August 2, 2006

Fat people in denial.

Obese people -- according to a new survey -- think they have healthy eating habits. Forty percent of them even say they do "vigorous" exercise at least three times a week. Do they also not think they're fat? Or are they just mystified about how they got that way?

46 comments:

Meade said...

What's wrong with being fat?

"Thomson Medstat is a data collection and analysis company that contracts with the federal government and about 20 states, on health projects. The data about eating and exercise are part of a larger package of survey information being marketed to employers, hospitals and other customers. It is not being published in a peer-reviewed scientific journal."

Consider the source.

Goesh said...

- saving half that sack of donuts for tomorrow is a healthy habit to them

HaloJonesFan said...

Would I look better if I lost a few pounds? Sure.

Do I look absolutely, disgustingly fat, the way so many people seem to these days? No.

But according to the government-defined standards...I am horribly, sickeningly fat, so fat that it's a wonder that I can move around without a little scooter.

And I think that's part of the problem. The government, having an agenda to Promote Public Health, has set the standards so amazingly low that everyone in the country is fat except possibly Kiera Knightley. I remember a few years ago when BMI was introduced...except that it was introduced as a quite side-note in press releases screaming about how Americans were now fatter than ever before! Just look--according to (recently revised) government standards, most of you are obese!

But I guess what I'm saying is that I'm using the aesthetic definition of "fat", rather than an arbitrary government standard of "fat", and I'll bet that most of the "fat" people in this study are thinking the same way.

Tom C said...

Simpler than that, Halo...it's not a conspiracy, it's a side effect. The BMI was introduced as a unisex measurement of obesity; it had the effect of making most men "overweight" or "obese" when we might call them "thick" or "chunky" (or in some cases, "Built"), while making women who looked the same "normal". It was done to help fight eating disorders.

Since most women, especially under 30, pay no attention to that nonsense, the introduction of the BMI seems to have been nothing but a negative. And most doctors still depend on the old gender-based charts to help people set target weights, as there's ample evidence that being in the "Overweight" category actually extends your life. Noble purpose, bad outcome.

Pogo said...

According to the fat police, the costs to society are so great that the State must intervene. As a result, you can expect increasing efforts to control your behavior imposed on you at the state and federal levels.

Do people mispercieve or lie about their own diets and exercise habits?
Probably.
My question is, if so, then what?
Answer: just watch England. Their intrusions into personal liberty are amazing.

As for "It was surprising how some responses from obese and overweight people paralleled those of thinner respondents.":
Horsehockey. Not surprising at all. Probably true, in fact. Some people are genetically much better at extracting calories and making fat than others. This was an enormous evolutionary advantage for millenia, as it prevented deaths from prolonged periods of starvation. Mass starvation was very common throughout history (and still exists), but the super-abundance of the West has for the first time in history obliterated that threat.

Are lots of people fat?
Yes.
So then what?
Do we step in and control what they eat, because clearly they cannot do so themselves, and they even lie about it? At least, that's the mantra of the fat police. Watch it formulate over the coming decade.

anon2 said...

I would not think that BMI is not a particularly reliable indicator of health. I'm 5'10" and 225, but I workout regularly and my bodyfat is only ~10%. I wonder how many of the "obese" people in the study really do exercise hard. At the gym, it appears to me that I'm not the only fit person who is "obese".

Joseph Hovsep said...

zHowever you care to measure it, Americans are fatter than people in other countries and fatter than they have been in the past. I don't think people should be obsessed with such simplistic measures as weight and BMI, but being overweight does cause lots of health problems, so its certainly something people should at least not be in denial about.

Too Many Jims said...

Halojonesfan is right that not all BMI defined obese people are "fat" in the colloquial usage of the term "fat".

For years I knew that I "should" lose some weight. This summer my wife wanted me to diet with her for her to lose a few pounds. I had never really dieted before (save for the time in junior high where I starved myself for a day and a half to make a weigh in for wrestling). In the first week of the diet I lost a few pounds and started trying to figure out how overweight I was. When I ran my numbers through the BMI calculator, I was disheartened to learn that I was "obese". After having lost more weight I am now just "insanely overweight" according to BMI.

