What do you think needs to be done to combat the obesity epidemic?

[maarsen]

4 hours ago, Kalbear said:

This is functionally impossible for about 30-35% of US citizens. There is simply a lack of available 'basic' ingredients anywhere near those people for prices they can afford. 

I have no argument with you on that point  Kal. We have the same issue up here in Canada. Urban gardening is one way of getting real food onto plates. Another would be to stop subsidizing sugar production. 

Don't get me started on the problem of hospital food up here. 

[Heartofice]

Interested to know how much more expensive basic ingredients are over there?

[Erik of Hazelfield]

Curiously it seems like sugar is not the sole culprit. Sugar intake seems to have stopped rising or even declined while obesity continues to rise.

http://wholehealthsource.blogspot.com/2015/11/carbohydrate-sugar-and-obesity-in.html?m=1

 

[Ormond]

46 minutes ago, Erik of Hazelfield said:

Curiously it seems like sugar is not the sole culprit. Sugar intake seems to have stopped rising or even declined while obesity continues to rise.

http://wholehealthsource.blogspot.com/2015/11/carbohydrate-sugar-and-obesity-in.html?m=1

 

One of the main points should be that there isn't any such thing as a "sole culprit" in the rise in obesity. I think it's quite probable that further research in genetics and epigenetics will show that diets that work to prevent obesity in some people will have no effect for others. There probably are many people whose systems react so that sugar is the biggest factor, and many others for whom sugar really isn't a problem. Unfortunately we still seem to be far from a place where we can reliably tell which category an individual is in and so give proper individualized advice.

[Isalie]

Is there any research at all supporting that idea? 

[Ormond]

9 minutes ago, Mikael said:

Is there any research at all supporting that idea? 

Don't have time to look this up extensively today, but to start you off here is a link to one study showing a difference in effectiveness of Low fat vs. high fat diet in people who have different alleles of a certain gene:

https://www.ncbi.nlm.nih.gov/pubmed/19687793

[baxus]

On 3/2/2019 at 8:58 AM, Kalbear said:

It's ineffective because it's incredibly difficult. It's much like telling a smoker the most effective way to not die from smoking-related diseases is to quit smoking. Okay, sure - but the quitting smoking thing is pretty hard, and it's hard because it's addictive and for a long time smoking was considered something social and expected.

Ineffective and incredibly difficult are not the same thing, are they? You can't say that something doesn't work because people don't do it. We will agree that diet and exercise combo is difficult to manage but if you do manage it, it's very effective.

Also, comparison you make between obese people and smokers is invalid. Obese people's equivalent to "just quit smoking" is that they start eating healthy 100% of the time and exercise at rather high levels of intensity as well as losing all the weight overnight. That's unrealistic and everyone knows it.

And let's not forget that, while smoking really was considered to be socially acceptable and even desirable, that was never the case for being obese.

On 3/1/2019 at 8:31 PM, lokisnow said:

Eating healthy and exercising are not torture, but the negative feedback loop obesity treatment cycle (that fails 93% of the time) presented to victims of obesity is generally implemented as (relative to peer group) severe deprivation and out-of-proportion intensity or volume of exercise--along with commensurate luxury tax obese people are expected to pay for the exercise and clean eating and lost value of the additional time devoted to exercise and food prep.

Are we talking about proper diet and exercise regimens or what people read in Cosmo or wherever?

Also, exercising doesn't require a lot of money. All you need are comfortable shoes so you can run, or walk if your weight eliminates running as an option. You start there. Then you can do some squats or burpees at home. There are dozens of scaling options for either of those, just look it up online. If you can't squat, just sit on the chair or couch and get up off it. Then you add some other stuff, as your fitness levels slowly improve. There's so much stuff you can do that require no money or almost no money that lack of money is not an excuse.

Do you think that people who are financially better off don't have to devote time to exercise and food prep? Not all non-obese people have personal chefs and butlers to do all that for them, you know?

Fighting obesity in an individual level does take time and effort. There's no two ways about it. Sure, having personal trainers to customize your workouts for optimal benefit is great (I imagine) but you still have to be the one who does the workout to get the benefits from it.

[Erik of Hazelfield]

I'm not sure I'm buying the idea that it's such a complex problem. I agree that the underlying causes of the so-called obesity epidemic are many and varied, but they all basically boil down to the same thing: that in today's society being unhealthy is easy while being healthy is hard. This leads us to a definable problem - how can we change our society to make it easier, cheaper or more attractive for people to make healthier choices in their everyday lives?

I'm not saying this problem is an easy one to solve, but at least it gets us somewhere. Saying something is "a complicated problem" is far too often followed by something along the lines of "so this or that simple solution won't work". And then nothing. It's a trick used disingenuously by gun advocates when discussing school shootings, and by soda manufacturers when discussing soda taxes. Instead of leading to solutions, the "it's complicated" argument tends to dismiss proposed solutions and in practice lead to status quo. I'm not saying that anyone here is being disingenuous in this way, but I fear that the end result might be the same. Saying the problem is complicated must be followed by proposed solutions, otherwise it gets us no closer to solving the problem.

