Three-Quarters of U.S. Adults Are Now Overweight or Obese
nytimes.com
nytimes.com
Unfortunately this fact has been hijacked by "fat positive" movements like Health at Every Size. They take this fact that BMI is an imperfect measure of health and stretch it waaaaay too far in my opinion, with most supporters translating it as "I can be healthy no matter how fat I am," which is definitely not true. There is an absolutely positive correlation with body fat, weight, and health. Unfortunately sane discussion on this is practically impossible no matter where you stand.
I assume you mean a positive correlation between body fat and weight, and a negative correlation with either of these metrics to overall health?
Not how a metric centred around 22.5 works.
A nonsense symbol?
The metrics you're looking for are body fat and muscle mass.
Healthy people with high BMI are not how they are by accident, they don't care about their BMI because they know why it's high and they know it's not an issue
it's a nothingburger; whether you use BMI or Body Roundness or whatever, most USA-ians are fat as hell.
"BMI is used to categorise people’s weight. BMI charts are mainly used for working out the health of populations rather than individuals.
Within a population there will always be people who are at the extremes (have a high BMI or low BMI).
A high or low BMI may be an indicator of poor diet, varying activity levels, or high stress. Just because someone has a ‘normal BMI’ does not mean that they are healthy.
BMI doesn’t take account of body composition, for example, muscle, fat, bone density. Sex and other factors which can impact your weight can also lead to an inaccurate reading. As such a BMI calculation is not a suitable measure for some people including children and young people under 18, pregnant women and athletes."
If the norm was to be like OP, then BMI would not be useful at scale.
Given that you need to know the outcome to determine if the measure is valid, it rather defeats the purpose of using the measure at all.
I actually thought you were preaching the same thing as the ones you are criticizing later on.
I agree that there is people with a high BMI that are quite healthy. So this is not a perfect indicator of health. Sure. But those people are a minority. At the scale of a country of ~346 millions people, having 3/4 of adults with a high BMI is a clear sign of an unhealthy population.
And, yes, unfortunately, some people decided that, because BMI doesn't work with a minority, we shouldn't care about it and, furthermore, shouldn't care about body composition.
Furthermore, I reckon the majority of the people discussing BMI, as in these comments, would tend to be outliers, too, based solely on the fact they care/understand.
The majority of the population has no fucking clue, and can’t even read nutrition labels. And I am not blaming them. This stuff should be taught in school—basic nutrition education.
The tricky part is getting people to understand bell curves, standard deviations, and outliers when explaining why a policy is the way it is.
Overweight people frequently have their problems ignored or downplayed, or given treatments for issues that they aren't experiencing, which leads to worse health outcomes.
I'm not denying that being overweight can be bad for one's health, just pointing out that when doctors provide worse treatment to a group of people that group has worse health outcomes and makes obesity more dangerous that it would be in a world without weight stigma.
"Health At Every Size" was how it started, encouragement that you can improve your health despite not losing weight. For example, if you don't normally work out but decide to start, you're probably going to gain weight first - adding muscle faster than you lose fat.
"Healthy At Every Size" is the corrupted version you're describing.
It takes at least a month to get your CNS firing correctly before your body can possibly build muscle in any significant way.
If you don’t work out and then you start, and you gain weight, you’re eating poorly, not gaining muscle.
https://www.washingtonpost.com/wellness/2024/04/03/diet-cult...
[1] https://en.wikipedia.org/wiki/South_Park:_The_End_of_Obesity
Something that helps me is body shaming. (Making a serious point here.) I have a sense of humor about life’s challenges and get a motivation boost from comments by strangers or familiars.
I personally value the motivation aid, as motivation is often hard to manufacture. I find comments & judgements hilarious, as long as they reflect reality, and have no practical impact.
I don’t judge my worth on my weight, but on my unstoppable optimism that yes, once again for the nth time, I am confident in my power to solve that problem, when time & circumstances allow. And until then? I am working on something else, worthy of progress.
At a particularly poor time in my body composition state, I initiated a turnaround by telling a friend I had really enjoyed being fat for the last several years, but thought it might be nice to be skinny for a change. His laughter played into my making a real commitment, that I followed through on.
Our brains are idiosyncratic things.
I think an instinct/habit to consciously hold two or more orthogonal and opposite viewpoints about all serious things, keeps our world views and option awareness nimble.
I have minority friends (of various blends) who are completely insensitive to mild discrimination most of the time. Just expect a fraction of people can’t get past pointless categorization and judgements. They either ignore it, to the point of looking right past it, or laugh or smile politely but pointedly in a way that draws attention to infractions in a way that disarms. People are often surprised by being called out, but not being shamed, discounted, or their immediate purpose side tracked in any way.
Humor and a thick skin go a long way in life to protect our mental & social health.
[Absolutely not making light of shaming or belittling anyone. We are not born with all the armor we need. But it is useful to know that our reactions to smaller expressions of rudeness can take positive forms, even provide opportunities to give unconfrontational feedback. They don’t have to undermine us.
The best victories are achieved by finding a stance that lets us master conflicts we encounter without need for concern or motion.]
