But once again, the AMA doesn't care what the cause is, only how treatment is applied to the health issue. They do not care that people will use the word disease as an excuse socially. Combat related PTSD is caused people joining the armed services and then going to war. All those are personal choices as well, but it is still treated by health care providers as a disordered that requires treatment. The same goes for being obese. They don't care how it happened and are only concerned with how to fix the health issue.
But obesity is just a symptom at best. The actual "disease" we are talking about here is gluttony.
In an attempt to excuse personal responsibility people are attacking the symptom (weight gain) instead of the problem (overeating).
You are dead set on trolling this thread. You points and posts have nothing to do with the AMA reasoning or the why they would label obesity as a disease. Your only purpose is to demand that people admit that gaining weight it do to eating to much. which is a give in. If that is your only goal, please leave. No one wants to have such a simplistic debate.
I don't consider it "trolling" to point out that obesity is caused by eating habits. People are personally responsible for what they put in their mouth, unless they are orally raped.
People are way too sensitive these days. Every personal shortcoming always has to be excused as the result of some external factor (disease, oppression, discrimination, etc.) instead of just admitting some people are lazy, gluttonous, or unmotivated.
Fat people are not afflicted by some external factor outside of their control. Even if they have a real medical problem that makes them prone to obesity--to be realistic, most fat people don't have such problems--they still make the final decision as to what and how much they eat.
The problem is that medically diseases aren't "some external factor outside their control." Hypertension? Within your control. Diabetes? Within your control. Calling it a disease doesn't excuse it, or make it any less of an issue. That's a fundamental misunderstanding of what a disease is.
If anything, the stigmatization of "being diseased" is more of a negative factor to discourage a given behavior.
When I look up definitions of disease they say things like: "impairs normal functioning", "interruption of the normal structure or function", "abnormal condition", etc.
So by those definitions I would still argue that obesity is not a disease. It is actually completely normal to gain weight when you eat too much. And when they stop overeating, they return to normal weight because their normal bodily function has not actually been interrupted at all.
Is sunburn a disease? It's not good to have a sunburn, and it carries health risks like skin cancer, but it is a completely natural and expected result of getting too much sun without sunscreen.
Diabetes is abnormal functioning of the body and requires treatment. It's not a completely natural and guaranteed result of a specific behaviour.
Obesity impairs normal function, it affects almost all of the systems of the body. Compared to normally functioning people, it IS an abnormal condition.
Normal body functions only become impaired after obesity has caused a real disease, like heart disease or diabetes. Until then their body is working just as every other human body does.
It's a risk factor for disease but not a disease itself.
The longer I let this dictionary definition sink in the more preposterous calling obesity a disease seems.
Patient: "Doctor, when I eat more calories than I burn my body stores those calories as fat. Help!" Doctor: "Working as intended."
A person could have heart disease but not notice until they have a heart attack. Does that mean that heart disease is not a disease? I don't understand the distinction you are making. If obesity causes all of these poor, abnormal health outcomes, even if it is one more step away from that outcome than a heart attack, doesn't that make it a disease according to your posted definition? If you are at higher risk for many bad outcomes, you are in an abnormal disease state. Eating too many carbohydrates and excess calories causes diabetes (working as intended?). Heart disease can be caused by the same things (working as intended?). Sorry if I'm not understanding your point correctly.
Just because something can cause disease doesn't make the risk factor itself a disease. I would use smoking as an example. Smoking can cause lung cancer, but smokers don't actually have a disease until they lose that lottery in life and become afflicted by cancer (or other disease resulting from smoking).
Obesity is a major risk factor for a host of diseases, but itself is not a disease. Someone could be obese but still have a normally functioning body. If they lose weight they may even return to normal risk levels, just as smokers reduce their risks of lung cancer after quitting.
Thank you. That helped me a lot.
Firstly, I would say that there are cancerous cells in your body all the time. You could have a small lung cancer and then it could go away naturally due to an immune system response.
Secondly, alcoholism is also considered a disease, even though theoretically not consuming alcohol would stop it.
I feel that the disease designation is meant to show that this is an abnormal state that warrants attention and change in behavior. I also think that it is somewhat arbitrary and I understand why you are saying what you are saying. Finally, obese patients rarely (almost never) lose weight permanently without intervention in the same way alcoholics rarely reform without intervention, and there are very few people in an obese state that function normally (the definition of normally is totally up for debate, but I hope you get the point I'm making, it changes the way people go about their daily lives).
It lets physicians do health and life style counseling and get reimbursed for it. That is one of the major reasons the AMA did this. I think its a good move.
On June 21 2013 07:39 On_Slaught wrote: Gary Taubes gives a VERY strong argument for why the calories equation has literally nothing to do with weight gain. He says that relying on the law of thermodynamics (which is what people are doing when they argue this) is making an 8th grade level math mistake. This law has no more impact on weight gain than the law of relativity does.
Rather his argument, for those who don't have the patience to watch the whole video, is that the common view is backwards (he goes into the history of how this was lost). Fat people don't get fatter because they eat more, they eat more because they are fat. Basic biology tells us that it has everything to do with how our hormones are influenced by our food (he goes into a lot of detail about how big genetics is to weight gain. Anybody who says it is a minor issue is completely un-grounded). The ultimate conclusion is that the specific substance which causes ALL fat creation in cells is insulin. Insulin is caused by carbohydrate intake. Therefore carbohydrate intake directly leads to fat increases. He argues that you can literally eat as much non-carbohydrated food as you want and you couldn't gain weight gain weight.