I'm for a soda tax, because the evidence suggests it works. As for more complicated taxation schemes, restrictions on how and where unhealthy food can be sold or other similar approaches, I'm for trying them on a small scale, studying the effects, and go ahead with implementing the most effective ones nationally. 

 

[ithanos]

Can we include a broader description of this epidemic instead of just calling out Obesity? I submit Metabolic Syndrome or Metabolic Dysfunction.

There are a cluster of conditions (of Metabolic Syndrome) that clinicians have observed which manifest across both obese and normal weight people. That's your; increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels - that when occurring together, increase your risk of heart disease, stroke and diabetes.

Its easy for us to single out the obese (as they had exhibit the most visual of these conditions) because we can see them in our communities, at our workplaces, in our friends and loved ones, and in the mirror. But to ignore that normal weight people are also at risk leads to only targeting the low hanging fruit and not what's rotten in the roots. 

Here is a diagram showing the "Inclusive" view of obesity and metabolic dysfunction. The numbers are for the USA population but are staggering none the less. Sorry I can't find a link to the source data for this diagram, though Dr R Lustig is usually fastidious with his references.
 

---------

Decisions made in the USA over 50 years ago (IE: whatever it takes, make food cheap) leveraged economies of scale to unwittingly leave us with communities resembling gingerbread homes. All very tasty and delicious... until we get sick. IIRC Hansel & Gretel escaped from their entrapment by tossing the Witch into the oven. So how can we do that now? Given that once we get rid of the Witch, we still have a gingerbread house to live in.

<caveat: this may seem a USA centric view, but as someone who has travelled to over 30 developed countries in the last 2 years (including the USA) I can tell you this with certainty - multinational food companies, peddling high volume 'food' commodities, pervade the developed world. They're not all US companies anymore, but they emerged from their templates.> 

I was recently listening to the latest DietDoctor podcast, with Dr Robert Lustig, youtube video here, and full transcription here. And Lustig had some sobering views on a couple issues already mentioned in this thread.

On sugar taxes...

Quote

You know, look… anything that reduces consumption is good.

The question is how do you do that on mass? How do you do that for everyone? Ultimately the only way is to decrease availability. This is the iron law of public health. You decrease availability which decreases consumption, which decreases health harms. The Iron Law of public health, true for tobacco, true for alcohol, decrease availability.

Now you don’t want to ban it. You know, banning doesn’t work. We tried that with alcohol and you saw what happened. That was called the 18th amendment and the 21st amendment. We’re not doing that again. What you have to do is you have to make it hurt. You make it available you make it hurt. You make it harder to get effectively.

So that’s this notion of soda taxes. I’ll be very honest with you. I am for reduction and consumption however it can be done. I think there’s a way better, easier, much more effective way of dealing with this issue of effective availability. Get rid of the subsidies.
 

and on cultural tectonic shifts...

Quote

The point is every single one of these required public education first, and then that softened the playing field and allowed for changes in legislation and litigation. This is going on now with food. And we’re probably out of the 30 years, we’re probably about 7 years.

You know, but it’s going to take a while, it’s still going to take a good 20 years before we’re going to see the real change. And I’ll tell you, you know what it takes? It takes a generation. And you know why it takes a generation?

Bret:  People need to die, unfortunately.

Robert:  That’s part A. The old people who won’t accept need to die, and B, you have to teach the children because then, when they get over 18, they vote.
 

 

[Kalbear]

On 3/2/2019 at 5:01 AM, Heartofice said:

Interested to know how much more expensive basic ingredients are over there?

Depends on what you mean, but basic things like fruit and vegetables are often simply not available to people near their homes in the US. I mean literally not there - there is no place that you can buy an apple within your commute distance. This is what is known as a food desert. For others, it's significantly more expensive per calorie than anything else, and when you barely have enough to live buying fresh fruit and veggies is a massive luxury. (This has been shown to be the case, btw; they gave food stamp recepients a bunch of extra money to see what extravagance they'd buy, and they bought fresh fruit and veggies overwhelmingly). 

 

On 3/3/2019 at 7:40 AM, baxus said:

Ineffective and incredibly difficult are not the same thing, are they? You can't say that something doesn't work because people don't do it. We will agree that diet and exercise combo is difficult to manage but if you do manage it, it's very effective. 

It is ineffective as a proposal for a policy. It might be an effective end goal, but it is entirely ineffective as a policy. It is akin to saying 'just say no' to drugs as a policy. 

On 3/3/2019 at 7:40 AM, baxus said:

Also, comparison you make between obese people and smokers is invalid. Obese people's equivalent to "just quit smoking" is that they start eating healthy 100% of the time and exercise at rather high levels of intensity as well as losing all the weight overnight. That's unrealistic and everyone knows it. 

