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Thread: AMA declares obesity a disease...thoughts?

  1. #21
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    The psychiatrist is IN ...5 cents

    Quote Originally Posted by Churchill View Post
    Agreed.



    Agreed.



    Agreed.

    And yet, so many of us do anyway.
    Behavior modification is really hard, even for ascetics like me.

    I have plenty of built-in "family history" excuses to use to fall into bad habits yet I don't for many reasons. Seeing other family members suffering from long term health problems or dying young from excesses have made me determined never to smoke anything, or take non-prescribed drugs of any sort.

    My only "vice" is that I only drink in moderation (2-3 drinks over a weekend), avoiding weekday/daily consumption. Tailgates and family gatherings lasting more than a few hours are exceptions. Theyve been happening in bunches lately

    Never too late for anyone to practice portion control, then frequency control of anything licit or illicit. Treats then become truly treats, to be savored ever more so.

  2. #22
    Quote Originally Posted by Churchill View Post
    At one point in my very early twenties, due to a troika of personal tragedy, I reached a point where I was a "pass out in the gutter" drinker.

    Giving that up was vastly easier than giving up the food (and the sedentary lifestyle) that will eventually kill me.

    I find the "slow suicide" reference to be quite interesting, as suicide and metal illeness is certainly something that runs in my family, and somethign I've considered from time to time in my life.
    Been there as well. Digging out was slow and painful. But well worth the struggle.

    But somehow I cant muster up the strength to avoid a large Italian sub at lunch?

    The human brain. Go figure.

  3. #23
    It probably doesn't apply to folks HERE, but there's also the economics of it... its more expensive to eat nutrient dense whole foods than it is to eat microwaveable, preserved, or fast food crap.

  4. #24
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    Quote Originally Posted by FF2 View Post
    how do you catch cancer?
    Oral sex per Michael Douglas.

  5. #25
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    Quote Originally Posted by Churchill View Post
    Agreed.



    Agreed.



    Agreed.

    And yet, so many of us do anyway.
    20 years ago..I hit a crossroad. I was borderline depressed. What worked for me was... I got up every morning and went for a run. Started a weightlifting regimen. Volunteered at the local Latino shelter and practiced Spanish.



    that led to meeting new and interesting people. That made me happier, happier NOT total happiness led to clearer thinking. I then moved to NC. Best thing I ever did.


    Start small, get out of bed half hour earlier every day and run one mile. Posting in the Polly forum I would suggest isn't helpful. I post very little here anymore in any serious manner. I literally don't watch much news anymore. I watch one hour of Spanish TV 5 times a week or so and I just joined a jazz band.

    We all fight it to some degree...... You are NOT alone.

  6. #26
    Some people can open a bottle of scotch pour themselves a double drink it then go to bed. Other guys open it and don't stop until they pass out. AMA considers that a disease called alcoholism.
    Some guys order a pizza pie have 2 slices and go about their business, other guys won't stop eating until the whole pie is gone.
    Both are diseases. How many times did you promise yourself
    That you would never drink again while hanging face down over a toilet bowl? Then 12 hours later say ok I'll just have one.
    Think about it.

  7. #27
    yes it is true...a bad description by dicky.

    But my point is that overeating creates the problem. Its very preventable!

    How about this: if its a disease then dicky does not have a cure. so if you are 400 lbs just stop eating sugar, pasta, potatoes, bread and beer and eat under 1500 calories a day every day and get on a treadmill 4 times a week and dicky cured you

  8. #28
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    Quote Originally Posted by dickkotite View Post
    yes it is true...a bad description by dicky.

    But my point is that overeating creates the problem. Its very preventable!

    How about this: if its a disease then dicky does not have a cure. so if you are 400 lbs just stop eating sugar, pasta, potatoes, bread and beer and eat under 1500 calories a day every day and get on a treadmill 4 times a week and dicky cured you
    TLDR



    Condensed version: stop eating so much

  9. #29
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    Twinkles will be returning to shelves in 3 weeks.

    Gastropods. UNITE!!'

  10. #30
    An interesting take below; one that I think has some merit.

    http://www.huffingtonpost.com/david-...b_3478322.html

    Obesity as Disease: Why I Vote No

    Posted: 06/21/2013 12:03 pm

    There is a certain irony in the nearly immediate juxtaposition of the rare introduction of a new FDA-approved drug for weight loss (Belviq) to the marketplace and the recognition of obesity as a "disease" by the AMA. A line from the movie Jerry Maguire comes to mind: "You complete me!" Drugs need diseases; diseases need drugs.

    And that's part of what has me completely worried. The notion that obesity is a disease will inevitably invite a reliance on pharmacotherapy and surgery to fix what is best addressed through improvements in the use of our feet and forks, and in our Farm Bill.

    Why is the medicalization of obesity concerning? Cost is an obvious factor. If obesity is a disease, some 80 percent of adults in the U.S. have it or its precursor: overweight. Legions of kids have it as well. Do we all need pharmacotherapy, and if so, for life? We might be inclined to say no, but wouldn't we then be leaving a "disease" untreated? Is that even ethical?

