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Obesity and Ozempic and more (6 Viewers)

is it possible to eat healthy. Of course. Is it easier to not eat healthily? Yep.

For sure.

What I'm fascinated by is the mindset that given the two choices, some feel they have to eat unhealthy and there's no ability for them to make a healthier choice. Like they're forced into it or something.
 
For addressing societal obesity: It doesn’t matter what people CAN do at an individual level. It matters what people actually DO at a society-wide level.

That's true as long as you accept people have no choice.

I don't accept that premise.
 
The FDA is at the very least, complicit. Look into corn subsidies. It HUGE business.
Before any discussion of personal responsibility happens, the FDA needs to end the gravy train.

There is no reason the US should not have the MOST stringent rules regarding ingredients. We are the richest country-- ever. We allowed this to happen, we gave the food lobbyists everything they wanted, and the country is blowing up, in a not good way.

Multi-pronged solution. You don't preach responsibility to addicts while allowing the cartels free reign.
 
That's true as long as you accept people have no choice.

I don't accept that premise.
It doesn’t matter if people have a choice. The result that in current socio-cultural conditions, the bad choices are almost invariably made … the result, that’s what matters.
 
I can say (as described in a lot more words in my other posts) that yes, it can be more complicated on an individual level and that also means it complicates things on a societal level as well. I don't think it is nearly as 'simple' as you think it is. You see it through your experience of "I just need to track my calories and limit how much I eat" and that is simple and it works but that isn't everyone's experience.

I think everybody agrees it can get complicated on an individual level.

The disagreement in this thread appears to be at the societal level.
That was my point though... I don't think I am a lone wolf crying in the wilderness here.

1. Educate people that lots of the food available is crap. Educate people that they need to move around. (That one feels like it's complete)
2. The people who understand there's lots of crap available instead choose the healthier options to eat.
3. The people who understand you need to move and take 10,000 steps a day do it.
The above was meaningless to me. I am very well aware and educated on food options and the need to move around. My understanding and desire to do was not enough.

If I am right that I am not an outlier (though I also don't think I am the standard either) then this may help but it is not a simple panacea either. I don't think this issue is anywhere near the realm of 'simple'.
 
is it possible to eat healthy. Of course. Is it easier to not eat healthily? Yep.

For sure.

What I'm fascinated by is the mindset that given the two choices, some feel they have to eat unhealthy and there's no ability for them to make a healthier choice. Like they're forced into it or something.
Where do you get this opinion that people “have to” or are “forced” to not eat healthily? I don’t see anyone in here saying that accept you.
 
I can say (as described in a lot more words in my other posts) that yes, it can be more complicated on an individual level and that also means it complicates things on a societal level as well
Your gout is a good example of complications. Made it harder than it already is
A week of being semi or actually bed ridden in a lot of pain for a week (and lesser pain much longer) makes it hard to keep active. Then you find out your diet that is the only thing you found that helped you lose weight was a major contributing factor to high Uric Acid levels. And then it all is a negative feedback loop as obesity is a major contributing factor to your body retaining higher levels of Uric Acid.
 
The FDA is at the very least, complicit. Look into corn subsidies. It HUGE business.
Before any discussion of personal responsibility happens, the FDA needs to end the gravy train.

There is no reason the US should not have the MOST stringent rules regarding ingredients. We are the richest country-- ever. We allowed this to happen, we gave the food lobbyists everything they wanted, and the country is blowing up, in a not good way.

Multi-pronged solution. You don't preach responsibility to addicts while allowing the cartels free reign.
A la cigarettes.
 
What I'm fascinated by is the mindset that given the two choices, some feel they have to eat unhealthy and there's no ability for them to make a healthier choice. Like they're forced into it or something.
The framing here leads to misunderstanding. Socio-cultural conditions don’t (generally) operate by anything we’d recognize as force. Instead, we’re fundamentally influenced through millions of small “contacts” all through our lives. Constant feedback builds a self-reinforcing network in our psyches. We don’t need to be forced — we’re already primed in that direction.

What we have to force, instead, is making the good decisions. We have to overcome … something … to make that happen at an individual level.

Drugs like Ozempic effectively reduce the level of force required to overcome that something.
 
It doesn’t matter if people have a choice. The result that in current socio-cultural conditions, the bad choices are almost invariably made … the result, that’s what matters.

Wow on the bolded.

Could not disagree more.

Of course it matters if people have a choice.

Behavior can change.

I don't accept that because people have made poor choices in the past to produce bad results that they have no choice but to continue making bad choices.
 
