Obesity is a structural problem

Written By: Anthony R0bins - Date published: 9:20 am, December 16th, 2015 - 59 comments
Categories: class war, health, national - Tags: briefing papers, health, obesity, Robyn Toomath

If I might plagiarise myself for a minute, obesity is a difficult topic to write about, so some quick preliminaries. First, people have a lot of natural variation in healthy body shapes and types, it is perfectly possible to be “fat” and healthy. Second, obesity is in part a socioeconomic issue and a function of the way that poverty limits options. Third, “fat shaming” is nasty, unhelpful, and far too prevalent.

Having said that, one doesn’t need to pick on individuals to acknowledge that collectively the incidence of obesity in rich countries is increasing, that it represents a significant public (and in many cases personal) health issue with multiple consequences, and that NZ is doing particularly poorly in these respects. As a society we have a problem. A growing problem:

Obesity and problem drinking are on the rise in New Zealand

An annual snapshot of the nation’s health shows 31 percent of adults are obese and problem drinking is increasing.
…
Children living in the poorest neighbourhoods were five times more likely to be obese than those living in the most affluent and, for adults, the equivalent rate ratio was 1.7 times, after adjusting for age, sex and ethnic differences.

More than 5.3 percent of the adult population was morbidly obese, up from 3.4 percent five years ago.

The hazardous drinking rate has risen again, returning to levels seen in 2006/2007

It’s no surprise that obesity is more prevalent amongst the poor: Obesity linked to cycle of poverty. And no surprise that obesity, drinking, and the use of other substances are all on the rise. I believe that these are in large part reactions to increasing poverty and stress. An interesting piece in The Guardian yesterday argues that eating problems are structural:

Obesity isn’t the half of it: fat or thin, our eating is disordered

It’s wrong to focus on obesity as a ‘national risk’ like terrorism. The truth is far more complex, and solutions shouldn’t be couched in warlike rhetoric
…
Is obesity a result of overeating? Yes, maybe, and no. There’s science and then there is the agenda of the various health, fitness and diet businesses mixed up in this. Sometimes fatness is the result of inadvertent repetitive dieting which can upset our metabolism. Sometimes it’s a result of eating the non-food foods that industry peddles. These drench our tastebuds with fat, salt and sugar combinations that overstimulate without giving a sense of satisfaction – other than reaching the end of the packet. Sometimes it is because these same non-food foods take a too-quick journey through our body without being properly digested.

Sometimes, as epigeneticists are discovering, it is to do with changes that occurred two generations ago, when food was very scarce. Sometimes, as Tim Spector of King’s College London, proposes, it is to do with changes caused by early and frequent antibiotic use which alter the flora in our gut.
…
Today, troubled eating is ubiquitous and grows with each generation. The women and men whose bodies sit comfortably within the proscribed “normal” may have equally unruly and chaotic appetites and eating difficulties. This is what needs recognising. We have disordered eating across the board. That is the true public health emergency. …

Similar conclusions are drawn by a NZ obesity campaigner Robyn Toomath in this piece at Briefing Papers:

Why I Don’t Ask People To Lose Weight
…
At the core of the free market ideology with respect to food is the belief that it is our choices that determine the nutritional environment and we are fat because we choose to be.

Maintaining this myth is dangerous from a public health perspective as it deflects attention away from strategies likely to be effective in reducing obesity rates. Strategies which maintain choice but ensure that the default favours the eating of healthy food and maintenance of regular exercise. I am talking about fiscal measures which make healthy food affordable and accessible, and efficient public transport in the place of cars. But making weight an issue of personal responsibility is also powerfully stigmatising. Doctors contribute to this by asking people to do something most are incapable of.
…
We know that obesity is genetic; we know that our environment is stacked against thinness; and there is no evidence for people becoming lazier or more self-indulgent. Very few people want to be fat. The societal pressure to be thin eclipses the medical imperative for most individuals. But diets don’t work. Only 15% of people who embark on a weight loss diet have maintained weight loss at the 5 year mark. I stopped asking patients to lose weight decades ago.

That piece was written in October. Since then, Robyn Toomath has given up:

I quit. After 14 years fighting New Zealand’s obesity crisis, nothing’s changed
…
I’ve been campaigning for an environment that favours slimness over obesity for 14 years and nothing’s changed. It’s time to call it quits.
…
The Labour government at the time [2001] identified childhood obesity as a major issue and determined to fix it. The ministers of health and education recognised this as a cross-sectoral problem and for several years New Zealand led the way with a health select committee inquiry in to obesity and type 2 diabetes, a comprehensive healthy eating, healthy action program funded largely through district health boards and a school nutrition program to ensure healthy food was sold in school cafeterias and tuckshops.

