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Obesity and Ozempic and more (4 Viewers)

Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?

For me, I’m 5’10” and 182 pounds. That’s like a 26 BMI which is “overweight.” Well, I’m admittedly overweight. The reason I currently don’t feel overweight and am not generally viewed as overweight, is that American standards have shifted such that people who are still overweight aren’t viewed as such.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.
I thought the whole idea of MBI was to taken into account muscle mass vs fat. Goes to show I don't know crap.
Nope. https://www.scientificamerican.com/...-ways-than-bmi-charts-to-assess-health-risks/

"Not only does BMI fail to distinguish between muscle and fat, but it says nothing about where that fat sits in your body"
 
In the short-term, I get it. Many people won't change their lifestyles and these drugs can improve their lives.

Long-term, we continue to foster this “just take a pill” approach in lieu of natural remedies. As medical “advances” continue, we will see this more and more. Where will it end? Will there be a point of no return?

Japan’s approach is far superior but we don’t have the culture to deal with the problem as effectively.
Probably more so the Contrave than the Ozempic.... if I did not take this pill, I really don't think I could change my lifestyle. I had tried... over and over.... trying all the different tricks and best practices and failure every time. I take an anti-addiction pill and suddenly I am free to make choices consistently that are building a healthy lifestyle. I was thinking about this driving home after dropping my daughter off at camp this morning. Never in a million years would I have said "I have a food addiction". That just would sound laughable and a crutch. A way to make me feel better about just being weak willed. As I outlined before, the only diet I had that worked for me worked because it addressed my addiction cravings in a way that still fit the diet. Even then, I had no idea that was the key for me. It wasn't until finally being defeated and going to the Doctor to talk about the ONE THING I NEVER wanted to do, which was surgery, and talking through all the various failed attempts.... then talking about the success on the low carb. It still didn't dawn on my that this might be an addiction even when my Doctor was talking to me about a pill that they give recovering alcoholics and drug addicts. At that point, all my barriers were broken and I said "sure, give it to me" and when I took it and felt the massive difference of no longer having this overwhelming urge, craving, drive that I needed to fill.... that I saw it was an addiction. This has really helped me understand what alcoholics and drug addicts go through and why it is so hard for them to quit in a way I never understood before.

If anyone takes Ozempic or any other drug to fix their weight problem then they are doomed to end up packing the weight all back on again just like when people go on restrictive diets... whatever the fad is at the time.... and then gain the weight back when they go off of it.

I am using these drugs to make progress now, get healthy and my goal is along that journey build into my life consistent lifestyle choices that are healthy. Without the drugs, I would not be able to do it other than perhaps surgery which I can now avoid thanks to this. But I wonder, with the surgery, the addiction would still be there. Over time you can 'overcome' what the surgery did for you. So.... that seems like it would have failed too for me.

There is hope that those that stay at a lower bodyweight for ~2 years eventually can stay there and get a new hormone set point without that intervention. Long term studies haven't nailed down exactly that timeline but oz is going to help in that area.
I have until the end of the year on Ozempic. Then the family deductible resets and it will cost $950 for 5 weeks. Nope. The bigger aid to me has been the Contrave. I am hoping that after time, coming off the Contrave the cravings will be gone.... or the very least more manageable and then in the meantime building healthy lifestyle choices that reinforce not falling to old habits.
You may want to look into Mounjaro once it resets. Same class of drug. Ozembic was running me >$400 a pop, Mounjaro is only $25 through my insurance. If insurance will cover, it should be easier since you've already 'tried' ozembic which is often a requirement.
Mounjaro (Zepbound as a weight loss drug) is actually a different class than Ozempic (Wegovy). The former bonds two different receptors involved in appetite/satiety/weight regulation, and is more potent, but has less long term data.

If I were obese, I’d gladly choose the more effective drug, especially at 1/8 the cost.
 