Of course it matters if people have a choice.
Not for addressing societal obesity it doesn’t. We need to aim for solutions that get results. Asking 100 million obese people to “make better choices” is already a known failure as a solution — the results demonstrate that. Over and over again.

Thinking about this in terms of choices an individual can make … that gets in the way of the top-of-the-mountain data-driven results-oriented view that’s needed to address the problem at a societal level.
 
Thinking about this in terms of choices an individual can make … that gets in the way of the top-of-the-mountain data-driven results-oriented view that’s needed to address the problem at a societal level.

Again, couldn't disagree more with your perspective choice doesn't matter. Or "gets in the way". I think that's a total and complete cop out.

But putting that aside, what type of results-oriented view and changes do you think are needed to address the problem at a societal level?

I don't accept we just throw up our hands and accept this is how it will always be.
 
Sustained weight loss is really hard for Americans but not for other cultures??

Yeah, not buying it.

Better diet, more exercise. Americans are lazy and fat.
With few exceptions, obesity is a problem in much of the developed world.

Yeah, the idea of lazy American's as it pertains to obesity is really lazy humans. We are basically the top major world power but just about everybody on the planet is overweight (by BMI) save several African nations and the far East.


Thanks. Why do most people think US is 36% and Japan, a very developed country, is 4%?

Cultural differences. And probably genetic differences as well.

Thanks. Can you elaborate? What specific cultural or genetic differences?

Cultural: the types of foods people eat, portion size (e.g., all you can eat buffets - I see all you can eat sushi in the U.S., but not in Tokyo when I was there), how much people walk or exercise (the average person, not fitness focused people), societal discrimination against people who are overweight (including employment). Just off the top of my head.

Genetic: no idea as to the science. But I do have anecdotal evidence that I’d love to hear @Terminalxylem weigh in on as he has a data set a thousandfold greater. My mom is Japanese and is from Hawaii. She was one of eight children and I have a ton of cousins in Hawaii. My cousins who are full Japanese are generally thin. My cousins where my aunt or uncle married a Hawaiian on the other hand are generally not thin. There are exceptions but it mostly holds. Culturally they are living in the same environment. I guess one could ask whether the Japanese people you know who live and have been raised in the communities where you live tend to be thinner or heavier than the average local populace?
 
Sustained weight loss is really hard for Americans but not for other cultures??

Yeah, not buying it.

Better diet, more exercise. Americans are lazy and fat.
With few exceptions, obesity is a problem in much of the developed world.

Yeah, the idea of lazy American's as it pertains to obesity is really lazy humans. We are basically the top major world power but just about everybody on the planet is overweight (by BMI) save several African nations and the far East.


Thanks. Why do most people think US is 36% and Japan, a very developed country, is 4%?

Cultural differences. And probably genetic differences as well.
Not saying you're wrong necessarily -- I'm open to the idea that the US was just destined by genetics and culture to have a higher baseline rate of obesity than Japan. But those can't explain (easily, anyway) why obesity has gotten so much worse in the US compared to, say, the 1970s. Our genetics and culture probably haven't changed enough to explain that.

Already mentioned but I think our culture has broadly speaking (I consider types of food that people eat and portion size to be aspects of culture).
 
Cultural: the types of foods people eat, portion size (e.g., all you can eat buffets - I see all you can eat sushi in the U.S., but not in Tokyo when I was there), how much people walk or exercise (the average person, not fitness focused people), societal discrimination against people who are overweight (including employment). Just off the top of my head.

Sure. But people are allowed to not gorge themselves on the all you can eat buffet, right?

And people know gorging themselves on the all you can eat buffet is a bad idea, right?
 
But putting that aside, what type of results-oriented view and changes do you think are needed to address the problem at a societal level?

I don't accept we just throw up our hands and accept this is how it will always be.
No one’s throwing up hands. We’re just framing the problem.

Societal-level change: Make the good individual decisions much easier to make and stick with — wrap both arms around satiety-inducing medications (Ozempic, etc.). Keep researching, improve them, make them more accessible and cheaper.

Improvements in the FDA as detailed above.

Bring back active play in schools — too many elementary schools replaced recess with extra academic instruction time.

Work-life balance is getting better for a lot of white-collar workers thanks to work-from-home and other changes. Perhaps home-prepared meals for the family can regain some shares yielded to fast food and take out over the last ~30-40 years.

Just some quick top-of-the-head thoughts.
 
