Losing Weight

[thrillbill]

(It looks like we need a topic of such instead of discussing it under a different forum)

This entry from the "flying business class post" said: Smiles is right that anyone can lose weigh - and even return to their ideal weight - simply by eating less. But more interesting is the thought that if you consistently gain just one ounce of weight per week, after 30 years you'll be 100 pounds overweight. Given how little food it takes to gain one ounce, it's amazing we aren't all obese - we eat so much more and work (physically) so much less than our ancestors.

There are all kinds of factors that can make us over weight... eating too much, the kinds of foods they eat, not exercising enough, ones metabolism and such...

What irks me as I get older is is tougher to loose weight.
Though I make an effort NOT to eat fried foods, too many carbs, and say away from the sweets, and I go to the gym 5 times a week (90 minute sessions-30 minutes on the eliptical) I find it to lose weight. Fortunately I am mostly muscle toned because of the weight training but it is hard to get rid of the fat that seems to gather around the belly when you get older. I would hate to think what I would look like if I didn't exercise and watch what I eat. --So , yes, when you are in your 20's and 30's, it is pretty easy to keep your weight down, but when you hit your late 40's and beyond, it gets hard to lose weight --even if you DO exericse. (Heaven forbid what I would look like if I didn't eat a certain diet of food and didn't exercise. ) :cyclopsani:

[lonelywombat]

(It looks like we need a topic of such instead of discussing it under a different forum)

This entry from the "flying business class post" said: Smiles is right that anyone can lose weigh - and even return to their ideal weight - simply by eating less. But more interesting is the thought that if you consistently gain just one ounce of weight per week, after 30 years you'll be 100 pounds overweight. Given how little food it takes to gain one ounce, it's amazing we aren't all obese - we eat so much more and work (physically) so much less than our ancestors.

There are all kinds of factors that can make us over weight... eating too much, the kinds of foods they eat, not exercising enough, ones metabolism and such...

What irks me as I get older is is tougher to loose weight.
Though I make an effort NOT to eat fried foods, too many carbs, and say away from the sweets, and I go to the gym 5 times a week (90 minute sessions-30 minutes on the eliptical) I find it to lose weight. Fortunately I am mostly muscle toned because of the weight training but it is hard to get rid of the fat that seems to gather around the belly when you get older. I would hate to think what I would look like if I didn't exercise and watch what I eat. --So , yes, when you are in your 20's and 30's, it is pretty easy to keep your weight down, but when you hit your late 40's and beyond, it gets hard to lose weight --even if you DO exericse. (Heaven forbid what I would look like if I didn't eat a certain diet of food and didn't exercise. ) :cyclopsani:

About 12 months ago catawampus mentioned he was on a wonder drug, which when I googled had some unpleasant side effects for those with a cardiac history.

Recently I went on [high] blood pressure tablets and they were prescribed with a mild diuretic. Whilst it has been slow I am now close to my weight of 20 years ago, losing about 2kg per month. Not that I was obese, but I had that stubborn fat around the middle, that I am pleased to see shrink.

It would be interesting to hear from cat as to what success he has had.

[catawampuscat]

To refresh my memory, I searched reduce-15 using the search feature on this forum and up came about six threads.
One was titled "being fat in Thailand" authored by the lonely wombat, last year, which ended up quite nasty and was blocked by
elephantspike. Another was titled "amazing slimming pills" authored by let me tell u and was quite civilized..

You can all search reduce-15 and read for yourselves, if interested, and we don't have to go thru all of it again but here are the results.....

A couple of years ago, I was frustrated trying to stop gaining weight, let alone lose it.. I was walking and exercising but still gaining.
In desparation, I tried the pill and ended up losing around 20 kilos. I had no side effects or issues whatsoever using the pill but after several
months, the pill stopped working and I stopped taking it.
Over time, I regained 5 or more kilos and would try to hold back the kilos. I did try the pills again but they had no effect this time.

Jumping into the present, I recently regained several more kilos and had put back on 10 kilos of the the 20 kilos I had lost.
I started up the pills again about a month ago and combined with working out regularly, I have dropped back 4 kilos and am back in
control. Five or six more kilos to go but frankly I am very comfortable in my skin right now..
This time the reduce-15 pills are helping again,and I am avoiding buffets like the plague and try to stay with the Thai food.
I did maintain most of the original weight loss for about two years but even with exercising, I started putting the weight back on..

