The real solution though are food purity laws. There are foods in convenience stores and some restaurants that cost the rest of society in the wake of their destruction. In other words the slimy operators do not pick up the cost which is a massive negative externality.
That is until you do the math and discover the healthier people live longer and cost society even more than the person who dies young.
<A few days ago, I wandered through a nearby mall and commented to my wife that every single person we passed was somewhere between fat and morbidly obese. >
https://www.cdc.gov/obesity/data/adult.html
From 1999â2000 through 2017âMarch 2020, US obesity prevalence increased from 30.5% to 41.9%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%.
Your mall sample was self-selected. The people who were languidly strolling through the mall werenât the same sample set as the ones who were at the gym or walking/ running outside. A few of the regulars at the YMCA gym are obese, but much less than the general population.
Itâs shocking that 40% of adults are obese and 10% are morbidly obese â a condition that was so unusual in earlier decades that the circus had a âfat ladyâ in their freak sideshow that wasnât much different than we frequently see everywhere today.
https://www.loc.gov/resource/highsm.40138/
Wendy
Fat shaming does not work at all well for most people. It is more of the knee jerk fantasy that everything comes down to individual choice when the evidence is overwhelming that most individuals, beginning as babies and continuing through life, are guided and directed primarily by the culture and situation around them.
Obesity starts in the womb.
Forget fat shaming and focus on overcoming our idiot corrupt subsidization of dangerous foods over FOOD (a very crude summary of complex stuff that needs to be done).
An almost always useful step for an individual or family seeking to overcome obesity is to hang out with people who are not obese as much as possible, in those places and doing those things that healthy people do. Going to fat farms and lose fat meetings might very well reinforce obesity.
Tax sugar, trans-fats, and etc., as if they were tobacco and for the same reason â for the good of society but more simply to recover the social costs that such bad stuff does to peopleâs health that we all pay for.
david fb
Fat shaming does not work at all well for most people.
Obesity starts in the womb.
The womb is a good place to start, the motherâs words in the open environment are next.
For each child decades ago that got fat there were the other children that were told for centuries, âif you eat too much you will get fatâ. Many of them, a very high percentage, respected that in full.
Today how many people at the dinner table tell a young child if you eat too much you will get fat? Of course that fat shaming worked well for centuries.
The problem were the tinkering wannabee scientists trying to specify which food component would make you fat. Instead of how much will make you fat by eating too many calories. The messing around with limiting carbs or fat has taken society way off track. Carbs and fat are okay with protein when there is moderation. The message of moderation was lost.
The full truth anyone overweight feels bad about it. I do not give a fig if they deny that. No one really shames them. No one really has to. And the battle against shame is because it is an internal reality that of course matters more than any external reality.
âfat-shamingâ
There is more of me to love!!! LOL
The Captain
There is more of me to love!!! LOL
The Captain
I am pretty sure you wont get a promotion. LOLAnd it was our dear government that would never lead us astray, that really pushed the stop-eating-fat crusade and told us to stuff ourselves with carbs instead
Except it didnât. Folk really need to give themselves more credit for any craptaculous eating habits they acquired when they heard the low fat message. As much as itâs very trendy to blame the obesity epidemic on some outside entityâŚgovernment, food industry, Ancel Keys etc⌠thereâs a lot of False Memory Syndrome floating around on this issue.
Iâm willing to suggest that back in the late 1970s and 80sâŚor even earlierâŚvery few folk who were eating their way to obesity and its consequences gave very much thought to every morsel that entered their mouth or wondering if their diet was in accordance with the principles of the food pyramid. Heck, if familiar with it at all, it was the cartoon version found on the back of cereal boxes or SnackWell cookie packs.
rec to veeEnn for False Memory Syndrome floating around on this issue.
I agree.
And I also think the âdietary scienceâ during most of my life, from the 60âs into the 10âs was lazy, delusional, amd worst of all dominated by models based on feeds for livestock rather than humans. It was quietly yet thoroughly corrupted by research money and other incentives provided by massive carbo merchants from Archer Daniel Midland to Monsanto to General Mills.
