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wdlove
Apr 1, 2004, 01:53 PM
Though obesity is now the second-leading cause of preventable deaths in the United States, doctors face a surprising problem in fighting the battle of the bulge: To most patients, they don't have much to offer beyond advice about diet and exercise.

The only two drugs approved by the US Food and Drug Administration for long-term weight loss typically help patients trim 15 pounds or less, and one, orlistat, can cause severe indigestion.

The problem, say researchers, is that decades of seeing obesity as an aesthetic problem instead of a health crisis have left basic scientific questions unanswered about the process of getting and staying thin. As a result, the quest for a potent diet pill has been scattershot and sometimes tragic, from the addictive amphetamines prescribed in the 1930s to the popular fen-phen pills of the 1990s that caused heart problems.http://www.boston.com/news/nation/articles/2004/04/01/in_fat_war_doctors_have_few_weapons/

Giaguara
Apr 1, 2004, 02:36 PM
They HAVE done soemthing.

Before ephedra (ma huang, mormon tea) was used for thousands of years for other than weight control (instead e.g. asthmatic issues, easing breath etc etc etc). .. then it started to be used for weight stuff, it was added for a lot of diet pills. Ephedra has a lot of side effects, so it was banned later (http://tinyurl.com/2jgbe) last year.

Now most diet pills are without ephedra. Many medicines contain ephedrine and pseudoephedrine, but their use is not in weight loss.

At least they have done that. No more useless ephedra side effects (incl. death).



I find it very interesting that 2 decades ago the thing that made you fat were the calories, one decade ago it was the fat, and now they are trying to make you believe that it is the carbs that make you fat.

And it is especially funny as Mr Atkins himself died obese, 6'2" vs 258 lb (http://tinyurl.com/27sn2). So write books about dieting, make millions and die obese yourself? :confused:


Serving sizes of food in US are gone insane in the past 30 years.

And another thing I would say to be responsable for fat is the pops. And the cars.

Dippo
Apr 1, 2004, 02:38 PM
To most patients, they don't have much to offer beyond advice about diet and exercise.

And if they dieted and exercised, they wouldn't need anything else :)

Dr. Zauis
Apr 1, 2004, 07:23 PM
And if they dieted and exercised, they wouldn't need anything else :)
Right, the only way to get fat is if your intake of calories is dramatically more than the rate at which you burn them.
Obesity is more of a lifestyle choice than a disease.

wdlove
Apr 1, 2004, 08:58 PM
Discipline, diet, and exercise are definitely the best approach.

Our metabolism is affected by genetics. So how fast a metabolism rate you have does have an affect. It also slows with age, I have found that to be true.

P-Worm
Apr 1, 2004, 10:30 PM
My question is: Why is it the doctors' problem in the first place?

P-Worm

Rincewind42
Apr 2, 2004, 08:24 AM
I find it very interesting that 2 decades ago the thing that made you fat were the calories, one decade ago it was the fat, and now they are trying to make you believe that it is the carbs that make you fat.

Most of that information came from WWII studies on weight and diet around the world. At the time they were more or less doing a pin the tail on the donkey, and didn't have enough money to research all the leads they could have found. The major outlier in their study that they were unable to account for was the Mediterranean region where they have a high-fat, high-fiber diet and far less occurrence of obesity and associated health problems. Recent research has basically pointed that it is fiber that helps them keep the weight off by slowing the processing of fats and carbohydrates in food. By slowing their processing, you slow the raise in blood sugar that accompanies their presence and prevent a wide-spread condition called Insulin Resistance (Pre-Diabetes).

When you eat something, whatever energy is in the food is processed into usable forms. Sugars are the first and fastest to be converted to glucose, followed by starches and fats. If you eat something that is very sugary then you are basically dumping a lot of sugar into your blood stream all at once which causes the pancreas to produce a huge amount of insulin. All the cells of your body gobble the glucose (blood sugar) up and the insulin goes away. The brain signals there is little sugar available and you get that hungry feeling again. And you reach for another sugar-fat bar. And we start again... Eventually going through enough of these cycles your cells start to ignore the insulin signals (because they have too much sugar already) and it just flows around your blood stream. You pancreas reacts by producing even more insulin and you can see where this is leading.

Now if instead you eat an Apple (fruit, which contains sugar and fiber; not the company) the situation is a bit different. In that apple it's harder for your digestive system to get at the sugar because of the fiber, and it is also a good bet that it takes you more effort to eat an apple than a candy bar. As such your blood sugar level doesn't raise nearly as quickly and you don't get that hungry feeling again 5 minutes later. Thus your pancreas produces a reasonable amount of insulin, your body absorbs the sugar slowly and you aren't hungry again for a reasonable amount of time (say an hour or two - this is just an apple we're talking about here :p).