> “Obesity comes from genetic, physiological and environmental interactions,” she said. “It’s not the fault of any one individual who has the disease.”
> There are many potential drivers behind the skyrocketing rates, including the wide availability of ultraprocessed foods, the challenges to accessing fresh fruits and vegetables and an increase in sedentary online activity.
Is it just me or is this completely contradictory? Obesity is just a matter of how many calories you ingest relative to how much you burn. The doctor says this is inaccurate, but then goes on to say that people are simply eating less healthy and exercising less. That is literally the point.
The potential of governmental regulation is incremental at best, and a deflection at worst.
That said, I wasn't criticizing drugs. I think they will help many with weight. I was criticizing the idea that sugar taxes and other attempts at government disincentives can reverse the obesity epidemic while the average American still watches more than 3 hours of TV a day and binge eats. Maybe we should try putting a flyer in the mail next?
It is like trying to reduce domestic abuse by placing a tax on baseball batts - wholly inadequate for the objective and indicating a fundamental failure to understand the nature of the problem.
https://www.vox.com/future-perfect/368528/us-military-army-n...
> Should a true national security emergency arise, America lacks the ability to mobilize as Israel and Russia have done. The Individual Ready Reserve (IRR) — comprising former active duty or selected reserve personnel who could be reactivated by the Secretary of Defense during wartime or a national emergency — is designed to act as a bridge from the AVF to a revived draft. Almost forgotten even by servicemembers, the IRR earned brief notoriety when some servicemembers were “stop-lossed” during the Iraq War — pulled from the IRR and returned to active duty involuntarily, usually to deploy again.
> Today, there are just over 264,000 servicemembers in the entire IRR. The Army’s IRR pool has shrunk from 700,000 in 1973 to 76,000 in 2023. Forget building new units in wartime: the IRR is now incapable of even providing sufficient casualty replacements for losses from the first battles of a high-intensity war.
> And even if more Americans could be encouraged to sign up, they may not be able to serve. Before Covid, fewer than three in 10 Americans in the prime recruiting demographic — ages 17 to 24 — were eligible to serve in uniform. Those numbers have shrunk further since the pandemic began. Only 23 percent of young Americans are qualified to enlist without a waiver, based on the most recent data. Endemic youth obesity, record levels of physical unfitness, mental health issues exacerbated by the Covid pandemic, and drug use have rendered the vast majority of young Americans ineligible for military service. Scores on the ASVAB — the military’s standardized exam for recruits, which tests aptitude for service — plummeted during the pandemic.
Turns out, if you don't build a system for your human pipeline to thrive, it comes back to bite. You can only neglect it for so long until the system goes from hobbling along to system failure.
It's a measure of security. If you know your enemy cannot sustain a war of attrition, it incentivises launching one against them.
Logistics matter far more in any war. In a war of attrition, however, production (not stocks) determine the outcome. (Soldiers are produced out of the civilian population.)
The reason OP's argument isn't urgent is there is no proximate war of attritition in which the stock America is running down are its soldiers. As a rich democracy, we're somewhat uniquely sensitive to troop losses. It's why we invest so heavily in technology to compensate.
> an offensive war against the US? Our geographical position makes that unrealistic
Those buffers of course. After which we don't have buffers. I'm not predicting imminent invasion of the homeland.
Like, if we lose our security positions in Europe and the West Pacific we're back where we were in the inter-War period.
The "buffers" are two massive oceans, those are not going anywhere for the next million years.
Russia can't sustain an invasion of its next door neighbor. There is zero chance of a hostile invasion of the mainland United States.
There are also nukes. Nobody is invading America any time soon. But losing that security space means conceding a massive chunk of our GDP and, with it, autonomy and quality of life. At the very least, the system of government that oversaw that failure would be replaced.
Being ready for war prevents war : Being unready for war invites it.
It's really simple: If you are leading an expansionist state, who are you going to attack first? The neighboring village/fiefdom/nation that trains like Sparta and is clearly ready to kick your military's asses back to your farthest border, or the other one whose population is mostly too fat to run down the street and spends their time chasing the latest TV show and fashion trend?
Another thought further down the line is to get some self-driving equipment installed, and use the cars before sending actual people. I feel like a relatively cheap kit could turn one into a ram and/or remote surveillance point.
No, just the most effective one once you've got an obese population. (Nicotine patches aren't the solution to cigarette smoking. But they are a great tool for cigarette smokers.)
1: Am an American. I want it now.
https://www.newsweek.com/surgeon-warning-about-weight-gain-o...
> "Been 6 months...still haven't gained a lb. It was a miracle medicine," said one user and another agreed, "Nope. Been off 18 months and Not. A. Pound. Gained."
>But this doesn't ring true for all, one user said: "This is very true was on Ozempic reached my goal weight then stopped and regained it all back. Just started again."
>"Lost 52 pounds on Ozempic in 5 months. Was taken off gained 85 pounds in 6 months. [Back] on Ozempic and dwn 7 pounds in 3 days. I'll just stay on it..."
