NBC: Fat-shaming may curb obesity, bioethicist says

[Symbol]

Obese people know they're fat, many of them are either:
.
C. Unhappy with how they look, and in denial about their ability to lose weight (ie they use bad genetics, medications, childhood issues, etc. as excuses)

To explain C- yes, there are people who are more genetically prone to being fat, there are certainly health issues, surgeries, medications, and any number of problems from a person's past which can all serve to increase the likelihood that a person will be fat. It does not mean that a person has to be fat and obese, and is likely an excuse.

What about a D? I am fat, but at the same time, I don't eat a lot of unhealthy foods, my caloric intake is between 2000-2500 per day. I do not eat fast food, because quite frankly that stuff is disgusting. My problem is the fact that injuries when I WAS NOT overweight and played sports has caused me to be no where near as active as I need to be. I have a knee injury that multiple doctors have ensured me might or might not work. I was in a car accident that has tore up my back, I have arthritis in my shoulder and both wrists.

Is this an excuse, no, I guess I could tone down my caloric intake to the point of making it dangerous for my health, I could attempt the surgery on my knee and maybe I can eventually have the ability to run again, then again, I may make it worse and it would keep me from even being able to walk. Not everything is as simple as putting things in a little list, and I am not attempting to put you down for your opinion, just providing you with certain facts that may add to your list or slightly give you more understanding of other parts of this situation.

[twa]

What about a D? I am fat, but at the same time, I don't eat a lot of unhealthy foods, my caloric intake is between 2000-2500 per day. .

Sounds like my brother , I eat two or three times that.
The guy is a ignorant jerk.

[TD_washingtonredskins]

Symbol, I don't mean this in an offensive way at all, so please don't take it as such.

Are you able to walk? Could you take walks totaling 1-2 hours per day? I think as we get older and more rickety, we have to find more creative ways to stay active. Not all of us can keep up the activity level we were used to. I went from playing 3 sports through high school, to jogging 4 miles per day 5-6 times per week, to now jumping rope/doing the elliptical a couple times per week. The reason is a combination of time commitments, my body slowing down as I age, and other priorities.

So, my point is, I understand that you can't jog or run. But if you can walk you can burn some calories. My mom has never jogged or done anything other than go on walks outside. She walks during her lunch hour and again in the evenings. She's in fantastic shape for someone over 60 years old. I think we just need to evolve. I know there are guys out there who do marathons in their 40s...but for every one of those there are probably 10 guys who stay in shape just fitting in some activity when they can.

[MissU28]

Why do we have to do anything at all?? Why do people need to find a cure for everything? People who are fat know it's unhealthy. Why do people feel the need to try and make everyone not fat? Educate them, but let people live how they want to live. Why are people so engrossed with other peoples' lives? I understand if it's your own family member, but fat-shaming people just to make yourself feel like you did your good deed for the day is stupid.

[pjfootballer]

Why do we have to do anything at all?? Why do people need to find a cure for everything? People who are fat know it's unhealthy. Why do people feel the need to try and make everyone not fat? Educate them, but let people live how they want to live. Why are people so engrossed with other peoples' lives? I understand if it's your own family member, but fat-shaming people just to make yourself feel like you did your good deed for the day is stupid.

I want to let you know I don't think shaming them is the correct way to go about this. But to answer the questions in order:

1) Because people are stupid and sometime need to be told what to do for their own good. Like seatbelts.
2) Because people die and we don't want them to?
3) Because healthcare costs have quintupled or more as our weight as a country goes up. Agree on the educate.
4) Because for every person that smokes, takes drugs or is obese, my health insurance premiums go up on my paycheck. I'm paying for other people to "live the way they want."

Again, 100% agree this guy is a nut and there is a better way to help people.

[Special K]

Why do we have to do anything at all?? Why do people need to find a cure for everything? People who are fat know it's unhealthy. Why do people feel the need to try and make everyone not fat? Educate them, but let people live how they want to live. Why are people so engrossed with other peoples' lives? I understand if it's your own family member, but fat-shaming people just to make yourself feel like you did your good deed for the day is stupid.