In the "low-fat" craze all of the food we eat was converted from being high in fat-calories (which take longer to process) to high in sugar calories (which are nearly instant to process, given the way these foods are often prepared). As such we made it easier for us to feel hungry all the time. But fat is not the enemy! And really neither is sugar. There are no enemies in our food (even cholesterol is being given a second look). There is very little of our food that doesn't get processed into glucose, amino acids, vitamins and minerals (fat cells convert glucose into fat). As such the real effort is to keep ourselves from eating all the time, and the high-sugar foods that we as a society have found ourselves eating in the name of weight loss don't help that at all.

If you really want to get the weight off, it will take patience (sorry, no get slim quick schemes), determination and discipline. Train yourself to ask for the half portions at restaurants, avoid those candy bars and eat your broccoli like mom used to say :). If you need help, there are lots of programs out there - go to the book store and read at least the intro chapter and decide if you like what they are saying and you can actually do the plans they outline. I personally couldn't stand the thought of doing Atkins - I don't like meat that much. I ended up on South Beach, and 2 1/2 months later I'm nearly 25 pounds less massive. I'm amazed too :). I planned on 50 pounds by the end of the year but if things keep going this well I may increase that. But food science hasn't had enough attention given to make all of the research out there packageable into nice neat "public knowledge" segments. If you want to find out what is the latest, your going to have to get messy. But the pay off is that waistline you've always wanted but never felt you could have.

JesseJames
Apr 2, 2004, 09:45 AM
I'm sorry but I don't waste sympathy on fat people.
IT'S THEIR OWN DAMN FAULT.

Giaguara
Apr 2, 2004, 10:39 AM
My fav excuse for being fat is the genetics.

I mean - when all family AND THE DOG AND THE CAT are fat. Must be hereditary .. :rolleyes: :D

Rince, your view is interesting.. mh? Interesting as well that of the traditional kitchens the japanese seems to keep the people leanest untill a later age. With mediterrranean kitchen most people start to put on some weight when they are about 35-40.

And the kids everywhere (us, uk, .. especially italy) go for snacks like soft biscuits with chocolate, creams etc (in uk more for potato chips) .. that's not going to be so great for them once they are 30. :o

rueyeet
Apr 2, 2004, 12:30 PM
I'm sorry but I don't waste sympathy on fat people.
IT'S THEIR OWN DAMN FAULT.

There is no substitute for a plain old healthy, balanced diet and excercise, true. But it's also true that some genetic or medical conditions can make those things a never-ending uphill battle.

My mother has suffered from the double-whammy of hypoglycemia and hypothyroidism since before I was born. I've watched her struggle with her weight my entire life. You can't tell me those things aren't mitigating factors.

Also, where weight problems are the result of eating disorders that displace emotional and self-esteem issues onto food, that "It's YOUR fault, fatso" attitude doesn't do much but reinforce the person's low opinion of themselves and make them reach for the food. If you're already a loser, why try?

Yes, ultimately weight is a choice....but a little compassion might help people who DO have additional challenges to make the right choices.

wdlove
Apr 2, 2004, 01:00 PM
My question is: Why is it the doctors' problem in the first place?

P-Worm

Is that rhetorical? Obesity is a serious illness that can ultimately lead to death. Doctors prefer preventative measures. It is easier to prevent an illness that the treatment.

Giaguara
Apr 2, 2004, 01:09 PM
Is that rhetorical? Obesity is a serious illness that can ultimately lead to death. Doctors prefer preventative measures. It is easier to prevent an illness that the treatment.

doctos live of people's diseases.

if people were not fat, did not eat junk etc and have all the related problems from heart diseases to fertility problems .. think about how many unemployed doctors woudl there be? :o

doctors would not survive giving those "eat healthily and exercize enough but not too much, and sleep enough" advice. why would anyone pay them for those advice, unless they really .. can't think it themselves? :o

Giaguara
Apr 2, 2004, 01:13 PM
actually ... tehy could do somehting that my uncle told me they do in scandinavia (he lives there, i don't): if an obviously obese person goes to (a public) doctor for a (minor) health issue, the doctor can advice him to FIRST take care of his weight and THEN take care of the other issues - that should be a good motive. ( I assume it excludes things like heart problems and broken bones etc though).

Awimoway
Apr 2, 2004, 01:41 PM
Being overweight is like being a smoker. --Sure, you can say it's their own fault, but that doesn't make you any less ugly for mocking people, as if you have no faults or flaws. :rolleyes:

We are going to go round and round on whose fault the obesity problem is--fat people for eating poorly or the restaurant and processed food industry for making portions enormous and loaded with sugar and fat. It's like the debate over violence in entertainment media--most people think it's detrimental to society, but the same people keep watching it. It's like high prices for Apple products and annual update fees--some people say Apple can do whatever they please if people buy it, others say it's wrong to squeeze us.