Surely we haven’t realized the full potential of health behaviour change and healthy default choices at scale. That class of interventions is considerably cheaper and more immune to trade disputes than GLP-1 agonists. But also deeply unprofitable for the pharmaceutical and processed food industries.
It can be done at an individual level, with no permission, and no training.
Where did those questions lead you?
A BMI above 35 (severe obesity) is "associated with significantly higher all-cause mortality" [1]. Regular obesity (30 to 35) is associated with higher morbidity, e.g. CVD, GERD and asthma. (Being underweight is more dangerous than being overweight [2].)
How did you conclude this? The evidence we have says obesity causes mortality [1].
> while I sit at a dinner table with friends and family eating significantly less than everyone and still gaining weight
Yes, this is metabolic syndrome. There is increasing evidence that some peoples' bodies will reduce base metabolism to compensate for reduced calorie intake or exercise, sometimes to the point of permitting starvation despite food intake, in an effort to conserve body fat.
Modelling nutrition thermodynamically is like trying to model flight with Newtonian dynamics. You can do it. But not in a practical way, and certainly not when it comes to edge cases.
> people are so committed to the idea of weight gain being a moral failing
Sorry you've experienced this. I've seen it too, in peoples' zero-information dismissal of e.g. Ozempic as a moral failing. (For disclosure, I've only dealt with weight gain as a cosmetic issue.)
Sun exposure causes melanoma. That doesn't make the beach evil. It just means that causation is established. It's not perfect. But if you're at risk of melanoma, knowing that causation helps. In the same vein, obesity causes mortality. That doesn't make being obese (or overweight) evil. It just means the causation is established. It's not perfect. But if you're obese, you and your doctors knowing that causation helps.
I wouldn't focus on that, food intake relative to others will be misleading.
Have you tried a food journal? For a week, take a picture of __everything__ you eat or drink. Go back and review it at the end of the week, a month would be better.
If you review it and think "yes, this is a reasonable amount of food" you now have a months worth of data to shop around to a doctor who can help you. If you have the opposite reaction, now you have a baseline to work against.
As an aside, do you drink a lot of soda?
Good luck, your tone is defeatist and I don’t have the energy to engage any more.
I don't think this is sufficient. I started tracking calories a few years ago, and it turned out one of the meals I thought was high-calorie was actually low-calorie.
Also with calorie tracking, only need to do it for a week or so and see if what you're eating is what you think you're eating. Something might add up to much more than you think.
What I have learned time and time again is that people are at best inaccurate at counting their caloric intake or at worst just entirely dishonest about how much they at eating. You are most likely eating a lot more than you think you are and have normalized it after 40 years of doing so.
It is possible that you may metabolize food slightly different from other people. What is not possible is that your body is defying conservation of energy and mass.
I wont go into all the possible problems with using dinner comparison as a benchmark, because the charitable take is that you sharing a sentiment, not proof of anything.
Your body has a lot of latitude in modifying its base metabolism. Folks with metabolic syndrome can reduce food intake to virtually zero and their bodies will still try turning off vital mechanisms before burning fat stores.
Most people get into obesity through bad habits. But good habits aren't enough to get out. (The exception to my first statement are those with genetic or hormonal factors.)
The challenge is that the syndrome is resistant to incremental change require a lot more than simply adopting what would otherwise be healthy steady state behaviors.
That is to say, the syndrome goes away if you get back to a normal weight, it is just extremely hard to do it. Im hopeful GLP-1 drugs will help some people break through this wall.
"Possible explanations have included earlier presentation of heavier patients, greater likelihood of receiving optimal medical treatment, cardioprotective metabolic effects of increased body fat, and benefits of higher metabolic reserves" [1].
In summary, obesity (BMI > 30) is a health problem. 40% of Americans are obese [2]. I'd be curious to see what fraction of overweight Americans become obese versus normal weight become either obese or underweight--the presumption seems to have been that being overweight (particularly when young) is a risk factor for obesity.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC4855514/
[2] https://www.niddk.nih.gov/health-information/health-statisti...
BMI has been in usage for over a century. Its never been a perfect measurement (neck is also taken into account in Navy tests IIRC), but function(weight, height) is good enough for the basics.
- a century ago a greater percentage of people were "normal" weight
- human physiology has not changed much over the past century
- our current definitions of overweight/obese correlate with negative health outcomes
I think the classification is largely correct even if you can haggle over some of the smaller details.
(EDIT: That said, people shouldn't be downvoting you just for asking the question, sorry that happened)
I didn't downvote. But if you're asking a question, ask it. Don't phrase it as a statement while pretending it's a question. And if you're making a statement, substantiate it. Ending a question with a period is borderline intellectually dishonest.
With improved nutrition, people are several inches taller than they were a century or so ago.
If the cause of being taller were internal, such as genetic changes: that would be a change in physiology.
Coincidence? My guess is no.
Enormous portions have a lot to do with hormones.
Semaglutide is a proven, popular weight loss drug that blocks these hormones. Various blood contaminants are known to mimic them.
Coincidence? My guess is no.
Where is your control? Is the argument less-fat countries, particularly those in Asia, have less PFAS and microplastics?