I was wonderfully lucky to grow up in a family dominated by homecooked meals, mostly freshly made salads and fresh vegetables served with small portions of intensely flavored meat and fish dishes, and old style Californio-Mexican cuisine (NOT TexMex but e.g. https://www.elcholo.com/menu.html), no sugar or bread on the table, and an attitude that was highly suspicious of anything my great grandmas did not eat (my little sister on opening her first TV dinner âWell, barf!â).
david fb
It is more of the knee jerk fantasy that everything comes down to individual choice when the evidence is overwhelming that most individuals, beginning as babies and continuing through life, are guided and directed primarily by the culture and situation around them.
It does no good to tell people they have no control over their weight/life style. It is also a false narrative. Genetics is rarely destiny and culture can be overcome.
I am sadly old enough to remember that the nutritional culture for the average American in the 1960s and 1970s was terrible. This was the era of Wonder bread, TV dinners, canned vegetables, even canned spaghetti. Yet obesity rates then were far lower than today. The genetics then isnât much different than today and the nutritional culture in the 1960s was much worse. We Americans are fatter than before because we Americans are more spoiled than before. We eat more and exercise less. We spend more time snacking and sitting.
Even simple things like routinely walking around the block immediately after dinner and parking far away from the restaurant can make a significant health difference.
https://www.healthline.com/nutrition/walking-after-eating
My wife is a doctor and she routinely urges her overweight patients to walk after dinner. She is amazed by how psychologically difficult this is for people who only want to head to their LazyBoy and remote control.
âWe have met the enemy and he is usââPogo
It is time to can the excuses and start holding ourselves accountable for our problems.
My mother died of gall bladder cancer at the age of 82. When she got her diagnosis, we went to the oncologist in Orange County. Probably a 8 story building with a wig store on the bottom. There were people in there that looked like the walking dead.
They had their own pharmacy and sold their own drugs. I asked how long the chemo would prolong my motherâs life. 3 months, maybe on a 9 to 12 month timeline. At the point she got sick, she was active, mowed her own substantial lawn. Very self-sufficient. If she took chemo, she would get nauseaous, need to stay out of the sun, etc. I called a palliative provider and spoke to a nurse. Asked her about the situation. She spoke in yes and no answers, haltingly when i asked her direct questions. Would chemo help my mom or make her life more difficult. Difficult.
Mom and I had a talk. What did she want? she wanted to keep doing what she was doing so thatâs what we did. She kept active, doing all her usual things up to the last three weeks.
I told the doctor our decision. He left a voicemail saying he was disappointed in our decision, but people think, well theyâre old so why try.
What s self-interested ass. And all Momâs other doctors ordered medications, for depression, which we decided against. Breast x-rays-for a terminal patient. They all acted like their 15 mins with my mom entitled them to make life altering decisions and bristled when questioned.
Be your own advocate and an advocate for those you love. Doctors: Ka-Ching for everything they do so what do you thing they advocate for?
There was a study done only a few years ago about what a doctor does when handed a terminal diagnosis in their own case. Most go home to die with no care.
Mom and I had a talk. What did she want? she wanted to keep doing what she was doing so thatâs what we did. She kept active, doing all her usual things up to the last three weeks.
Part of my Momâs last will and testament, âI want to die at home.â I didnât find this out until after she died but I knew her well enough that I carried out her wishes.
I told the doctor our decision. He left a voicemail saying he was disappointed in our decision,
Stupid, arrogant doctor!
I had a similar discussion with our doctor after he said he needed to take my mother to the hospital to examine her properly. I asked him, âIf you take my mother to the hospital, will you cure her?â He replied âI canât promise that.â So I declined. Later we had another conversation:
Denny: âDoctor, what do you think about my decision?â
Dr: âMedically itâs the wrong decision but humanly, itâs probably the right one.â
I was next to Mom as she quietly left this earth the following day, her last wish fulfilled.
The Captain
My Mom was quite a lady, she survived two world wars and three husbands!