Good post. For solutions, I'd be interested to continue talking about how Japan can achieve a 4% obesity rate while we have 36%. From the podcast, they talked about some things that would seem insane for the US - like companies weighing their employees and requiring them to maintain a certain weight. The US Military does that of course requiring people to be a certain fitness level. I'm sure other things like police and firemen and paramedics and such do as well. But I don't see other companies being able to do that. But maybe they do. I wonder how it goes over in Japan.

Wasn't sure if you saw the article below -- posted it in this thread this past Saturday. It's clear to me that to achieve a society-wide reduction in obesity down to Japan's level, the U.S. would have to become, socio-culturally, a lot like Japan. And not just in the obesity-facing aspects ... in almost all aspects: lack of social cynicism, social trust, ready acquiescence to government and to experts, lower expectations of privacy, collectivism over individualism, and many more.

Many of the same arguments regarding vaccine uptake apply - there’s no way Americans can be expected to behave like the Japanese.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

ETA: I'm definitely in need of losing more weight. I hit 60 and cut loose for a while. Getting back but without losing some muscle I'll never be in the "normal" range using BMI as the metric.
 
People know the food is bad. Everyone drinking Coca Cola knows sugar is bad for you.

Japan educates their people about proper diet. That lean protein and vegetables and non fast food is good for you, right?

That's not a secret.

I think American people also know this.

Spend any amount of time in nutrition based forums with people actually looking for help and trying to make better choices, and I think you would be absolutely floored by how few people actually do understand this, though to be a bit "more" correct, it's an excess of sugar, and added sugar, that is bad for you, not just a blanket sugar is bad otherwise you will have people demonizing foods like fruits and vegetables because they have sugar in them.

The general lack of knowledge about caloric intake, what macro nutrients are, sources of calories, etc. is astounding.
 
For the average person (not competitive athletes or muscleheads), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
It's just weight divided by the square of your height. Doesn't take into account how much of that weight is muscle, fat or bone, or any other demographic factors like age, gender, ethnicity, etc.

I mean, fat people will have a high BMI and skinny people will have a low BMI, but that's about the extent of its insight. It's not a good guideline for what you should weigh, and insurance companies and the government really should not be using it to determine any financial penalties.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

That’s why I carved out “muscle heads” from the observation along with competitive athletes. And I don’t mean that as a pejorative.

And I agree there are much better ways to make an assessment, but I think BMI is still useful as a shortcut for the majority of Americans (or at least two-thirds I guess). I think BMI is disliked by a lot of people because it tells people who don’t think they are overweight that they are.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

That’s why I carved out “muscle heads” from the observation along with competitive athletes. And I don’t mean that as a pejorative.

And I agree there are much better ways to make an assessment, but I think BMI is still useful as a shortcut for the majority of Americans. I think BMI is disliked by a lot of people because it tells people who don’t think they are overweight that they are.
Mentioned earlier waist to height ratio. Very simple and a much better metric.
 
The comparison to smoking is useful in a lot of ways imo. I'm 51, and when I was a kid virtually EVERY adult I knew smoked. Now, nearly nobody does. But bringing the discussion back around to Ozempic and the other current weight loss drugs--I'm curious how much we think drugs like Chantix allowed the U.S. to largely break the smoking addiction society-wide? I know personally I was never a smoker, but I know several folks who smoked for decades who had tried to quit multiple times but were only successful in stopping after getting a Chantix prescription.
Chantix helped, as it doubles to triples the rate of effective smoking cessation, more so than any other intervention.

But smoking is on the out largely because of changes in societal acceptance, which have been greatly influenced by policy.

So both are important.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes or muscleheads), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
It’s not perfect, but one of the better quick-and-dirty estimates of overweight/obesity, with plenty of data showing its value as a proxy for healthy weight.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?

For me, I’m 5’10” and 182 pounds. That’s like a 26 BMI which is “overweight.” Well, I’m admittedly overweight. The reason I currently don’t feel overweight and am not generally viewed as overweight, is that American standards have shifted such that people who are still overweight aren’t viewed as such.
Yeah, most people attributing their bloated BMIs to extra muscle are probably off the mark. On the contrary, BMI tends to underestimate adiposity in comparison to better tools like DEXA, especially in white males.

