Sunday, February 24, 2008

Obesity

I'm not a militant fat person - you know, those people who think everything in their life that goes wrong is because they're fat and everyone hates fat people. Surveys tend to bear out that being fat is something our society really looks down on. However, I guess I haven't had that experience myself - that I know of, anyway. So, I'm not a militant fat person.

But, that said, there are a few things people assume about fat people that really tick me off.

1. Fat people have no energy and are lazy.
I don't think anyone who knows me would consider me lazy. And I have more energy than almost anyone else I know. So, while some people may not have energy, that is not a given. I go, go, go most of the time.

2. Fat people are horribly unhealthy.
People are individuals and actuaries don't know everything. My cholesterol is 103, with a very low amount of "bad" cholesterol.. I just took my blood pressure and it is114/70, with a pulse a 46. My sugar is normal. That's probably more heridity than anything else, although I do eat lots of fruits, vegetables and nuts and very little meat compared to the national average.

3. Losing weight is very straightforward - fewer calories, more movement - and it's just a matter of willpower
It may be easy for some people, but it's not for others of us. We all "get" the equation - less calories and more movement - but for some of us there is something that keeps us from being able to put that into practice. If I knew what it was, I'd share it with everyone, but I don't know. I know I'm driven to eat in ways that other people are not.

I know some people can't put down alcohol or drugs or their credit cards or gambling or bad relationships or whatever. I'm not sure why people can't see that food is an addiction for others of us. But, unlike alcohol or drugs, we can't simply avoid it.

Hunger is the only autonomic system we expect people to have conscious control over. Why is that? In a purely objective sense, doesn't that seem a little weird? It's like expecting people to control consciously how many times a minute they blink. When I try to diet, that's what it feels like, by the way - that I must be constantly thinking about food - what I can eat, what I cannot eat, when I can eat, etc. etc. etc. It feels much like the effort that would be required to control the blinks of your eye. I know that may seem preposterous to those of you with "normal" relationships to food, but that is seriously how it feels. Can you understand why that is exhausting? And just too much to actually accomplish?

4. Diets
Diets fail 97% of the time. If any other medical procedure failed this much we would never offer it as a solution. Can you imagine deciding to have open heart surgery knowing there was only a 3% chance it would be successful? Would your doctor suggest setting your broken arm if there were only a 3% chance it would come out healed? Yet this same doctor will suggest diets, knowing they're doomed to fail.

It's as if fat people are not worthy of anything resembling a real treatment. Oh, lots of lip service is paid to obesity, but it's all talk. There has never been a single, effective treatment offered for obesity. Ever. Not one.

Why is that? Obviously, we can create human beings in petri dishes, it would seem we could treat obesity.

I truly don't know the answer to that question, other than it's something people view as not necessary for treatment - after all, it's simple - more movement, less calories - if people aren't going to do that then they're not going to bother taking a pill. Ah, but of course, this is where they're all wrong. It seems like there would be some major money in it for drug companies, but so far no one has bothered to put serious effort into it.

5. Fat people are a drain on the health care system.
This is simply false. In reality, "healthy" people are the most costly for the health care system over a lifetime.

Following is a story from the Associated Press:


Fat people cheaper to treat, study says


By MARIA CHENG, AP Medical WriterWed Feb 6, 6:25 PM ET

Preventing obesity and smoking can save lives, but it doesn't save money, researchers reported Monday. It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.


"It was a small surprise," said Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."


In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers.


Van Baal and colleagues created a model to simulate lifetime health costs for three groups of 1,000 people: the "healthy-living" group (thin and non-smoking), obese people, and smokers. The model relied on "cost of illness" data and disease prevalence in the Netherlands in 2003.


The researchers found that from age 20 to 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.


On average, healthy people lived 84 years. Smokers lived about 77 years, and obese people lived about 80 years. Smokers and obese people tended to have more heart disease than the healthy people.


Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on.


The cost of care for obese people was $371,000, and for smokers, about $326,000.


The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars.


"This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars," said Patrick Basham, a professor of health politics at Johns Hopkins University who was unconnected to the study. He said that government projections about obesity costs are frequently based on guesswork, political agendas, and changing science.


"If we're going to worry about the future of obesity, we should stop worrying about its financial impact," he said.


Obesity experts said that fighting the epidemic is about more than just saving money.


"The benefits of obesity prevention may not be seen immediately in terms of cost savings in tomorrow's budget, but there are long-term gains," said Neville Rigby, spokesman for the International Association for the Study of Obesity. "These are often immeasurable when it comes to people living longer and healthier lives."


Van Baal described the paper as "a book-keeping exercise," and said that governments should recognize that successful smoking and obesity prevention programs mean that people will have a higher chance of dying of something more expensive later in life.


"Lung cancer is a cheap disease to treat because people don't survive very long," van Baal said. "But if they are old enough to get Alzheimer's one day, they may survive longer and cost more."


The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.


"We are not recommending that governments stop trying to prevent obesity," van Baal said. "But they should do it for the right reasons."


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On the Net:


PLoS: http://medicine.plosjournals.org





1 comment:

Anonymous said...

Love this post! My husband is "obese" and I get so tired of all the stupid myths out there. He may weigh twice my weight, but he's so much healthier than me it's not funny.