“If we can get even a small number of obese people to lose weight, it might have a ripple effect, and we could contribute to reversing the obesity epidemic,” Fowler says.
READ MORE:? USA Obesity Page 2
Doctors Refusal to Treat Obese Patients May Raise Legal Problems
More than 10% of doctors in a recent survey refuse to accept patients who are too fat. While some doctors decline to perform operations on patients who refuse to quit smoking, the two situations are different from a legal point of view, says expert.
FOR IMMEDIATE RELEASE
May 17, 2011 – More than 10% of obstetrics-gynecology doctors in a recent survey refuse to accept patients who are too fat.? While there have been instances in which doctors decline to perform operations on patients who refuse to quit smoking, the two situations different from a legal point of view, says the man behind using legal action as a weapon against the problems of smoking and obesity.
First, people who are obese may qualify for protection under the Americans With Disabilities Act [ADA], as well as under state statutes which prohibit discrimination based upon weight or personal appearance.? In sharp contrast, smokers are not protected against this type of treatment under any statutes, says public interest law professor John Banzhaf, who pioneered the use of the ADA to protect nonsmokers from exposure to tobacco smoke in workplaces and public place.
Second, the federal government has officially classified obesity as a “health status” which is a protected category under certain health care statutes, and as a “disease” under others.? On the other hand, the government has ruled that being a smoker is only a “behavior” entitled to no such protection.? As one consequence, federal law permits charging smokers higher health insurance premiums without any limits, and even if the policy is not part of a wellness program meeting federal standards, whereas the same is not true for the obese.
Third, patients who need an operation can quit smoking in only a few days to qualify for the procedure, even if they return to smoking once they are discharged from the hospital.? On the other hand, many obese patients cannot safely lose enough weight even over weeks or months, during which they could die or suffer other serious complications if the operation is not performed promptly
Fourth, many people still believe (correctly or not) that obesity is often caused by heredity, genes, childhood eating, and other factors over which adults have little if any control. On the other hand, most people see buying and using cigarettes as a habit or a choice, making it easier to justify a medical exclusion policy for the small percentage of Americans who still smoke.
Fifth, although there is evidence that for many people smoking involves addiction, that addiction is to the drug nicotine, not to the act of smoking itself, which is a behavior. Because those who desire to quit smoking (e.g., for a medical procedure) can ingest nicotine from nicotine gum, nicotine patches, nicotine spray, nicotine inhalers, and e-cigarettes, their decision to ingest it by smoking rather than by using nicotine replacement products is a choice.? Since it is a choice rather than an addiction, disease, or health status, it seems more legally justified to restrict access to medical care to smokers than to the obese.
JOHN F. BANZHAF III, B.S.E.E., J.D., Sc.D.
Professor of Public Interest Law
George Washington University Law School,
FAMRI Dr. William Cahan Distinguished Professor,
Fellow, World Technology Network,
Founder, Action on Smoking and Health (ASH)
Creator, Banzhaf Index of Voting Power
2000 H Street, NW, Suite S402
Washington, DC 20052, USA
(202) 994-7229 // (703) 527-8418
Fatty foods may cause cocaine-like addiction
March 30, 2010
By Sarah Klein, Health.com
(Health.com) — Scientists have finally confirmed what the rest of us have suspected for years: Bacon, cheesecake, and other delicious yet fattening foods may be addictive.
A new study in rats suggests that high-fat, high-calorie foods affect the brain in much the same way as cocaine and heroin. When rats consume these foods in great enough quantities, it leads to compulsive eating habits that resemble drug addiction, the study found.
Doing drugs such as cocaine and eating too much junk food both gradually overload the so-called pleasure centers in the brain, according to Paul J. Kenny, Ph.D., an associate professor of molecular therapeutics at the Scripps Research Institute, in Jupiter, Florida. Eventually the pleasure centers “crash,” and achieving the same pleasure–or even just feeling normal–requires increasing amounts of the drug or food, says Kenny, the lead author of the study.