And societal standards for what constitutes a healthy weight vs. too thin already skew heavy, and are moving in the wrong direction imo.
 
The problem is that's not a societal solution. How can we make meaningful changes at the societal level, recognizing that hoping for more personal responsibility isn't going to work?

What exactly do you mean by "changes at the societal level"?

What type of things are a "societal solution"?
When I say societal solution or societal level, I'm talking about large changes in the health of the country. For example, we've seen the 36% of Americans are obese stat reported in here. I'm assuming that we/society wants to get that number down. I'll define societal solution as anything that brings that number down in a meaningful way. For example, outlawing sugar would probably do it. That's not to say outlawing sugar is a good idea, but it would likely work.

What we do know, though, is that hoping for millions and millions to just decide they need more personal responsibility to eat healthier and exercise more won't bring that number down. Therefore, it's not a societal solution.

If the reason people taking responsibility for their own diet and exercise isn’t societal because too many people won’t take responsibility and won’t do what’s necessary, seems like you’re conflating “societal” with “effective “.

Do you mean it needs to be a government solution?
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

That’s why I carved out “muscle heads” from the observation along with competitive athletes. And I don’t mean that as a pejorative.

And I agree there are much better ways to make an assessment, but I think BMI is still useful as a shortcut for the majority of Americans (or at least two-thirds I guess). I think BMI is disliked by a lot of people because it tells people who don’t think they are overweight that they are.
Here's a better "real world" comparison. Using info my wife told me today, my FIL (who is taller than me) weighs 10lbs less than me, yet his waist is 10" bigger than mine. He has little bird legs and arms but a nice round belly. Based on BMI alone he is much more fit than me. In fact his BMI says he's very near "normal".

Here's more on BMI flaws, including from the AMA.

"Given the report’s findings, the new policy supports AMA in educating physicians on the issues with BMI and alternative measures for diagnosing obesity."

 
Spend any amount of time in nutrition based forums with people actually looking for help and trying to make better choices, and I think you would be absolutely floored by how few people actually do understand this, though to be a bit "more" correct, it's an excess of sugar, and added sugar, that is bad for you, not just a blanket sugar is bad otherwise you will have people demonizing foods like fruits and vegetables because they have sugar in them.

The general lack of knowledge about caloric intake, what macro nutrients are, sources of calories, etc. is astounding.

Thanks. That’s interesting.

I may well be giving people too much credit.

But for instance here, I feel like just about every single person here understands the basics of nutrition. Sure, we’re not indicative of the general public in everything but it seems like this is basic stuff.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

ETA: I'm definitely in need of losing more weight. I hit 60 and cut loose for a while. Getting back but without losing some muscle I'll never be in the "normal" range using BMI as the metric.
Can you elaborate a little on the weight you gained weightlifting?

I also lifted regularly for years, but never got “big”, though I added 20-30# of muscle along the way. Despite that, my BMI never sniffed obese.

In middle age, I’ve lost some of that muscle mass, and gained fat. Really hard to stave off those changes, even if diet and exercise are good.

But I’ve never known a musclebound 60-year-old, and certainly none that look like the two athletes you linked, who surely have single digit body fat %.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

That’s why I carved out “muscle heads” from the observation along with competitive athletes. And I don’t mean that as a pejorative.

And I agree there are much better ways to make an assessment, but I think BMI is still useful as a shortcut for the majority of Americans (or at least two-thirds I guess). I think BMI is disliked by a lot of people because it tells people who don’t think they are overweight that they are.
Here's a better "real world" comparison. Using info my wife told me today, my FIL (who is taller than me) weighs 10lbs less than me, yet his waist is 10" bigger than mine. He has little bird legs and arms but a nice round belly. Based on BMI alone he is much more fit than me. In fact his BMI says he's very near "normal".

Here's more on BMI flaws, including from the AMA.

"Given the report’s findings, the new policy supports AMA in educating physicians on the issues with BMI and alternative measures for diagnosing obesity."