Of course it matters if people have a choice.
Not for addressing societal obesity it doesn’t. We need to aim for solutions that get results. Asking 100 million obese people to “make better choices” is already a known failure as a solution — the results demonstrate that. Over and over again.
There are a lot of obese people who cannot make substantive changes easily.

There are a lot more who CAN.

Dismissing individual responsibility, which it sounds like you are, is as bad as absolving the FDA because everyone should be responsible for themselves
 
Not over 50 years, I will agree.... how about over 1,000 years??? Or even more??

Not sure over 1000 years.

But what I'm saying is in this particular situation of obesity, the outcome has changed dramatically over 50 years. And because I don't think genetics change that fast, it leads me to believe the change is not caused by genetics. (Said by someone who knows next to nothing about genetics ;) )

I think genetics can impact which foods you crave and how much you need to eat until you reach satiety. If an obese couple had a child and gave it up for adoption, do you think that child would be more likely to end up obese than a child born of two super skinny parents given up for adoption? If so, genetics does at least play some role. But again I’m the furthest thing from a scientist so I’m just making layman observations.
 
Cultural: the types of foods people eat, portion size (e.g., all you can eat buffets - I see all you can eat sushi in the U.S., but not in Tokyo when I was there), how much people walk or exercise (the average person, not fitness focused people), societal discrimination against people who are overweight (including employment). Just off the top of my head.

Sure. But people are allowed to not gorge themselves on the all you can eat buffet, right?

And people know gorging themselves on the all you can eat buffet is a bad idea, right?
What’s your point?

You keep hammering on This . Of course is the answer to both.
 
Cultural: the types of foods people eat, portion size (e.g., all you can eat buffets - I see all you can eat sushi in the U.S., but not in Tokyo when I was there), how much people walk or exercise (the average person, not fitness focused people), societal discrimination against people who are overweight (including employment). Just off the top of my head.

Sure. But people are allowed to not gorge themselves on the all you can eat buffet, right?

And people know gorging themselves on the all you can eat buffet is a bad idea, right?
What’s your point?

You keep hammering on This . Of course is the answer to both.

Simple. My point is I believe people have a choice. I've made that point repeatedly.

Others seem to think that doesn't matter.
 
1) Socio-cultural influence changed over about 40-50 years, and were marshaled strongly against cigarettes (government played the major role here, as it happens).

So what is the equivlant for obesity?
See above. Because eating is necessary to live, it will be a wider set of socio-cultural changes needing to take place. No magic bullets.

What do you mean "see above".

I'm asking you what government changes need to be made towards obesity to make it like cigarette use?

I personally don't believe we have to rely on the government to save us. But interested in your opinion on this and what they must do if we are incapable of making healthier choices on our own.
 
is it possible to eat healthy. Of course. Is it easier to not eat healthily? Yep.

For sure.

What I'm fascinated by is the mindset that given the two choices, some feel they have to eat unhealthy and there's no ability for them to make a healthier choice. Like they're forced into it or something.

I don’t think anyone is saying they have no choice. A smoker can quit smoking and a drug addict can quit using. It’s difficult, but yes, it is absolutely possible. But if we want to tackle the problem, we need to understand that it is too difficult for many to make the choice so they give up. And if there is a pharmaceutical aid to help people make better choices (just like with smoking and drugs) I think we should be supportive of efforts to make getting healthy easier. But of course always being wary of potential dangerous side effects as you have observed previously.
 
I'll be honest. I'm kind of shook at the adamant dismissal of personal responsibility.
You know what tho? I was just thinking as you were asking for a comp to how we handle the obesity epidemic.

There is no comp, and the USA (government, media, family, individual---all of us) makes it harder to kick this addiction than any other.

You tell me another drug addiction, where the addict goes to a family function, and everyone at the party is ACTIVELY trying to get the addict off their treatment.
 
Dismissing individual responsibility, which it sounds like you are, is as bad as absolving the FDA because everyone should be responsible for themselves
Individual responsibility to do what?

Eat less and exercise? Once again, the results here, over large numbers of people and over time, just aren’t good enough. Giving the same advice over and over doesn’t work.

Individual responsibility to address one’s obesity in some manner? Once effective society-wide solutions come into play — as is just starting to happen in recent years — then, yes, I can get on board that individuals need to avail themselves of these solutions. Still some financial/insurance hurdles that need to drop to improve the societal outcomes, but we’ll get there.
 
And to remind people, I have two very close friends who've used Ozempic to lose a ton of weight and get healthier.

I'm not arguing against Ozempic. I'm trying to understand the bigger problem of how 36% of our population is obese.

And more importantly, how we fix that.
 