If you are desparate and nothing else works, it might be worth trying the pills but you need strong motivation as they are not magic
and only an aid. Of course, check with your physician before starting any new exercise program or medication ... :cat:

Fat farangs wearing g strings on Jomtien Beach :puke:

I was hoping to change my name from Fattman to Slimmerman but its proving very difficult. Eating too much, insufficient exercise, too much time in front of my computer posting on SGT, and a fat father, all conspire against me. Being a lazy bastard isn't helping either.

Please don't change a bit darling... I love you just the way you are :drunken: :drunken:

[Mi Cow Chai-old]

What does this have to do with Thailand?

[Lunchtime O'Booze]

What does this have to do with Thailand?

God only knows but do as I did-liposuction !

Who has the time or inclination to do friggin exercises and the older you get , the more you enjoy fine dining ( and the odd drink or two)

Get the lot sucked out..worked for me and the fat doesn't come back ( well not on my belly but it does elsewhere)

Fat farangs wearing g strings on Jomtien Beach :puke:


Shock sure . But no cocaine can be found in it ! :flower:

Fat farangs wearing g strings on Jomtien Beach :puke:


Shock sure . But no cocaine can be found in it ! :flower:

What about Cavitiy Search?? :idea: :idea:

To refresh my memory, I searched reduce-15 using the search feature on this forum and up came about six threads.
One was titled "being fat in Thailand" authored by the lonely wombat, last year, which ended up quite nasty and was blocked by
elephantspike. Another was titled "amazing slimming pills" authored by let me tell u and was quite civilized..

You can all search reduce-15 and read for yourselves, if interested, and we don't have to go thru all of it again but here are the results.....

A couple of years ago, I was frustrated trying to stop gaining weight, let alone lose it.. I was walking and exercising but still gaining.
In desparation, I tried the pill and ended up losing around 20 kilos. I had no side effects or issues whatsoever using the pill but after several
months, the pill stopped working and I stopped taking it.
Over time, I regained 5 or more kilos and would try to hold back the kilos. I did try the pills again but they had no effect this time.

Jumping into the present, I recently regained several more kilos and had put back on 10 kilos of the the 20 kilos I had lost.
I started up the pills again about a month ago and combined with working out regularly, I have dropped back 4 kilos and am back in
control. Five or six more kilos to go but frankly I am very comfortable in my skin right now..
This time the reduce-15 pills are helping again,and I am avoiding buffets like the plague and try to stay with the Thai food.
I did maintain most of the original weight loss for about two years but even with exercising, I started putting the weight back on..

If you are desparate and nothing else works, it might be worth trying the pills but you need strong motivation as they are not magic
and only an aid. Of course, check with your physician before starting any new exercise program or medication ... :cat:


It sounds as if what you were purchasing is what is known as Reductil (Sibutramine Hydrochloride). It comes in 10mg and 15mg capsules but most guys need the 15mg. The capsaules are dark blue and white.

I originally got them prescribed in the UK but I had to visit the surgery twice a month for blood pressure tests as they are known to cause an increase in BP in some people. The fact that I have no history of high BP suggests to me that it might be a common side-effect.

You're right, they work great and without any exercise, but you do have to cut down on food. Like you I did well but I stopped taking them during a trip to Thailand and never really got back into the routine.

Last year, I too visited the exact same pharmacist as yourself - she is great for anything you need - and I bought around 120 capsules to start taking when I got home. But they weren't very effective second time round.

They work by controlling some chemical in your brain so you don't feel hungry. Theres another type called Xenical which act differently - they stop absorption of fat from food.
The only problem is that if the fat you eat isn't absorbed - where does it go? That's right, out your arse, suddenly and without warning! There are people all over the world going around shitting themselves on Xenical.

:cheers: :cheers: :cheers: :cheers: :cheers:

[markie1]

thats what that smell is at sunnee plaza is it ,those people letting go out there ar>>,WARNING ,dont sit next to a forang if you think hes on a diet ,you might regret it :bom:

[catawampuscat]

scotty, you are correct with the name of the drug and the one I used was a generic from India. My own experience was
very positive and noticeable and several friends/acquaintances tried it without success. I believe you really need strong
motivation and desire to lose weight and it only helps you eat less, by dampening your appetite and giving you a feeling
of being full sooner than usual.

I tried the xenical and also found it unpleasant and expensive..
Several friends do use it successfully and I believe you get
used to the looseness and gassy sensations in time but it wasn't for me..

Exercise, liking walking, speeds the weight loss but of course, if you eat less you will lose weight and if the drug affects your
appetite control center in your brain, you will stop or slow down on the binging and overeating..

One friend, who takes blood pressure medication, checked with his doctor about the drug and was advised that if he could lose
weight it would help his high blood pressure and that would balance out the risks and his doctor gave him the green lite but
alas, he found the drug seemed to have a dampening effect on his libido/performance and no effect on his appetite...