Even though it correlates with some diseases, BMI is not a measure of physical fitness.
 
Spend any amount of time in nutrition based forums with people actually looking for help and trying to make better choices, and I think you would be absolutely floored by how few people actually do understand this, though to be a bit "more" correct, it's an excess of sugar, and added sugar, that is bad for you, not just a blanket sugar is bad otherwise you will have people demonizing foods like fruits and vegetables because they have sugar in them.

The general lack of knowledge about caloric intake, what macro nutrients are, sources of calories, etc. is astounding.

Thanks. That’s interesting.

I may well be giving people too much credit.

But for instance here, I feel like just about every single person here understands the basics of nutrition. Sure, we’re not indicative of the general public in everything but it seems like this is basic stuff.
It would be interesting to start a nutrition thread, where people delineated what constitutes a healthy diet. While I’m sure we’d agree on a few things, I bet overall nutritional knowledge is all over the map.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.
It’s not perfect, but in terms of a rule it kinda is all we have.

As an example, would you be ok with let’s say a 25% premium increase if you have a BMI over 32?
 
Spend any amount of time in nutrition based forums with people actually looking for help and trying to make better choices, and I think you would be absolutely floored by how few people actually do understand this, though to be a bit "more" correct, it's an excess of sugar, and added sugar, that is bad for you, not just a blanket sugar is bad otherwise you will have people demonizing foods like fruits and vegetables because they have sugar in them.

The general lack of knowledge about caloric intake, what macro nutrients are, sources of calories, etc. is astounding.

Thanks. That’s interesting.

I may well be giving people too much credit.

But for instance here, I feel like just about every single person here understands the basics of nutrition. Sure, we’re not indicative of the general public in everything but it seems like this is basic stuff.
I think you are giving people too much credit. I guess also depends on what you mean by the basics of nutrition. But my sense is people don't really know all that much. And most don't look at labels so don't even know what they're eating half the time.
 
I think the lack of "will power" makes more sense when we treat sugar as a drug.
Said it a start of thread sugar/caffeine is an addiction, very similar to alcohol.

Plus eating relieves a countless number of emotions.

I'm struggling to lose the 30 pounds I gained because I have 2 good weeks, then fall off the wagon. Food not even sweets is so ingrained in you psyche that when you have the same habits for 30-40 years but obviously can't work it off like you used too it's a tough road

Yes it's a mental battle. And I'm not one that celebrates obesity body positivity non sense. But I do have an understanding how hard it can be
 

Man it seemed that everyone was smoking in Tokyo when I was there a few months ago.
This seems high for US and low for Japan from my travels. I might see 1 person in 100 smoking in the US. 15% seems impossible unless they are counting occasional stuff really tight or there are sections of the population that just smoke like crazy.
 

Man it seemed that everyone was smoking in Tokyo when I was there a few months ago.
This seems high for US and low for Japan from my travels. I might see 1 person in 100 smoking in the US. 15% seems impossible unless they are counting occasional stuff really tight or there are sections of the population that just smoke like crazy.
Ever been down south, Chief?
 
Spend any amount of time in nutrition based forums with people actually looking for help and trying to make better choices, and I think you would be absolutely floored by how few people actually do understand this, though to be a bit "more" correct, it's an excess of sugar, and added sugar, that is bad for you, not just a blanket sugar is bad otherwise you will have people demonizing foods like fruits and vegetables because they have sugar in them.

The general lack of knowledge about caloric intake, what macro nutrients are, sources of calories, etc. is astounding.

Thanks. That’s interesting.

I may well be giving people too much credit.

But for instance here, I feel like just about every single person here understands the basics of nutrition. Sure, we’re not indicative of the general public in everything but it seems like this is basic stuff.
It would be interesting to start a nutrition thread, where people delineated what constitutes a healthy diet. While I’m sure we’d agree on a few things, I bet overall nutritional knowledge is all over the map.

Possible. But I think most everyone knows what basic healthy eating is.

