Since everyone has been paying for everyone else's healthcare for decades now through the constantly increasing insurance premiums that gave us an unsustainable Cadillac healthcare system, don't you think that all these intrusive steps taken to reduce the need for healthcare are just a smoke screen for the out of control healthcare bubble? Sure, you can reduce your cost of gasoline by never using your car, just like you can reduce your cost of healthcare by never needing it; but then why even have it?
We all need or will need health insurance. But most plans are geared to intervening late and poor coverage of chronic diseases. The new law tries to move in the direction of incentives to intervene earlier when outcomes are better and cheaper.
A week ago I was at a question and answer session with the superintendent of a major public school system, and when school lunches and nutrition came up, the focus was very clearly on the needs of special groups of kids -- peanut allergies, other allergies, halal or kosher requirements, whether or not to keep chocolate milk. Even this year, after all that has been in the news about childhood obesity and Michelle Obama's "let's move" program, he responded to the obesity issue that affects ALL children as "of course that's important too, and PE is a part of it also." No details beyond that. I understand from an admin standpoint that a child can die from an allergy and that parents of kids with any special requirement will be louder than the parent population as a whole, but this really made me despair. What more can be done to get at this problem at the school ages, when habits are really open to change? Is there legislation tied to Let's Move that has been passed, or is it hung up in one of the two houses? The general effort has had such bipartisan support (Mike Huckabee, etc.) that I thought now was the window for real change. I care deeply about this issue having had to lose 50 pounds a few years ago to get back to a healthy range. Only then did I realize how little I even knew about what to eat based on my previous "education."
Congress is working on an expanded school lunch bill to encourage better lunches. What I think what you are seeing is a reflection of how more parents are engaged on those specific items, while nutritional value of foods and PE is not something that typically a lot of parents push.
The "science" underpinning this entire discussion is incredibly flawed. The BMI in particular is so "one size fits all" as to be essentially useless. According to the BMI, most military servicemen (and probably all professional athletes) are overweight, and would be lumped in the "two thirds of all Americans" who are overweight or obese. For example, a 5' 11" man may weigh up to 196 pounds before the Navy even begins to consider whether a sailor is overweight. At that point, the Navy performs a body fat measurement to "ascertain if the sailor falls within the prescribed Navy Body Fat standards." Heres the problem: at that weight, the BMI indicates that the sailor is at least 17 pounds overweight and halfway to obese. According to the BMI, that sailor would need to lose 41 pounds [!] and weigh 155 pounds just to be in the middle of "normal weight." Indeed, were that sailor to lose 61 pounds and weigh 135 pounds, he would not be considered underweight by the BMI. At least the old Metropolitan Life Insurance height and weight tables acknowledged small, medium, and large frames. Sheesh!
The BMI is a great tool but mainly for population-level assessments. It has been shown to leave out a lot of people, especially women and some minorities, who may have BMI in the normal range but are metabolically obese. Other info, such as waist circumference, may be better to judge an individual's excess weight
Clearly, as overweight/obese becomes more prevalent people get used to seeing more people overweight. But I think BMI may undercount many and overcount a few.
Could not agree more. The problem is worse than you describe. The USDA has many programs passed by Congress, called "check-offs" which are designed precisely to increase human consumption of specific foods, like dairy (think cheese) meat, pork, even popcorn.
"Personal responsibility" has always been part of the equation. Problem is that only a few people can really control their weight. Weight is a function of personal behaviors, genetics and the environment. If you want to understand the interplay of these forces, see my site, www.downeyobesityreport.com
I think that there has been a lot of attention on the need no can deny to try to prevent obesity. Unfortunately, the results are not very encouraging. In fact over 60% of the country is overweight or obese. About half of adults are trying to lose weight at any one time. We need more tools to help those trying to lose weight.
I sympathize but the point the government and others are trying to make is that your actions are part of a larger picture. Many people are now entering Medicare, for example, with conditions caused by obesity. We will all be paying for their care. I do agree that the government and employers need to avoid being punitive with people who cannot control their weight and not blame individuals for condtions they have limited control over. On the other hand, you could probably replace the high fat foods with lower-calorie items. Better for you; better for all of us.