“People know intuitively that there’s more to [overeating] than just willpower,” he says. “There’s a system in the brain that’s been turned on or over-activated, and that’s driving [overeating] at some subconscious level.”
In the study, published in the journal Nature Neuroscience, Kenny and his co-author studied three groups of lab rats for 40 days. One of the groups was fed regular rat food. A second was fed bacon, sausage, cheesecake, frosting, and other fattening, high-calorie foods–but only for one hour each day. The third group was allowed to pig out on the unhealthy foods for up to 23 hours a day.
Not surprisingly, the rats that gorged themselves on the human food quickly became obese. But their brains also changed. By monitoring implanted brain electrodes, the researchers found that the rats in the third group gradually developed a tolerance to the pleasure the food gave them and had to eat more to experience a high.
They began to eat compulsively, to the point where they continued to do so in the face of pain. When the researchers applied an electric shock to the rats’ feet in the presence of the food, the rats in the first two groups were frightened away from eating. But the obese rats were not. “Their attention was solely focused on consuming food,” says Kenny.
In previous studies, rats have exhibited similar brain changes when given unlimited access to cocaine or heroin. And rats have similarly ignored punishment to continue consuming cocaine, the researchers note.
The fact that junk food could provoke this response isn’t entirely surprising, says Dr.Gene-Jack Wang, M.D., the chair of the medical department at the U.S. Department of Energy’s Brookhaven National Laboratory, in Upton, New York.
“We make our food very similar to cocaine now,” he says.
Coca leaves have been used since ancient times, he points out, but people learned to purify or alter cocaine to deliver it more efficiently to their brains (by injecting or smoking it, for instance). This made the drug more addictive.
According to Wang, food has evolved in a similar way. “We purify our food,” he says. “Our ancestors ate whole grains, but we’re eating white bread. American Indians ate corn; we eat corn syrup.”
The ingredients in purified modern food cause people to “eat unconsciously and unnecessarily,” and will also prompt an animal to “eat like a drug abuser [uses drugs],” says Wang.
The neurotransmitter dopamine appears to be responsible for the behavior of the overeating rats, according to the study. Dopamine is involved in the brain’s pleasure (or reward) centers, and it also plays a role in reinforcing behavior. “It tells the brain something has happened and you should learn from what just happened,” says Kenny.
Overeating caused the levels of a certain dopamine receptor in the brains of the obese rats to drop, the study found. In humans, low levels of the same receptors have been associated with drug addiction and obesity, and may be genetic, Kenny says.
However, that doesn’t mean that everyone born with lower dopamine receptor levels is destined to become an addict or to overeat. As Wang points out, environmental factors, and not just genes, are involved in both behaviors.
Wang also cautions that applying the results of animal studies to humans can be tricky. For instance, he says, in studies of weight-loss drugs, rats have lost as much as 30 percent of their weight, but humans on the same drug have lost less than 5 percent of their weight. “You can’t mimic completely human behavior, but [animal studies] can give you a clue about what can happen in humans,” Wang says.
Although he acknowledges that his research may not directly translate to humans, Kenny says the findings shed light on the brain mechanisms that drive overeating and could even lead to new treatments for obesity.
“If we could develop therapeutics for drug addiction, those same drugs may be good for obesity as well,” he says.
September 3, 2008
Todd Kruse
Having spent my early years growing up in small town Iowa I have fond memories of attending our county fair along with the Iowa State Fair with my parents.? So this Labor Day weekend was another passing of the generational torch as my wife and I took the kids to the Minnesota State Fair to continue the family tradition.? I have to believe the word “fair” is an Old English word meaning – “food on a stick market” – since visitors can sample a full range of food items stuck on a stick for easy consumption.? Here is a sample of the foods for sale this weekend:
Big Fat Bacon
Deep Fried Candy Bars
Deep Fried Spam Curds
Now I am not a US Department of Agriculture (USDA) manager but I have to guess that a meal consisting of deep fried spam curds followed by a deep fried candy bar for dessert does not meet the USDA’s food pyramid guidelines.? Personally I don’t care what people eat at the fair even the hugely obese people we saw riding around in rental carts I simply do not want to pay for their medical bills via a “universal health care system” as numerous politicians promise they will create for the USA.?? This is classic government at cross purposes with itself – while the USDA implements the government’s “cheap and easily available food” policy via agricultural subsidies and food stamps their counterparts at the Department of Health and Human Services (HHS) are declaring a “war on obesity” – and you can guess the end result I hope:? they take more and more of our income to fight the problems they helped create in the first place.