One other problem associated with weight loss, especially quick and major weight loss is loose flabby skin. Ones' skin doesn't shrink
quickly and without the fat, the skin folds and sags and it looks far more hideous than when full of fat.
The bodys skin is stretched enormously when one is 60 or more kilos overweight and especially the gut/stomach area.
Tummy tucks are one way to cut off the excess skin and somehow tighten it all up but it is major surgery and dangerous.

The big problem with sagging excess folds of skin is when you have to take your clothes off in the light in someones elses presence.
Tummy tuck sounds like its nothing but then you have to get a butt lift and a tit lift and on it goes.. Better to lose weight slowly... :cat:

I have never tried a high-carb, low-protein diet. But I can vouch for the opposite (low-carb, high-protein) -- basically, the Atkins diet. I've been on it for the past two weeks, and have dropped 4 kilos -- all the while eating all the meat I want.

[Aunty]

I have never tried a high-carb, low-protein diet. But I can vouch for the opposite (low-carb, high-protein) -- basically, the Atkins diet. I've been on it for the past two weeks, and have dropped 4 kilos -- all the while eating all the meat I want.

Ooooooh really, and is it self-saucing?

[Aunty]

scotty, you are correct with the name of the drug and the one I used was a generic from India. My own experience was
very positive and noticeable and several friends/acquaintances tried it without success. I believe you really need strong
motivation and desire to lose weight and it only helps you eat less, by dampening your appetite and giving you a feeling
of being full sooner than usual.

I tried the xenical and also found it unpleasant and expensive..
Several friends do use it successfully and I believe you get
used to the looseness and gassy sensations in time but it wasn't for me..

Exercise, liking walking, speeds the weight loss but of course, if you eat less you will lose weight and if the drug affects your
appetite control center in your brain, you will stop or slow down on the binging and overeating..

One friend, who takes blood pressure medication, checked with his doctor about the drug and was advised that if he could lose
weight it would help his high blood pressure and that would balance out the risks and his doctor gave him the green lite but
alas, he found the drug seemed to have a dampening effect on his libido/performance and no effect on his appetite...

One other problem associated with weight loss, especially quick and major weight loss is loose flabby skin. Ones' skin doesn't shrink
quickly and without the fat, the skin folds and sags and it looks far more hideous than when full of fat.
The bodys skin is stretched enormously when one is 60 or more kilos overweight and especially the gut/stomach area.
Tummy tucks are one way to cut off the excess skin and somehow tighten it all up but it is major surgery and dangerous.

The big problem with sagging excess folds of skin is when you have to take your clothes off in the light in someones elses presence.
Tummy tuck sounds like its nothing but then you have to get a butt lift and a tit lift and on it goes.. Better to lose weight slowly... :cat:

You see your problem, Catty, is that you're just a lazy, out of control greedy pig. You don't need pills to suppress your appetite, you just need to exercise some will power and self-control and make the choice to keep your big gaping cake-hole shut! Make the choice! Stop filling it with food! Now anything else that you may come up with to explain your double-triple-chins and ample rolls of fat are just pure self-denial and delusions on your part!

If you don't believe me, you need to go and discuss this (in private) with Prof. Allieb. He knows all there is to know about you fatties.

[allieb]

I have never tried a high-carb, low-protein diet. But I can vouch for the opposite (low-carb, high-protein) -- basically, the Atkins diet. I've been on it for the past two weeks, and have dropped 4 kilos -- all the while eating all the meat I want.

Didn't know I was in the car behind you did you.

[thrillbill]

... the one I sat next to when flying economy! :compress:

I have never tried a high-carb, low-protein diet. But I can vouch for the opposite (low-carb, high-protein) -- basically, the Atkins diet. I've been on it for the past two weeks, and have dropped 4 kilos -- all the while eating all the meat I want.

be careful of the long term effects of a high protein diet - can increase the likelihood of kidney stones. and u DO NOT want them!

[quote="Chao Na":11f9kc8t]I have never tried a high-carb, low-protein diet. But I can vouch for the opposite (low-carb, high-protein) -- basically, the Atkins diet. I've been on it for the past two weeks, and have dropped 4 kilos -- all the while eating all the meat I want.

be careful of the long term effects of a high protein diet - can increase the likelihood of kidney stones. and u DO NOT want them![/quote:11f9kc8t]

There are risks implicit in every diet plan. But, ultimately, the risks presented by being a fat fuck far outweigh them.