They didn't back in the day, which was my point. A whole lot of the same arguments about smoking in the 50s and food today are identical, and backed by the industries in question identically. 

On 3/3/2019 at 7:40 AM, baxus said:

And let's not forget that, while smoking really was considered to be socially acceptable and even desirable, that was never the case for being obese. 

Being obese is not so bad, but that's not the problem - the problem is what is acceptable to eat. We don't shame people for drinking a few beers, or eating candy, or having their kids eat candy. We don't shame people for going out to pizza or eating hamburgers. We don't shame people for eating absurd portion sizes at Cheesecake factory. We shame them for getting fat, even though there's literally no possible way not to get fat with the food that most people have social access to. 

On 3/3/2019 at 7:40 AM, baxus said:

Are we talking about proper diet and exercise regimens or what people read in Cosmo or wherever?

Also, exercising doesn't require a lot of money. All you need are comfortable shoes so you can run, or walk if your weight eliminates running as an option. You start there. Then you can do some squats or burpees at home. There are dozens of scaling options for either of those, just look it up online. If you can't squat, just sit on the chair or couch and get up off it. Then you add some other stuff, as your fitness levels slowly improve. There's so much stuff you can do that require no money or almost no money that lack of money is not an excuse.

Exercising requires a whole lot of money, though not directly. How many parents have access to an hour of time that they can go running? Or even walking? How many kids have access to that kind of time, and a neighborhood which permits it? When you work two jobs at 60+ hours a week, have another 2 hours a day commuting, have to deal with providing food for children and caring for elderly and whatnot, you'll find that exercise is, actually, something you cannot afford - because you cannot afford taking the time to do these things. 

The obesity epidemic is hitting the poorest people in this country, and that should give you a pause for consideration. How on earth is it that the people who can't afford to eat some times are actually overweight? It isn't because they're choosing not to exercise. 

And all that being said, exercise is simply not a good solution for losing weight. Exercise is awesome, is great for health, is great for a whole lot of things, but we have to stop the notion of exercise being a punishment for being overweight. This is another cultural viewpoint that has to go. 

On 3/3/2019 at 7:40 AM, baxus said:

Fighting obesity in an individual level does take time and effort. There's no two ways about it. Sure, having personal trainers to customize your workouts for optimal benefit is great (I imagine) but you still have to be the one who does the workout to get the benefits from it.

The real issue is not that it takes effort - it is that it takes an absurd, anti-social amount of effort to do so reasonably, for most people in the US. When our supermarkets are 70% full of food which is demonstrably bad for you AND that food is the cheapest, that's a problem. When you say 'don't drink soda' yet soda is cheaper than actual potable water for many poor people, that's a problem. 

There are billions and billions of dollars spent in marketing horrible food to children - food known to cause childhood and adult diseases, be hugely addictive, and is often bad for the environment. If you don't think that a whole culture bent on making kids want McDonalds and candy and cookies and chips and soda isn't the problem, you're never going to solve the problem. 

[Centrist Simon Steele]

On 2/27/2019 at 6:09 PM, lokisnow said:

hmm, well the mantras of diet and exercise have a 7% efficacy rate at treating obesity, so that's a 93% failure rate, we need a better treatment.

it probably needs a multi faceted solution, but nothing will cause the current mantra to succeed absent serious rationing and famine events brought on by climate change. (and this would probably just cause a backlash of food hoarding and elites becoming deliberately obese as a signifier of wealth.

Portion sizes are too big, foods are too calorie dense, science has caused a lot of the obesity epidemic by engineering foods that short circuit the brains of the vulnerable and induce excess-to-unending calorie consumption among those worst afflicted. 

And many of those afflicted are victims of abnormal tissue growth cycles, and their overeating was driven by their malfunctioning tissue growth, we need to base treatment regimes on treating this baseline disease state, rather than treating a symptom.

And take away stigma from a quick drug fix if any is invented.  if we can induce tissue growth via steroids, we can probably induce adipose apoptosis via a similar mechanism. but there would undoubtedly be massive cultural pushback from elites and media, neither would want the victims of obesity getting access to a safe and reliable drug intervention.

 

I wonder if the concept of "diet" is problematic--as in, it's short term. Diet is a way of life. When you change your diet to healthy foods, it's hard at first, but I think the most effective way to combat obesity. I also think 10,000 steps a day is really good.

And you're right. Medical solutions should have no stigma.

[baxus]

4 hours ago, Kalbear said:

It is ineffective as a proposal for a policy. It might be an effective end goal, but it is entirely ineffective as a policy. It is akin to saying 'just say no' to drugs as a policy. 

Once again. No, it is not ineffective. It is EXTREMELY effective. It may be difficult to manage to stick with it, as I already said, but if you do manage to stick with it you will lose weight and get healthier.