I don’t mean how many calories in a gram of fat or defining ketosis. I mean all you practically need:
  • Avoid fast food.
  • Avoid sodas.
  • Avoid sugar
  • Avoid fried foods.
  • Keep calories around 2000 (printed on every food label)
  • Eat lean protein
  • Eat lots of vegetables
I think almost every person in this thread knows more than enough to eat healthy.
 
I think the lack of "will power" makes more sense when we treat sugar as a drug.
Said it a start of thread sugar/caffeine is an addiction, very similar to alcohol.

Plus eating relieves a countless number of emotions.

I'm struggling to lose the 30 pounds I gained because I have 2 good weeks, then fall off the wagon. Food not even sweets is so ingrained in you psyche that when you have the same habits for 30-40 years but obviously can't work it off like you used too it's a tough road

Yes it's a mental battle. And I'm not one that celebrates obesity body positivity non sense. But I do have an understanding how hard it can be
Absolutely. I found it far easier to give up alcohol (which was an addiction for me, not just a casual thing) than to cut out sugar.
 
The problem is that's not a societal solution. How can we make meaningful changes at the societal level, recognizing that hoping for more personal responsibility isn't going to work?

What exactly do you mean by "changes at the societal level"?

What type of things are a "societal solution"?
When I say societal solution or societal level, I'm talking about large changes in the health of the country. For example, we've seen the 36% of Americans are obese stat reported in here. I'm assuming that we/society wants to get that number down. I'll define societal solution as anything that brings that number down in a meaningful way. For example, outlawing sugar would probably do it. That's not to say outlawing sugar is a good idea, but it would likely work.

What we do know, though, is that hoping for millions and millions to just decide they need more personal responsibility to eat healthier and exercise more won't bring that number down. Therefore, it's not a societal solution.

If the reason people taking responsibility for their own diet and exercise isn’t societal because too many people won’t take responsibility and won’t do what’s necessary, seems like you’re conflating “societal” with “effective “.

Do you mean it needs to be a government solution?
Just insert the word “scalable” instead of “societal.”
 
"Big Sugar" doesn't force me to drink Coca Cola or eat Snickers.
No they sure don't. I'd be curious to know how much things we ingest today has added sugar in them now compared to 50 years ago? It's 5pm and I'm too lazy to fire up the Googles but I'd argue that it isn't all about personal choice. I think there has been some nefarious "slipping in of the sugar" into our diet on the sly to amplify the addiction.

I'll go put on my :tinfoilhat:and sit in the corner now.

But with food labels, it's so easy now.

I guess I could see someone who couldn't read having trouble with inadvertently getting more sugar than they choose. But that seems like a small number of people.

If the battle was educating people about food, and that there's a lot of bad food out there, that battle is won.

People know the food is bad. Everyone drinking Coca Cola knows sugar is bad for you.

Everyone knows never walking or getting any exercise is bad for you.

Most of the people in this thread grew up in the 70’s and 80’s before nutrition labels were introduced (‘94). I’d be willing to bet a large percentage of us are addicted to sugar on some level and it happened early on.

Now that doesn’t address why many still buy all that stuff and stock our homes with it - making the cycle continue with our kids.
 
If the reason people taking responsibility for their own diet and exercise isn’t societal because too many people won’t take responsibility and won’t do what’s necessary, seems like you’re conflating “societal” with “effective “.

Do you mean it needs to be a government solution?
You're making this way more complicated than it needs to be. My entire point is that society is looking for an effective solution at a macro level. I am specifically NOT conflating societal with effective. That is, we know that personal responsibility is effective, but only at an individual level and not at a societal level.

The point others, and I, are making is that "personal responsibility" isn't a macro (or societal) solution precisely because it isn't effective at a macro level.

I'll make this as clear and direct as I can: @Joe Bryant - What "thing", and define thing however you like, will help lead to a significant decrease in nationwide obesity level?
 
If the reason people taking responsibility for their own diet and exercise isn’t societal because too many people won’t take responsibility and won’t do what’s necessary, seems like you’re conflating “societal” with “effective “.

