This food nanny is discouraged about obesity rates

Mirror, mirror on the wall.

From an AP report:

Adult obesity still isn’t budging, the latest government survey shows.

The national telephone survey found 13 states with very high rates of obesity last year. Overall, the proportion of U.S. adults deemed obese has been about the same for years now.

“A plateau is better than rising numbers. But it’s discouraging because we’re plateauing at a very high number,” said Kelly Brownell, a Duke University public policy expert who specializes in obesity.

Maybe Brownell is just projecting?

Yale's Kelly Brownell one of the most prominent food nannies.

Duke’s Kelly Brownell one of the most prominent food nannies.

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17 responses to “This food nanny is discouraged about obesity rates

  1. The only solution to obesity is having a substantial energy barrier between the food and its consumer. I tend to shed 50+ pounds when I live alone but gain weight again when there is somebody around who insists that the fridge must always be full. I only go looking for food when I am really hungry, and that’s not even every day. Also, using the family car as a shopping cart is a very bad idea for the same reason — it makes lethal amounts of food instantly accessible.

    Obesity is a survival mechanism; can’t do anything about it when survival is not at risk and there is a surplus of food.

    Just treat food the same way chemists treat flammables — lock it in a steel cabinet. There must be a barrier of some sort. Some people can erect a barrier in their minds; many can’t.

  2. Brownell and the very obese woman who was surgeon general (and who lectured us about eating too much) seem to be par for the course. More governmental power is all they are seeking.
    You must do as we order you to do–but we can eat all we want.

  3. Hoookay, are obesity numbers stable or do we have a rising obesity epidemic? Make up your minds, nannies.
    Considering the population as a whole is aging significantly, and that most people do gain inches and pounds as they age, it’s possible that the stable obesity rate actually is better than the rising rate we might have expected.
    Mr. Brownell thinks the rate is “very high” but by what definition? Weight correlates poorly to health outcomes or death and causes of death. Granted I’d enjoy the sight of a world with fewer heavy people in it, that’s no standard for the world to use.
    Gene, some people will eat whatever food is at hand because it is. Those folks may do well to modify their behavior accordingly. Whether I’ve lived alone or with family, though, I’ve never been inclined that direction. There’s no universal drive to eat all that’s available.
    For that matter, we bought a pint of brandy at Christmas to try to make mulled wine and we still have 2/3 of it.

  4. “Granted I’d enjoy the sight of a world with fewer heavy people in it, that’s no standard for the world to use.” Especially if they are on the same aereoplane.
    The definition of obese keeps sliding down. Morbidly obese may be a problem. Fat, not so much.

    • All definitions of obesity I have seen seemed arbitrary. They use simple-to-calculate but meaningless criteria like body mass index.

      I experience two problems caused by extra weight and fat, so I define obesity it as a condition where one or both of these problems trouble me.

      Problem 1: I am too heavy to be able to load my knee joints properly. I can carry heavy things; I can’t squat under load, and stepping down from a foot-high surface is painful even without additional load. Also, weight imbalance on the belly side strains my back. This problem goes away with a 20% weight loss.

      Problem 2: GERD. While there are a number of pathological conditions that can cause it, obesity never fails to do it in otherwise healthy people. Few people know it, but the fact is that “gastroesophageal sphincter” is just a fancy name for a rudimentary group of muscles that doesn’t really do anything useful. The angle of His is a weak protection, and it only sort-of works in people with normally-sized stomachs, and only in a vertical position. Also, in normal people, diaphragm muscles provide some assistance, and the combination of all these factors seems to be sufficient to keep the stomach sealed, but only just.

      An overloaded stomach loses its angle of His. A regularly overloaded stomach grows in size and becomes ever more difficult to seal. A bloated stomach and abdominal fat work together to distend the diaphragm and widen the oesophageal hiatus, so any assistance from the diaphragm that is possible in normal people is lost. The stomach becomes an open bottle, spilling its contents with every jolt.

      This is the point beyond which obesity can become morbid. Oesophagus suddenly thinks it is now duodenum and starts transforming its tissues accordingly. But we’re not babies anymore. Any late-life transformation like this has a very high chance of turning malignant. So if obesity itself does not kill you, several years of continued reflux will give you oesophageal cancer, guaranteed.