There is absolutely NO WAY that a person who eats reasonably healthy and exercises three times a week for an hour will not get healthier than they were before starting to do that. I do understand that there is difficulty in achieving such a goal, I have seen it in some of my close friends and family who can't do it or just plain won't do it.

There is no magic pill - "here, take this and carry on like you were" and you lose weight and increase your fitness levels and overall health. That's not going to happen. Period. It will take time and effort on an individual's part and it may be extremely difficult for some people to achieve that, but the alternative is remaining obese.

4 hours ago, Kalbear said:

They didn't back in the day, which was my point. A whole lot of the same arguments about smoking in the 50s and food today are identical, and backed by the industries in question identically.

Are you honestly trying to pin the whole problem on the food industry? They should definitely bear their share of the blame but they are not in the business of making people healthier, they're in the business of making money. They are not your friends and they do not have your best interest in mind when making their decisions and plans and quarterly reports and whatnot.

Sooner you lose this notion that food companies should pay attention to what you eat, the better.

It's government's job to regulate that but people in general can't be bothered to make the government do their job so there's that.

Bottom line is that an individual can't make food industry change to suit his/her best interest. Individual needs to change him/herself to do what is in his/her best interest. Enough individuals do that and food industry will change. How long do you think it would take for soda companies to do something about amounts of sugar in their products if their sales dropped significantly and kept dropping?

4 hours ago, Kalbear said:

Being obese is not so bad, but that's not the problem - the problem is what is acceptable to eat. We don't shame people for drinking a few beers, or eating candy, or having their kids eat candy. We don't shame people for going out to pizza or eating hamburgers. We don't shame people for eating absurd portion sizes at Cheesecake factory. We shame them for getting fat, even though there's literally no possible way not to get fat with the food that most people have social access to. 

We don't shame people for drinking a few beers because there's nothing wrong in drinking a few beers in itself. A person can have a few beers and just go home or go out and have a good time. If they start causing problems like being loud and/or annoying, getting into fights etc. their behavior is seen as unacceptable. There are some legal limits to what you can do after a few beers as well.

A candy now and again will do no harm either, be it to you or your kids. Pizza, hamburgers, all that is fine. In moderation. If someone's diet consists only of pizzas and hamburgers then they are the one responsible. No one is forcing you to eat that too often, it is your choice. It may be easier to grab a burger than it is to prepare a meal yourself but there's still a choice there.

4 hours ago, Kalbear said:

Exercising requires a whole lot of money, though not directly. How many parents have access to an hour of time that they can go running? Or even walking? How many kids have access to that kind of time, and a neighborhood which permits it? When you work two jobs at 60+ hours a week, have another 2 hours a day commuting, have to deal with providing food for children and caring for elderly and whatnot, you'll find that exercise is, actually, something you cannot afford - because you cannot afford taking the time to do these things. 

The obesity epidemic is hitting the poorest people in this country, and that should give you a pause for consideration. How on earth is it that the people who can't afford to eat some times are actually overweight? It isn't because they're choosing not to exercise. 

And all that being said, exercise is simply not a good solution for losing weight. Exercise is awesome, is great for health, is great for a whole lot of things, but we have to stop the notion of exercise being a punishment for being overweight. This is another cultural viewpoint that has to go.

First of all, obesity is not just US problem and I'm not talking about US only. I don't even live in the US.

In my neck of the woods (Belgrade, Serbia) there are a lot of neighbourhoods that allow walking, running, there are even outdoor gyms that allow you to do some other exercise as well. The part of the city I grew up in had a bunch of basketball courts, football (not what Americans call football) courts, a lot of space to ride a bike, a lot of trees to climb and be physically active. And no, it was not some exclusive part of the city, a gated community for the rich or anything like that. It was a building block in the new part of the city, built by communist regime back in the day.

There's no time is also a bullshit argument. Here's why. A quick google search shows that US population watches TV for 4 hours a day on average (2017 data). Now, I'm sure that there are people who are in the situation you describe, but if we are talking about the average obese person, then I'm sure that they are rather close to this average. If someone chooses to watch TV for 4 hours instead of watching TV for 3 hours and walk 1 hour a day, then I'd say that's once again a matter of personal choice.

4 hours ago, Kalbear said:

The real issue is not that it takes effort - it is that it takes an absurd, anti-social amount of effort to do so reasonably, for most people in the US. When our supermarkets are 70% full of food which is demonstrably bad for you AND that food is the cheapest, that's a problem. When you say 'don't drink soda' yet soda is cheaper than actual potable water for many poor people, that's a problem. 

There are billions and billions of dollars spent in marketing horrible food to children - food known to cause childhood and adult diseases, be hugely addictive, and is often bad for the environment. If you don't think that a whole culture bent on making kids want McDonalds and candy and cookies and chips and soda isn't the problem, you're never going to solve the problem.

