Saturday, January 12, 2008

Obesity now a 'lifestyle choice'

Given the genetics of it, it is often a difficult choice

As adult obesity balloons in the US, being overweight has become less of a health hazard and more of a lifestyle choice, the author of a new book says. "Obesity is a natural extension of an advancing economy. As you become a First World economy and you get all these labour-saving devices and low-cost, easily accessible foods, people are going to eat more and exercise less," health economist Eric Finkelstein said. In The Fattening of America, published this month, Finkelstein says adult obesity more than doubled in the US between 1960 and 2004, rising from 13 per cent to around 33 per cent.

Globally, only Saudi Arabia fares worse than the US in terms of the percentage of adults with a severe weight problem - 35 per cent of people in the oil-rich desert kingdom are classified as obese, the book says, citing data from the World Health Organisation and Organisation for Economic Cooperation and Development.

With the rising tide of obesity come health problems and an increased burden on the healthcare system and industry. "But the nasty side-effects of obesity aren't as nasty as they used to be," Finkelstein said. "When you have a first-rate medical system that can cure the diseases that obesity promotes, you no longer need to worry so much about being obese," he said. "With our ever-advancing modern medicine there helping to save the day (at least for many people), are government and the media blowing the magnitude of the 'obesity crisis' out of proportion?" his book says.

A study in which Finkelstein and colleagues at the RTI International, an independent research institute in North Carolina that works on social and scientific problems, asked overweight, obese and normal weight people to predict their life expectancy came up with a total difference of four years. Normal weight respondents predicted they would live to 78, the obese to 74, and the overweight 75.5.

Other studies that looked at death data back the conclusion that people who carry excess weight tend to die slightly earlier, the book says, and draws the conclusion that "many individuals are making a conscious decision to engage in a lifestyle that is obesity-promoting". "People make choices, and some people will choose a weight that the public health community might be unhappy about. Why should we try to make them thinner?" Finkelstein said.

Linda Gotthelf, a doctor who heads research at Health Management Resources, a private, nationwide firm that specialises in weight loss and management, agreed that Americans now live longer but stressed that quality of life declines with age. "People are living longer but with more chronic diseases," Dr Gotthelf said. "That brings a diminished quality of life, especially for the obese who have more functional limitations as they age and tend to be on multiple medications."

Dr Gotthelf disagreed that people chose to be obese. "There are studies in which people have said they would rather lose a limb or be blind than obese. Being obese is not a desire," she said. "For many, this is a problem they have struggled with for many years... it gets discouraging after a while," she said. "I would not doubt that if you asked obese people if they could push a button and not be obese, close to 100 per cent would say they would push the button."

Finkelstein says he wrote The Fattening of America to "encourage discussion of what I understand is probably an uncomfortable position for a lot of people." Even if private industry and government take steps to protect society against the costs of obesity, many Americans "will likely continue to choose a diet and exercise regimen that leads to excess weight," because losing weight requires too many lifestyle sacrifices, his book warns.


Health warning over sugar-free gum

A nasty one for the food freaks

Chewing large amounts of sugar-free gum could lead to chronic diarrhoea and damaging weight loss, according to a study by German doctors.

A 21-year-old woman had diarrhoea and abdominal pain for eight months, and lost 11 kilograms (24lb), the British Medical Journal reports. A 46-year-old man lost twice as much in over a year. After no cause was found they were asked about diet. Both heavily consumed sorbitol, a sweetener found in chewing gum and sweets. Every day the woman ate up to 20 grams of sorbitol, the man 30 grams. The source was gum, and the man also ate sweets. After being told to stop, they got better. "The investigation of weight loss should include detailed dietary history with regard to sorbitol," Juergen Bauditz and his colleagues conclude. Linking sorbitol to diarrhoea is not new: just 20 grams causes it in about half the general population, the team says, but warnings are usually in small print.

Wrigley's said that the evidence was that up to 40 grams of sorbitol could be consumed. It labels such products: "Excessive consumption may produce laxative effects."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


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