      This problem, too, goes away after even a small weight loss, but equally reliably, a small gain or even a single instance of over-eating will bring it back. It’s all simple mechanics.

      • Howdy Gene
        You have identified real issues and markers that guide you in your weight management. That, good sir, is a health-related outcome for you and so an appropriate guide for you and others with similar experience.
        I also have GERD symptoms and I’ve had them for 35 years now. They began when I was a young buck with a waist of about 28 inches. I’ve not seen the symptoms particularly relate to a moderate increase in my waist (I’m up to 31-32 inches) and I get good control with famotidine or ranitidine. But that’s my experience; some people will fit closer to your model and some to mine and some think we’re both in left field.
        In any event, weight management is an individual issue rather than a public health problem. I think we’ll all agree that the food nannies should learn to mind their own business. It’s wrong to be judgmental! (I want to get that on a t-shirt.)

        • Sorry to hear that, Geoff. It sucks to have to manage your stomach as though it was a dumb chemical reactor, although it is common at our age to manage something, or even a few things at once.

          I have a couple relatives who suffer from a GERD variant you describe. They are not obese and their problems are probably caused by their peculiar anatomy or by excessively energetic peristalsis. What bothered me was how little they and even their physicians understood about their ailment. One of them (a female) is managing fine now that I was able to tell her whatever I knew about it. I essentially told her, eat one bite at a time, do not drink too much, avoid foodstuffs that take longer to digest, do not recline or lie down after having a meal and wait until you’re really hungry before having another. Squat to pick things up rather than bend — that kind of stuff. She tells me she hasn’t had a reflux in a long time, now that she has learnt to manage it. But the condition is, of course, crippling. She can’t do any high-energy stuff. She wouldn’t be able to work on a farm with a stomach like that. Fortunately, she does not need to: she is a corporate lawyer.

          My other relative does not find what basically amounts to limiting and timing his food intake acceptable. He lifts weights, juggles dumbbells and plays rugby. He jogs ten miles every day. These activities require a lot more food that his unusual stomach configuration can stomach (for want of a better word). So instead of limiting his activities (which I understand are considered super-cool and super-healthy in his social circles) he manages his heartburn.

          Generally, life occurs on the edge. We develop until we hit a limit and generally just stay there. It is not always the same edge or the same corner for everybody, but that’s pretty much how things go in life.

          That makes governments jealous. They want us to respect their made-up limits, rather than nature’s.

  5. GoneWithTheWind

    Obesity is genetic you get it from your parents not your food. It is interesting that we have an obesity rate between 20%-40% (depending on the definition of obesity) so the food nannies declare it is the food we eat that causes it. Do they not understand that we also have 80%-60% who are not obese eating the same food. Hmmm! So if it were the food we would all be obese.

    • Of course it is genetic — and metabolically regulated, with a strong positive feedback (the more you eat, the more you feel hungry). We’ve evolved to assimilate as much food as possible as quickly as possible, while it is available (and it mostly wasn’t while we were evolving).

      The 60%-80% who are not obese may be too busy, self-restrained, or limited in some other way. It is eating ad lib for long periods of time (as opposed to having chanced upon a dead horse once a month, if you are lucky) that results in obesity. Just a little over a decade ago, when I had to work away from home (and thus from food), and while at home I was busy fixing the house or messing around with cool stuff in my machine shop, and food was sort of expensive, I was nowhere near obese. Now that I’m renting a home where everything is taken care of, I am busy working on just one thing, and I have easy access to food both at home and at work, without any limits time-wise or quantity-wise, I am on the verge. I only drift a safe distance away from it when the situation changes: when I travel or when nobody else is around.

      The “food nannies” are focused on several kinds of food that they claim cause obesity. That is just stupid. They need to learn basic biology. All food causes obesity if it is ad lib and if the energy gained from it exceeds the cost of digestion.

      Somebody pointed out to me that Danes are generally a lot leaner than, say, the inhabitants of the British Isles or the US. At a glance, that seems to be true. But their food costs about five times as much!