Why obesity has become such a concern is the impact it has on the health of our nation. Obese people are placing an immense burden on our health care system and costing taxpayers an unbelievable amount of money in treating diseases that are largely preventable. We are seeing an epidemic of overweight and obese children presenting with chronic diseases usually manifesting in adulthood (40's & 50's) are now occurring more regularly in young children.

As far as the comparison to smokers made in this report: many of the diseases they suffer from are a result of smoking and thus, preventable. I believe the nation's (and even worldwide) public approach to decreasing tobacco use (massive campaigns on billboards, cigarette packs, awareness days, and on and on) is where this bioethicist is drawing a large part of his strategy from. Which is a headscratcher for me since I think the underlying psychological factors of obesity make it a very different issue than that of tobacco use and one has to be devoid of common sense to so closely relate the two.

Anyway, bottom line of why people care is the impact that it has been proven to have on our health care system. It affects all of us whether we are obese or not...

[Corcaigh]

Not to forget, they are not an aesthetically pleasing sight as I look out the window.

[Jumbo]

Why do we have to do anything at all?? Why do people need to find a cure for everything? People who are fat know it's unhealthy. Why do people feel the need to try and make everyone not fat? Educate them, but let people live how they want to live. Why are people so engrossed with other peoples' lives? I understand if it's your own family member, but fat-shaming people just to make yourself feel like you did your good deed for the day is stupid.

Another fair and valid perspective.

As I noted earlier, one (not the only) primary diver for such "bashing" or "judging" is simply to serve one's own self-identity/ego "needs" (via posturing as "better than" a "lesser" in some category of "measurement").

When in operation, it is an immature (in the developmental sense) form of self-validation, and it's noted existence in an individual is usually met with fierce denial and protests of how "secure" they are and how they're just "stating facts."

It's a particularly powerful drive among young to middle-age males, in our culture, and not unrelated to "competition" in general.

In more benign manifestations, it is a normal for us to define ourselves by as much in opposition to something we see in others, as it is to make positive declarations about ourselves.

But that can still be internalized like an intelligent grown-up and in useful fashion: "I prefer being as fit as I can" or "I work on staying fit even when it's hard" or "I don't like being too overweight" versus "Ewww---fatties. They suck and should get it together."

[MissU28]

I want to let you know I don't think shaming them is the correct way to go about this. But to answer the questions in order:

1) Because people are stupid and sometime need to be told what to do for their own good. Like seatbelts.
2) Because people die and we don't want them to?
3) Because healthcare costs have quintupled or more as our weight as a country goes up. Agree on the educate.
4) Because for every person that smokes, takes drugs or is obese, my health insurance premiums go up on my paycheck. I'm paying for other people to "live the way they want."

Again, 100% agree this guy is a nut and there is a better way to help people.

1 and 2) I guess I am not that empathetic towards people. If someone is smoking when they know it's deadly, or tanning when they know it's deadly, or racking up the pounds when they know it's deadly, sorry, I don't feel the same sort of empathy towards them that I would someone who got sick after living a healthier life. I used to tan a lot in college- if I found out I had melanoma now, I would blame myself for being an idiot. Back then I knew it was bad, yet I still did it.

I don't agree with laws that are preventative. If someone wants to be an idiot, let them. If they die because of it, it sucks, but they knew the risk. Obviously, this is the libertarian in me. I know that sounds harsh, but I am a huge believer in personal responsibility.

3-4) That can be an argument, if our premiums are truly going up because of other people. I don't want to subsidize other people. Their insurance bills should be higher.

---------- Post added January-24th-2013 at 05:02 PM ----------

I can understand the health insurance argument. But maybe the problem isn't whether we should change these people, it's how to change the health insurance mandates so they are fair for people based on their lifestyles.

[Special K]

3-4) That can be an argument, if our premiums are truly going up because of other people. I don't want to subsidize other people. Their insurance bills should be higher

I definitely understand your frustration and I agree with changing insurance rules. However, what do you think about patients not paying private insurance premiums, like those on Medicaid and Medicare? What do you think should be done with that.

Please don't take this as a sarcastic question, I'm genuinely curious as to your thoughts on this.

[Jumbo]

And I completely agree with this from Special K:

Why obesity has become such a concern is the impact it has on the health of our nation. Obese people are placing an immense burden on our health care system and costing taxpayers an unbelievable amount of money in treating diseases that are largely preventable. We are seeing an epidemic of overweight and obese children presenting with chronic diseases usually manifesting in adulthood (40's & 50's) are now occurring more regularly in young children.

