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


Varysblackfyre321

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As with any complex social problem here, there are multiple causes to the worldwide increase in obesity and so there is no simple quick fix.

Whatever is done needs to focus most on childhood obesity, however, because there is a great deal of research showing that the majority of people who were medically obese as children have a near impossible task of permanently losing enough weight to get out of the obese category. People can often lose weight, but it is really difficult to keep the weight off and every time one does lose weight and then regain it, losing the next time becomes harder. So tackling diet and exercise patterns of children so that fewer become obese in the first place would probably lead to more long term success than weight loss programs for already obese adults.

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2 hours ago, Derfel Cadarn said:

Get food producers to stop putting so much crap (i'e sugar) in food. Or at least be honest. Look at the amount of sugar in so-called fat free healthy yoghurt, for example.

I never eat anything called fat-free as it has just as many calories added from sugar.  Just eat less prepared food or prepare your own from basic ingredients.

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I'm all for environmental changes to change people's choices. Soda taxes, forbidding marketing of junk food aimed at children, laws saying candy cannot be sold in the same supermarkets as food, mandatory limits on portion sizes, stuff like that.

I know these solutions are controversial, but at least they have some amount of evidence going for them (google soda tax if you're interested). Also it's pretty clear that it's changes in our environment that has caused the obesity epidemic in the first place*, so it makes sense to focus our efforts there. 

*Think about it. The only other explanations for the obesity epidemic are biological changes in our bodies (which is obviously nonsense; evolution doesn't work on the timescale of decades) or that people of today somehow lacks the willpower of people 30 years ago, who could resist the temptations that today's people fall for. Both explanations are ridiculous. People are gaining weight due to more easily accessible junk food and possibly also more sedentary jobs. If we want to reverse the obesity trend, we'll have to reverse some of the trends that led us here. 

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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.

 

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This problem is so complex that it definitely can't be fixed from one side only.

Changing how the food industry works is a huge task and even if we were to accomplish that, it would take years, if not decades. On the other hand, exercising more and paying attention to your diet is something that an individual can do to help himself/herself right away.

9 hours ago, 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.

I'd say that failure rate pretty much corresponds to the failure rate of people sticking with diet and exercise. ;) 

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7 hours ago, baxus said:

This problem is so complex that it definitely can't be fixed from one side only.

Changing how the food industry works is a huge task and even if we were to accomplish that, it would take years, if not decades. On the other hand, exercising more and paying attention to your diet is something that an individual can do to help himself/herself right away.

I'd say that failure rate pretty much corresponds to the failure rate of people sticking with diet and exercise. ;) 

It’s a sadistic feedback loop problem, if it were effective people would stick with it, but it’s ineffective and they bail because why inflict continual torture to no result upon yourself?

on the other hand, There’s a lot of people that enjoy seeing the torture though, and are invested in maintaining both their pleasure and their relative position to the afflicted, so we should probably consider their intersectional interests in maintaining this treatment regime.

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The problem is that even though diet and exercise works great for the individual, it's been a great failure for many decades at a population level. With knowledge, time, money or determination you can get as fit as you like - but it's too hard. We have too many things going against us:

- Our bodies and minds are genetically hardwired to love junk food

- Food companies know this, so they use all kinds of tricks to use it and sell more food 

- Junk food is cheap, easily available and often purposely exposed to sell more (like placing candy near the counter or using Disney characters to sell cereal so unhealthy it should be considered candy)

- Average serving sizes have increased in most places

- Many foods contain large amounts of fat, sugar and salt to make them tastier

- The amount of exercise we can squeeze into our schedules is seldom enough to compensate for a poor diet

All this has created a society where unhealthy is the new normal. If you eat healthy and exercise regularly, you might be seen as some kind of health freak. If you're normal weight you're often being called skinny. (At the same time we have this ideal of an athletic body that very few people live up to, and fat shaming that helps no one and drives some people into eating disorders. We have a weird schizophrenic relationship to our bodies.)

So how to correct this? A soda tax is an obvious place to start I think. Sugar sweetened drinks are really the worst food in the world. They're so bad you're better off eating jelly beans (Link to study). Also they're much more easily definable than many other types of junk food. Several countries and cities around the world are now trying this, with positive results being reported for example in Philadelphia. People buy less soda, opting for bottled water instead.

You may say it's patronising or nanny state, but this is the kind of stuff that works. Individual responsibility doesn't. It's perfectly fine to be against this kind of solutions on ideological grounds, but then you'll also have to concede that you're giving up on the obesity epidemic. 