There are risks implicit in every diet plan. But, ultimately, the risks presented by being a fat fuck far outweigh them.

sure, but i prefer to try to keep the weight down with a healthy balanced (non-fad) diet, exercise, beer, and more exercise. dont forget there are lots of unhealthy skinny people too.

http://www.latimes.com/features/health/ ... 4538.story (http://www.latimes.com/features/health/la-he-theoryintro14-2008jul14,0,5684538.story) is the link to this article which further discusses the "Virus theory", "stress theory" and other theories.

Many years ago I used fen-phen which allowed me to loose about 1 pound a day. It worked on the brain area that controls hunger and increased metabolism. Too bad it gave some heart valve problems and was pulled from the US market.


What's making us fat?
A critical look at the virus theory, the corn syrup conjecture and other (wishful?) thinking.
By Karen Ravn, Special to The Times
July 14, 2008
CALL IT Fattergate. Americans are getting scandalously big for their britches (and shirts and skirts and dresses and suits). And scientists would like to know why, so they can make it stop. After all, this sharp trend toward a well-rounded population has some pretty hefty (and heinous) consequences for public health.

There's a simple explanation for the weight gain, of course: People consume more calories than they burn. The favorite explanation: They eat bigger portions of less nutritional foods at easier-to-get-to fast food places, even as they hunker down more and more faithfully in front of their TV and computer screens. "Most of us say it is a combination of reduced energy expenditures plus dietary intake not declining enough," says Barry Popkin, a nutrition professor at the University of North Carolina at Chapel Hill.

But why does that happen far more often now than 30 years ago? It's not obvious, says Susan Roberts, a senior scientist at the Human Nutrition Research Center on Aging at Tufts University in Boston: "There is definitely no definitive answer on 'what went wrong.' "

Even as researchers try to refine the eat-too-much-move-too-little theory, some are entertaining other ideas (obesity virus, anyone?). Read on for some of their theories, as well as a weigh-in from our panel of obesity researchers.

www.latimes.com/features/health/la-he-theoryintro14-2008jul14,0,5684538.story (http://www.latimes.com/features/health/la-he-theoryintro14-2008jul14,0,5684538.story)

[Aunty]

As a medical scientist who, until recently, used to lecture to post-graduates in obesity ( oh Aunty, you skiting bitch, blowing your own trumpet again! How very dare you! If you hadn't said anything, I'd have believed every word you said, but now that you told us that, I ain't believing a word because you're just showing off and don't know a thing you're talking about) I thought for some it might be interesting to read these recent opinion pieces in the British Medical Journal (Feb 2008) which highlight many of the controversies that rage in science over the causes and consequences of human obesity.

As you can see, we are far from an agreed understanding on anything. But clearly none of these foolish academics are familiar with the cake-hole theory of the great Prof. Allieb, of Saudi Arabia, and his colleagues at Sawatdee Gay Thailand who has established the true cause (and by definition its treatment) of human obesity. It's their own fault because they can't keep their fat cake-holes shut!



Is the obesity epidemic exaggerated? Yes

Patrick Basham, professor, John Luik, senior fellow
Johns Hopkins University, 1717 Massachusetts Avenue NW, Washington DC 20036, USA, 2 Democracy Institute, London EC1V 4PY
Correspondence to: P Basham patrickbasham@gmail.com
doi: 10.1136/bmj.39458.495127.AD

The UK health secretary declared last week that we are in the grip of an obesity epidemic. Patrick Basham and John Luik believe that the problem is less clear cut, but R W Jeffery and N E Sherwood say that obesity is a growing global problem

The claims, both in the media and in professional publications, about an epidemic, its causes, consequences, and cure often exceed the scientific evidence and mistakenly suggest an unjustified degree of certainty. The fact that cases are "clearly above normal expectancy" anchors the concept of an epidemic. In this respect, describing obesity as an epidemic is subject to two difficulties.

Definition of normal
Firstly, it is difficult to determine normal expectancy. Much of the data on overweight and obesity are limited, equivocal, and compromised in terms of extent and the reliability of the measurements and the populations sampled. In the US, for example, data about population weights date from only 1960. Several pieces of evidence, however, suggest that the contemporary situation may be close to, rather than in excess of, normal.