However this does not free people from personal responsibility. It happens to be that many of the best tasting food happens to create insulin so personal discipline is still a huge factor.
It's nice to actually listen to somebody who at least gives sound scientific basis for his arguments rather than the pure shit being dredged up in this thread. And even for the people not spouting pure shit, there is no basis other than the ubiquity of their stance upon which they base it.
On June 21 2013 07:38 RockIronrod wrote:
On June 21 2013 07:30 nukeazerg wrote: Biology is not physics. Boys get lean with more muscle during puberty and girls get 50% fatter. This does not mean the girls ate more.
Biology, like all things, is subject to the laws physics. Are you just trolling or do you really think your "big bones" are the Higgs Boson and mass just appears on your body? Where the fuck do you think fat cones from?
Case in point.
Before immediately jumping on the Taubes train take a step back and think about it.
Taubes is correct when he says, “Those who get fat do so because of the way their fat is regulated.” But they still couldn’t get fat without eating too many calories for their particular metabolism, and if a way can be found to decrease their calorie intake to a level appropriate for their metabolism, they will lose weight.
What about weight loss itself? If Taubes’ thesis is correct, we would expect studies to consistently show a strong superiority of low-carb diets for weight loss. This 2010 study showed no difference in weight loss between low fat and low carb diets over a 2 year period, although low-carb dieters had more favorable changes in lipids. A 2009 study in NEJM compared weight loss from diets with different compositions of fat, protein and carbohydrates and found that low-carb diets were not superior, and that clinically meaningful weight loss results from weight loss diets “regardless of which macronutrients they emphasize.” An accompanying editorial suggests that behavioral factors are more important to weight loss than the type of diet, and that a total environmental approach is needed.
Taubes says right off the bat that “these competing ideas should be tested” and admits that such testing has not been done; but since obesity is such a serious problem, he says it is urgent that we institute his diet recommendations now, without waiting for the evidence. Yet he criticizes the low-fat diet campaign for doing just that: we went beyond the evidence and instituted society-wide changes based on inadequate data, with what Taubes considers to be disastrous results. How can he be so certain we should go beyond the evidence this time?
The whole thing is a good read though if you have time.
Thanks for posting that, will go read it. Some quick notes on Taubes's video; I don't necessarily agree with all of his conclusions, such as the low-carb emphasis and even he made some comparisons at the end of the video where people from cultures with high carb/low sugar diets that come to America acquire health problems which would logically point to sugar. Taking pieces from Taubes and Pollan I feel like corn plays a big part mixing both sugars and carbs- making diets like Atkins fairly useless. I think the other 6-part video that was posted in this thread did a good job explaining the science. However, I do think he did a good job challenging conventional wisdom as far as blaming overeating or calories in vrs calories expended etc. He provided historical examples of Indian tribes or South American countries that were consuming much fewer calories than the recommended standard, yet still had problems with obesity. One study was factory workers in Peru (iirc) challenging the exercise paradigm.
I'm not considering it case closed yet, but I definitely feel that he is on the right track.
Edit: Read the article and agree with the criticism of the low-carb emphasis, but not with calories in/out status quo.
I feel like calling obesity a disease, and recognizing it as such will have an effect on young people, teens, people in their early 20's. It will make them feel complacent to their condition and make them feel stigmatized even more, thus making it really hard for them to find the power within them to change their habits and the way they eat. I read something the other day that saddened me quite a bit, ''there are fat people, and there are old people, but there aren't old fat people''.
there are multiple hormones in your body that control appetite(ghrelin,leptin), there are hormones that control metabolism(thyroxine), and neural circuits responsible for feeding behavior(hypothalamus). Increased ghrelin levels means more appetite, increased leptin levels means decreased appetite. When you are always eating, leptin levels are always high, receptors for it gets desensitized and eventually leptin loses its potency. Same problem with diabetes II where high insulin levels desensitize the receptors and insulin doesn't normally do its job anymore, because sugar levels are always high. Basically feeding is regulated by hormones in combination with neural circuits. When any of these are out of balance, due to environment or genes it can be easily classified as a disease.
edit: the underlying causes that lead to obesity are diseases, but obesity itself is a symptom imo. One cannot say "I have obesity", but they can have leptin resistance, insulin resistance, hypothyroidism, social factors, psych factors --> that lead to obesity
I feel that calling obesity a disease is misleading and that the current definition of obesity could lead to some very muscular people technically having the disease of being fat. On the other hand, I could see this as helping some people. Still, I doubt very much that obesity levels will sink substantially when the average American watches something like 5 hours of TV per day. I don't think this will be nearly enough to change the culture of sedentary lifestyles and poor diets.
On June 22 2013 09:14 Kickboxer wrote: If you can't sprint, you have a condition. I think it's pretty hard to argue against that.
People who sprain their ankle can't sprint. We don't call them diseased. We don't call the handicapped diseased either.
You people can't rely on horrible definitions like "impairs normal function" because then almost anything is disease.
You are talking about illnesses, not diseases. Seriously, before this discussion can be had you have got to learn to use the correct terms. You can disagree all you like with the definition of "disease", that however does not make you right.
EPT
