” weight people actually had higher risks of death than the “overweight” people. In contrast, for for smokers the risk ratio of death by lung cancer, compared to non-smokers, is 23.3 for men and 12.7 for women.

Finally, the success rate for quitting smoking is far, far higher than the success rate for “quitting” being fat, and carries virtually no health risks of its own. Telling people to not smoke, difficult as it is, is much more reasonable than telling them not to eat. :-p

But I’m not convinced that any such consensus exists in the scientific community; on the contrary, exactly how unhealthy fat is remains a subject of great controversy among scientists.

No matter what the deniers say the debate is over.

(Sorry. The parallel with another issue was just too great to resist an attempt at ironic humor.)

Can we all agree that more likely than not obesity has long term health consequences? We teach children the dangers of smoking even though we all hear stories of the occasional smoker living to a ripe old age. Same with the dangers of drinking and drug use. We teach children the dangers of unprotected sex. We show (or used to. I am not sure what they do now days) films of horrible automobile accidents to impress on them the dangers of the road. How is the obesity thing any different?

Stupid useless number.

Kids’ sports are not always the answer, either. How much time do they spend actually getting exercise and how much time are they standing relatively still while waiting to work on (or while actually working on) a specific skill? Half an hour in the batting cage sharpens the eye-hand coordination but doesn’t do shit for your aerobic fitness. Both my kids went through all kinds of sports - soccer, lacrosse, hockey, tennis and softball. Great stuff, but it doesn’t necessarily make you fit.

This is so untrue. BMI is a quick and dirty measurement of height and weight ratio that was made to be used by lay people. Those without access to an EKG, a body fat measureing “dunk” container, a phebotomist and a pathology lab to examine blood work. BMI was made so that everyday people can get a very broad picture of whether they are over or underweight or not.

I work in healthcare, and although physicians will sometimes talk to patients about their BMI in regards to their weight and health, I don’t think any of them find it “the standard way to measure health.” I think you’d be laughed right out of the doctor’s lunch table if you were a doctor who said that.

Anyway, I do think it is entirely possible to teach kids to eat a variety of 5 fruits and vegetables, get X amount of protein, carbs, fat and other micronutrients, try to exercise at least 30 minutes a day, etc. etc. And never mention any child’s weight or BMI. It is not necessary. It may be that doing these things will make some kids lose weight, but others might not. The important thing is process not product. All of us, no matter what our weight, will be healthier if we eat better.

BTW, my sister is 5′7″ and weighs 115 (which according to BMI is underweight) and she eats crap food. No veggies, lots of frozen french bread pizza, sedentary lifestyle. And I’ll just tell you, cuz I don’t give a crap who knows my weight. I am 5′5″ and weigh about 160, which is overweight according to BMI. I eat better than her, more balanced meals, more whole foods as compared to processed, etc. I also exercise more, and walk a lot more in my everyday life because I can’t drive. Plus have two preschoolers to run after. I admit that I eat too many sweets, it is my downfall. But if I cut down or even eliminate sweets? I will still never be 115 pounds. And I will still have a more healthy diet and more active lifestyle that her.

Its all in the process.

What if it’s not obesity, but yo-yo dieting, that causes diabetes? You’d see the same correlation: fat people are told to yo-yo diet, so they get diabetes, and viola, fat people end up with diabetes. Doctors see the correlation, and like morons assume causality.

If this were the case, that dieting and not obesity causes diabetes, then you would expect to see no increase in diabetes amongst fat people who eat healthily, exercise regularly, and don’t diet (compared to skinny people who do the same). Anybody have a link to a study?