The earliest national survey shows that in 1960 45% of the US population was overweight, accordingto sex specific weight for height tables (corresponding to a body mass index of 25 to <30).1 In the 1970s, 22% of US men aged 18-19 were overweight compared with 16.7% of boys aged 12-19 in 2002.2 FogelтАЩs ongoing work in various countries on the relation between health, mortality, nutrition, and technology suggests that as populations grow healthier, prosperous, and long lived they gain in height and weight.3

Moreover, current data are highly equivocal in their support for claims of an epidemic. For example, the average population weight gain in the US in the past 42 years is 10.9 kg or 0.26 kg a year.4 Yet, between 1999-2000 and 2001-2002, according to the National Health and Nutrition Examination Survey, there were no significant changes in the prevalence of overweight or obesity among US adults or in the prevalence of overweight among children.2

Association with mortality
Secondly, the determination of the categories of normal, overweight, and obese is entirely arbitrary and at odds with the underlying evidence about the association between body mass index and mortality, a fact that destroys the indexтАЩs scientific pretensions and diagnostic value. The bands for overweight and obesity in the US, for example, are the product of the 1997 National Institutes for Health task force report on the prevention and treatment of obesity that supposedly links these bands to increased risk of death. However, the study on which the report is based does not support these linkages.5 It found that the death risks for men with a body mass index of 19-21 were the same as those for men who were overweight and obese (29-31).

The studyтАЩs findings are not unusual. Flegal and colleagues found the weight group with the lowest death rate was overweight,6 while GronnigerтАЩs analysis found negligible differences in risk of death among people with body mass values from 20 to 25.7 Even where there are significant associations, the risks are so modest as to be highly suspect. For example, whereas the reported lung cancer risks for smokers are typically 10-15 times higher than for non-smokers, the death risks for overweight and obese people are in many instances closer to 0.5-1.75 above those for people with normal weight.8
Despite the supposedly abnormal levels of overweight and obesity, life expectancy continues to increase. According to the UK Office for National Statistics, the current life expectancy of 77.2 years for men and 81.5 for women will rise by 2031 to 82.7 and 86.2, respectively.9

Morbidity
Moreover, the association of overweight and obesity with higher risks of disease is equally unclear, partly because of the multifactoral character of these diseases. Increases in overweight and obesity have been paralleled by falls in US total cardiovascular mortality and mortality from coronary heart disease and stroke, as well as in prevalence of hypertension and hypercholesterolemia.101112

Several factors justify scepticism about the link between non-insulin dependent diabetes mellitus and overweight and obesity. They include the absence of compelling direct evidence that excess fat is the cause of insulin resistance, the fact that the link fails four of the Austin Bradford Hill criteria for causality, and that increased physical activity and dietary changes reduce diabetes risk in advance of, or in the absence of, weight loss.13

There is considerable evidence that most fat adults were not fat children.14 Moreover, the thousand families cohort study found both little consistency between childhood overweight and adult obesity and no net increase in adult risk of disease for overweight children or teenagers. Nor did childhood thinness protect against either adult obesity or coronary vascular disease.14 15

Some in the public health community believe that deliberate exaggeration or, indeed, misrepresentation of the risks of diseases or certain behaviours or our capacity to prevent or treat them on a population-wide basis is justified, if not demanded, in the interests of health. Since many of the exaggerations come from people who understand the scientific uncertainties around overweight and obesity, it seems that these individuals have adopted such an approach to the obesity epidemic. The unwelcome implications of this for science policy and for evidence based medicine dwarf those of any obesity epidemic, real or imagined.

doi: 10.1136/bmj.39458.495127.AD
________________________________________
Competing interests: None declared.

http://www.bmj.com/cgi/content/full/336/7638/

[Aunty]

Is the obesity epidemic exaggerated? No

R W Jeffery, professor1, N E Sherwood, research investigator2

1 University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, 1300 S Second Street, Minneapolis MN 55454-1015, USA, 2 HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA
Correspondence to: R W Jeffery jefferyrw@gmail.com
doi: 10.1136/bmj.39458.480764.AD

The UK health secretary declared last week that we are in the grip of an obesity epidemic. Patrick Basham and John Luik believe that the problem is less clear cut, but R W Jeffery and N E Sherwood say that obesity is a growing global problem

An abundance of observational and experimental data show the growing prevalence of obesity, defined as a body mass index 30, and the causal role of obesity in adverse health outcomes. These data substantiate our position that the seriousness of the obesity epidemic is not exaggerated. The fact that obesity is developing rapidly in many parts of the globe is incontrovertible. The World Health OrganizationтАЩs Global Database on Body Mass Index includes the most comprehensive international data available on obesity trends.1 Absolute prevalence of obesity varies among countries (0.7%- 78.5%). However, large rises in prevalence have been observed across the globe over the past few decades. Rates of obesity in adults have roughly tripled in Japan (from 0.84% in 1980 to 2.86% in 2001), Brazil (from 2.4% in 1974-5 to 8.9% in 2002-3), England (from 6.2% in 1982 to 22.6% in 1999), the United States (from 11.5% in 1990 to 34.1% in 2004), and Seychelles (from 4.2% in 1989 to 15% in 2004) to give a few examples.1

