Fat is apparently the new normal. Looking at the charts in P*D's second reference, somewhere north of 80% of adults are overweight, obese, or severely obese.


Big Al

Dol, thanks for sharing your experience.

And it fits with my (again, acknowledged as casual) reading of recent research. I don't think medical science understands even half of what changes are happening in the body with regards to weight and metabolism and so on,

And Dol's comments, and wtg's here

quote:

it would mean our lives revolving around weight maintenance. Not sure that's a good choice for our mental well-being.

Also point to how hard it is to lose weight and keep it off.

P*D seems determined to make this about personal choice -- which I think is a dramatic oversimplification.

But we might say that there is a choice, that some of us might know we *could* lose weight and keep off. But the effort and time-commitment to do so is so onerous -- what Dol and WTG are sharing is that it's a "choice" between a life devoted to weight maintenance or being overweight.

And, I would say that is not a real choice.

quote:

it's a "choice" between a life devoted to weight maintenance or being overweight.

And again, the only people who can choose to have a life devoted to weight maintenance are people with a lot of economic and cultural privilege.

If we could afford a personal nutritional consultant, personal grocery shopper, personal chef, personal trainer and time off from work to exercise with that trainer, we would all probably have much lower bmis....

ETA which is to say, I am convinced that something has happened to modern humans biologically that makes it very difficult to lose weight and keep it off. It's not just "make healthy choices" ...

I'm saying the choices people make is probably a significant part of the story of national weight gain over long stretches of time. I'm not saying the whole problem would go away if people were just mentally stronger ... finger wag, finger wag.

I don't dismiss the difficulties of losing weight. I would note that Dol's personal story (a datum) is also about choice ... to be "normal." I put that in quotes because her situation isn't really what the national "obesity problem" is all about. Someone who wants to move their BMI from 29 to 25 isn't the nation's problem. The problem is the epidemic of obesity. Real obesity, not pinch an inch or two. Getting people to some notion of perfection isn't the point.

We have a real problem when the obesity prevalence has risen from 22.9% in the late 80s to 42.4% by 2018. People whose BMI is 45 represent walking morbidity, with all the personal, family, and social problems that that entails. Telling people who are that overweight "you're fine and beautiful just way you are" doesn't do them any good. Neither does shaming, of course. And I'm not advocating that. Neither was Maher, by the way. A physician who isn't concerned by a patient's gross obesity isn't much of a physician.

Over the last 60 years the average American's intake of calories has risen by about 25% to over 3,600. That's a big problem. Couple that with the increasingly sedentary work day and you have a recipe for obesity.

My wife's practice is mostly young women from very low-income backgrounds, and a huge fraction are recent Hispanic immigrants. The population is overwhelmingly obese. We're not talking a few points higher than the perfect slim BMI. Wanna know what they eat? They're not going hungry. They're eating vast amounts of processed sugars, and corn flour is often the only "vegetable" consumed in the household. Seriously, the tortilla is the veggie. This is why the obesity problem is so difficult to deal with in this group.

Money is of course part of the problem, but it's only one part of it, and probably not the biggest part.

I don't know what, if anything, is taught in today's schools about diet and health. In today's environment, "don't tell people anything possibly upsetting" may limit our ability to educate kids about nutrition. And I'm sure that the lunches they are being fed right after the nutrition class often contradict the lesson! [I certainly know that was true when I was in school]

But if you don't bring nutritional education to the family, I'm not sure there is much of a lasting effect of giving kids a once-a-week sermon in healthy eating? How to do that in a culturally sensitive way? Got me, but unless we create a culture of healthier eating, along with public policy that discourages the abuse of sugar, we don't have much of a chance against the big forces driving obesity upward.

I don’t disagree with a lot of what you are saying, Piano*dad. I think we just need to be really careful about using the word “choice”. It doesn’t solve any problems, causes shame and defensiveness in the folks who need help, and superiority in those who naturally have an easier time maintaining a healthy weight.

My personal opinion is that the larger obesity problem is about the rise of convenience foods and changing household roles, which resulted in people not knowing how to cook. I don’t think showing students what healthy eating means (and, in Ontario anyways, this is in the K-8 curriculum) doesn’t help if people don’t know how to cook. We now have families with literally generations of non-cooking households. And the cooking that was done in the in-between generations frequently involved cans of cream of something soup mixed with ground beef, pasta, and cheese. If you are from a culture that placed great importance on cooking, but then the time allotted for doing that cooking disappeared because two incomes is now a requirement to make ends meet, you end up with generations of folks who don’t know how to do it.