Who says that it take an "absurd, anti-social amount of effort"? What's absurd about taking an interest in what you eat and trying to improve it? What's absurd about dedication 1h three times a week to exercise? What's anti-social about it?

Once again, there's no problem with taking your kids to McDonald's once in a while. Do it. Let the kids enjoy it.  Just don't make it a regular thing or a daily thing.

There is a cultural aspect to it, no denying that. Still, it's down to an individual to do their best to eat reasonably healthy and raise their children in the same manner. As I said, it's difficult, but it can be done.

[Heartofice]

6 hours ago, Kalbear said:

Depends on what you mean, but basic things like fruit and vegetables are often simply not available to people near their homes in the US. I mean literally not there - there is no place that you can buy an apple within your commute distance. This is what is known as a food desert.

I'd never heard of food deserts before, seems quite incredible. Having said that, it doesn't seem that there is any real correlation between food deserts and obesity rates:
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1106078

"Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed."

As someone who has last weight in the past I will say that it is difficult. However it is a matter of changing most of the patterns in your life and being pretty aware of the patterns that exist. Sticking to a diet requires a constant vigilence for what goes in your mouth, it can take months to build up a habit of not eating too much.

Most people I know who are overweight and want to lose weight often tell me 'oh I don't want to have to watch everything I eat!!' as if its some great hardship. But the problem for them right now is that they are totally unaware of the amount of calories they are consuming, and on a sheer calorie balance level, that is crucial. Using a food tracker app like MyFitnesspal I'd say was incredibly important, knowing what you are going to eat that day and setting a calorie limit on your eating is IMO the most effective way to lose weight bar none. Other people tend to lose weight through some backdoor of cutting carbs or going Paleo, but its essentially doing the same thing.

 

Quote

We don't shame people for going out to pizza or eating hamburgers. We don't shame people for eating absurd portion sizes at Cheesecake factory. We shame them for getting fat, even though there's literally no possible way not to get fat with the food that most people have social access to. 

We probably shame fat people who eat those things, but then most people can get away with eating the odd cheesecake or pizza, as long as its not an everyday occurrence. 

 

Quote

Exercising requires a whole lot of money, though not directly. How many parents have access to an hour of time that they can go running? Or even walking? How many kids have access to that kind of time, and a neighborhood which permits it? When you work two jobs at 60+ hours a week, have another 2 hours a day commuting, have to deal with providing food for children and caring for elderly and whatnot, you'll find that exercise is, actually, something you cannot afford - because you cannot afford taking the time to do these things. 

Exercising is also a pretty ineffective way of controlling you calorie balance, especially in regards to traditional cardio. Going for a light jog will probably not burn off the chocolate bar you ate, and if you are in a 500cal surplus every day then you are going to need to jog for about an hour every day to counteract that, thats assuming you then don't eat more because jogging has made you hungrier than normal. Plus more intense forms of cardio can be done in a shorter period of time and are just effective if you really want to that. Some form of resistance training can be done 3 times a week depending on goals too. I don't think the 'exercise takes too much time' excuse really checks out.

 

Quote

The real issue is not that it takes effort - it is that it takes an absurd, anti-social amount of effort to do so reasonably, for most people in the US. When our supermarkets are 70% full of food which is demonstrably bad for you AND that food is the cheapest, that's a problem. When you say 'don't drink soda' yet soda is cheaper than actual potable water for many poor people, that's a problem. 

I mean, I haven't seen these food deserts, but I can't believe its impossible to stay in a calorie balance by shopping in those places. Chicken and frozen veg must be available? Not everyone has to eat pasta and pizza every day. It seems like a far greater indicator of obesity is socio economic status and cultural background. Working class Londoners I know have a pretty dire diet history, its all chips and beans, english fry ups, curries etc. Its a big cultural shift to get people out of that eating pattern, because its seen as completely normal and doesn't require time to cook these things (newsflash, I'm a lazy chef and I can eat a healthy meal that took me 5 minutes of prep time, no problem) 
 

[Isalie]

Theres no denying its a class issue. Which is weird i think, because in Sweden at least, there are no food deserts and people arent too poor to buy fruit and vegetables, but theres still a significant class divide when it comes to obesity. 

We should all exercise to stay healthy, but anyone running in order to lose weight is fooling himself. (Though im sure exercise can work as a motivator to eat well)

I think that on an individual level, we all must make out choices and accept their consequences, but on a collective level, we clearly need to both regulate the food industry and educate the children if we want to reverse the current trajectory (which we definitely should since, as has been noted from the very start of the thread, obesity starts early, is very hard to reverse and kids can not be held accountable for what they eat).

[Bennis of the Brown Shield]

1 hour ago, Mikael said:

Theres no denying its a class issue. Which is weird i think, because in Sweden at least, there are no food deserts and people arent too poor to buy fruit and vegetables, but theres still a significant class divide when it comes to obesity. 