Just before the election, the Public Health Act was revised to include a clause that would allow the deputy director general of health to regulate if industry failed to keep promises designed to improve public health.

Labour lost the election to a conservative party that campaigned against the “nanny state”.
…
The principle that was lost in all of this is that, of course, we are sentient beings capable of choice, and that this is highly valued, but choices are made in context.

If the context is a community with no fruit and vegetable shops, but a string of fast-food outlets along the high street, then people choose between one form of unhealthy food and another.

If junk food advertising on television and the internet is associated with cartoons and games and hardly any healthy food is advertised, then children choose (demand) this food. If brown bread is three times the cost of white, poorer people will buy the white. The default needs to change so the healthier option is the easier one and only governments can achieve this, through regulation.

I’ve been saying these things for years and our government remains resolute in its support for an approach which is a proven failure. Not only have numbers kept rising but a personal responsibility approach is stigmatising.
…
Citizens, not advocates, need to demand that healthy food is affordable and accessible, that traditional ways of eating are preserved and that our cities favour exercise.

Structural problems need structural solutions. Progress on this major public health issue has been set back by a decade because we elected a useless National government. Add it to the list along with many other issues, notably planning for our aging population (superannuation) and action on climate change (e.g. the ETS). The Brighter Future is a disaster.

59 comments on “Obesity is a structural problem ”

Comments are now closed

Stephanie 1

16 December 2015 at 9:44 am

A couple of counter views – me on Robyn Toomath’s “quitting”
https://bootstheory.wordpress.com/2015/11/27/the-despair-of-obesity-battlers/

And this piece, which notes “positioning “obesity” as something that must be combatted inevitably positions fat people as the enemy”.
http://www.artshub.com.au/news-article/opinions-and-analysis/grants-and-funding/jackie-wykes-and-andrea-waling/100000-for-a-few-pounds-of-flesh-250133

Plus one radical idea: how about we talk about incidences of *real* medical issues instead of using unscientific measures of body size (i.e. BMI) to make assumptions about people’s health and lifestyle?
- Lanthanide 1.1
  
  16 December 2015 at 11:24 am
  
  BMI is a cheap and effective tool to characterise someone’s overall body weight. It doesn’t work for people who are outliers, such as rugby players or others who are extremely physically fit, and it doesn’t work for middle-aged Indian men.
  
  But for the average person, BMI is a perfectly valid and useful tool.
  - Stephanie 1.1.1
    
    16 December 2015 at 12:06 pm
    
    You are incorrect.
    http://www.npr.org/templates/story/story.php?storyId=106268439&sc=fb&cc=fp
    - Lanthanide 1.1.1.1
      
      16 December 2015 at 12:27 pm
      
      Here’s a peer reviewed study:
      http://journals.lww.com/nutritiontodayonline/Fulltext/2015/05000/Body_Mass_Index__Obesity,_BMI,_and_Health___A.5.aspx
      
      The gist of it is: BMI is a useful tool, because as I noted it is readily available and cheap to obtain, compared to any other mechanism for determining body fat which do a much better job than BMI however the information simply isn’t available. It is useful for population-level studies. But it shouldn’t be used for non-average people.
      
      Like all tools, if it misused, it can do great harm. But that doesn’t mean it is “unscientific” as you stated.
      - RedLogix 1.1.1.1.1
        
        16 December 2015 at 1:12 pm
        
        Agreed. BMI is a useful proxy at a population level, but less useful for individuals.
        
        At an individual level you need to take into account bone structure, lean muscle and fat proportions. I’ve got the bone structure of brick out-house, so at my very, very leanest I never got below a BMI of about 26 … but it’s still useful to me as a relative measure.
    - David 1.1.1.2
      
      16 December 2015 at 12:33 pm
      
      If you don’t like BMI, then the other tools are hip to waist ratio’s and height to waist ratios. Waist should be less than half height, above that and you are overweight.
      
      BMI is, like most things, an indicator. It’s not the absolute rule, but it’s useful non the less.
  - McFlock 1.1.2
    
    16 December 2015 at 12:43 pm
    
    For a given value of “average”. But nobody is “average”.
    