  6. GoneWithTheWind

    Sorry you are bordering on obese but as I said you should have picked skinny parents. Your weight as it is guided by your genes is not “exact” but in a range. And of course your genetics may predetermine that you be skinny as a young person but quite rotound when you get older. Thus it is easy to believe it is “simply” how much we eat or how much we excercise. So yes! You can get to the lower range of your genetically predetermined weight if you excercise a lot and/or diet. But when you return to a more “normal” lifestyle your genes will show their true predetermination. Most humans see life in terms of themselves, their friends and family and of course their limited experience. As in “when I was busy i weighed less” so we think excercise would make us all look like Twiggy. Or we see a obese person eating a big meal and conclude they are overweight simply because they over eat. (the tendency to over eat is of course genetic and part of the genetic propensity to be obese). But how many of us look at a skinny teen eating two days worth of food at one sitting and conclude that over eating makes you skinny??? Gee! Why not? Well because of our biases. You believe that obese people simply over eat so you look for it and by golly you find it and it confirms you bias. That skinny teen??? Sorry, your blinders didn’t let you see that or process what you saw. So the bottom line is if your genes say you will be obese then you will be obese. You can postpone it or mitigate it with strict diets and big excercise but your genes will win in the end. Good luck.

    • GoneWithTheWind: you come across as though you think that our trajectories are predetermined by our genes. That is emphatically not true. Genes do not encode behaviour; they are assembly instructions, and many are rather indirect, as instructions go. There is one gene that says, “Put an eye here, please”. It does not care what kind of eye it is — a faceted eye like an insect eye, or an eyeball; it only determines the segment of the body in which the insect eye or a mammalian eye will develop. In fact, these genes are even interchangeable: a fly Hox gene inserted in a human will command the formation of a human eye, and the other way round. This makes you appreciate how removed the genetic code is from the final result. All that is predetermined is the kind of machinery you get and how it assembles itself; the trajectory it follows is determined by its interactions with the environment.

      This is what gets left out from most conversations about obesity: it is a relatively new condition for most people. We know Queen Anne was so massively obese she required a lift to get out of her bedroom. But she was a queen; she could afford that. Most people in our grandfathers’ generation were no strangers to starvation. The problem of having enough food for everybody had not been solved until mid-20th century. So even if it were true that some of us are predisposed to obesity while others are not, we had no way of knowing that. The predisposed ones never had enough food to get there, unless they were extremely wealthy.

      But I have reasons to doubt that there are significant variations in the mechanisms of obesity. You realise that there are genes that vary a great deal and there are genes that are conserved, right? For example, ribosomal genes are so conserved that pretty much all forms of life today share e the same set. Our core metabolism, including the glycolytic system and the fatty acid synthesis, is also very conservative. Not only does it not vary from one generation to another, but it does not vary from one large clade of animals to another. There is almost no difference between mammalian and avian variants of the core machinery. And that machinery is already predisposed to obesity, to use your expression. The reason for that is that the reactions linking the upper stages of glycolysis to the fatty acid synthesis (through pyruvate) are product-activated. That’s one big positive feedback. There are negative feedbacks, too, but those are mostly due to hormones, which vary more than the core metabolism. It is due to defects in the genes coding for hormones that you we have the ever-hungry ob/ob mice. But cases like that are freak exceptions. Our core machinery is invariant and it acts in predictable ways.

      My parents are what you would call skinny. One of my grandfathers was quite plump, but then again, he was very well-off. I myself was plump and young, skinny and young, skinny and old, and now I am obese by some standards and just “overweight” by others. I gained 20 kg in just one year, but I lost the same amount during the previous 6 months, simply due to a change in circumstances. I am aware of age-related changes (we call them development), but at least in my case, they do not seem to be significant.

      We interact with our environment, and the environment is far from homogenous.