But there’s still more at work that just that. It’s a heinously complicated problem at the societal level, and it cannot be boiled down to a handful of simple-to-change factors.

I know you're sincere and thoughtful, but I think I disagree.

I don't think it's that complicated.

1. Educate people that lots of the food available is crap. Educate people that they need to move around. (That one feels like it's complete)
2. The people who understand there's lots of crap available instead choose the healthier options to eat.
3. The people who understand you need to move and take 10,000 steps a day do it.

I fully admit I may be naive. But I don't think it's that complicated.

Humans have a space between Stimulus and Response. We can think.

I dog may not have the ability to weigh out choices and make the best one.

Humans do.

And I'm puzzled and discouraged why it seems we don't.

This is NOT meant to be political. But do you remember when these very things were a big focus of Michelle Obama’s MOVE program? And don’t you remember how much crazy backlash there was? People absolutely losing their minds at the idea of adding a salad bar in schools or removing sugar soda machines. Eating what we want when we want is very much a part of American culture/freedom. That doesn’t make it not a choice, to your point, but it’s part of who we are culturally. I do think things are starting to change however.
 
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And to remind people, I have two very close friends who've used Ozempic to lose a ton of weight and get healthier.

I'm not arguing against Ozempic. I'm trying to understand the bigger problem of how 36% of our population is obese.

And more importantly, how we fix that.

I’m surprised it’s only 36%. By BMI standards?
 
If I understand you, you think people are incapable of doing that without drugs. Right?
Individuals? Are capable of doing it without drugs and socio-cultural changes.

American society as a whole? Not capable of doing by diet and exercise as things currently stand. Socio-cultural changes are necessary. Medications are an acceptable part of the solution insofar as they get results.
 
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Individual responsibility to address one’s obesity in some manner? Once effective society-wide solutions come into play — as is just starting to happen in recent years — then, yes, I can get on board that individuals need to avail themselves of these solutions. Still some financial/insurance hurdles that need to drop to improve the societal outcomes, but we’ll get there.
The 'then' here is the problem. No need to wait on getting people to eat correctly.

Americans need to change the e kind of food they consume. Eating less of it is wonderful. But not nearly as wonderful as changing one's diet. Ozempic etc. can be part of the answer, but that's not what is gonna happen. What's gonna happen is that people will consider it the ONLY answer, and eat less garbage. Which is better than more garbage, but the only way to get off the Ozempic will be changing diets so one isn't craving that stuff.
 
Here's the thing, at least the way I see it. Once one gets to be morbidly obese, it's not just a matter of cutting back. It's a matter of eating practically nothing. And that is darned hard to do. Drugs like Ozempic and Mounjaro make it much, much easier, if not possible at all.
 
To accept responsibility for their own health and not say they are powerless to be healthy because society and culture are somehow against them.
Again, I disagree with the framing. Society and culture are the sea in which we swim. We’re made in society and culture.

And once again, when one person overcomes their being to make diet and exercise work for life, that’s great. But that one person’s success says nothing about the success of diet and exercise in addressing obesity at a societal level.
 
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Cultural: the types of foods people eat, portion size (e.g., all you can eat buffets - I see all you can eat sushi in the U.S., but not in Tokyo when I was there), how much people walk or exercise (the average person, not fitness focused people), societal discrimination against people who are overweight (including employment). Just off the top of my head.

Sure. But people are allowed to not gorge themselves on the all you can eat buffet, right?

And people know gorging themselves on the all you can eat buffet is a bad idea, right?

Joe: You asked me to explain what I meant when I referenced cultural and genetic difference in response to your question about why Japan has only a 4% obesity rate. I did so earnestly. Your response here is not only dismissive, it is borderline rude. Just saying. [Edit: In rereading, I think what may have happened here is that you conflated our exchange here to the debate about choice you were having with others. If that was the case, not borderline rude. For the record, I don’t dismiss your assertions about choice.]

As for your question, it is a good one (and one I tried to answer). Why do you think Japan has a 4% obesity rate and America a 36% rate?
 
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I don’t think anyone is saying they have no choice.

People are saying, "It doesn’t matter if people have a choice."

I don't accept that premise.

I don’t either. But will repeat the rest of my post that you cut off. A smoker can quit smoking and a drug addict can quit using. It’s difficult, but yes, it is absolutely possible. But if we want to tackle the problem, we need to understand that it is too difficult for many to make the choice, so they give up. And if there is a pharmaceutical aid to help people make better choices (just like with smoking and drugs) I think we should be supportive of efforts to make getting healthy easier. But of course always being wary of potential dangerous side effects as you have observed previously.
 
