Comments on: Obesity Screening Often Overlooks Eating Issues

By: Susan Koppelman

Susan Koppelman — Sat, 28 Jul 2012 21:01:30 +0000

I detect, as I read these comments, a lot of ideas that seem predicated on the desire to make money, to find a market for a particular set of skills and credentials. “Hmmm, how can I use the oppressive and pointless war against obesity to make a buck?” The real trouble with HAES is that no one is going to get rich off of it. Some will make some money being in the setting the rest of the world straight and helping people loosen their addiction to the worship of unnatural ideas about body size, weight, health, ad beautfy. But there won’t be a lot of return customers. Once you kick the addiction to internalized bigotry, you don’t need to pay for anything more. You just live your life and feel good about yourself, proud that you have survived the soul murder and eager to go forward with your life. Whereas those folks selling diets — which, if you remember, fail 95% of the time — get a lot of return business. Keep selling an unreachable goal to a marketplace trained to want desperately the product you’re selling and it’s a dance all the way to the bank, to the Cayman Islands, to buying gold to hold onto during the depression. Then your only problems are how to hold on to your clientele and how to invest and spend your bounty.

By: Susan Koppelman

Susan Koppelman — Sat, 28 Jul 2012 18:56:48 +0000

The calories in/calories out idea has been for so long rendered laughable by scientifically testing it as if it were a description of reality, it is so thoroughly disproved, that I wonder if the idiots who promolgate the idea, as have some in the list of commentors here, just for the sake of argument. Surely those people aren’t serious — nor do I believe they are that stupid, so what is their reason for saying stupid things?

By: Shivaun Nestor

Shivaun Nestor — Tue, 17 Jul 2012 21:52:09 +0000

I so appreciate this article. As someone who for over 2 decades has worked with adolescents regarding sexuality and body I so support Ms. Weaver’s recommendations. The focus on BMI in a fat-phobic culture can only increase eating disorders throughout the population, and as the author points out, will miss out on nutrition and exercise counseling for “normal weight” people, many of whom will have eating disorders, who might benefit. The emphasis on weight and the resulting stigmatization of heavier people (as illustrated by a number of commentators here), has resulted in an epidemic of very unhealthy yo-yo dieting which has itself greatly contributed to the obesity epidemic. If weight management were a simple matter of calories in / calories out, as York and others seem to imply, no one would be obese in such an environment, where fat folk experience discrimination on a daily basis. More to the point, it is a myth that being overweight in and of itself is a health risk. A number of studies over the years have found that people with BMIs higher than the normal range actually have better mortality (death) and morbidity (disease) outcomes than their “normal” counterparts, and that the health outcomes of those in the underweight BMI range – which would include the majority of actresses and supermodels now widely perceived as the “ideal” – actually have far worse health outcomes.

By: Jennifer Frank, Ph.

Jennifer Frank, Ph. — Tue, 17 Jul 2012 21:21:45 +0000

People like York and Grant are espousing outdated and short-sighted information, respectively. York: there is a large, ever-growing body of evidence that becoming fat is not as simple as calories in equals calories out. You suggest we stop the blame game, but you are, in fact, blaming people for what you personally fail to understand. Grant: health premiums are already supposed to be based on health, and fat people are already paying more than others, based purely on their weight. If your argument is that people in dangerous situations should pay more insurance, that is even more reason not to base insurance rates on BMI, which doesn’t distinguish health from weight, but on factors indisputably correlated with health problems, like blood pressure, heart disease, blood sugar, etc. If you look at the data you will find many thin people who have these problems and many fat people who don’t. It makes better economic sense for all of us for the health and insurance industries to determine who really needs intervention, rather than creating unnecessary expenses for the healthy and automatically overlooking the unhealthy whose problems aren’t visible to the naked eye.

By: Lisa

Lisa — Tue, 17 Jul 2012 21:07:02 +0000

I really appreciate the comments from Judith Matz, she’s right on target, unlike some of the commenters who are woefully out of date in their assumptions about other people’s health.

First off: pestering people about their weight – which creates body dissatisfaction – leads to MORE weight gain, not weight loss (see “Body satisfaction, Weight Gain and Binge Eating Among Overweight Adolescent
Girls” Sonneville, Calzol, Horton, Haines, Austin & Field). This is something any eating disorders clinician could tell you, but it’s nice to have some new well done studies showing this. So if you don’t want people gaining more weight, stop making them feel bad about their body size. Be more size accepting.