There is a fine line, a gray area, between personal choice and responsibility and corporate responsibility to society. But such fine-grained nuances are not easily grasped in American culture, so we'll continue to bash each other the head over who to blame.

wdlove
Apr 2, 2004, 01:53 PM
doctos live of people's diseases.

if people were not fat, did not eat junk etc and have all the related problems from heart diseases to fertility problems .. think about how many unemployed doctors would there be? :o

doctors would not survive giving those "eat healthily and exercise enough but not too much, and sleep enough" advice. why would anyone pay them for those advice, unless they really .. can't think it themselves? :o

There would still be a need for preventative care. A lot of medicine will revolve around treatment of the gene itself to accomplish this goal. There will still be accidents of all kinds that will need medical treatment. Some health insurance carriers now reward doctors for preventative care. Prevention is cheaper than treating an actual disease.

Rincewind42
Apr 2, 2004, 02:07 PM
Rince, your view is interesting.. mh? Interesting as well that of the traditional kitchens the japanese seems to keep the people leanest untill a later age. With mediterrranean kitchen most people start to put on some weight when they are about 35-40.

This used to be true (in fact, this is where the original carbohydrates are good thinking came from). But back then you didn't see massively processed rice nearly as much as you do today. In fact nearly all foods made today have their natural fiber processed out of them. As such they go straight to your blood for a quick raise in blood sugar levels. But no food is absolutely good or bad for you, it's all in moderation...

And the kids everywhere (us, uk, .. especially italy) go for snacks like soft biscuits with chocolate, creams etc (in uk more for potato chips) .. that's not going to be so great for them once they are 30. :o

Yea, I learned long ago that such things are not good as your first reach snack...

Awimoway
Apr 2, 2004, 03:42 PM
My fav excuse for being fat is the genetics.

I mean - when all family AND THE DOG AND THE CAT are fat. Must be hereditary .. :rolleyes: :D

...

And the kids everywhere (us, uk, .. especially italy) go for snacks like soft biscuits with chocolate, creams etc (in uk more for potato chips) .. that's not going to be so great for them once they are 30. :o

I disagree. Bad habits, formed at whatever age, are hard to break. And that's the point. Unhealthy cravings are genetically programmed. Hunter-gatherers craved sweets and fats because they got them so rarely, and in their natural form--fruits, the occasional kill, was quite good for their survival. Now that the biggest health problem is because we have too much of a good thing, in too refined of portions, we have a health problem.

It's too easy to just blame the people who eat. Is it their fault broccoli tastes like dog ****? And that's why doctors who tell their patients "Get out of my office and don't come back until you lose some weight," are practicing bad medicine. Not that they have any choice, though, and that's the point of this thread. There simply aren't many medical helps for this problem. And there ought to be.

The human race in most parts of the world has evolved in the last 100 years. Scarcity has been erased. But the evolution hasn't been biological, and we may now need to force a biological "evolution" to catch up with the economic and technological evolution. Whether we do it with genetic engineering or more conventional medical means, it needs to be done. I'm sure genetic engineering could make broccoli tickle our brains as readily as Twinkies.

Giaguara
Apr 2, 2004, 04:22 PM
I disagree. Bad habits, formed at whatever age, are hard to break. And that's the point. Unhealthy cravings are genetically programmed. Hunter-gatherers craved sweets and fats because they got them so rarely, and in their natural form--fruits, the occasional kill, was quite good for their survival. Now that the biggest health problem is because we have too much of a good thing, in too refined of portions, we have a health problem.

It's too easy to just blame the people who eat. Is it their fault broccoli tastes like dog ****? And that's why doctors who tell their patients "Get out of my office and don't come back until you lose some weight," are practicing bad medicine. Not that they have any choice, though, and that's the point of this thread. There simply aren't many medical helps for this problem. And there ought to be.

The human race in most parts of the world has evolved in the last 100 years. Scarcity has been erased. But the evolution hasn't been biological, and we may now need to force a biological "evolution" to catch up with the economic and technological evolution. Whether we do it with genetic engineering or more conventional medical means, it needs to be done. I'm sure genetic engineering could make broccoli tickle our brains as readily as Twinkies.

The bad eating habits formed in the early childhood are more difficult to break than those formed later in life. The children who learn to like fatty food will more likely like it later in their life than those who had or have less fatty and less processed food when they were small.

Broccoli tastes bad? Must be a genetical mutation that I have then. I do like broccoli. And I know many other people who do too.
But when it comes to most chips - potato chips, any chips that are not oven baked - my body is just not used to them. Especially if I have had any alcohol prior to eating chips - .. lets' say the chips just do not stay in my digestive system.
And another genetical mutation? I don't want to eat dead animals. (or alive animals by the matters).