We should all exercise to stay healthy, but anyone running in order to lose weight is fooling himself. (Though im sure exercise can work as a motivator to eat well)

I think that on an individual level, we all must make out choices and accept their consequences, but on a collective level, we clearly need to both regulate the food industry and educate the children if we want to reverse the current trajectory (which we definitely should since, as has been noted from the very start of the thread, obesity starts early, is very hard to reverse and kids can not be held accountable for what they eat).

If there was a lot of unmet demand for healthy foods in some communities you'd think that the convenience stores in the areas would start offering that. Seems more likely that they have noticed that their customers generally aren't very interested in such products (or can't afford them, I guess), and hence have reduced the shelf space for them.

If not, and there actually is a great unmet demand for healthier options in those communities, someone reading this thread should just start opening stores offering such foods there. You should be able to easily take market shares away from the existing convenience stores. 

[Kalbear]

8 hours ago, baxus said:

Once again. No, it is not ineffective. It is EXTREMELY effective. It may be difficult to manage to stick with it, as I already said, but if you do manage to stick with it you will lose weight and get healthier. 

When it only works 7% of the time, it is ineffective. If you had a goal to quit smoking and it worked 7% of the time, it would be ineffective. Even worse, diet and exercise do work, but most people revert to what they were like beforehand. Relapsing means it is also not effective. 

8 hours ago, baxus said:

There is no magic pill - "here, take this and carry on like you were" and you lose weight and increase your fitness levels and overall health. That's not going to happen. Period. It will take time and effort on an individual's part and it may be extremely difficult for some people to achieve that, but the alternative is remaining obese. 

The alternative is instead of promoting massive individual effort in the face of overwhelming social and personal and genetic pressure and shaming people who cannot overcome their existence as humans in the face of this, we start figuring out and combatting the overall causes.

8 hours ago, baxus said:

Are you honestly trying to pin the whole problem on the food industry? They should definitely bear their share of the blame but they are not in the business of making people healthier, they're in the business of making money. They are not your friends and they do not have your best interest in mind when making their decisions and plans and quarterly reports and whatnot. 

Basically it is the food industry's problem. Cigarette manufacturers and opioid manufacturers are also in the business of making money - that does not remotely excuse their behavior for selling things that are known health risks, known addictive consumptives, and marketed towards people who cannot reasonably choose for themselves. 

There are a whole lot of studies on this, but basically humans are a lot closer to dogs than cats, in that if there's food, we'll eat it - especially high-calorie foods. A cool study showed that if you make a human forget that they ate a meal they'll eat that meal again - even if they already ate it. The only reason humans stop eating is because it's socially unacceptable or they are literally too physically full to eat more. 

Essentially your argument is that humans need to have more self-control, which again is like telling a heroin user to beat it by just saying no. It doesn't work in the vast, overwhelming majority of cases. 

8 hours ago, baxus said:

It's government's job to regulate that but people in general can't be bothered to make the government do their job so there's that.

If we cannot regulate harmful industries from causing harm, we might as well give up, because the only other solution is to engineer humans to not be addicts. 

8 hours ago, baxus said:

Bottom line is that an individual can't make food industry change to suit his/her best interest. Individual needs to change him/herself to do what is in his/her best interest. Enough individuals do that and food industry will change. How long do you think it would take for soda companies to do something about amounts of sugar in their products if their sales dropped significantly and kept dropping?

They have dropped significantly, as it turns out, and they have made changes - by selling even worse things like energy drinks and nutrasweet-laden drinks. But they certainly haven't started selling healthier options. 

8 hours ago, baxus said:

We don't shame people for drinking a few beers because there's nothing wrong in drinking a few beers in itself. A person can have a few beers and just go home or go out and have a good time. If they start causing problems like being loud and/or annoying, getting into fights etc. their behavior is seen as unacceptable. There are some legal limits to what you can do after a few beers as well. 

If you want people to lose weight you need to have them cut alcohol; alcohol for confusing reasons seems to depress the weight loss of people beyond the actual calories. 

8 hours ago, baxus said:

A candy now and again will do no harm either, be it to you or your kids. Pizza, hamburgers, all that is fine. In moderation. If someone's diet consists only of pizzas and hamburgers then they are the one responsible. No one is forcing you to eat that too often, it is your choice. It may be easier to grab a burger than it is to prepare a meal yourself but there's still a choice there. 

You can choose to just do a bit of heroin. No harm in that. 

8 hours ago, baxus said:

In my neck of the woods (Belgrade, Serbia) there are a lot of neighbourhoods that allow walking, running, there are even outdoor gyms that allow you to do some other exercise as well. The part of the city I grew up in had a bunch of basketball courts, football (not what Americans call football) courts, a lot of space to ride a bike, a lot of trees to climb and be physically active. And no, it was not some exclusive part of the city, a gated community for the rich or anything like that. It was a building block in the new part of the city, built by communist regime back in the day. 

