Not much on the telly tonight, so I ended up watching "My 600 lb. Life" --- the show where folks go to Houston for bariatric surgery… some successful, some not so much.
After watching a couple episodes, I'm left with some mixed feelings.
Is super morbid obesity:
1) a disease along the same lines as alcoholism and drug addiction?
2) a lifestyle issue (poor food choices, lack of exercise, laziness)?
3) a mental health issue (poor self esteem, depression, etc.)?
What have you seen in your practice re: number of super morbidly obese admissions, bariatric surgeries, disease processes related to super morbid obesity, difficulty caring for super morbidly obese patients.
Really? A box of Kraft Mac and cheese equals one serving? Sorry to pop your zealous bubble but I can feed 3 people like it says on the box. Anyone who actually eats a whole box by themselves is a gluttonous pig.
Is that "knowledge" from personal experience or just your opinion from your so called "research"?
You aren't popping my zealous bubble. :) (I have a zealous bubble? ).
I was speaking of the portion size I see people chose.
If people look at what the FDA says is a portion, people are surprised and we as nurses know that.
I doubt if you went out to Appleby's and ordered a steak and baked potato and mac and cheese that the portions would come out like a deck of cards (steak), a computer mouse (baked potato), or a tennis ball (mac and cheese). And if they did, people would be mad.
I'm glad you are keeping portions under control. That doesn't mean the majority of Americans are though. What many of us are saying is people are eating too much, portions are too big.
To Marion Nestle, a professor of nutrition, food studies, and public health at New York University, that's one of the reasons the relationship between agricultural subsidies and obesity is clear. Because prices of these staples are low, so are those of HFCS, hydrogenated fats, and corn-fed meats. And the cheapest way to make foods taste good, she says, is to add sugars and fat.Compounding the problem, says Barry Popkin, a professor of nutrition at the Carolina Population Center of the University of North Carolina at Chapel Hill, is that fattening foods are supported whereas healthy fare isn't. We put maybe one-tenth of one percent of our dollar that we put into subsidizing and promoting foods through the Department of Agriculture into fruits and vegetables,†he says. As a result, the price gap between high-sugar, high-fat foods and more nutritionally valuable fruits and vegetables is artificially large. That means in supermarkets and restaurants, red meats, sugar-and fat-loaded products, and fast foods not only appear to be the best buys but in proportion to even moderate salaries are downright cheap.
We can surely blame the individuals for making poor individual choices. Unfortunately, the agricultural business model is not focused upon good nutrition, it is focused on increasing yield and profit and the subsidies they enjoy are actually promoting the very food types that are making us obese.
For years, fat was a four-letter word. We were urged to banish it from our diets whenever possible. We switched to low-fat foods. But the shift didn't make us healthier, probably because we cut back on healthy fats as well as harmful ones.
I SERIOUSLY do not ask this to stir up a ****storm, but here are my 2 questions. I have wondered this for years:
1) If obesity is a disease, why did our ancestors not seem to have it? In all of the historical photos/paintings that I have seen in my life, I have yet to see a pioneer or a settler depicted as 400#. Or a cowboy or an Indian, for that matter.
They didn't eat the food that caused insulin spikes, the carb craving cycle and IR.
2) If obesity is a disease, why is the US so very far ahead of other developed countries in morbid obesity % of population? Is this a genetic condition that is limited to 1/3 of North America.
I don't think obesity is a disease, I believe it to be a condition or state that genetically the endomorphs and psycho-socially the more dysfunctional or challenged have a higher risk and/or propensity for.
And for the record, I myself am considered obese. Not morbidly so, but obese nonetheless. I know exactly why I am, but it's definitely not disease.
Do you really think you're obese because you're lazy and eat without sensible restriction?
If that were the case, I would have been obese at several times in my life. But because of my genetics and psychosocial status, I have failed to be obese and I can afford and am motivated to buy the best of foods. Even my crap is made of quality ingredients. And even that daily wine, aged cheese and carton of Haagen Dazs isn't enough to make me obese. At most a muffin top. Eating sensibly and moderate exercise (like 30 min on the stationary bike and some squats) puts me in a bikini. At 50.
So how can you call yourself whatever it is you're keeping to yourself when I probably have done the same thing but have different results?
Do you really think you're obese because you're lazy and eat without sensible restriction?
If that were the case, I would have been obese at several times in my life. But because of my genetics and psychosocial status, I have failed to be obese and I can afford and am motivated to buy the best of foods. Even my crap is made of quality ingredients. And even that daily wine, aged cheese and carton of Haagen Dazs isn't enough to make me obese. At most a muffin top. Eating sensibly and moderate exercise (like 30 min on the stationary bike and some squats) puts me in a bikini. At 50.