One last comment on the USDA before I close with some observations on the state fair – have you heard this USDA joke??
Fred, a USDA worker sat down next to his colleague, Tony, in the cafeteria when he noticed that Tony was crying. “Hey Tony, what is wrong today?” said Fred. To which Tony replied,?? “My farmer died this morning…………..”?
Yes there are too many bureaucrats working at USDA.
While my family did not actually buy any food items that came on a stick such as the pork chop on a stick or the foot long corn dog on a stick but we did stop by the crepe food booth.? As we placed our order we noticed the very young girl working at the cash register which led to two very important discoveries as we talked to her.? First, she was only 8 years old so I am certain the Department of Labor will have to launch an investigation so monetary fines can be assessed.? Second, we noticed this 8 year old girl was working without direct adult assistance yet she was able to give us the correct change when we paid for our meal.?? Clearly she must have been home schooled or there was some form of school choice in her school district!!??
Truth is, healthy people cost us all a lot of money
July 21, 2008
By FROMA HARROP
The word “prevention” has a nice ring in any health-care discussion. Thus, many politicians argue that programs to stop smoking, improve diets and otherwise promote wholesome living save money in the long run. A healthier population at less cost — sounds like a win-win situation.
Unfortunately, that formulation is a pleasant fantasy.
Medical economists agree that cancer screenings and gym classes can lead to physical well-being and longer lives. But in the interests of honest accounting, they add that prevention does not reduce overall health-care spending. On the contrary.
Let’s put it bluntly: Longer lives cost more money. Those who make it to 90 thanks to exercise and six daily servings of vegetables are more likely to suffer the expensive ravages of old age. Everyone dies of something.
So he who avoids a fatal heart attack at 70 is more at risk of cancer at 80. Those extra 10 years can mean extra CT scans, hip replacements and physical therapy, even for those in relative good health.
Despite this reality, the cost-saving virtues of wellness programs echo along the presidential campaign trail. Democrats Hillary Clinton and John Edwards talked them up — as did Republican Mike Huckabee. The presumptive major-party nominees, Democrat Barack Obama and Republican John McCain, both include “prevention” in their health-care proposals.
“Prevention is absolutely the right thing to do,” Arthur Garson Jr., the provost at the University of Virginia Medical School, told me. “The issue is, do not expect to get to the end of the day and have enough money from prevention savings to pay for the uninsured.”
Author of the book Health Care Half Truths, Garson cites a recently published study on the high cost of healthy people. Dutch researchers found that medical spending on smokers, who died at an average age of 77, was $100,000 less than on nonsmokers who were thin and died at 84.
Companies that include wellness programs in their employee benefits may indeed see a savings in lower medical costs and absenteeism. But what they have done, really, is delay the onset of serious illness during the employees’ working years and pass it onto Medicare, when the taxpayers take over.
A study reported in The New England Journal of Medicine finds that only 19 percent of preventive interventions save money. Their value depends on the particular intervention and the sort of people who get it. “For example, drugs used to treat high cholesterol yield much greater value for the money if the targeted population is at high risk for coronary heart disease,” write the authors, Joshua T. Cohen, Peter J. Neumann and Milton C. Weinstein.
Rapidly rising prices for health care also add to the expense of moving big-ticket medical procedures into later years, explains Garson, a cardiologist. “In today’s world, where the rate of medical care inflation is twice the rate of regular inflation, anything done 10 years from now is, in real dollars, 25 percent more expensive.”
There are two ways to deal with that problem, according to Garson. Get medical costs down, and “keep people as healthy as possible as long as possible so that they don’t spend as much money being sick.”