Do you mean it needs to be a government solution?
You're making this way more complicated than it needs to be. My entire point is that society is looking for an effective solution at a macro level. I am specifically NOT conflating societal with effective. That is, we know that personal responsibility is effective, but only at an individual level and not at a societal level.

The point others, and I, are making is that "personal responsibility" isn't a macro (or societal) solution precisely because it isn't effective at a macro level.

I'll make this as clear and direct as I can: @Joe Bryant - What "thing", and define thing however you like, will help lead to a significant decrease in nationwide obesity level?

To me, it seems like you are both on the same page actually. Societal = broadly effective.
 
Good post. For solutions, I'd be interested to continue talking about how Japan can achieve a 4% obesity rate while we have 36%. From the podcast, they talked about some things that would seem insane for the US - like companies weighing their employees and requiring them to maintain a certain weight. The US Military does that of course requiring people to be a certain fitness level. I'm sure other things like police and firemen and paramedics and such do as well. But I don't see other companies being able to do that. But maybe they do. I wonder how it goes over in Japan.

Wasn't sure if you saw the article below -- posted it in this thread this past Saturday. It's clear to me that to achieve a society-wide reduction in obesity down to Japan's level, the U.S. would have to become, socio-culturally, a lot like Japan. And not just in the obesity-facing aspects ... in almost all aspects: lack of social cynicism, social trust, ready acquiescence to government and to experts, lower expectations of privacy, collectivism over individualism, and many more.

Many of the same arguments regarding vaccine uptake apply - there’s no way Americans can be expected to behave like the Japanese.
This is spot on! US citizens would not accept the government intrusion/ mandates or the discrimination that the Japanese live under. Plus, Japan considers itself in crisis mode right now, regarding the fact that the younger generations are completely ignoring the healthy lifestyle guidelines set up by Japan. It’s weird to understand the Japanese perspective when we see what’s going on in the US. My guess is that the Japanese are in crisis mode because they are afraid of becoming what the US has become.

The older generations are still using unhealthy habits (smoking) to curb hunger sensation. I was surprised with the Times article as semiglutide injections/ oral drops are promoted everywhere in Japan and it’s inexpensive due to being subsidized by the government. I think the difference is that I’ve been boots on the ground 100% immersed in the Japanese culture for seven years..
 
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I found this article interesting. Japan educates kids in school about proper diet. This is government mandated.



Japan educates their people about proper diet. That lean protein and vegetables and non fast food is good for you, right?

That's not a secret.

I think American people also know this.

Yeah, we need more than education. We really need indoctrination.

Please don't misunderstand my post. I certainly am not for government involvement into my or anyone's life. I was just sharing the information in the article.
 
Can you elaborate a little on the weight you gained weightlifting?

I also lifted regularly for years, but never got “big”, though I added 20-30# of muscle along the way. Despite that, my BMI never sniffed obese.

In middle age, I’ve lost some of that muscle mass, and gained fat. Really hard to stave off those changes, even if diet and exercise are good.

But I’ve never known a musclebound 60-year-old, and certainly none that look like the two athletes you linked, who surely have single digit body fat %.
Never did I say I was a musclebound 60yo (wouldn't have said that about 30 or 40yo me either) or that I looked like either of those 2 pics. I used those 2 pics to highlight 2 different body types showing that 1 of those 2, who are both extremely fit, is considered overweight by simple BMI. Can't even tell you how much muscle I gained because that wasn't something I really thought about. I only thought about pushing more weight than anyone else in the gym and worked out 2 hours/day 6/days a week to (try to) get there. I too have lost muscle and gained fat since the "height" of those days, probably as much as 20 lbs muscle lost or more :-)shrug: ) . My chest is down a couple of inches, my biceps are down to 16", and because of my going the "F it" route as I turned 60 and that lasting until early this year I added some bad pounds (quite a few). (Also did that during the "shutdown" but that was different) That's on the way back down and should be back to good in about a month, not that it's too bad now. I don't spend 2 hours in a gym lifting anymore, in fact I don't even go to a gym. I have my own gym in a basement room but the most I'll spend on weights is about 30 minutes several times a week. On a day like today I'll go for a 20-25 mile bike ride. Others I'll use the rowing machine for 6000m, the elliptical, do some kettlebell, and something I need a lot more of, stretching. Probably should consider doing Yoga, thought about tai chi too. Once I'm back down to my target weight (within a month probably) I'm going to see how much more I can drop. I'll certainly continue to lose muscle as I age and that'll get me closer/close to a "normal" BMI but I'm not worried about that metric, it just gives me something to shoot for. WtHR is just above .5 but I'm hoping to be at or below that soon (also within about a month).