So how can you call yourself whatever it is you're keeping to yourself when I probably have done the same thing but have different results?
Well, according to your answer, I must be one of the more dysfunctional or challenged
My nursing school ran a small clinic inside of a public housing building for elderly people, mostly military. It was a total dump right next to the downtown area of the city. There were NO grocery stores for miles in any direction, and these were extremely poor people with no cars, who took public transportation (and paid for it) if they had to go anywhere. So tell me - if the only option in walking distance is a convenience store stocked to the brim with lottery tickets, cigarettes, candy, potato chips, and the occasional carton of milk... are you going to pay public transit fees both ways with arms loaded full of groceries, or are you going to walk for free to the convenience store and just make do with whatever you can live off of from there?
I can tell you from doing "home" visits in those people's apartments that most of them had empty refrigerators (except for the beer and milk, of course) and pantries full of Cheetos. It was really sad.
Specializes in Psych, Addictions, SOL (Student of Life).
This is an extremely complex issue people who suffer from morbid obesity as with any addiction often suffer from clinical depression, medical problems such as slow thyroid and adrenal malfunction. Having a body in a chronic state of Inflammation also contributes. The question remains; What came first? The obesity or the other problems? I have struggled with weight issues my whol life. At one point in my early 20's (I am 52 now) I lost 100 pounds but have been stalled in the low 200's since. I eat a very healthy diet but I have fibromyalgia which cause severe exaustion and at times extreme physical pain. I just started a new plan being studied by a nurse friend of my doing research in obesity and chronic inflammation and for the first time in years am losing weight and more importantly have a real reduction in physical pain whch allows me to exercise more.
I think by the time someone gets to 600 pounds one does have to look at both the physical/biological and psychiatric components if any success is to be achieved. There is nothing served by being judgemental and shaming someone who already feels bad enough especially when they are facing a true life and death situation. Just my 2 cents.
I don't think that there's that much difference between what makes a person become and stay obese or head towards super obese. Obviously there is some tipping point for someone to go into the 500lb + category but I believe they must have common risk factors or characteristics as the people who become obese and are unable to lose the weight with any reasonable means.
We have several people in our small office who are more than 100 - 150 lbs overweight. All are women, most are educated in health science, most make at least 80K a year, ages range from 30's-60's, all live in an area of California with abundant access to quality food and temperate weather. I don't know because it's surely not something anyone can talk about but I don't think they have mental health problems, addictions and they sure aren't lazy. If there was just some simple solution of just do xyz and get their thyroid treated, they wouldn't weigh over 300lbs.
There are just too many hard working people with relatively unlimited resources who are far into the very unhealthy weight ranges for it to just be limited to the problems of the super obese.
Do you really think you're obese because you're lazy and eat without sensible restriction?
If that were the case, I would have been obese at several times in my life. But because of my genetics and psychosocial status, I have failed to be obese and I can afford and am motivated to buy the best of foods. Even my crap is made of quality ingredients. And even that daily wine, aged cheese and carton of Haagen Dazs isn't enough to make me obese. At most a muffin top. Eating sensibly and moderate exercise (like 30 min on the stationary bike and some squats) puts me in a bikini. At 50.
So how can you call yourself whatever it is you're keeping to yourself when I probably have done the same thing but have different results?
I don't have the "research" at hand :) . . . .. but I have doubts that most people are lucky like you. To be able to eat whatever you want and not gain weight seems like a rare occurrence.
I was thin and ate what I wanted as a young adult and closing into 40. I didn't show when I was pregnant until after 6 months in my 20's.
But as I've aged, I think my metabolism has slowed down and I struggle more with weight. And I never exercised as a young adult but now I slowly jog and work out with weights and still have trouble with weight-loss. For the first time ever, I ran a half-marathon last October as well and trained for it and never really lost any weight.
And I don't eat many carbs (Atkins) at all right now and have slowly lost weight. If I were to go back to the pasta gorging I'm sure I'd gain it all back quickly.
But I'm not addicted.
Spidey's mom, ADN, BSN, RN
11,305 Posts
You aren't popping my zealous bubble. :) (I have a zealous bubble?
).
I was speaking of the portion size I see people chose.
If people look at what the FDA says is a portion, people are surprised and we as nurses know that.
I doubt if you went out to Appleby's and ordered a steak and baked potato and mac and cheese that the portions would come out like a deck of cards (steak), a computer mouse (baked potato), or a tennis ball (mac and cheese). And if they did, people would be mad.
I'm glad you are keeping portions under control. That doesn't mean the majority of Americans are though. What many of us are saying is people are eating too much, portions are too big.