The best kind of aging, he says, is to “have early old age last as long as possible and late old age last 15 minutes.”
Yes, preventive care is a good thing because a long and healthy life is a good thing. We shouldn’t lose sight of that big picture. But let’s not deceive ourselves into believing that wellness programs can reduce medical spending over the long haul. That may come off as an attractive selling point for a health-care plan, but it’s not so.
Harrop is a syndicated columnist in Providence, R.I.
Aug 12, 2008
By LINDSEY TANNER
CHICAGO (AP) — You can look great in a swimsuit and still be a heart attack waiting to happen. And you can also be overweight and otherwise healthy. A new study suggests that a surprising number of overweight people – about half – have normal blood pressure and cholesterol levels, while an equally startling number of trim people suffer from some of the ills associated with obesity.
The first national estimate of its kind bolsters the argument that you can be hefty but still healthy, or at least healthier than has been believed.
The results also show that stereotypes about body size can be misleading, and that even “less voluptuous” people can have risk factors commonly associated with obesity, said study author MaryFran Sowers, a University of Michigan obesity researcher.
“We’re really talking about taking a look with a very different lens” at weight and health risks, Sowers said.
In the study, about 51 percent of overweight adults, or roughly 36 million people nationwide, had mostly normal levels of blood pressure, cholesterol, blood fats called triglycerides and blood sugar.
Almost one-third of obese adults, or nearly 20 million people, also were in this healthy range, meaning that none or only one of those measures was abnormal.
Yet about a fourth of adults in the recommended-weight range had unhealthy levels of at least two of these measures. That means some 16 million of them are at risk for heart problems.
It’s no secret that thin people can develop heart-related problems and that fat people often do not. But that millions defy the stereotypes will come as a surprise to many people, Sowers said.
Even so, there’s growing debate about the accuracy of the standard method of calculating whether someone is overweight. Health officials rely on the body mass index, a weight-height ratio that does not distinguish between fat and lean tissue. The limits of that method were highlighted a few years ago when it was reported that the system would put nearly half of NBA players in the overweight category.
A number of experts say waist size is a more accurate way of determining someone’s health risks, and the study results support that argument.
Dr. Robert Eckel, a former American Heart Association president and professor of medicine at the University of Colorado, said the new research may help dismiss some of the generalizations that are sometimes made about weight and health.
Study co-author Judith Wylie-Rosett emphasized that the study shouldn’t send the message “that we don’t need to worry about weight.” That’s because half of overweight people do face elevated risks for heart disease, explained Wylie-Rosett, a nutrition researcher at Albert Einstein College of Medicine in New York.
But, for those without elevated risks, losing weight “might be important only from a cosmetic perspective,” she said.
To arrive at the estimates, scientists analyzed nationally representative government surveys involving 5,440 people age 20 and over, and extrapolated to calculate nationwide figures.
The new study, appearing in Monday’s Archives of Internal Medicine, used government surveys from 1999 to 2004 that included lab tests and height and weight measurements. Participants reported on habits including smoking and physical activity.
In all weight categories, risk factors for heart problems were generally more common in older people, smokers and inactive people. Among obese people who were 50 to 64, just 20 percent were considered healthy compared with half of younger obese people.
The results underscore how important exercise is for staying healthy, even for people of healthy weight, Wylie-Rosett said.
The authors noted that fat tissue releases hormones and other substances that affect things like blood vessels, cholesterol and blood sugar. The results suggest this interaction varies among overweight and obese people, the authors said.
The results also add to mounting evidence that thick waists are linked with heart risks.
Among people of healthy weight in the study, elevated blood pressure, cholesterol and other factors were more common for people with larger waists or potbellies. This often signals internal fat deposits surrounding abdominal organs, which previous research has shown can be especially risky.
Similarly, among overweight and obese adults, those in the “healthy” category tended to have smaller waists than those with at least two risk factors.
Dr. Lewis Landsberg, a Northwestern University obesity expert, noted that the research didn’t look at heart disease, and that not everyone with high risk factors develops heart problems.