A little doctor story for you. On my first visit for a physical my former PCP was doing the stethoscope (breath in...) on my back and said something like "How does a 50+yo computer nerd get a large back like this?" Years of lat pulldowns and various rows with crazy weights doc.
 
Spend any amount of time in nutrition based forums with people actually looking for help and trying to make better choices, and I think you would be absolutely floored by how few people actually do understand this, though to be a bit "more" correct, it's an excess of sugar, and added sugar, that is bad for you, not just a blanket sugar is bad otherwise you will have people demonizing foods like fruits and vegetables because they have sugar in them.

The general lack of knowledge about caloric intake, what macro nutrients are, sources of calories, etc. is astounding.

Thanks. That’s interesting.

I may well be giving people too much credit.

But for instance here, I feel like just about every single person here understands the basics of nutrition. Sure, we’re not indicative of the general public in everything but it seems like this is basic stuff.
It would be interesting to start a nutrition thread, where people delineated what constitutes a healthy diet. While I’m sure we’d agree on a few things, I bet overall nutritional knowledge is all over the map.

Possible. But I think most everyone knows what basic healthy eating is.

I don’t mean how many calories in a gram of fat or defining ketosis. I mean all you practically need:
  • Avoid fast food.
  • Avoid sodas.
  • Avoid sugar
  • Avoid fried foods.
  • Keep calories around 2000 (printed on every food label)
  • Eat lean protein
  • Eat lots of vegetables
I think almost every person in this thread knows more than enough to eat healthy.
Those are certainly steps in right direction but good nutrition is really more than that. I'll give a few quick examples from friends of mine, these are all recent and these guys are generally pretty healthy, i.e. play sports look generally healthy. All 3 had pretty serious health issues flagged by a doctor 1) struggles with weight gain which is also impacting his knees and his ability to play sports, had no idea that eating a salad w/ blue cheese or ranch dressing every day was contributing to this. 2) signs of diabetes, when discussing nutrition w/ him says "sugar is sugar" thinking a soda and a bowl of raspberries was the same thing 3) also signs of diabetes despite having no weight issues, was not eating any whole grains eating lots of white flour products regularly.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

ETA: I'm definitely in need of losing more weight. I hit 60 and cut loose for a while. Getting back but without losing some muscle I'll never be in the "normal" range using BMI as the metric.
I'm considered obese by a typical BMI chart for that exact reason. Even while I was in the military I had to get "measured" because I didn't pass the height weight standards alone. I also have room to cut some weight as I'm typically around 18% body fat. I'd have to drop 50 lbs to get into the normal "optimal" range and that just isn't happening.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

ETA: I'm definitely in need of losing more weight. I hit 60 and cut loose for a while. Getting back but without losing some muscle I'll never be in the "normal" range using BMI as the metric.
I'm considered obese by a typical BMI chart for that exact reason. Even while I was in the military I had to get "measured" because I didn't pass the height weight standards alone. I also have room to cut some weight as I'm typically around 18% body fat. I'd have to drop 50 lbs to get into the normal "optimal" range and that just isn't happening.
The struggle is real. 😀
 
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I found this article interesting. Japan educates kids in school about proper diet. This is government mandated.



Japan educates their people about proper diet. That lean protein and vegetables and non fast food is good for you, right?