Speaking as a (now former) obese person, I do think that I was mystified about how I got that way. In my case I had gained an average of about 4 pounds over the last 15 years. Sounds like a lot (and it is) but when you are 195 pounds (which is the high end of where I am "supposed" to be for BMI purposes) who worries that you are weighing in at 199. The next time you check your weight you are a bit further from 195 but not much further from 199 and so on. The problem for me is that the way up was so incremental and the way back down seems so far away.

Ed said...

I vlogged about this topic back in April (turn your sound way up, I had my microphone volume too low).

Freeman Hunt said...

BMI doesn't work for people with significant muscle mass. Body fat % is the real indicator of how fat a person is.

Most people underestimate their caloric intake. The obese people in this survey are probably underestimating more than others.

Probably true, in fact. Some people are genetically much better at extracting calories and making fat than others.

That's not really true unless you're talking about differences in ability to put on muscle. Metabolism is mostly based on one's lean body mass. More muscle = more calories burned.

Losing weight is just a math problem. Calculate RMR, multiply by activity level, eat fewer calories than that, and you lose weight.

RogerA said...

Nicely said, Freeman Hunt. There is no magic in weight loss: burn more calories than you ingest and you will lose weight (although it is more difficult for women than men.) The other thing to help you in that regard is portion control--It is very revealing to actually measure out what constitutes a "serving." About half of what most people might think.

Pogo said...

Re: "Losing weight is just a math problem."

I disagree. While it is certainly true that weight loss will occur when calories in are less than calories out, that's far too simplistic.

Nutrition specialists have the mistaken notion that people all burn calories more or less similarly. I think it's much murkier than that.

Supposedly my 20 year old self had the same metabolic rate as my current self at 45. Bull. I was far less active then, but much thinner. I ate constantly, and far more than I eat now.

Persons with Alzheimer's disease lose weight even when their caloric intake is constant and unchanged from their norm, and far before the disease is even diagnosed. Why?

In short, nutrition folks think they have it figured out, but they don't.

While eat less and do more makes sense, forgetting that humans are primarily designed to live long enough to procreate (not to live to be old) is a bad mistake. To achieve reproduction, we must avoid starvation and death by attack. So all of our systems are geared for two simple purposes.

But we now live in the most food-abundant time in the history of mankind, and one of the safest. We are simply victims of our own success.

It's much more complicated than kcal in < kcal out.

And ultimately, the only answer the fat police will be able to conjure up is coercion.

jeff said...

I knew a guy in the Army - did PT daily, passed his PT tests, never saw him eat immoderately (okay, a cheeseburger w/fries at lunch is not excessive), but he was never even close to the body type the military puts on recruiting posters.

None of us could figure out why.

Palladian said...

Isn't it weird to call people "fat"? How many words are there that are both a word for a thing and a descriptive term for someone who has an abundance of said thing. Not "you are carrying a lot of extra fat" but "you are fat". Strictly speaking, everyone is fat in the sense that part of our physical composition is various kinds of fat, as well as water and other things. "Overweight" doesn't work, at least in a general sense, because it implies a universally accepted standard weight (I know, I know, there are standard weights for people of certain heights and genders and ages, but I'm just linguistically riffing here!). It is weird that "fatness" is still a moral judgment for many people; I'm often amazed at the virulent hatred rained down on heavy people, the kind of hatred that can only be the result of high moral dudgeon. Humans are merciless primates when identifying and purging weak and/or overindulgent pack members.

And anyway, if you're carrying a lot of extra weight, many normal activities are "vigorous" exercise. I burn a lot more calories walking around than does your average starving actress.

Freeman Hunt said...

Supposedly my 20 year old self had the same metabolic rate as my current self at 45.

Only if you maintained the same muscle mass--which is rare. Muscle mass is the key to the whole thing. That's why eating enough protein is so important during weight loss. Most people lose something like 1 pound of muscle for every 3-4 pounds of fat lost when dieting because they don't eat enough calories, don't eat enough protein, don't do enough strength training, or a combination of the three. This kills their RMR, and it's why so many people yo-yo diet.

Also, most people don't maintain their muscle mass with age. If you maintain the same muscle mass even though it's harder to do with less hormones, you'll maintain the same metabolism.