    To me, BMI is a population health tool. Saying “60% of the adolescent population is obese” or whatever can give an indication of the health of your population, and the relative resource issues your healthcare system might face in ten or twenty years time.
    
    But BMI on an individual level is often useless, and not just for fringe cases. In my case, I always carry extra weight, but there is a line above which shit starts breaking more often (and takes longer to fix, these days). That line has nothing to do with the line between “normal” and “obese”, or “obese” and “morbidly obese” on the BMI measures. It’s a limit I’ve noticed personally with things like blood pressure, joint problems, back pain. Drop ten pounds, everything returns to normal. Keep the weight, I become a pill jockey.
    
    And as for the weight I’d have to be to be “normal”… lol.
    - Lanthanide 1.1.2.1
      
      16 December 2015 at 1:27 pm
      
      Most people will be within 1 standard deviation of the average. So while in your particular case, BMI may correlate poorly with negative health symptoms you experience, for a large bulk of the population BMI should correlate fairly well with the negative weight-related health symptoms those people might suffer.
      - McFlock 1.1.2.1.1
        
        16 December 2015 at 1:47 pm
        
        Yes, most people will. Hell, I probably do.
        
        But almost nobody will have health effects that come into play bang on the BMI delineations of “underweight”, “normal”, “overweight”, etc. That’s the problem with it. For most people the BMI will only be off a little bit or a fair bit, for a few it will be way off, and the only way of knowing whether conforming to a BMI objective is making a specific patient unhealthy is to use the case-oriented tools the GP should be using in the first place, rather than a population hammer for an individual patient’s screw.
    - weka 1.1.2.2
      
      16 December 2015 at 2:55 pm
      
      “To me, BMI is a population health tool. Saying “60% of the adolescent population is obese” or whatever can give an indication of the health of your population, and the relative resource issues your healthcare system might face in ten or twenty years time.”
      
      How so? What’s are the health issues from obesity itself (as opposed to say diabetes or heart disease) that can be determined in this way?
      - McFlock 1.1.2.2.1
        
        16 December 2015 at 3:13 pm
        
        we-ell without necessarily getting into the correlation/causation thing, in western societies particularly obesity is associated with things like type II diabetes, stroke, coronary heart disease, and hypertension, gallbladder disease, osteoarthritis, sleep apnoea and respiratory problems and some types of cancer. Not to mention whether DHBs will need to buy bigger beds and adapt cargo hoists.
        
        So maybe you have a population in the early twenties who are more overweight than the current bunch of 40 or 50 year olds. Down the line you can expect a bubble in some of those conditions, so it might be worthwhile kitting out a specialist ward in a couple of years..
        
        Psycho Milt 1.1.2.2.1.1
        
        16 December 2015 at 3:59 pm
        
        What’s are the health issues from obesity itself (as opposed to say diabetes or heart disease) that can be determined in this way?
        
        It gives you an indication of the future health of your population in that obesity is correlated with a bunch of health issues (see McFlock above), most likely because they’re caused by the same thing (eg obesity and Type 2 diabetes in the same person are both a result of insulin resistance). It would help if people stopped saying obesity caused these illnesses, of course – even among “health professionals,” you get people saying stuff like “obesity is linked to Type 2 diabetes” with the implication that the one caused the other.
        
        weka …
        
        16 December 2015 at 6:04 pm
        
        Yep, see my comment below as well. It’d be great if people started talking about insulin resistance (or as below, Metabolic Syndrome). Talking about insulin resistance would change the conversation completely about diet and exercise.
        
        Corokia …
        
        16 December 2015 at 10:35 pm
        
        “Talking about insulin resistance would change the conversation completely about diet and exercise.”
        How so ?
        Because increasing exercise is an effective way to reduce insulin resistance. Doesn’t change the conversation completely, its the same message. People need to move.
        
        I agree with Anthony that society needs to be structured so that the default and/or cheaper options are the healthy ones. That is of course, if you believe (as I do) that we have a society where we fund public health care.
        
        It makes sense fiscally to try and reduce the incidence of type 2 diabetes.
        It is also morally right to try and reduce the number of people suffering it’s horrible consequences- kidney failure, blindness , amputations and early death. A government which puts the profits of the food industry ahead of the suffering of it’s people is a government made of immoral arseholes- sounds like what we’ve got.
        
        weka …
        
        16 December 2015 at 11:30 pm
        
        Of course. But when we talk about body shape and size as a pathology we can’t practice good public health. We live in a society that routinely shames people for their bodies, especially people who are big. Looking at body weight (or BMI) and telling people to diet to lose weight is not working. We could instead talk about health and disease eg Syndrome X and the factors that contribute that some people have control of. We can also talk about the ones they don’t have control of but that society does.
        