    On the other hand, if we are thinking lifelong pharmacotherapy for all, is that really the solution to such problems as food deserts? We know that poverty and limited access to high quality food are associated with increased obesity rates. So do we skip right past concerns about access to produce and just make sure everyone has access to a pharmacy? Instead of helping people on SNAP find and afford broccoli, do we just pay for their Belviq and bariatric surgery?

    If so, this, presumably, requires that everyone also have access to someone qualified to write a prescription or wield a scalpel in the first place, and insurance coverage to pay for it. We can't expect people who can't afford broccoli to buy their own Belviq, clearly.

    There is, of course, some potential upside to the recognition of obesity as a disease. Diseases get respect in our society, unlike syndromes, which are all too readily blamed on the quirks of any given patient and other conditions attributed to aspects of character. Historically, obesity has been in that latter character, inviting castigation of willpower and personal responsibility and invocation of gluttony, sloth, or the combination. Respecting obesity as a disease is much better.

    And, as a disease, obesity will warrant more consistent attention by health professionals, including doctors. This, in turn, may motivate more doctors to learn how to address this challenge constructively and compassionately.

    But overall, I see more liabilities than benefits in designating obesity a disease. For starters, there is the simple fact that obesity, per se, isn't a disease. Some people are healthy at almost any given BMI. BMI correlates with disease, certainly, but far from perfectly.

    The urge to label obesity a disease, and embrace the liabilities attached to doing so, seems to be a price the medical profession is willing to pay to legitimize the condition. It may also be an attempt to own it (and the profits that come along with treating it), whereas that right and responsibility should really redound to our entire culture. Is it necessary for obesity to be a disease for it to be medically legitimate? I think not.

    Carbon monoxide poisoning is medically legitimate, but it is not a disease -- and there's a good reason for that. It is poisoning, so the fault lies not with our lungs, but with what is being drawn into them. Your lungs can be working just fine, and carbon monoxide can kill you just the same. Perfectly healthy, disease-free bodies can be poisoned.

    None would contest the medical legitimacy of drowning. If you drown, assuming you are found in time, you will receive urgent medical care -- no matter your ability to pay for it. If you have insurance, your insurance will certainly pay for that care.

    But drowning is not a disease. Perfectly healthy bodies can drown. Drowning is a result of a human body spending a bit too much time in an environment -- under water -- to which it is poorly adapted.

    And so is obesity. Our bodies, physiology, and genes are much the same as they ever were. Certainly these have not changed much in the decades over which obesity went from rare to pandemic. What has changed is the environment.

    We are awash in highly-processed, hyper-palatable, glow-in-the-dark foods. We are afloat in constant currents of aggressive food marketing. We are deluged with ever more labor-saving technological advances, while opportunities for daily physical activity dry up.

    We are drowning in calories. And that's how, in my opinion, we should make obesity medically legitimate: as a form of drowning, not as a disease.

    With drowning, we don't rely on advances from pharmaceutical companies. No one is expecting a drug to "fix" our capacity to drown. Our capacity to drown is part of the normal physiology of terrestrial species.

    Our capacity to get fat is also part of normal physiology. Obesity begins with the accumulation of body fat, and that in turn begins with the conversion of a surplus of daily calories into an energy reserve. That's exactly what a healthy body is supposed to do with today's surplus calories: store them against the advent of a rainy (i.e., hungry) day tomorrow. The problem that leads to obesity is that the surplus of calories extends to every day, and tomorrow never comes.

    Thinking of obesity as a form of drowning offers valuable analogies for treatment. We don't wait for people to drown and devote our focus to resuscitation; we do everything we can to prevent drowning in the first place. We put fences around pools, station lifeguards at the beaches, get our kids to swimming lessons at the first opportunity, and keep a close eye on one another. People still do drown, and so we need medical intervention as well. But that is a last resort, far less good than prevention, and applied far less commonly.

    There is an exact, corresponding array of approaches to obesity prevention and control; I have spelled them out before.

    Disease is when the body malfunctions. Bodies functioning normally asphyxiate when breathing carbon monoxide, drown when under water for too long, and convert surplus daily calories into body fat. Perfectly healthy bodies can get obese. They may not remain healthy when they do so, but that is a tale of effects, not causes.

    The most important reasons for rampant obesity are dysfunction not within our individual bodies, but at the level of the body politic. We do need medicine to treat obesity, but more often than not, it is lifestyle medicine. Lifestyle is the best medicine we've got -- but it is cultural medicine, not clinical.

    That's where our attention and corrective actions should be directed. If calling obesity a disease makes us treat the condition with more respect, and those who have it with more compassion, and if it directs more resources to the provision of skill-power to adults and kids alike, it's all for the good. But if, as I predict, it causes us to think more about pharmacotherapy and less about opportunities to make better use of our feet and our forks, it will do net harm. If we look more to clinics and less to culture for definitive remedies, it will do net harm. If we fail to consider the power we each have over our own medical destiny, and wait for salvation at the cutting edge of biomedical advance, it will do net harm.