Cardio is not the key, though it's very important for good overall health and will increase your activity modifier. Strength training and nutrition are the real tickets for people who want to lose weight.

Lean body mass (including muscle) is part of the RMR calculation. Like I wrote before, it's all a math problem.

I know a great many people who have lost large amounts of weight and kept it off. ALL of them incorporated a significant amount of strength training.

HaloJonesFan said...

RogerA: You bring up a good point about portion control. I remember thinking much the same thing during the heyday of the Atkins Diet--namely, that people weren't losing weight because of Magic Meat Power, they were losing weight because they were eating fewer calories. They just weren't used to thinking of food in terms of calories--they were used to thinking of it in terms of volume. So they would cut out six hundred calories of pasta and replace it with three hundred calories of sausage, but it looked like the same amount of food.

Pogo said...

Freeman,
I think we are in agreement about how to lose weight; I'm not a therapeutic nihilist.

Rather, the article says that people are mistaken or lying about their caloric intake. I say that's false. For the reasons you stated, calories in may in fact be similar for the fat and the thin, but their bodies use it differently , according to their activity (among other things).

And it is certain that there are some outliers who are more likely to become super-obese than others. I am fortunate to have inherited the thin side of my family, and do not struggle with weight much at all. I just think calling it a 'simple math problem' is simplistic. If it were true, weight loss would be a mere matter of applying an abacus.

I think it's far more complex than that. and the failures of most weight loss programs suggest I'm correct.

SippicanCottage said...
This comment has been removed by the author.
Freeman Hunt said...

Rather, the article says that people are mistaken or lying about their caloric intake. I say that's false.

I can't be positive, but I think that they are probably mistaken. Most people I know who are struggling to lose weight or keep weight off are not able to accurately estimate the calories in what they are eating. Like RogerA wrote, the portions are often totally out of whack.

If it were true, weight loss would be a mere matter of applying an abacus.

And I would say that it is. I have never met someone who "applied the abacus", made corresponding changes to activity and nutrition, and failed. It's just math and action. (Note: I should write "just real math. There are, for example, RMR calculators out there that only ask for sex, age, height, and weight. That's ridiculous. Body fat % should always be included.)

I think it's far more complex than that. and the failures of most weight loss programs suggest I'm correct.

Failures of most weight loss programs do not suggest that the math doesn't work. They suggest that people enjoy eating as they please and not having to exercise regularly. Changing how you spend your time and how you eat is a lot of work, and, for most people, not particularly fun.

Freeman Hunt said...

I gaze into my crystal ball, and I see Freeman is putting on some weight. The best kind.

:) Definitely the best kind. Heard the heartbeat two days ago. Very cool.

knoxgirl said...

I think there's a bunch of people out there whose work really serves no useful purpose... but they have to show something for their paycheck or their research grants, so we end up with "obesity epidemic!" and "omigod secondhand smoking!"

I've worked with people like this and the effects of their labor were, of course, on a much smaller scale, but the end result was to make everyone's lives harder.

The whole weight thing is personal, and it's mostly common sense. Do we really need these studies and surveys?

knoxgirl said...

wow, freeman hunt, congratulations! (My son is eleven months old today and more fun everyday... so much to look forward to!)

Palladian said...

Freeman's a Freewoman?! Amazing how much one assumes from a name. Congratulations on that extra weight!

Sippican, glad to know there's a fellow dudgeoner out there. Who can resist a good ol' fashioned 16th century word?

charlotte said...

To each his own, from skinny actresses to new supersized gurneys. My teenager once sat sideways on one hip the entire flight between New York and Rome, because a very large gentleman seated next to her spilled halfway into the seats on either side of him.

She had a physical the other day, and the doctor told her that at 5'-9 1/2" she should weigh between 160 and 170 pounds(!), not 115. She almost burst out laughing.

Freeman Hunt said...

Thanks for the congrats, knoxgirl and Palladian. We're pretty darn excited.

I think Meade may be right about considering the source. Some of those stats are pretty suspect. Like the 40% of obese people who say that they vigorously exercise three times a week. Way less than 40% of the people I know would say that they exercise vigorously this often. These researchers must run in fitter circles.