I find the gatherer-hunter myth to be very westernized. If you lived in Africa - like the earliest humans would be supposed to live - why would you go and eat animals? In tropics you can live on fruit. Or - having the dead animals .. humans are the only animals who cook their meat. As protein destroys in temperatures above 110 F it would make most sense to eat it raw .. :eek:

Awimoway
Apr 2, 2004, 04:39 PM
Broccoli tastes bad? Must be a genetical mutation that I have then. I do like broccoli. And I know many other people who do too.
But when it comes to most chips - potato chips, any chips that are not oven baked - my body is just not used to them. Especially if I have had any alcohol prior to eating chips - .. lets' say the chips just do not stay in my digestive system.
And another genetical mutation? I don't want to eat dead animals. (or alive animals by the matters).

I find the gatherer-hunter myth to be very westernized. If you lived in Africa - like the earliest humans would be supposed to live - why would you go and eat animals? In tropics you can live on fruit. Or - having the dead animals .. humans are the only animals who cook their meat. As protein destroys in temperatures above 110 F it would make most sense to eat it raw .. :eek:

It has been shown that people's palates vary. It's not all conditioned by childhood (though this certainly plays a big role). What I've heard is that the main difference is one of intensity of taste. To some people, everything tastes more intensely. These people prefer blander (often fattier) food and it's subtler nuances. Others have less sensitive palates and foods like broccoli that have an overpowering, strong taste to the sensitive types have a milder, pleasanter taste to others. Less sensitive ones find bland foods to be boring.

And I don't have a problem with the hunter-gatherer theory being "westernized," though perhaps "northernized" would be more appropriate--we may have all come from Africans, but that doesn't mean that there weren't intermediate ancestors for most of us, and even Africa wasn't immune to the ice age we had 10,000 years ago--it was certainly much cooler there then.

JesseJames
Apr 2, 2004, 05:44 PM
Awimoway, are you by any chance a little overweight?

Apple //e
Apr 2, 2004, 05:46 PM
Though obesity is now the second-leading cause of preventable deaths in the United States, doctors face a surprising problem in fighting the battle of the bulge: To most patients, they don't have much to offer beyond advice about diet and exercise.

The only two drugs approved by the US Food and Drug Administration for long-term weight loss typically help patients trim 15 pounds or less, and one, orlistat, can cause severe indigestion.

The problem, say researchers, is that decades of seeing obesity as an aesthetic problem instead of a health crisis have left basic scientific questions unanswered about the process of getting and staying thin. As a result, the quest for a potent diet pill has been scattershot and sometimes tragic, from the addictive amphetamines prescribed in the 1930s to the popular fen-phen pills of the 1990s that caused heart problems.http://www.boston.com/news/nation/articles/2004/04/01/in_fat_war_doctors_have_few_weapons/


i think the main stumbling block to creating the "im too fat pill" is the lack of the complementary "im too lazy pill"

fortunately the necessary "i believe in miracles" pill was created aeons ago

Awimoway
Apr 2, 2004, 06:15 PM
Awimoway, are you by any chance a little overweight?

http://forums.macrumors.com/showthread.php?postid=778733#post778733

I suppose in this thread you'll be asking me if I'm a schizophrenic sleepwalker? :rolleyes:

I just have no patience with condescending self-righteous a******* who rush to judgment about other people and their problems. "IT'S NOT MY PROBLEM," may be true, but that doesn't make it any less morally bankrupt. So stay out of a thread on the subject if it's not your problem.

JesseJames
Apr 3, 2004, 11:27 AM
Hmmm. I see.

applebum
Apr 3, 2004, 10:59 PM
...humans are the only animals who cook their meat.

???? Are there some animals, other than humans, that cook their broccoli?

Thomas Veil
Apr 4, 2004, 08:01 AM
Obesity is more of a lifestyle choice than a disease.
That's the single hugest misconception overweight people have to deal with. It may be true for some people, but it's hardly a universal truth.

My wife's entire family is overweight, and you can bet your chubby little behind that a lot of it is genetic. My wife eats less than I do, eats healthier, and is more physically active...yet weighs considerably more than I do.

We still have a long way to go educating people that being fat is not necessarily some kind of "weakness".

Giaguara
Apr 4, 2004, 11:09 AM
???? Are there some animals, other than humans, that cook their broccoli?

I can tranquilly eat my broccoli and jalopeņos raw.

Can you do that for the dead anim .. I mean things such as beef?

wdlove
Apr 4, 2004, 07:51 PM
I can tranquilly eat my broccoli and jalopeņos raw.

No thank you on the jalopeņos however you serve, just too hot for my taste. But I love broccoli, my wife uses it in salad. She also just barely cooks them so they are almost like raw with the crunch.