    Long before labeling obesity a disease, the AMA lent the full measure of its support to the Hippocratic Oath and medicine's prime directive: First, do no harm. Obesity is much more like drowning than a disease. Calling it a disease has potential in my opinion to do harm. And so it is that I vote: No.

    -fin

    Dr. David L. Katz; http://www.davidkatzmd.com/

  11. #31
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    Not being obese, I don't feel like I have enough weight behind the issue (no pun intended) to make a judgement whether it's a true disease. The comparison to alcoholism seems to make sense to me though -- as if there's a trigger in one's brain that makes it extremely difficult to avoid making the wrong decisions, health-wise.

    That being said, I think there's still a LOT of misinformation out there regarding obesity, even regarding how we measure it. For example, I can't believe people still take the BMI seriously. It's such a faulty evaluation tool. If you're 6'0 240lbs, you could either be overweight, or Ray Lewis. Maybe body fat percentage is a better indicator.

  12. #32
    Body fat % is definitely a better measurement. There's a lot of misinformation out there, and a lot of non-education out there too.

    I heard one suggestion that this decision now basically sends a message to the less educated that don't understand nutrition that "hey, its not your poor food choices - its not your fault at all - that you're fat", which is a dangerous message IMO.

    Its a complex issue. Lots of groups stand to make a lot of money off Americans being fat as well. Not to mention, eating healthy is more expensive and time consuming than eating easily available pre-made crap.

  13. #33
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    Quote Originally Posted by Brooklyn Jet View Post
    An interesting take below; one that I think has some merit.

    http://www.huffingtonpost.com/david-...b_3478322.html
    I can see the argument for both sides, but in my opinion, this doctor hits the nail on the head.

    Technically, obesity can be a disease in certain cases (addiction, biological disorder), but today's epidemic is driven by environment much more so than anything biological or psychological.

    I would much rather see society try to tackle this problem by focusing on the roots of the issue instead of putting a medical band aid over the problem through pharmaceuticals.

  14. #34
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    Quote Originally Posted by adb280z View Post
    Someone who eats cheeseburgers and fries all day, is 350 lbs and won't exercise doesn't have a disease they're just fat.
    I'm 300lbs and just outran the skinny bastich on the next treadmill. I'm quite sure my diet is better than his. It's my metabolism. Just think, the French are generally healthy but eat the most fattening foods. I'll manage without free diet pills though.

  15. #35
    Quote Originally Posted by parafly View Post
    I can see the argument for both sides, but in my opinion, this doctor hits the nail on the head.

    Technically, obesity can be a disease in certain cases (addiction, biological disorder), but today's epidemic is driven by environment much more so than anything biological or psychological.

    I would much rather see society try to tackle this problem by focusing on the roots of the issue instead of putting a medical band aid over the problem through pharmaceuticals.
    Totally agree. Dr. Katz' blog entries are pretty spot on, IMO. One sentence jumps out:

    We could fix obesity. It's hard, because profit and cultural inertia oppose change. But it's not complicated.
    Too often we confuse hard with complicated. If you're obese, its hard to lose weight. But for the majority, its not complicated. Eat closer to nature. Eat less. Move more. Focus not necessarily on lbs and BMI, but on body fat, cardiovascular health/BP/cholesterol, etc.

    As a society, we should be focusing on reasonable measures that will make that easier, while not impeding businesses' ability to turn a profit. Better nutritional education vs. banning all super-sized drinks for one. Maybe looking at the amounts of subsidies for crops that get turned into additives and crap like HFCS.

  16. #36
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    Quote Originally Posted by southparkcpa View Post
    20 years ago..I hit a crossroad. I was borderline depressed. What worked for me was... I got up every morning and went for a run. Started a weightlifting regimen. Volunteered at the local Latino shelter and practiced Spanish.



    that led to meeting new and interesting people. That made me happier, happier NOT total happiness led to clearer thinking. I then moved to NC. Best thing I ever did.


    Start small, get out of bed half hour earlier every day and run one mile. Posting in the Polly forum I would suggest isn't helpful. I post very little here anymore in any serious manner. I literally don't watch much news anymore. I watch one hour of Spanish TV 5 times a week or so and I just joined a jazz band.

    We all fight it to some degree...... You are NOT alone.
    holy crap; 30 years ago I had the same shift: started running up at the resevoir witht eh NYRR club; played FF in the Great Meadow on Sundays and Jack LaLane nautilus on BWay - got real healthy; invited to parties...ultimately to SF.

    wow

  17. #37
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    Obesity is not a disease. It's a state of being, and often a symptom of something else, but not a disease.

    I feel the same about alcoholism. Addictions are not diseases. They are often symptoms of a larger [mental] disorder(s).

  18. #38
    Quote Originally Posted by Traitor Jay & the Woodies View Post
    Obesity is not a disease. It's a state of being, and often a symptom of something else, but not a disease.

    I feel the same about alcoholism. Addictions are not diseases. They are often symptoms of a larger [mental] disorder(s).
    Food and alcohol both directly stimulate hormones that the body craves.

  19. #39
    One question will it hit the mandate list.

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