But I will add that dietary/exercise related issues of much of the "non-fat" population, that are at least as much behaviorally related as the "fatties", are not getting the same highlighting as they are (or as tobacco or alcohol abuse).

Sadly, to my informed speculation, this is at least partly because they do not trigger certain aspects of our "cultural personality" to "object to them" and identify them as a demographic. I.E. they are not "fatties" (or drunks or smokers) but have diets and lack of exercise that make them a demographically significant user of health systems, too.

[MissU28]

I definitely understand your frustration and I agree with changing insurance rules. However, what do you think about patients not paying private insurance premiums, like those on Medicaid and Medicare? What do you think should be done with that.

Please don't take this as a sarcastic question, I'm genuinely curious as to your thoughts on this.

I don't know, I haven't thought it through. I'm not even sure how those programs work, to be honest with you. I just know that a chunk of my money gets paid to Medicare each month. Maybe your medicare/medicaid contribution can be dependent on your own health? If you're a smoker, you have to pay a certain extra percentage or something. I don't know how people would monitor that and I"m sure people would lie, but I don't want to pay for other people. Or privatize medicare? I don't know enough about either program to make a valid argument.

[Special K]

But I will add that dietary/exercise related issues of much of the "non-fat" population, that are at least as much behaviorally related as the "fatties", are not getting the same highlighting as they are (or as tobacco or alcohol abuse).

Sadly, to my informed speculation, this is at least partly because they do not trigger certain aspects of our "cultural personality" to "object to them" and identify them as a demographic. I.E. they are not "fatties" (or drunks or smokers) but have diets and lack of exercise that make them a demographically significant user of health systems, too.

That's interesting that you bring that up. I absolutely agree with this as people can look "normal," but have terrible nutrition/exercise habits that greatly increase their risk of insulin resistance that helps lead to chronic diseases obese people routinely suffer from. And yes, sadly this demographic is largely ignored (until someone suffers a massive MI) in the nutrition and exercise discussion and educational outreach.

One of the most prominent quotes I have taken away from the book I'm currently reading about insomnia (self-help so I can stop being a complete vampire ) written by an esteemed sleep expert from Harvard is that "exercise is the closest to a 'magic bullet,' healthwise, that there is." When I started reading, I didn't think there would be as big of an emphasis on nutrition and exercise in an insomnia book (don't really know why, they are obviously closely tied to many sleep disorders ).

My experience, as well as my opinions stemming from reading research and what the real experts have to say about health and wellness, is that national discussion and outreach regarding exercise and nutrition is SEVERELY lacking among ALL demographics. We really are doing a disservice to our population, and particularly the youngest ones by tying exercise and nutrition so closely to obesity and "weight issues," when this is a subject that needs to be extended to the population as a whole, whether you appear "healthy" or morbidly obese.

I don't know, I haven't thought it through. I'm not even sure how those programs work, to be honest with you. I just know that a chunk of my money gets paid to Medicare each month. Maybe your medicare/medicaid contribution can be dependent on your own health? If you're a smoker, you have to pay a certain extra percentage or something. I don't know how people would monitor that and I"m sure people would lie, but I don't want to pay for other people. Or privatize medicare? I don't know enough about either program to make a valid argument.

I just ask, not because I have any solid evidence at my fingertips at the moment, because I think a large portion of preventable diseases reside in this insurance demographic.

[twa]

]I can understand the health insurance argument. But maybe the problem isn't whether we should change these people, it's how to change the health insurance mandates so they are fair for people based on their lifestyles.

why not charge them for how much they use it?

I want a rebate

[PeterMP]

why not charge them for how much they use it?

I want a rebate

Because some people can't afford to pay for how much they use it, and many of them are the same people that have issues with making good decisions to their diet/exercise regimes (which is almost certainly partly cultural and societal).

And for various reasons (partly moral and partly because of the larger public health issues related to things like infectious diseases) we want a robust healthcare system that the vast majority of the population can access.

If your fat and you can't pay your fat "fee", what happens when you can't afford regular antibiotics and you end up growing antibiotic resistant TB?