Still, he said, the study shows that waist measurements can help assess health.
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The Obese Without Cardiometabolic Risk Factor Clustering and the Normal Weight With Cardiometabolic Risk Factor Clustering
http://archinte.ama-assn.org/cgi/content/full/168/15/1617
Long-living healthy people medically more expensive in long run
February 05, 2008
•? A Dutch study compared the health-care costs of three groups: thin and nonsmoking, obese people and smokers.
•? Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes, and healthy people had the most strokes.
•? Ultimately, the thin and healthy group cost the most, about $417,000, from age 20 on. The cost of care for obese people was $371,000, and for smokers, about $326,000.
•? The results counter the common perception that preventing obesity will save health systems worldwide millions of dollars.
•? The study did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.
In the Fatosphere, Big Is In, or at Least Accepted
By RONI CARYN RABIN
January 22, 2008
For years, health experts have been warning that Americans are too fat, that we exercise too little and eat too much, that our health is in jeopardy.
Some fat people beg to differ.
Blogs written by fat people — and it’s fine to use the word, they say — have multiplied in recent months, filling a virtual soapbox known as the fatosphere, where bloggers calling for fat acceptance challenge just about everything conventional medical wisdom has to say about obesity.
Smart, sassy and irreverent, bloggers with names like Big Fat Deal, FatChicksRule and Fatgrrl (“Now with 50 percent more fat!”) buck anti-obesity sentiment. They celebrate their full figures and call on readers to accept their bodies, quit dieting and get on with life.
The message from the fatosphere is not just that big is beautiful. Many of the bloggers dismiss the “obesity epidemic” as hysteria. They argue that Americans are not that much larger than they used to be and that being fat in and of itself is not necessarily bad for you.
And they reject a core belief that many Americans, including overweight ones, hold dear: that all a fat person needs to do to be thin is exercise more and eat less.
“One of the first obstacles to fat acceptance is breaking down the question of whether being fat is a choice,” Kate Harding, founder of the blog Shapely Prose, said in an interview. “No fat acceptance advocate is saying you should sit around and wildly overeat. What we’re saying is that exercise and a balanced diet do not make everyone thin.”
Ms. Harding, a 33-year-old yoga enthusiast from Chicago, promotes the idea of health at any size (she is a 16). She started Shapely Prose (kateharding.net) last April, after noticing that posts about fat in her personal blog hit a nerve. Since then, it has quickly become one of the most popular fat acceptance blogs, with an average of 3,710 page views per day, according to Sitemeter, a Web statistics program.
People come in different shapes and sizes, bloggers like Ms. Harding say, and for those who come extra-large, dieting is futile. Many of the bloggers label their sites “no-diet zones.” (Don’t even mention weight-loss surgery.)
“You relapse, and then you go on a diet again, and this time you’re going to do it, it’s really going to be it this time,” Marianne Kirby, a 30-year-old blogger from Orlando, Fla., who writes The Rotund (therotund.com), said in an interview. “And it still doesn’t work, not long-term — you end up heavier than before. And you say to yourself: Why did I fall for this again?’ ”
The blogs have drawn their share of negative, even vicious comments. But for overweight readers, the messages are empowering — and liberating.
“Girlfriend, let me tell you, I am finally coming to grips with myself,” one fan commented on Ms. Harding’s site. “I will always be fat. I accept that now.”
Harriet Brown, a 49-year-old blogger in Wisconsin and an occasional contributor to The New York Times, encourages readers to take her “I Love My Body Pledge” (at harrietbrown.com), in which they promise not to talk “trash” about “how fat my thighs or stomach” are, and not “call myself a fat pig.”
Fat Fu’s anonymous blog (fatfu.wordpress.com) has a ruthless deconstruction of recent research like the “fat friends” study, as well as one of the most comprehensive lists of links to the fatosphere, including online communities, fashions and health sites for fat people. The Big Fat Deal blog (bfdblog.com) suggests 10 ways to be a “body positivity activist,” including “Be yourself,” “Understand that a lot of people are hateful morons” and “Don’t be afraid to order the cheesecake.”