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Obesity is a "slow death" problem, just like climate change, many types of cancer, insufficient saving for retirement, etc.  We know what is required to avoid the horrible future but the immediate trade-off is very difficult to accept.  Calorie-dense food tastes great every day but my foot won't get amputated for decades.  And people generally have a cognitive bias toward the present at the expense of their future selves.

The one positive is that avoiding obesity is better than the climate change problem: if you incur the foregone pleasure/convenience/savings of calorie-dense food now then you benefit directly from your own effort.  Unfortunately climate change is a situation that requires a very large number of people to coordinate their effort in order to generate any benefit for anyone.

The very low success rate of diet & exercise in delivering weight loss is not a surprise when you are basically trying to end a persistent addiction.  Once you are over-weight, your body resists any weight loss.  This is especially problematic for childhood obesity before an individual has true agency or control over their diet.  Hunger is a pretty strong craving to ignore, even if you know that you don't need that many calories.  We can attempt to educate and regulate away obesity just like smoking and substance abuse, but it will be harder to do when everyone still eats every single day and needs to maintain responsible decisions pretty consistently at most meals for the rest of their lives. 

And there is ultimately a moral decision of whether we should have prohibition of calorie-dense foods or whether people should have agency to choose to eat what they want.

 

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16 hours ago, lokisnow said:

It’s a sadistic feedback loop problem, if it were effective people would stick with it, but it’s ineffective and they bail because why inflict continual torture to no result upon yourself?

on the other hand, There’s a lot of people that enjoy seeing the torture though, and are invested in maintaining both their pleasure and their relative position to the afflicted, so we should probably consider their intersectional interests in maintaining this treatment regime.

How on Earth do you come to the conclusion that eating healthy and exercising are ineffective? That's literally the best combo when fighting obesity.

Seeing diet and exercise as torture is a pretty big part of the problem.

People too often get in to the trap of seeing diet and exercise as an all in or an all out issue. Paying more attention to what you eat does not mean that you can never have pizza or sodas again, just have it less often. The same goes for exercise - you don't need to reach the Olympics, just need to get your ass of the couch. Training for an hour three times a week is more than enough to see significant improvements.

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I would start by trashing the word "epidemic" to describe the very, very, complex social, economic and environmental forces that are interacting in ways that permit a larger range of the population to become obese.  "Epidemic" implies a disease that can be "cured." It also, at least to me, implies that people who have problems with their weight are somehow sick or wrong and are contagious.  While obesity can certainly be a leading contributor to various kinds of disease, that does not mean that it, itself, is a disease that can be transmitted from one person to another.*

There are so many potential causes:  packaged food, fast food, sodas, food deserts, increase in sedentary amusements, lack of walkable communities, sedentary employment, commoditization of exercise, fad diets, class, race, and regional pressures, I could go on.  I'm personally very opposed to "taxes" on behaviors.  I've expounded on this in other threads, so I won't do it at length here again, but I don't think it works.  Among other reasons I think for certain things (including sugary foods and drinks) people will be relatively price inelastic.  And so these taxes will just be regressive tariffs on the people least able to afford them.  Speaking of sedentary work, I've got to trot off and do some, but I will come back, and have more thoughts.....

 

 

*Yes, I take Ormond's point that parents have a huge impact in respect of children.  I completely acknowledge this.  I also acknowledge "contagious" mass hysterias.  But I tend to think the panic over "obesity" falls in that bucket too. 

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I agree with mostly everything that has been said here.

One thing that has really opened my eyes is the difference eating real food (as much as I really hate that term) makes to weight loss and maintaining healthy habits. Some of my friends have really opened my eyes, because they have a real taste for eating fresh fruit and veg, where I would naturally need to smother it in sauces or just ignore it because I just don't like it. 
I also had the demonisation of carbs, but there is something to the over reliance of cheap carbohydrate sources to pad out meals, do we really need all that pasta, rice, bread etc?

Of course sugar as well only adds to the problem, but again, I don't like to demonise it as many seem to, in moderation its fine. 

So I think if I was going to boil it down to 2 things, it would be poor quality "not real" foods, and then more importantly, a relationship with food that goes beyond hunger. Food is now so easy to get hold of that we can eat whenever we like. And we use food to try and fix our emotional problems, distract ourselves, we eat socially, we eat without even thinking about it. It very rarely is because we are genuinely hungry.

I've spent time in the past doing fasting, and that really makes you examine your relationship with hunger and what you often mistakenly assume to be hunger. When I realised that my hunger response was often nothing more than my bodies automatic timing mechanism, getting ready for a meal at a certain time of day, then I started to think of it differently. When I stopped eating breakfast, for days I thought I would starve, but then my body caught up. It turns out I wasn't genuinely hungry. And also being hungry isn't actually that bad for you, it could well have a number of health benefits if you look into it. I think we have all forgotten what the natural state of hunger is like.