I think the expert's advice is both right and naive. We don't live in a world where growing our own food and preparing it are convenient and low cost. Groups have estimated the costs (see my web site under Economics). Today the STOP Obesity Alliance is issuing a report on the additional costs individuals incur. See the Washington Post website for more info.
Legislation can't fix it but it can help. We made an enormous investment in HIV/AIDS, as well as cancer and heart disease, all of which have behavioral aspects and continue to make progress. The same can happen for obesity.
As an obese person who is currently losing weight, I have been forced to change my opinion of what influence health-care reform will actually have on the obesity problem in this country. I fear that health-care reform will force doctors to promote the current conventional wisdom of low-fat diets with lots of processed "diet" foods. Well, I have years of experience gaining weight on these products. If we'd quit making things "healthy" by replacing the fat with sugar so foods can be promoted as low-fat, and if we'd quit adding sugar to otherwise healthy foods, like canned vegetables, and if the medical establishment actually provided obese people with solutions that work, we wouldn't have to worry so much about public funding and surgical treatments. Instead, my tax dollars are going to be wasted because so many of the people trying to lose weight are doing their best to eat what they are told are the better options, and it's just making their problems worse.
Unfortunately, many physicians do not understand obesity and do not do a good job counseling patients on weigh managment. This can be fixed with better medical school and continuing medical education.
Congratulations. It isn't easy. I use an Iphone app as well which is helpful although I can't it has changed my weight much. As much as people get tired of the message, we have to keep trying to educate people.
I can just Amen! Obesity is a global problem anywhere the Western lifestyle has been adopted. We engineered ourselves into this problem and we have to engineer our way out of it.
What do you think of these corporate wellness programs? do you think they will reduce obesity? Do you think they should be compulsory?
I have a lot on my website about this issue. I don't think there is much evidence that they work. However, it they reinforce the message for finding ways to control weight I don't object. What I don't agree with is any penalty for individuals who are unable to lose weight. It is very hard and we need to encourage good behaviors while not penalizing those who can't reach a particular goal.
An excellent idea. You know a lot of public health campaigns, like seat-belts and smoking, worked to make children agents of change within their families. Maybe those are models we can use for obesity.
I understand your point but it is not meat alone which is causing the obesity epidemic.
Sure. There are several. One is to subsidize fruits and vegetables so that their prices are more competitive with prepared food. The second is to change the Nutritional Label which is easily manipulated. I've suggested 'front of package' calorie information so that you would see foods with something like 240/out of a recommended 2,000 calorie a day. The Food and Drug Administration is looking into that change right now.
I'm in your demographic so I know what you mean. However, nostalgia for how it was is a poor roadmap for going forward. Remember in those days that women were expected to be home cooking and shopping. Many families don't and can't live that way anymore
Do you think the Childhood Obesity initiatives of Michelle Obama and Bill Clinton are doing any good? or are they mainly for PR? How about Huckabee? Is he for real?
I think it is too early to tell about Michelle Obama's program. It certainly has promise. Clinton Foundation has done some good work but stil a work in progress. All these voices reinforce the need for personal and social action to attack this problem.
Not likely. I don't think those ideas would work. Keep in mind that even a person with obesity experiences hunger. Probably obese individuals have greater levels of hunger than normal weight persons. And the effect of hunger, the cravings, attention to food, are the same. So people will find ways to find relief from hunger. Prohibition didn't work for alcohol and it is unlikely to work for food consumption.
Couldn't agree more. We need to recognize obesity as a disease in its own right.
Insurance companies are as much to blame as anyone. When I asked Anthem BCBS if I could see a Dietician because diabetes runs my family as we get older and I wanted to make sure that I was making the right choices in changing my eating habits to avoid the problem (which I currently don't have) and they said it would NOT be covered. Only if I was diagnosed as being diabetic it would be covered. How stupid is that.
Stupid and very typical. As I said, the insurance industry does a very poor job at intervening early to prevent chronic diseases, like obesity, diabetes and heart disease.
I agree. The problem is that we can get into some very complex statistical areas. This has been the case with trying to define childhood obesity. The older, long-term data has some flaws as well which later studies bring out.
I think there is a difference between helpful government action and unhelpful action. Expanding research on obesity and funding more efforts to reach children and adolescents early before they start to put on weight can help.
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