Cool beans. That isn't the case for a whole lot of people in the US. Especially rural Americans, who have very little places they can walk safely, have longer commute times, do not have public parks, etc. There's a reason that in America the people who are less likely to be overweight are the ones in urban areas. 

8 hours ago, baxus said:

There's no time is also a bullshit argument. Here's why. A quick google search shows that US population watches TV for 4 hours a day on average (2017 data). Now, I'm sure that there are people who are in the situation you describe, but if we are talking about the average obese person, then I'm sure that they are rather close to this average. If someone chooses to watch TV for 4 hours instead of watching TV for 3 hours and walk 1 hour a day, then I'd say that's once again a matter of personal choice. 

Yes, because I'm sure a person cooking dinner for their family is totally fine with just walking at that point instead of watching TV. People watch TV while doing other things, like taking care of kids and the like.

And, as I said, exercise isn't the real problem. Americans are eating something between 500 to 1000 calories per day more than they did 50 years ago. In order to burn that off, you have to be exercising vigorously for an hour or more. The bigger problem isn't the exercise not being done - the bigger problem is the consumption. 

8 hours ago, baxus said:

Who says that it take an "absurd, anti-social amount of effort"? What's absurd about taking an interest in what you eat and trying to improve it? What's absurd about dedication 1h three times a week to exercise? What's anti-social about it? 

It's absurd when your coworkers ask you to go to lunch and you can't because you have to eat the thing you packed from home. It's absurd when you tell your family that you can't spend time with them because you need to go walking for an hour after you get home from your 14+ hour workday. It's absurd because going to the supermarket is about 80% bad choices, which also happen to be the cheapest ones. 

8 hours ago, baxus said:

Once again, there's no problem with taking your kids to McDonald's once in a while. Do it. Let the kids enjoy it.  Just don't make it a regular thing or a daily thing. 

How does this jive with the notion that businesses bear no responsibility? They want to make it a daily thing, and they promote it that way too. And our society accepts it and encourages it. 

8 hours ago, baxus said:

There is a cultural aspect to it, no denying that. Still, it's down to an individual to do their best to eat reasonably healthy and raise their children in the same manner. As I said, it's difficult, but it can be done.

It certainly can be done, but if it's that difficult (and every single study indicates that it is), it's not going to be effective. Which is why I say that as a policy, 'just diet and exercise' is an incredibly ineffective one. 

[Kalbear]

7 hours ago, Heartofice said:

"Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed." 

It's not just fast food. There's this gross phenomenon in the US where Dollar General stores come in to impoverished neighborhoods and people shop there because they're incredibly cheap and they can't afford other things. And that kills the supermarkets in the area, and soon Dollar General is the only food source around.

And they don't sell frozen veg and a whole lot of chicken. 

7 hours ago, Heartofice said:

As someone who has last weight in the past I will say that it is difficult. However it is a matter of changing most of the patterns in your life and being pretty aware of the patterns that exist. Sticking to a diet requires a constant vigilence for what goes in your mouth, it can take months to build up a habit of not eating too much. 

I 100% agree. It is absolutely doable. But it requires a whole lot of conscious effort to fight against everyone else and everything else around you, and that effort is simply not going to be attainable for most people who are already under massive amounts of environmental, social and physical stressors every single day. 

7 hours ago, Heartofice said:

Most people I know who are overweight and want to lose weight often tell me 'oh I don't want to have to watch everything I eat!!' as if its some great hardship. But the problem for them right now is that they are totally unaware of the amount of calories they are consuming, and on a sheer calorie balance level, that is crucial. Using a food tracker app like MyFitnesspal I'd say was incredibly important, knowing what you are going to eat that day and setting a calorie limit on your eating is IMO the most effective way to lose weight bar none. Other people tend to lose weight through some backdoor of cutting carbs or going Paleo, but its essentially doing the same thing.

Yep, I also agree, and this is also incredibly hard for most people to do. Food tracking is one of the most effective things for losing weight (even if you don't follow a diet, just tracking the food makes people lose weight), and it is also the thing people are most resistant to actually do. They'd rather follow a diet than track the minutiae of food. 

Again, these things are possible to do. But as a policy goal, putting all the onus on the individual will inevitably fail for the vast majority of people, and when you're talking about 100 million people in the US that means it doesn't solve the crisis. 

7 hours ago, Heartofice said:

We probably shame fat people who eat those things, but then most people can get away with eating the odd cheesecake or pizza, as long as its not an everyday occurrence. 

We need to not shame fat people or thin people - we need to shame the restaurants. We need to shame cheesecake factory for having a 'breakfast burrito' that is 2730 calories. 

7 hours ago, Heartofice said:

Some form of resistance training can be done 3 times a week depending on goals too. I don't think the 'exercise takes too much time' excuse really checks out. 