        “Doesn’t change the conversation completely, its the same message.”
        
        For 30 or more years we’ve been told that dietary fat is bad and that people should avoid it. Where do you think they are getting their calories from instead? If the conversation changes to insulin resistance and what that means in terms of maintaining health, then a whole range of factors come into play, including people finding the diet that works for them rather than this one size fits all thing.
        
        It gets worse when you start breaking it down by things like ethnicity (eg Māori and Pacific Islanders have different genetic metabolic responses to food than Caucasians) or gender (women’s metabolism in middle age and through menopause can’t be compared to men’s).
        
        “Because increasing exercise is an effective way to reduce insulin resistance.”
        
        And some people can’t, for various reasons, so what then? So much of our public health messaging is built around norms of white, fit men.
        
        weka 1.1.2.2.1.2
        
        16 December 2015 at 6:00 pm
        
        Yeah, I was actually wanting to go into the correlation/causation thing 😉
        
        The hoists etc makes sense, although I’m guessing that the BMI tool being used included a hell of a lot of people that won’t be needing those i.e. they’re overestimating what ‘obesity’ is.
        
        My own point would be, let’s just stop talking about obesity as a health problem unless it actually is (eg someone is too big to fit in a hospital bed or, I’m guessing, something like sleep apnoea is directly related to the increase in body fat and its effect on breathing). Instead we could be talking about the epidemic of Syndrome X or Metabolic Syndrome, which directly covers heart disease, type 2 diabetes, and will probably eventually figure in things like some cancers and alzheimers.
        
        The more I look at the whole obesity epidemic thing the more it looks like fat phobia. Otherwise we’d be talking about actual diseases and their (pretty bloody obvious) causes.
        
        The other major problem here, the elephant in the living room, is the fact that the public health message about dietary fat and cholesterol and associated illness has been wrong for 30 years. God knows how that clusterfuck is going to be sorted out while trying to address the diseases caused in part by the very high carb diets we’ve been told to eat all this time.
        
        Psycho Milt …
        
        16 December 2015 at 7:01 pm
        
        Yes, absolutely. We’re not even starting down the right path yet.
        
        McFlock …
        
        16 December 2015 at 9:58 pm
        
        Yeah, well, that’s my point about BMI. If a doctor tells a patient “conform to these norms or you’ll get this” that’s fucked. But if a planner sees that a measurable metric that correates with resource needs is on the increase or decrease, screw causation. Plan for the thing that will likely happen.
        
        weka …
        
        16 December 2015 at 11:30 pm
        
        Right, but they’re still measuring the wrong thing if they say that x% of NZers are obese when it’s patently not true.
        
        McFlock …
        
        17 December 2015 at 12:02 am
        
        But it is true, from a population perspective.
        
        weka …
        
        17 December 2015 at 10:00 am
        
        No it’s not. People are varying degrees of overweight above whatever BMI level has been chosen. Not all of them are obese.
        
        Sorry, but this whole framing of people with varing degrees of body fat as somehow ill is completely and utterly ridiculous, even at the population level. I’m saying this in the context of other stupidities like the dietary fat is bad and makes you die message, and the whole shifting of the cholesterol normal range to get as many people on statins as possible. Both those are now coming back to bite us on the arse. We are clearly quite bad in some areas at public health measuring, targeting and messaging (and very good in other areas).
        
        McFlock …
        
        17 December 2015 at 12:23 pm
        
        Yes, individuals vary.
        
        But looking at the whole population, the categories like “obese” or “underweight” are associated with different thresholds of morbidity and mortality. Hence the applicability of the population tool in resource planning and population evaluation.
        
        this whole framing of people with varing degrees of body fat as somehow ill is completely and utterly ridiculous,
        
        I agree. But that’s not what happens from a population perspective.
        