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8 hours ago, baxus said:

How on Earth do you come to the conclusion that eating healthy and exercising are ineffective? That's literally the best combo when fighting obesity.

Seeing diet and exercise as torture is a pretty big part of the problem.

People too often get in to the trap of seeing diet and exercise as an all in or an all out issue. Paying more attention to what you eat does not mean that you can never have pizza or sodas again, just have it less often. The same goes for exercise - you don't need to reach the Olympics, just need to get your ass of the couch. Training for an hour three times a week is more than enough to see significant improvements.

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.

(that economic consequence of the negative feedback loop obesity treatment cycle is no joke, and one of the biggest reasons successful obesity treatment is mostly segregated to the upper class and upper middle class. and the massive amount of money extracted from obesity victims to enforce this luxury tax is a big part of the reason we will never see an effective drug based intervention allowed to come to market--because such a drug would be "cheating" the profiteers out of their billions and a massive cultural campaign to brand any such drug based intervention as "cheating" or otherwise morally reprehensible would be ennacted to try to preserve their interests)

And the people with natural immunity saying "I can still eat pizza" or "I can still drink soda" ("i'm just not a pig") or "I'm still fit but I'm not an Olympian" ("not like those lazy slobs that just don't try") are part of the peer group problem of the disease--just because such folk suffer no consequences from interacting with the obeseogenic environment they assume a mantle of relative cultural superiority that entitles them to make moral judgments about those suffering from the disease.

Close to 100% of disease victims have been implementing treatment regimes daily since their mid teens, when the abnormal tissue growth cycle begins, many of the younger generation, have been implementing treatment regimes since as young as four years old. But that 93% failure rate is a brutal number to overcome, so in spite of most of those "fat, lazy slobs" having dedicated a significant portion of their lives and incomes to overcoming the disease (unlike the "virtuous" non-obese judging caste who are definitely _not lazy_ when they netflix and chill more than they go to the gym) they still continue to fail.

For many victims, they have the disease, as well as a physical job that causes them to burn 2000-6000 calories more daily than the virtuous caste, yet the disease persists, as it always has.

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I'm convinced that the obesity issue will not be solved until "SCIENCE" can come up with a genetic cure.  There are way too many emotional and societal factors which make humanity as a whole unable to cope with them.  (It's late and I'm blathering.  Hope this makes sense.) 

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On 2/27/2019 at 9:13 AM, maarsen said:

I never eat anything called fat-free as it has just as many calories added from sugar.  Just eat less prepared food or prepare your own from basic ingredients.

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. 

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20 hours ago, baxus said:

How on Earth do you come to the conclusion that eating healthy and exercising are ineffective? That's literally the best combo when fighting obesity.

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.

We will probably have to do something similar to the way we fought smoking in the US - public shaming of the practices, massive education of the public to the dangers of some kinds of food, restriction of the most dangerous kinds of things. This is especially hard because unlike cigarettes a lot of the reason we're in this situation is because the most harmful kinds of food are also the ones that are hugely affordable. 

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There are some quite interesting studies out there, connecting economic deregulation with obesity. Economic deregulation tends to boost stress levels among the wider population (less job security), and stress tends to result in the body hoarding fat - basically, it's the evolutionary "there's a crisis coming! Best not starve!" Combine that with the availability of fast food, and you're left with the situation that poor people in the West tend to be fatter than rich people, while the reverse is true in the Third World.

"Exercise more" is up there with "eat less" as a mantra from a food industry obsessed with escaping responsibility. Telling people to exercise more often just makes them hungrier - which makes them eat more.

So, in addressing obesity:

  • Reduce social stress. Improve job security. Allow more holidays. Take a stricter approach to regulating monopolies (there is actually a correlation in the US between obesity increasing and the spread of Walmart to a particular local area).
  • Tax the hell out of added sugar (get it out of breakfast cereal, for a start). America's corn syrup problem is unique to them, but the general sugar problem still stands. The stuff is sodding poison.
  • No more advertising for fast food. It can go the way of cigarette advertising.
  • Nutrition and food preparation compulsory in schools.
  • Change food labelling laws to make it easier to identify the healthier options.
  • Investment in effective public relations to push back against the power of the Sugar and Fast Food industries. These guys have their lines all sorted. They don't and won't take an attack lying down.
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On 2/28/2019 at 3:39 AM, Derfel Cadarn said:

Get food producers to stop putting so much crap (i'e sugar) in food. Or at least be honest. Look at the amount of sugar in so-called fat free healthy yoghurt, for example.

The irony being that fat - even saturated fat - was never the problem.

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