That's not a secret.

I think American people also know this.

Yeah, we need more than education. We really need indoctrination.

Please don't misunderstand my post. I certainly am not for government involvement into my or anyone's life. I was just sharing the information in the article.

I think government involvement in battling the obesity crisis should pretty much be a given. Aside from national defense, I can’t think of a more important priority than national health. At a minimum, we should be improving health and nutrition curriculum in public schools starting at a very early age to combat the marketing children are bombarded with every day.
 
Curious, would you be for or against allowing health insurance companies to charge those with a lower BMI less (so by extension charging those with a higher BMI more)?

Same idea with charging smokers more than non smokers.
Not BMI, it's a flawed metric.

For the average person (not competitive athletes), why is BMI a flawed metric, at least as a quick diagnostic? Serious question, not taking a position.
These are competitive athletes that I'll use as an example.

5'9" 136lbs (weigh in weight). In the normal range

5'11" 185lbs (weigh in weight). Used to fight at 205, likely walks around well over 190. Overweight according to BMI.

There are plenty of "average" guys who are not competitive athletes who have considerable muscle mass and BMI does not take that into account.

But you’re admittedly using competitive athletes as examples. Is it a flawed metric for you?
Yes, as it is for a huge number of people. Don't want to make this an "I lift bro" thing but I used to lift hard and I got "big". And there's plenty of people just like me at gyms all over the country. See the link I posted above. From that: "And a third of those who were identified as overweight by their BMI had normal amounts of body fat."

ETA: I'm definitely in need of losing more weight. I hit 60 and cut loose for a while. Getting back but without losing some muscle I'll never be in the "normal" range using BMI as the metric.
I'm considered obese by a typical BMI chart for that exact reason. Even while I was in the military I had to get "measured" because I didn't pass the height weight standards alone. I also have room to cut some weight as I'm typically around 18% body fat. I'd have to drop 50 lbs to get into the normal "optimal" range and that just isn't happening.

Name checks out!
 
But with food labels, it's so easy now.
Now, yes. The Nutritional Food Label didn't really come into existence until 1994 according to this article. And the one that we are familiar with today that lists out everything didn't come around until 2020 so while it's been around for a while, it's also fairly recent. I grew up in the 70's & 80's. Sugar was the drug of the day for kids like me.
 
Most of the people in this thread grew up in the 70’s and 80’s before nutrition labels were introduced (‘94). I’d be willing to bet a large percentage of us are addicted to sugar on some level and it happened early on.

Now that doesn’t address why many still buy all that stuff and stock our homes with it - making the cycle continue with our kids.
Shoulda read AAA's response and just ditto'd it :thumbup:
 
If the reason people taking responsibility for their own diet and exercise isn’t societal because too many people won’t take responsibility and won’t do what’s necessary, seems like you’re conflating “societal” with “effective “.

Do you mean it needs to be a government solution?
You're making this way more complicated than it needs to be. My entire point is that society is looking for an effective solution at a macro level. I am specifically NOT conflating societal with effective. That is, we know that personal responsibility is effective, but only at an individual level and not at a societal level.

The point others, and I, are making is that "personal responsibility" isn't a macro (or societal) solution precisely because it isn't effective at a macro level.

I'll make this as clear and direct as I can: @Joe Bryant - What "thing", and define thing however you like, will help lead to a significant decrease in nationwide obesity level?

To me, it seems like you are both on the same page actually. Societal = broadly effective.
That's fine, but it still leaves the question outstanding. Addressed to all who continue to espouse personal responsibility as a solution at the individual level:

What solution, of any kind, will have a positive impact on nationwide obesity rates?
 
That's fine, but it still leaves the question outstanding. Addressed to all who continue to espouse personal responsibility as a solution at the individual level:

What solution, of any kind, will have a positive impact on nationwide obesity rates?

Assuming no outside health complications like insulin issues or physical immobility, do you think personal responsibility in eating healthy and exercise is a solution at the individual level?
 

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