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Ozempic etc. can be part of the answer, but that's not what is gonna happen
I agree that in the long term, medications like Ozempic will only be part of the solution. I believe more and better solutions will be developed and employed. Some medication, some socio-cultural changes, some laws. Market forces may respond to first-level solutions to chase at least some portion of unhealthy foods into a less prominent place in the American diet.
 
Once one gets to be morbidly obese, it's not just a matter of cutting back. It's a matter of eating practically nothing
This a great point. There’s a huge difference between losing that pesky holiday-season 15 pounds and losing 150+ pounds. Goes double when food is your lone source of biological reward.
 
Sustained weight loss is really hard for Americans but not for other cultures??

Yeah, not buying it.

Better diet, more exercise. Americans are lazy and fat.
With few exceptions, obesity is a problem in much of the developed world.

Yeah, the idea of lazy American's as it pertains to obesity is really lazy humans. We are basically the top major world power but just about everybody on the planet is overweight (by BMI) save several African nations and the far East.


Thanks. Why do most people think US is 36% and Japan, a very developed country, is 4%?

Cultural differences. And probably genetic differences as well.
Not saying you're wrong necessarily -- I'm open to the idea that the US was just destined by genetics and culture to have a higher baseline rate of obesity than Japan. But those can't explain (easily, anyway) why obesity has gotten so much worse in the US compared to, say, the 1970s. Our genetics and culture probably haven't changed enough to explain that.

Already mentioned but I think our culture has broadly speaking (I consider types of food that people eat and portion size to be aspects of culture).
Fair enough. And on reflection, "smoking" should be part of this too. To be clear, I think stigmatizing smoking is a good thing, but it's hard to deny the obvious side effect of that.
 
Sustained weight loss is really hard for Americans but not for other cultures??

Yeah, not buying it.

Better diet, more exercise. Americans are lazy and fat.
With few exceptions, obesity is a problem in much of the developed world.

Yeah, the idea of lazy American's as it pertains to obesity is really lazy humans. We are basically the top major world power but just about everybody on the planet is overweight (by BMI) save several African nations and the far East.


Thanks. Why do most people think US is 36% and Japan, a very developed country, is 4%?

Cultural differences. And probably genetic differences as well.
Not saying you're wrong necessarily -- I'm open to the idea that the US was just destined by genetics and culture to have a higher baseline rate of obesity than Japan. But those can't explain (easily, anyway) why obesity has gotten so much worse in the US compared to, say, the 1970s. Our genetics and culture probably haven't changed enough to explain that.

Already mentioned but I think our culture has broadly speaking (I consider types of food that people eat and portion size to be aspects of culture).
Fair enough. And on reflection, "smoking" should be part of this too. To be clear, I think stigmatizing smoking is a good thing, but it's hard to deny the obvious side effect of that.

That’s an excellent point. Still a good amount of smoking in Japan.
 

From the article:

Well, it is true that the country requires that companies and local governments measure the waistlines of citizens between the ages of 45 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population, The New York Times reported.

Those exceeding government limits - 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks - and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight, the Times reported.

If necessary, those people are steered toward further re-education after six more months.

The hope is that the campaign will encourage healthy lifestyles and keep diabetes, heart disease and strokes in check.

Still, it is not a crime to be fat in Japan, as most of these viral posts state. Japanese citizens can't be fined or imprisoned for being overweight.

In January 2008, Japan passed the "Metabo Law," named after metabolic syndrome, a cluster of conditions - increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels - that occurring together can increase the risk of heart disease, stroke and diabetes, Snopes.com reported.

"If you have metabolic syndrome or any of the components of metabolic syndrome, aggressive lifestyle changes can delay or even prevent the development of serious health problems," the law stated.

To reach its goals of shrinking the overweight population, the government imposes financial penalties on companies and local governments that fail to meet specific targets.

With the new law, for example, Matsushita, a company that makes Panasonic products, has to measure the waistlines of not only its employees but also of their families and retirees, the Times reported.

NEC, Japan's largest maker of personal computers, said at the time the law went into effect that if it failed to meet its targets, it could incur as much as $19 million in penalties. To avoid that, the company started measuring the waistlines of all its employees over 30 years old and sponsored metabo education days for the employees' families.
 
With millions of dollars in fines at stake, I would think employers in Japan would (likely unapologetically) discriminate against not only the morbidly obese but anyone who is overweight in hiring decisions. That would be against the law in many jurisdictions in the U.S.
 

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