There was a study done only a few years ago about what a doctor does when handed a terminal diagnosis in their own case. Most go home to die with no care
Do you recall which journal this study was published inâŚbecause Iâm willing to bet they donât. Maybe more accepting of a diagnosis with poor prognosis, certainly less likely to threaten law suits or worse against their care team to demand futile interventions and possibly less likely to be duped by âalternativeâ practitioners promising miraculous cures with all manner of WOO! from homeopathy to cottage cheese enemas (Old Lags from the H&N board will know what I mean) Going home to die with no care is an unlikely scenario.
Just like with everyone else, a âterminal diagnosisâ can be handed out at any age and stage of life/career. Over the past few decades, friends and colleagues of my husband and I have gone through this and made a choice to follow the sort of aggressive, misery inducing therapy I wouldnât even entertain. Usually for the practical purpose of gaining just a bit more time to be able to put family affairs in order, see teenage offspring graduate college or their first child/grandchild born etc etcâŚand every once in a while lived for much longer than ever anticipated.
I bet this study was hugely flawed and full of confirmation bias on the part of the authors.
My wife is a doctor and she routinely urges her patients to walk after dinner. She is amazed at how difficult this is for people who only want to head to their LazyBoy and remote control
Husband and I were discussing this very topic on our early morning walk the other dayâŚas in how long term overweight patients/clients seem not to realise just what us ânaturally leanâ folk do to actually be naturally lean.
Thereâs a huge advantage in never having been fat. Quite apart from all the metabolic and hormonal drivers to overeating that comes with excess adiposity (the physiology) the things that lean folk do thatâs so differentâŚcontrolling energy intake (whether you want to or not), and exercising appropriately (again, whether you want to or not)âŚare such longstanding habits that theyâve become wellâŚhabits
My stable weight range (of about 128-132lbs on a 5â6" fairly muscular frame) is achieved by, Iâm guesstimating, a daily energy intake of around 2000-2200Cals, give or take with an energy output that matches it. This doesnât allow for many desserts, glasses of wine or much time on the tuchis.
Iâm in Emeritus mode now, but back when I was teaching group exercise classes it wasnât uncommon for class members to quiz me on tips for staying in my sort of shapeâŚlooking for the illusive secret, I guess. Almost invariably when Iâd go to the trouble of outlining my eating habits and training strategies (in addition to my upwards of 5 classes per week of SPIN, group strength with the occasional boot camp thrown in) complete with spread sheets and data from my current wearable, their reactions would range from disbelief to resentment.
âWell, no wonder youâre so skinny if you do all thatââŚfor all the world as if I was somehow cheating.
âWell, if I ate like that, Iâd be skinnyââŚwell, yesâŚisnât that the point?
Every once in a while the very same convo would nudge someone in the direction of behaviour change.
Like I always sayâŚweight management is as least as much psychology as physiology
Do you recall which journal this study was published inâŚ
It was a Stanford study: âMost physicians would choose a âno-codeâ status for themselves if they were terminally ill, but would tend to pursue aggressive treatment for patients facing a similar prognosisâ https://med.stanford.edu/news/all-news/2014/05/most-physiciaâŚ.
Here is the article in the well-respected journal PLOS One 2014: https://journals.plos.org/plosone/article?id=10.1371/journalâŚ
Conclusion of paper: âOur study raises questions about why doctors continue to provide high-intensity care for terminally ill patients but personally forego such care for themselves at the end of life.â
It wouldnât surprise me if fear of malpractice allegations plays a role. Much easier to justify doing everything one can to a grieving relative.
Conclusion of paper: âOur study raises questions about why doctors continue to provide high-intensity care for terminally ill patients but personally forego such care for themselves at the end of life.â
My Momâs doctor had the answer, two different magisteria, Medicine vs. Humanities, two different courses of action. The question then shift to, âWho has the right to decide?â
The Captain
Good find, btresistâŚif only to illustrate that different folk, with different experiences can read/hear the same message and come to a different conclusion.
Assuming this is the study mentioned upstream, I donât think it actually supports the statement that physicians are more likely to go home to die without care when receiving a diagnosis with poor prognosis.
First off, from the abstract you linked to, this was an advance directive simulation right? Totally hypothetical in healthy (as far as they know) individuals. As in a group of subspecialists filled out a questionnaire that asked them to imagine what theyâd want if they were in need of resuscitationâŚthat is usually taken to mean on the brink of death such that youâd be a corpse without intervention.