Second: the mortality risk for overweight and obese people is no greater than for ‘normal’ people when hypertension and diabetes are controlled for (see: (Jerant & Franks’ “Body Mass Index, Diabetes, Hypertension, and Short-Term Mortality: A Population-Based Observational Study, 2000–2006″ J Am Board Fam Med July-August 2012 vol. 25 no. 4 422-431). What we know is that there are plenty of fat people who are just as healthy (and non-eating-disordered) as their thin compatriots, and plenty of thin people with diabetes and/or hypertension and/or disordered eating who are being undertreated because hey, they’re BMI says their “healthy”. Is this fair to them?

We all really need to stop making assumptions about people’s health, behaviors and lifestyles based on their body sizes. We’re harassing people who don’t need the harassment and ignoring people who might need some help. When are we going to finally “get it”: The data just does not support the very tired, very old fat=unhealthy paradigm. Let’s get over it!!

By: Ellie

Ellie — Mon, 16 Jul 2012 11:35:27 +0000

The more my own doctors harped on me about how important it is to eat right and lose weight, the worse it makes me feel about myself. They always seem so critical and rather than helping me it makes me feel like they are really working against me and any effort that I have ever nade trying to lose weight. Why don’t they see that this is hard, harder for some of us than it is for the rest? Hard to kick those bad habits that we have been entrenched in since early in life? And harder still to see that under most of this we feel like a failure already?

By: grant

grant — Sun, 15 Jul 2012 23:21:44 +0000

So let’s look at it this way- most of the time you see higher rates of heart disease and such among the overweight population. I am not saying that we all have to be model thin, that would not be the way that we are built. Some are bound to be a little heavier and some a little thinner. But all I am saying is that we should have to at least keep up our end of the bargain. We should at least have to maintain some ideal of health for the insurance companies to take a chance on us. Don’t I have to pay higher homeowner insurance rates if I live in a flood or hurricane zone? Don’t I have to pay higher auto insurance rates if I have a horrid driving record? With that in mind? then why shouldn’t I have to pay higher premiums for health insurance if I am less than the ideal candidate?

By: nathan

nathan — Sun, 15 Jul 2012 15:07:11 +0000

grant, its not necessary that those who are overweight are unhealthy.different people have different body types and a lot of factors go into deciding a person’s weight,frame,etc.one could be of the ideal weight and still have poor eating habits.

and let us not even get started on anorexia.it is as harmful,if not more than,obesity.you wouldn’t expect an insurance company to charge someone a higher premium because they are excessively lean,now,would you?

By: Shaun B

Shaun B — Sat, 14 Jul 2012 22:47:14 +0000

I may have a BMI much greater than you but if you are eating all the wrong kinds of food and my BMI is higher not due to bad eating habits but genetic or something then you are in the red, not me!

By: russell bernard

russell bernard — Sat, 14 Jul 2012 20:15:41 +0000

as much as I agree with Judith Matz,i still think people with a high BMI need to be made a target of these drives because although anybody can be unhealthy in their eating habits, it is usually people with these high BMI that are most at-risk for health issues related to eating and obesity.

By: grant

grant — Sat, 14 Jul 2012 13:37:32 +0000

What’s wrong with insurance companies charging higher premiums to people who are overweight and obese?
If they want to pay the higher premiums then go ahead and keep the weight on.
If they choose to have their premiums reduced then find a way to eat right and exercise and the weight will come off..I don’t think that it is wrong at all for those who have something going on that they could prevent to have to pay a higher price for insurance. That includes smokers too.

By: Emmett

Emmett — Sat, 14 Jul 2012 11:20:17 +0000

Very educated, york. Note the intended sarcasm.

I have been heavy for most of my life and it all started with hiding food as a child and then progressing from there. My weight was always a way for me to hide. I didn’t want anyone to see me, so I ate and hid behind the fat. I knew that once you get big, people really do stop seeing you. They don’t wish to have to deal with those issues so they ignore you. And of course then it gets out of control and you don’t know how to make it stop even once you have started to believ that you could be ready to change.

By: york

york — Fri, 13 Jul 2012 22:19:45 +0000

Last time I checked people get fat cause they eat too much.

When are we going to stop the blame game and just admit the facts? They have no willpower or otherwise they would be able to stop when they’ve had enough.

For most of them there is never enough cause they have lost sight of the important things. For them it’s all about food and satisfaction that they get from the food.

Push awau from the table a little early every now and then and you wouldn’t have those problems.

By: Bridget

Bridget — Fri, 13 Jul 2012 18:11:44 +0000

This is one of those issues that we continue to treat the symptoms of something but not the real cause. Most people don’t get this way because they simply like to eat too much. For most obese people there is an underlying cause for this type of behavior that never gets acknowledged and cured. For some it may be that they have fears that they are trying to control or other emotions that they are trying to stuff away with the food. Whatever the root cause we are ignoring that and only looking to get people to slim down. I want people to look good and feel good physically, but none of that can happen and be maintained without changing how they look and feel emotionally and mentally too.