  7. GoneWithTheWind

    Not everything is “predetermined” by our genes but much is. Obesity, especially “true obesity” (300, 400, 500 lbs) is genetic. But your range of weight and the way this varies by age is still very genetic. Many people maintain a reasonable weight until about 55-60 and then put on a gut. They don’t weigh 300 lbs and their arms and legs may be skinny but they have this big gut. Generally so didn’t their parents and grandparents. They “could” get rid of the gut with a low calorie diet. lots of willpower and an excercise program. Does this mean it isn’t genetic? No! They simply are varying their weight within that range their genes have “predetermined” they will be. It is rare that you will find a truely obese person who: A) doesn’t want to lose weight, B)hasn’t tried everything to lose weight, and C) was successful (sometimes they were successful for a year or two but simply couldn’t deal with the starvation diet necessary to maintain the lower weight). Why is this? If it were “merely” a matter of eating the same diet that you or I eat (and I eat a lot including what I call fourthmeal which is mostly chips, candy and other junk) then they could easily do that. But in reality they cannot, they are genetically obese and cannot lose the weight. Suprisingly this does happen in cultures with zero junk/fast/refined food and in cultures where working hard is necessary to survival. Most of Africa, much of the South Pacific and much of Central and South America have epidemic obesity rates and did 1000 and 2000 etc. years ago. The obesity rates for most of Europe and much of Asia are much lower. (Interestingly diabetes rates are high in cultures with high obesity rates as well.) Genetics? Diet? Culture? Laziness? Or the more obvious and provably predictable genetics?

    By the way, for something to be genetic does not “necessarily” mean that it runs true in each generation. You could have skinny parents and grandparents and still have a genetic propensity to be obese. The exact genes you inherit are partially a crapshoot and partially predicatble science. Then too there is the problem of who is your daddy! We assume our loving childhood father is our father but only one person knows for sure. Similarly we don’t know who our grandfathers are. Talk about a crapshoot!

    • I have seen some seriously obese people whose parents are not obese. Apart from genetics, which admittedly can pre-determine certain conditions, we have free will. It’s easy to apply, but more importantly, it doesn’t cost a thing!

  8. What are we talking about? All life that has a differentiated adipose tissue uses it as a reservoir. We inherit it not from our parents, but from an ancestor so distant that it is common to all vertebrates and much else.

    But obesity predates even that. Even yeast can be obese with lipid droplets.

  9. GoneWithTheWind

    “I have seen some seriously obese people whose parents are not obese.” Maybe their grandparents were obese, genes don’t always translate directly and specifically. Maybe their “dad” was not their “father”.
    As for free will that seems to imply that ever so common insult that obese people simply choose to eat themselves into obesity. Very difficult to do. And it flies in the face of common sense. Please do yourself a favor and ask the next 50 obese people if they choose to be obese. More then likely all 50 of them will tell you quite clearly they have done everything they can to lose the weight and cannot do it any more then they could make their feet smaller or change their eye color.

    “All life that has a differentiated adipose tissue uses it as a reservoir.” Indeed. And yet many people, arguably about 80% never over fill that reservoir. Obesity is an inherited trait and very difficult to overcome. Just as being skinny is. Find some skinny person and offer them a large cash prize if they can get their BMI to the obese stage. I’m betting they can’t even become obese if they tried to.

    • “As for free will that seems to imply that ever so common insult that obese people simply choose to eat themselves into obesity. Very difficult to do.”

      It’s the only way to do.

      • Yes, that’s the only way. But free will is never free. It has a managerial cost, and this cost may be insurmountable.

        That’s why I propose that food be removed from one’s dwelling. The cost of getting it when it is needed must be non-zero, but there is a whole range of provisioning costs that are high enough to prevent overeating but still much lower than the management cost of free will.

        I fared best when my nearest grocer’s was three miles away over a steep hill. I brought home only as much food as would fit into my backpack, and because I knew I was unable to make such trips every day, I had to ration my supplies. They lasted anywhere between one and two weeks, and I kept losing weight during the entire year I lived there.

        The craziest thing that happens in an average matrimonial home starts with: “Honey, we’re out of butter. We need to do some shopping”. The next thing you know, the fridge is stuffed full of tasty goodies. Two days later, “Oops! We’re out of eggs!”

        When I lived alone, I would only go shopping after I was out of everything remotely edible for a day or two. That foraging pattern is the closest to natural I can imagine. I am totally going back to it as soon as I can.

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