The prevalence of obesity among children and adolescents has also increased greatly. The US National Health and Nutrition Examination Survey indicates that the prevalence of obesity in 1976-80 was 6.5% among 6-11 year olds and 5% among 12-17 year olds. In 2003-4 it was 19% and 17% respectively. These disturbing trends are mirrored in other countries. Prevalence of overweight among school age children has been reported as high as 35% in parts of Europe, and it has been estimated that the European Union can expect to see the numbers of overweight and obese children rising by around 1.3 million a year by 2010.2 A recent review of childhood obesity trends from 25 countries with data on school age children and 42 countries with data on preschool populations shows that obesity has increased in most countries, with the sharpest increases in economically developed countries and urban areas.3

Health effects
The adverse effects of obesity on health are well established, serious, and causal. Overweight and obesity increase the risk of many serious health conditions, including hypertension, hypercholesterolaemia, diabetes, coronary heart disease, and some forms of cancer.456789 A dose-response relation between body mass index and the risk of developing chronic diseases is even observed among adults in the upper half of the "healthy" weight range (that is, body mass index of 22.0-24.9).6

Increases in body weight are strongly associated with increased insulin resistance at the cellular level, which may be a fundamental mechanism driving many disease processes. Three large clinical trials have shown that behavioural interventions targeting weight reduction and physical activity in people with impaired glucose tolerance improve the natural course of diabetes.101112 Lifestyle change with a 7% weight loss delayed the development of type 2 diabetes in high risk individuals by 58% over four years compared with the control group.12

Because effective, sustained weight loss is not easily achieved clinically or by traditional public health education measures,1314 we are facing the potential for a major health crisis. When will the obesity driven health crisis arrive and how serious it will be has been the subject of much speculation. Not all diseases related to obesity have paralleled obesity trends. For example, the incidence of cardiovascular disease incidence has fallen steeply as body weight has risen, perhaps because of improvements in diet or better treatments for risk factors such as raised blood pressure and blood lipid concentrations.
However, examination of trends in the disease most strongly linked to obesity, diabetes, is very concerning. Data from the Behavioral Risk Factor Surveillance System and the National Ambulatory Medical Care Survey (1995-2004) show that during a period in which the prevalence of overweight and obesity increased by nearly 24%, the prevalence of diabetes increased by about 76% and the number of diabetes related visits to primary care doctors more than doubled.15

Health economists and epidemiologists have made projections about the potential impact of future obesity trends. Most agree that the contribution of obesity to current healthcare costs is high and that it is likely to get much higher.161718 Some have argued that we may even see real falls in life expectancy within a few decades.19

In summary, a large body of scientific evidence documents that overnutrition and obesity are a major global health problem. With the continuing rise in obesity and limited treatment efficacy, options for averting a poor public health outcome seem to rest either on the hope that scientists are wrong in their projections or speedy investment in the development of more effective public health measures to deal with it. We think the second option a more prudent scientific and policy choice.
doi: 10.1136/bmj.39458.480764.AD
________________________________________
RWJ is supported in part by National Cancer Institute grant (transdisciplinary research on energetics and cancer) CA116849 and National Institutes of Diabetes and Digestive and Kidney Diseases grant (Minnesota Obesity Center) DK50456.
Competing interests: None declared.

http://www.bmj.com/cgi/content/full/336/7638/245

[Aunty]

Two responses published by the journal in response to their articles.

Is the obesity epidemic exaggerated? Clues from a developing country

Pascal Bovet,
Senior lecturer
University Institute of Social and Preventive Medicine (IUMSP), 1005 Lausanne, Switzerland,
Arnaud Chiolero, Fred Paccaud

Basham and Luik submit that the epidemic of obesity has been exaggerated (1). We think that the large average weight gain of 10.9 kg in the U.S. population between 1960 and 2002 (2), which the authors allude to, is compatible with an epidemic (i.e. with an increase тАЬclearly above normal expectancy").

Data from developing countries provide additional arguments in favor of a global epidemic, and further insight with regards to its scale and consequences. For example, based on three population-based examination surveys between 1989 and 2004 in the Seychelles (Indian Ocean, African region) (3), the yearly average weight gain of the population was two times larger in a rapidly developing country (3) than in the U.S. between 1960 and 2002 (2), respectively 0.46 and 0.26 kg per year.