For most people in the US, exercise does take too much time. They don't have the time to spend walking an extra hour a day, because they've already used that extra time in their commute. They could do it, yes, but the point isn't to make someone do something for a few months; the point is to make sustainable goals that a person can do for a lifetime, and because of lifestyle and sprawl things like exercising an hour a day is simply not a sustainable goal for a whole lot of people. 

7 hours ago, Heartofice said:

I mean, I haven't seen these food deserts, but I can't believe its impossible to stay in a calorie balance by shopping in those places. Chicken and frozen veg must be available?

It is not, at least not at the prices that are acceptable to people. 

7 hours ago, Heartofice said:

Not everyone has to eat pasta and pizza every day. It seems like a far greater indicator of obesity is socio economic status and cultural background. Working class Londoners I know have a pretty dire diet history, its all chips and beans, english fry ups, curries etc. Its a big cultural shift to get people out of that eating pattern, because its seen as completely normal and doesn't require time to cook these things (newsflash, I'm a lazy chef and I can eat a healthy meal that took me 5 minutes of prep time, no problem) 

Right, that's what I'm saying. Food deserts are a problem but they're not the proximate cause. The problem is that for most poor people, bad food is both part of their culture and what they can afford. We can't fight it by saying it's an individual choice, because we already know that given the choice between an addictive behavior and a non-addictive behavior most people can't choose the latter, or won't, and it won't work. 

And then you have Trump rolling back school lunch requirements, and you see how hard this is going to be. If we want people to eat healthy, we need to indoctrinate early, make it a habit and something that everyone does, and make it weird if you don't. We need to make hour-long walks part of the culture that people just do, and if you skip it you're looked at as weird. We need to make cheesecake factory as absurd as smoking in planes. Until you start doing that, you're basically telling heroin addicts that they should just go cold turkey and what's the problem, yo.

[Erik of Hazelfield]

I'm intrigued by the idea of shaming Cheesecake Factory for serving the 2730 kcal breakfast burrito. Can company shaming be part of the solution? 

In Sweden there's currently lots of debate about "flight shame", where people feel guilty about flying to their vacation destinations due to its climate footprint. A blogger has been tagging celebrities' vacation pictures on Instagram with comments like "Thailand: 3 tons of CO2". Maybe something similar is possible for restaurants and supermarkets?

"90% of what Supermarket X sells is junk food. Shame!"

"No item on Hamburger Chain Y's menu contains less than 900 kcal. Shame!"

"Theatre chain Z serves soda in 64 oz cups. Shame!"

I'm not entirely sure we can just blame the food companies because they are, after all, just trying to make money in a competitive environment. If people want giant size servings, they must provide it or lose business to someone who does. (This is also part of the reason I favour legislation - if the same rules apply to everyone, then no one will be forced to choose between profit and ethics.)

So the food companies aren't completely to blame for the obesity epidemic. But if we want legislation, for example a soda tax, it seems to me that "the evil multinational companies are killing our children with unhealthy products" is an easier sell than "the government needs to regulate how food can be sold because we can't be trusted to choose right by ourselves". If we want any change on this, we need to build a movement calling for this kind of action, because it certainly doesn't seem like an election winning issue right now.

[Kalbear]

5 minutes ago, Erik of Hazelfield said:

I'm not entirely sure we can just blame the food companies because they are, after all, just trying to make money in a competitive environment. If people want giant size servings, they must provide it or lose business to someone who does. (This is also part of the reason I favour legislation - if the same rules apply to everyone, then no one will be forced to choose between profit and ethics.)

 

I continue to not understand this argument. If a company sold a product it knew was harmful to its consumers and did so in spite of that harm (or potentially because of it - because the harm also was addictive) we should, rightly, flip the fuck out. And there is a whole lot of evidence suggesting that companies know precisely how harmful and addictive their food is, and simply go on. 

Again, compare this to something like marketing cigarettes to kids - something that tobacco did for 20+ years, even when cigarettes were illegal to be sold to minors. Why is it okay for that to be effectively outlawed, but when we talk about food being harmful it becomes just individual choice? 

And no, I don't agree that we need to make it more about shaming them and less about humans unable to make the right choice. Maybe the marketing goes that way, but make no mistake - humans have a real hard time making the right choice, and it's going to kill us. 

[Ormond]

3 hours ago, Kalbear said:

Cool beans. That isn't the case for a whole lot of people in the US. Especially rural Americans, who have very little places they can walk safely, have longer commute times, do not have public parks, etc. There's a reason that in America the people who are less likely to be overweight are the ones in urban areas. 

 

I know I'm a picky academic -- I agree with 90% of what you say, but the idea that rural Americans have "very little places they can walk safely" seems absurd on the face of it. I understand the longer commute times and lower access to parks and other facilities specifically created for exercise or recreation. But when there isn't really bad weather, people who live in rural areas should have plenty of places they can walk for exercise safely.