Thatâs very different from, say, getting a diagnosis of a primary CNS lymphoma thatâs pretty extensive because of late diagnosis and the treatment is somewhat experimental, will cause you to lose your hair and feel absolutely lousy during its course. Letâs call this patient Marianne (for human interest in anecdata)âŚwho, while actually having an advance directive/DNR in place, still opted for this hugely expensive, shot in the dark treatment. Which workedâŚ6 years ago.
As mentioned way upstreamâŚeveryone wants to go to Heaven, but not right now.
"I am sadly old enough to remember that the nutritional culture for the average American in the 1960s and 1970s was terrible. This was the era of Wonder bread, TV dinners, canned vegetables, even canned spaghetti. Yet obesity rates then were far lower than today. The genetics then isnât much different than today and the nutritional culture in the 1960s was much worse. We Americans are fatter than before because we Americans are more spoiled than before. We eat more and exercise less. We spend more time snacking and sitting.
Even simple things like routinely walking around the block immediately after dinner and parking far away from the restaurant can make a significant health difference."
In the 1960s, you had âin seasonâ veggies and fruits. Otherwise it was canned veggies for 70% of the year, and fruit in sugary sauce out of a can. You âcouldâ still eat a decent diet if you wished. We always had a family sit down dinner. At least one veggie on the plate along with potatoes and small portions of meat. As a family we ate out about ONCE A YEAR, other than maybe a few times âon vacationâ where we went tent camping.
There were five TV channels in the NYC area. In many areas of the country - from 1 to 3 TV channels. Not much for kids in the evening other than network news.
Then along came frozen veggies - much better and not full of sodium in cans.
Yech! TV dinners.
Of course, the big ads on TV were for âbreakfast cerealsâ full of sugar⌠and snack foods and candy bars.
Never had a pizza till I went off to college in mid 60s.
Yet, Iâd rather spend my 10 or 20c allowance on buying a balsa rubber band powered plane kit, or plastic model plane to put together than a candy bar or can of âsodaâ. or bottle of soda back then. that was a âtreatâ. (yeah, we had lots of Kool-Aid a cookouts during the summer. Hot dogs for the kids. Hamburgers for the adults. Sliced tomato.
Now? Average Family probably gets 5 take out meals a week. Pizza galore!
Anyone ever have family sit downs?
200 channels on the TV. Always âsomethingâ to watch or re-watch.
Big Gulp 7-11 drinks, 32 oz of 800 Calorie Cokes or Pepsi!
Only 99 cents!
All you can eat buffets!
Yeah, welcome to the fat era of the 21st century.
t.
âIf she took chemo, she would get nauseous, need to stay out of the sun, etc. I called a palliative provider and spoke to a nurse. Asked her about the situation. She spoke in yes and no answers, haltingly when i asked her direct questions. Would chemo help my mom or make her life more difficult. Difficult.â
My BIL was diagnosed with State 4 pancreatic cancer in Dec at age 69. Decided to do âeverythingâ possible. Had operation. Spent the next 9 months in/out of hospitals, radiation treatment, chemo. He was âsickâ 99% of the time for the next 9 months. Essentially bed ridden or feeling rotten not able to do much. Could not keep food down. Every second or third week emergency trip to hospital, in between scheduled treatments. Yeah, he had 9 months of âlifeâ but it was miserable. He was âkept aliveâ but barely.
Unfortunately, for pancreatic cancer, itâs often caught only late - at the Stage 4 level - when itâs already begun to spread everywhere. No symptoms till itâs already âtoo lateâ .
t.
"Conclusion of paper: âOur study raises questions about why doctors continue to provide high-intensity care for terminally ill patients but personally forego such care for themselves at the end of life.â
Depends upon the cancer type. Some are quite successfully treated. Breast cancer? decent survival rate. Lung cancer? Good outcome if caught early.
Others like pancreatic cancer caught at Stage IV have short outcomes, require intensive operation, radiation, chemo - and often the cancer has spread so far - youâre a goner. Less than 5% five year survival and most of those are âcaught earlyâ before Stage IV is reached.
t