However, we agree with Basham and Luik that the consequences of the epidemic need further research. For example, the Seychelles surveys showed that, during the last 15 years, the upward trend in weight (the prevalence of overweight increased from 37% to 59%) was associated with a 50% increase of the prevalence of diabetes, as expected (4). On the other hand, mean blood pressure did not increase over time; moreover the relationship between weight and blood pressure unexpectedly decreased over successive surveys, independent of treatment (3). These findings from the Seychelles are consistent with the upwards trends for diabetes but downward trends for blood pressure (and blood cholesterol) in the U.S. population between 1980 and 2000, and lower risk of hypertension (and hypercholesterolemia) associated with obesity in 1999/2000 than in 1960/62, not fully accounted by treatment (5).

A better understanding of the trends of obesity and its consequences is needed to inform effective prevention programs. However, the upward trends of weight in most populations are definitely worrying for specific diseases (e.g. diabetes) and this warrants prevention interventions without delay. This is especially true for developing countries, which may face both a particularly steep epidemic of obesity and a lack of resources for relying on treatment strategies to manage diabetes and other obesity- related diseases.



Debate about fatness increases health risks

Kathy J. Kater,
Psychotherapist, Specialist in Promotion of Healthy Body Image, Eating, Fitness and Weight
Private Practice, St. Paul, MN, USA, 55109

The debate over whether the health risks of obesity are exaggerated seriously detracts from a more crucial concern. Whether or not obesity increases health risks, the real question is what should we do for our health in any case?

Weight loss or control is constantly recommendedтАФdisregarding the fact that weight is not a behavior, and as such it is not ours to тАЬcontrol.тАЭ Weight results from a multitude of factors, some of which are in our controlтАФhow we eat, how active or sedentary we areтАФbut many of which are internally regulated, and thus are not. In recent years a host of studies have shed light on why some sedentary folks can eat like horses and remain lean while their neighbors consume moderately, train for triathlons, and stay fat. If we limit ourselves to healthy means, over the long run the best anyone can hope for is to influence weight, not control it.

It turns out that prescription of weight loss as a solution to fatness has made things worse. Research published in 1950 by Ancel Keyes first demonstrated how and why even a moderately restrictive diet is counterproductive for long term weight loss. New studies bear this out: weight can be lost on virtually any contrived plan to restrict calories or food groups, but between 80 and 95% of this weight is predictably regained, usually with added pounds. If you doubt this well corroborated data, just consider how many people you know who have gone on a diet once. If dieting was effective why would it be a perennial activity, and why would most dieters be fatter today than before their first diet?

Aside from weight loss, what recommendation with so many unpleasant side affects and a 90% failure rate would still be prescribed? None the less we persist in the belief that if we can make people feel bad or afraid enough about their weight they will тАЬdo somethingтАЭ about it. This flies in the face of new studies documenting that body dissatisfaction does not serve as a motivator for healthy behaviors. To the contrary, research has finally confirmed what those working to reverse body image problems have known for years: unhappiness about weight leads to disordered eating, weight gain, and poorer overall health. In light of this, why do we persevere like Sisyphus in unrelenting talk about weight, the risks of fatness, and the need for weight loss as if this will make people repent? In four decades the thinner we have tried to be, the fatter we have become. Worrying about weight is a self-fulfilling prophesy. But if fat phobia and efforts at weight control are contributing to the problem, what is the solution?

Studies have consistently shown that fatter people who are fit are at lower risk for health problems than thin people who are not fit. Given this, someone should be asking whether itтАЩs fatness or lack of fitness that is the problem. But even this debate detracts from the vital question: what should we do in any case? The solution is so obvious, perhaps it defies notice. What if instead of fear and loathing of fatness, health promotion initiatives were to pushed the value, ways and means for wholesome eating and fitness for everyoneтАФirrelevant of size? If a sustainable healthy lifestyle were the goal instead of size, some people would remain fat and some would be thin, but virtually all would be healthier. IsnтАЩt this the point?

It is troubling that so few leaders in health care cannot see that shifting the focus to how we live rather than what we weigh is an effective solution that empowers all people of every size and shape to be the best they can be. Few could argue that a fit and well-fed populous of diverse sized people would not be preferable to the status quo. Campaigns to support the development of healthy, realistic body images, wholesome, stable eating, and lifetime fitness habits regardless of shape, size, or weight could eliminate much of our populationтАЩs тАЬweight problem.тАЭ

Competing interests: None declared

[jimnbkk]

"Is the obesity epidemic exaggerated? Yes"

With all the scientific mumbo-jumbo above, you can dismiss the words 'epidemic' perhaps. But you need only walk down the street of an American city to see that, epidemic or not, there are a lot of really fat asses waddling about.