Pogo said...

Re: "Failures of most weight loss programs do not suggest that the math doesn't work. They suggest that people enjoy eating as they please and not having to exercise regularly."

Freeman,
I am sheepish because I think we're talking about the same thing, just differently. My point is that it is not merely a math problem about total caloric intake. If it were, weight loss would be far easier.

I am actually unsure why weight loss is so difficult, and I'll be fascinated to learn as the facts unfold over time. Some people do indeed prefer to be inactive and simply eat. Not really true with everyone. There's more to it than that.

As I said, I think the evolutionary basis for maximizing intake is neglected. The effects of culture, childhood abuse, addiction genetics, mental illness, age-related loss of 'energy' or drive, and medical disorders all need to be factored in. These aren't simply overcome by logic, or math (and I know you know that). Behavior is so hard to change. If it were easier, we wouldn't be talking about it.

P.S. Hurray for heartbeats and little feet and the new bump! Take care.

MadisonMan said...

catherine, was the gentleman very large, or just plain fat?

Maybe all those fat people think they've overweight, not fat. Or maybe they were asked if they're obese, and they think they're fat.

It's interesting in the comments how fat is shied away from as an adjective for someone predisposed to adipose.

Maxine Weiss said...

Well-Nourished.

Robust.

Rubinesque. (Peter Paul Rubins?)

Zaftig.

Ample.

Generous.

Well-endowed?

Peace, Maxine

charlotte said...

He wasn't "fat", madisonman, he was almost a physical impossibility.

Harkonnendog said...

HaloJones,
Atkins works for lots of reasons, including the one you mentioned. Most important, I think, is that protein makes you less hungry than fat or carbs, especially high glycemic carbs.

MadisonMan said...

Well, that's the first cat I've seen that is 2 feet in diameter. I wonder if it's pregnant. I wonder why the hair hasn't rubbed off its belly!

knoxgirl said...

...I don't think that cat has walked in a while

charlotte said...

I think you're right, knoxgirl, but what about wrestling? Sumo neko!!

Morven said...

I suspect what we're really seeing here is a bad survey combined with most peoples' nature that they don't answer surveys truthfully when they feel a moral judgment in the question.

Nobody wants to admit they're a fat slob who overeats and doesn't exercise. Thus, there's a good change that if you survey any population they'll claim they eat less and exercise more than the truth.

37383938393839383938383 said...

Instead of caring what people say, we should tie consequences to the outomes. That is, reduce the federal budget deficit by conditioning spending on health. You want welfare? Get in shape. Social security? Get in shape. Federal grants for education? Get in shape. Medicare? Get in shape. Public health costs go down if people comply and spending drops is people don't. It's win-win.

Eli Blake said...

The funny thing is, people aren't just fatter, but a study out recently said we are much larger than our ancestors, even those of just a couple of generations ago. Even the average American adult female today would have been taller, heavier and maybe even stronger than most men in ancient times or the middle ages. And we are healthier and live longer than people lived not so long ago too.

Obviously, it's nothing genetic, but people aren't the same as they used to be and we will probably have to get some data on the current population before we can draw conclusions about it. I think there is enough data out there to indicate that being very obese is dangerous to your health, but much of the old data and conventional wisdom may not apply, or may apply diffently than it used to.

Joan said...

Ah, one of my soapbox issues...

Not all calories are metabolized in the same way. Carbs will trigger an insulin response which fats and proteins do not. People with diabetes or insulin resistance can have a tremendously hard time losing weight even if they have maintained muscle mass and do not have an excessive overall caloric intake.

In other words, it is not correct to say a calorie is a calorie is a calorie, and all weight loss is a simple math problem. I don't have much respect for nutritionists who ignore basic biochemistry like insulin response.

I've been plump and I've been skinny and right now I'm comfortably in between but haven't really been keeping track because 1) my clothes still fit and 2) no one recoiled in horror when I showed up at the beach in a bikini that I would've been embarrassed to wear a few years ago, but now everyone's wearing them, so I figured, what the heck.

digressions:
Freeman: congratulations! My best wishes to you, along with a recommendation for Penelope Leach's "baby and child" book, it's the best.