I know a few people who learned how to cook during the pandemic because of Hello Fresh and Blue Apron. Obviously these people had the means to order expensive meal kits. Once the pandemic waned, some of them kept on cooking, learning how to shop for themselves rather than have the planning done for them. Others went back to not cooking at all because they don’t have the time and energy after working all day. How do we make learning to cook inexpensive, tasty, healthy foods a priority for EVERYONE, but especially younger people in working and middle class households?

P*D,

quote:

I'm saying the choices people make is probably a significant part of the story of national weight gain over long stretches of time.

And I'm saying I think "choice" plays less of a role than you are suggesting, and that people's actual choices are far more constrained than you are acknowledging.

quote:

unless we create a culture of healthier eating, along with public policy that discourages the abuse of sugar, we don't have much of a chance against the big forces driving obesity upward.

I agree with this completely. And it's probably not just sugar, but also all the heavily processed foodstuffs, and the white starchy carbs as well. And probably also lack of sufficiently diverse gut bacteria and microbiome health and diversity...


Dol:

quote:

I think we just need to be really careful about using the word “choice”. It doesn’t solve any problems, causes shame and defensiveness in the folks who need help, and superiority in those who naturally have an easier time maintaining a healthy weight.

+100.

quote:

How do we make learning to cook inexpensive, tasty, healthy foods a priority for EVERYONE, but especially younger people in working and middle class households?

In my opinion, we could prioritize health by addressing just what Dol is saying. We could decide to subsidize healthy foods, and in particular healthy ready-to-eat food, which is a joke right now. In my local grocery store, I could buy a small salad with protein, greens, etc., for about $7--for a side salad. This rivals restaurant prices. When it becomes economically feasible, and as easy as stopping at McD's on your way home, perhaps people will be able to choose more healthy alternatives.

Ditto for school meals - Muffin's Sister can certainly fill us in here. Of course, the GOP would love to eliminate free breakfast/lunch for low income kids in schools (and perhaps they already have in some states), which kind of proves my point.

We show what we value by putting money there. We as a nation aren't concerned about health, in my opinion. (Putting on the tin foil hat now: perhaps because we are so influenced by big pharma, health insurance companies, and farm subsidies for things like corn?)

We had a thread in the past where we discussed this subject. I mentioned my sustained loss of 35 lbs. It came from reducing the feeding zone from nonstop to 6 hours, essentially 2 meals - and knocking out sugar and most starches. The running/lifting didn't have anything to do with it.

What's amazing to me is that with diet being such a huge influence on every aspect of our lives - from overall health to energy, and productivity. But we still are getting mediocre messaging on how to go about losing weight - i.e. reduce calories without any discussion of how a set point works, or it's strictly a calories in/calories out basis. A calorie of sugar is processed differently than a calorie of sugar. An a calorie of Cheerios isn't good for you either - even if it is "whole grain."

quote:

Originally posted by Nina:

In my opinion, we could prioritize health by addressing just what Dol is saying. We could decide to subsidize healthy foods, and in particular healthy ready-to-eat food, which is a joke right now. In my local grocery store, I could buy a small salad with protein, greens, etc., for about $7--for a side salad. This rivals restaurant prices. When it becomes economically feasible, and as easy as stopping at McD's on your way home, perhaps people will be able to choose more healthy alternatives.

McD’s used to have “premium salads” on the menu, about $7 with a piece of freshly grilled or freshly fried chicken on a bed of fresh greens. McD’s discontinued it presumably because, over time, they found that it didn’t sell well compared to their other offerings.

quote:

Originally posted by kluurs:
We had a thread in the past where we discussed this subject. I mentioned my sustained loss of 35 lbs. It came from reducing the feeding zone from nonstop to 6 hours, essentially 2 meals - and knocking out sugar and most starches. The running/lifting didn't have anything to do with it.

What's amazing to me is that with diet being such a huge influence on every aspect of our lives - from overall health to energy, and productivity. But we still are getting mediocre messaging on how to go about losing weight - i.e. reduce calories without any discussion of how a set point works, or it's strictly a calories in/calories out basis. A calorie of sugar is processed differently than a calorie of sugar. An a calorie of Cheerios isn't good for you either - even if it is "whole grain."

Cutting out carbs was exactly the advice my lipidologist gave. It allowed me to lose 45 pounds. It isn't easy.

(And then I gained back 10 pounds when I returned to my wicked eating ways, but I'm struggling to remedy that.)

For me, the keys are pretty close to what you suggest: minimizing carbs; exercising regularly, preferably twice a day (it doesn't have to be long, as long as you get your heart rate up); and not starting to eat until 11AM or later.

quote:

Originally posted by Axtremus:

quote:

Originally posted by Nina:

In my opinion, we could prioritize health by addressing just what Dol is saying. We could decide to subsidize healthy foods, and in particular healthy ready-to-eat food, which is a joke right now. In my local grocery store, I could buy a small salad with protein, greens, etc., for about $7--for a side salad. This rivals restaurant prices. When it becomes economically feasible, and as easy as stopping at McD's on your way home, perhaps people will be able to choose more healthy alternatives.