I am not 'fat', but I do have a tummy. And, as I've reported before, when I'm in Thailand and eating mainly Thai food, I lose weight. My tummy goes down. Last time I was there (May) I lost 7 pounds. I'm coming for 2 months next time. My hope is I will lose at least 10 pounds!!

Eating better is the key. I'm convinced that Thai food is better for me. Not so much salt (I can stop my bp meds after I've been there a few weeks). Not so much fat (I eat a lot of seafood when I'm in Thailand). Enough exercise (I try and walk a few miles every day. I try to walk at least one direction beach to Pattaya). When I'm home, I eat American food mostly, and it's not as healthy. And, apparently my willpower isn't all it should be either.

So you can equivocate as much as you want about what causes weight gain. But, for me the bottom line is: Eat less. Eat smarter. Exercise. You'll lose weight. Period.

[Aunty]

"Is the obesity epidemic exaggerated? Yes"

With all the scientific mumbo-jumbo above, you can dismiss the words 'epidemic' perhaps. But you need only walk down the street of an American city to see that, epidemic or not, there are a lot of really fat asses waddling about.

I am not 'fat', but I do have a tummy. And, as I've reported before, when I'm in Thailand and eating mainly Thai food, I lose weight. My tummy goes down. Last time I was there (May) I lost 7 pounds. I'm coming for 2 months next time. My hope is I will lose at least 10 pounds!!

Eating better is the key. I'm convinced that Thai food is better for me. Not so much salt (I can stop my bp meds after I've been there a few weeks). Not so much fat (I eat a lot of seafood when I'm in Thailand). Enough exercise (I try and walk a few miles every day. I try to walk at least one direction beach to Pattaya). When I'm home, I eat American food mostly, and it's not as healthy. And, apparently my willpower isn't all it should be either.

So you can equivocate as much as you want about what causes weight gain. But, for me the bottom line is: Eat less. Eat smarter. Exercise. You'll lose weight. Period.

Isn't another way to explain your experience with your weight, Jim, to say that it's the environment (and your response to it) that is controlling your weight and not you? In environment (A) the US, you weigh more, in environment (B) Thailand you weigh less. If your weight was simply just up to you, why can't you do that which you do in Thailand, in the US? Not possible? Is that because they are two very different environments?

[jimnbkk]

The environment: Yes. In Thailand I cook none of my meals (except an occasional cereal/coffee in the room for breakfast). At home, I cook all, or almost all of my meals. Big difference. I cannot cook Thai food. I've never tried. In Thailand I like Tom Yum Talay (seafood soup) with steamed rice. And, I can eat it nearly daily. I occasionally succumb to KFC, but not too frequently. And when I'm in TukCom, I'll walk past the ice cream place on the ground level and sometimes I'll get something there too.

[francois]

You see your problem, Catty, is that you're just a lazy, out of control greedy pig. You don't need pills to suppress your appetite, you just need to exercise some will power and self-control and make the choice to keep your big gaping cake-hole shut! Make the choice! Stop filling it with food! Now anything else that you may come up with to explain your double-triple-chins and ample rolls of fat are just pure self-denial and delusions on your part!


Are you serious Aunty? The Cat is in excellent shape compared to most farang at the beach. Also has more will power and self-control (except maybe when posting) then any of I know in LOS.

[Smiles]

Aunty, how much do you weigh?

Cheers ...

[catawampuscat]

thanks francois :cheese: for your kind words and support..
aunty has made it to my ignore list for obvious reasons and only a letter from his rehab center :drunken: will
change that. On second thought, even that will not suffice..

It is a marvelous thing to be able to flush away the filth and garbage with the simple use of the "ignore" feature..
The only scary thing is I have become sympathetic with the colonel in his endless battle with aunty
and realize that homi was correct on that subject all along.. very scary but true. :cat:

[Aunty]

Evidently, Catty, an appreciation of irony is not one of your strong points! I'm actually on your side!

Although my weight is actually none of your business, Smiles, let me however disabuse you of any shallow notion that my interests in obesity must be because I'm fat. (I remember well the early days of homosexual law reform and gay lib when any str8 man who stood up for the rights of Gays was instantly and falsely branded a closet homosexual in an attempt to discredit his arguments. I smell the same rat here!).

I weigh 79kgs and I am 182cm tall and I have maintained more or less that weight most of my adult life. I don't watch what I eat from a weight perspective, I don't need to. My genes do it for me. I do however watch what I eat from a nutritional perspective. Satisfied, your royal highness?

What a multi-skilled little person our Tourette is. Thank God I can claim her as a member of my talented family