Many of the bloggers are women whose writing has a distinctly feminist flavor, but there are male fat-acceptance bloggers like Red No. 3 (red3.blogspot.com), who says: “See, I don’t have a problem with fat. My body is simply adorned, and I’ll take that.”
But some experts say this sort of message is dangerous and undermines public health efforts to rein in obesity. “We do have to be careful not to put all the blame on the individual,” said Dr. Walter C. Willett, professor of nutrition and epidemiology at the Harvard School of Public Health. But he added, “The large majority of people who are overweight are overweight because of lifestyle.”
The bloggers argue that changes in definitions over time, along with flaws in the body mass index formula, have pushed more Americans into the “fat” and “obese” categories, and they point to provocative studies suggesting that there may be benefits to being overweight, including a large study that found that underweight Americans are more likely to die than those who are moderately overweight.
Several other recent studies on heart patients and dialysis patients have also reported higher survival rates among heavier patients, suggesting that the link between body size and health may be more complex than generally acknowledged. Another study of people over 60 found that being fit has more bearing on longevity than simply being thin.
The bloggers’ main contention is that being fat is not a result of moral failure or a character flaw, or of gluttony, sloth or a lack of willpower. Diets often boomerang, they say; indeed, numerous long-term studies have found that even though dieters are often able to lose weight in the short term, they almost always regain the lost pounds over the next few years.
Ultimately, these bloggers argue, being skinny may have far more to do with the luck of the genetic draw than with lifestyle choices.
“We accept that some people are tall and some people are short,” said Rachel Richardson, 28, of Cincinnati, who writes a blog called The F-Word (the-f-word.org). “Yet we seem to think all people should be thin — it just doesn’t make sense.”
Fat acceptance bloggers contend that the war on obesity has given people an excuse to wage war on fat people and that health concerns — coupled with the belief that fat people have only themselves to blame for being fat — are being used to justify discrimination that would not be tolerated toward just about any other group of people.
“I’m not surprised there are so many of these blogs now,” Ms. Richardson said. “Anti-obesity hysteria has reached a boiling point. Blogging is a way for people to fight back.”
By Larry Brian Radka
The so-called “educated elite,” who frown on the smoking solace of poor working-class people, have led the attack on smokers and their holy rights.? Their ardent followers are dumb ex-smokers, obese ex-smokers now, who no longer participate in God’s holy activity.? Those pea-brained ex-smokers, fat hypocrites staggering along in a herd of aimless animals, can think of nothing now to do with their restless hands and mouths.? So they constantly grab and gulp down fatty foods as they swell up like bloated corpses.? Eventually their diabetes-ridden carcasses are trucked to hospitals.? Yet, after being unloaded among snickering attendants, those dumb overgrown elephants still have the ignorant audacity to roll over in their broken-down beds and point their greasy nicotine-stained fingers at visiting smokers.
By Avram Goldstein
By Jacqueline S. Homan
? Copyright 2007 The Smoker’s Club, Inc. Please repost with link back to this original article.
Nanci Hellmich
Obesity is contagious.
July 22, 2007
Rigel Gregg
If you’re the type who gets motivated to change by hearing scary statistics, then here’s a doozy: experts predict that if Americans continue gaining weight at the current rate, by the year 2015 (that’s only 8 years from now!) 75 percent of us will be overweight or obese.
That’s not only a majority, but a major majority. Every group in society (kids, adolescents, adults) is steadily gaining weight, and considering that 66 percent of adults were overweight or obese in 2004, I guess it’s not really a big stretch that we’ll hit 75 percent by 2015. How depressing!
Study predicts 75 percent overweight in U.S. by 2015
WASHINGTON (Reuters) – If people keep gaining weight at the current rate, fat will be the norm by 2015, with 75 percent of U.S. adults overweight and 41 percent obese, U.S. researchers predicted on Wednesday.
July 11, 2007
Contact William Hathaway at whathaway@courant.com
Antis: What to expect
The Cold Sharp Slap Of Reality