McD’s used to have “premium salads” on the menu, about $7 with a piece of freshly grilled or freshly fried chicken on a bed of fresh greens. McD’s discontinued it presumably because, over time, they found that it didn’t sell well compared to their other offerings.

I'm thinking cost, the fact that it really wasn't healthy, and was high-calorie had something to do with it. Why have a carpy salad when you can get a burger?

McDonald's kale salad has more calories than a Big Mac

quote:

Originally posted by Nina:

quote:

Originally posted by Axtremus:

quote:

Originally posted by Nina:

In my opinion, we could prioritize health by addressing just what Dol is saying. We could decide to subsidize healthy foods, and in particular healthy ready-to-eat food, which is a joke right now. In my local grocery store, I could buy a small salad with protein, greens, etc., for about $7--for a side salad. This rivals restaurant prices. When it becomes economically feasible, and as easy as stopping at McD's on your way home, perhaps people will be able to choose more healthy alternatives.

McD’s used to have “premium salads” on the menu, about $7 with a piece of freshly grilled or freshly fried chicken on a bed of fresh greens. McD’s discontinued it presumably because, over time, they found that it didn’t sell well compared to their other offerings.

I'm thinking cost, the fact that it really wasn't healthy, and was high-calorie had something to do with it. Why have a carpy salad when you can get a burger?

McDonald's kale salad has more calories than a Big Mac

When I worked at Burger King (many many moons ago) their grilled chicken salad as it was served had more calories and fat than a Whopper with Cheese, large fries, and large milkshake. The dressing was a big part of that, but definitely not all. When you eat fast food, everything that you “know” about healthy food goes out the window.

I pick up bits and pieces of the school lunch situation when chatting with Muffin's Sister, certainly not enough to really address this conversation. I do recall some interesting nuggets.

When she first started in school cafeteria work a few years ago, Michelle Obama's effort to improve school lunches came up during training. She is in a heavily (heavily!) Republican area, so much so that she says she can sometimes see her vote in local elections, yet Michelle Obama's work was held in very high esteem by the people she works with. When her requirements for school lunches were rolled back, I wondered if we weren't seeing an unintended large-scale experiment--would the health of a seven-or-so-year cohort be appreciably better than people just older or younger because they ate better as children and perhaps learned better habits in the long run?

Fortunately, that long-term study has been spoiled, at least where Muffin's Sister works and hopefully elsewhere, in that her school system elected to continue following the Obama-era guidelines voluntarily.

Interestingly, those guidelines show us the insidious impact of the prepared foods available to the rest of us. Take breakfast cereal. The school cafeteria market is large enough that the manufacturer of Cinnamon Toast Crunch makes special single-serve packages for schools with the required percentage of whole wheat and sugar. Is that healthier version available to the rest of us? No, probably because the profit margin is lower and there is nobody willing to make the manufacturer accept that in the name of public health.

Her cafeterias depend heavily on packaged food, so there must be scads of products that are made in healthier versions for schools. I know that she said she works for Smucker's largest client west of the Mississippi because of the number of Uncrustable sandwiches they buy. What do you want to bet that you or I couldn't buy the school lunch versions for our kids and grandkids?

She has also done some interesting work with developing recipes that use government commodity foods but can be made in kitchens geared toward prepackaged food, and she's given talks on this.

Based on all this, I'd presumed that school cafeterias that cook from scratch like ours did back in the day were a thing of the past, but she says they're common in rural areas. The economics of scale are such that it's cheaper to cook from scratch when you're only cooking for a few. This seems counter-intuitive to me, but it probably has to do with labor costs.

For much of the past 50 years, the nutrition guidelines were (are?) heavily influenced (written) by sponsored industries. Just think how difficult it was to have smoking shown to be harmful. With food, that is more challenging. I may have mentioned that in grad school, I worked briefly for a food company that had a pet food subsidiary. Speaking with one of their marketing people, she said that making food that the dog/cat would find nutritionally viable wasn't the issue. The thing owners sought was to have the pet come running down the hall to get to the food. You wanted the creature to crave the food. The same applies to our processed (and GMO) foods - create foods that people can't stop eating. With both members of a couple working, prepared foods are a godsend - but also are nutritionally not in the same ballpark as home cooked foods that rely less on sugar and other gimmicks to make them "tasty - can't get enough of that good tasting food.
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While I recognize choices matter greatly, I have struggled hard to gain weight, so I have sympathy for those who struggle to lose it.

Where I draw the line with the ideologues is when they pretend obesity is healthy. Seems like we should be able to find a middle ground between condemning obesity and glorifying it.