SippicanCottage: I crossed the Sippican River on Rte 195 in MA this afternoon, and thought of you.

SippicanCottage said...
This comment has been removed by the author.
Noumenon said...

Here's a quote from the Merck manual that turned me away from the "burn more calories than you ingest" crowd.

"Weight is regulated with great precision. For example, during a lifetime, the average person consumes at least 60 million kcal. A gain or loss of 20 lb, representing 72,000 kcal, involves an error of no more than 0.001%."

It is the regulation system, not the number of calories, that matters.

Here's another: sorry, my link has gone premium. Mice get more calories out of food depending on what bacteria they have in their intestines. With Methanobrevibacter smithii, waste products get broken down into usable food and the mice get 15% fatter; without it, waste accumulates. 85% of people have this bacterium in their guts; next research stage: how much of it?

In the realm of biology, it would be very surprising if simple arithmetic governed the relationship between calorie intake and weight gain. It's more likely to be complex.

Freeman Hunt said...

In other words, it is not correct to say a calorie is a calorie is a calorie, and all weight loss is a simple math problem.

I would agree that a calorie is not a calorie, but it still comes down to math even if you include carb/fat/protein ratios in the math.

There is no mystery to getting in shape.

Tom C said...

It seems to me that there are probably 10 different ways for people to lose weight...the issue is finding the one that works for you. Having just portion-controlled my way down from BMI-obese to BMI-overweight, I'd say that works, but it really just works for me and some 10% of the world like me.

Cause there's 2 issues: what happens if you stay on the "Diet" and how likely you are to stay on it given what your life and health is after you do it for a while. Clearly with portion/calorie control you will lose weight if you stay on; many people can't. So they might try something else which they can stay on. Or just figure, "what the hey? I'm already alive longer than my old man!" and have a bag of Fritos.

Noumenon said...

There is no mystery to getting in shape.

I think it's a complete mystery. As some magazine article I read pointed out, it's impossible to do controlled experiments with diet regimens because there's no proven way to lose weight and keep it off to use as a control group. We haven't a clue.

Freeman Hunt said...

I think it's a complete mystery. ... We haven't a clue.

Good nutrition and exercise. How is that a complete mystery?

Joan said...

LOL, Freeman -- what's "good" nutrition?

The Food Pyramid says I need to consume a jillion carbs a day; my endocrinologist and my own experience tells me that if I eat much more than 75g/day, I'm going to feel lousy and gain weight.

Fat is still identified as the big bogeyman of nutrition, and yet there are entire societies which subsist mostly on fat and in which heart disease is non-existent.

It's not really a mystery, it has just become so politicized and so entangled with big money that, as with many other subjects, it's very difficult to get the straight story out.

Even exercise is not the cure-all that people think it is. My sister-in-law, for example, has been briskly walking her Husky puppy on twice-daily 4-mile jaunts since December, and hasn't lost an ounce. Her legs have toned but she was expecting more in the way of weight loss/general fitness than she has seen.

Ann Althouse said...

I agree that it's a mystery, but you can extract one truth: if you're still fat, you need to eat less. It doesn't matter why other people don't get fat when they seem to eat the same thing. Look at your own situation. If you're still fat, cut down. Eat less, and weigh yourself. Do it every day for the rest of your life. There's nothing wrong with you. It's just the natural impulse that allowed your ancestors to survive through famines. You have a healthy urge and a healthy body, but in times of affluence, that will make you fat. You've got to go against your nature and eat less. Until you're not fat any more. Or, as Roseann Barr once said: "Just be fat and shut up."

Freeman Hunt said...

what's "good" nutrition? ... The Food Pyramid says ...

Good lord, not the Food Pyramid. :D Unless one wants to have nutrition defined by lobbyists.

For someone who doesn't know anything about nutrition or exercise, I think Body for Life is probably one of the best books to start with. A lot of the people I know who have lost significant weight (30 to 100+ lbs.) started with this book and went on from there. A helpful website with quite a few people who have lost a lot of weight and kept it off is John Stone Fitness.

All in all though, Ann pretty much sums it up. If you're trying and not losing, you're eating too much food.