        Yes, BMI is often used inappropriately by GPs as a convenient fib to get unhealthily fat patients to lose weight. But when used properly, BMI is a useful and accurate measure of an entire population.
- Lucy 1.2
  
  17 December 2015 at 8:40 am
  
  Stephanie – a voice in the wilderness. Robyn has spent 14 years telling people that they are fat because they are lazy and need to go to the gym an hour a day (at least that was what she told me) and withholding the drugs that could have made a difference – Metformin for someone with pre diabetes on the grounds that they needed to make better food choices and not rely on drugs. This view is now widely disproved and was at the time when she pronounced that it was easy to work full time, bring up a family, run a house hold, exercise an hour a day and make good food choices when you start a 6 and get to bed at 11 5 – 6 days a week. I was not extremely obese but my GP referred me to get some help and all I got was fat shamed by a woman who looked anorexic. So I have little time for her or her crusades.
  - Psycho Milt 1.2.1
    
    17 December 2015 at 11:56 am
    
    …withholding the drugs that could have made a difference – Metformin for someone with pre diabetes on the grounds that they needed to make better food choices and not rely on drugs….
    
    Pretty rich when you consider the “better food choices” people like Toomath were recommending raised your risk of Type 2 Diabetes rather than lowering it.
  - Rosie 1.2.2
    
    17 December 2015 at 11:58 am
    
    Ditto +1 to Stephanie and +1 to you too Lucy.
    
    When I heard the news on RNZ that Robyn Tootmath was standing down I said out loud “good riddance hater”. She may have had some some genuine concern for public health but it never came across like that. Just from her tv interviews all I saw was a person who was intolerant of and disgusted by fat people. To her fat people are people who need to be whipped into her ideal of what healthy person is, and only then would they become acceptable to society.
    
    It sounds like you had an unpleasant and totally unhelpful experience with her.
    
    There is so much to the topic of obesity and I haven’t got time to delve into today – Stephanie has covered off a lot of good areas in her boots theory posts and I would recommend that haters, or even people who are confused by mixed messages and want to know more, should read them.
    
    What I will finish on is my observation that in the media the line between public health concern and fat shaming is razor thin. Faux concern for the public health ‘burden” all too easily falls into the pit of fat shaming and abuse. The notion of “Public health” can be such a convenient foil for hatred.
    
    If people care so much about “public health” all of sudden then where is the concern for painfully real and damaging public health issues like suicide?
galeandra 2

16 December 2015 at 10:40 am

Slapdown. Counterfactual?? Hah. Just a rant, an opinion- fest. You use the fat word btw, obesity’s realities are often quite different, and scarily, quite often out of sight.
Psycho Milt 3

16 December 2015 at 11:13 am

Progress on this major public health issue has been set back by a decade because we elected a useless National government.

Who’s in government makes no difference. The population’s been getting steadily fatter regardless of who’s in power, since we were dumb enough to let self-proclaimed “experts” convince us we needed nutritional guidelines. Toomath is part of the problem, not the solution – if the rest of the “healthy food” witterers would also quit, we might get somewhere.
- Corokia 3.1
  
  16 December 2015 at 10:43 pm
  
  Your comment presumes that the increase in obesity is a result of the population having actually paid attention to and acted on the advice of “healthy food” witterers.
  
  Are there not to be any guidelines or advice on ‘healthy eating’?
  - Psycho Milt 3.1.1
    
    17 December 2015 at 6:10 am
    
    That presumption is correct. After decades of propaganda, it’s “common knowledge” (ie false information that people imagine to be true) that animal fats, animal products in general and red meat in particular are bad for you, and that your diet instead should largely consist of grains, vegetables and fruit. Even people who imagine they’re not paying attention to or acting on the advice of “healthy food” blatherers have absorbed that propaganda.
    
    This “knowledge” is slightly less pervasive among the poor, but still pervasive. The poor always tend to have higher rates of obesity because shit refined carbs are always way cheaper than real food, but these days they have the additional problem that they’re constantly being bombarded with advice from “experts” that their diet should instead consist of slightly-less-shit somewhat-less-refined carbs.
    
    And yes, it would be better to have no nutritional guidelines at all than guidelines that are guaranteed to increase obesity and (more importantly) its associated illnesses.
NZJester 4

16 December 2015 at 11:22 am

Why is it that a lot of the unhealthy items are so much cheaper than the healthy ones?
If you are thirsty and away from home and need to buy a drink for some reason it is cheaper to buy a soft drink than it is to buy a bottle of water. I still do not understand how is it that a soft-drink that takes far more processing to make than a bottle of water does can end up cheaper on the shelves. When I was younger water fountains used to be available in most of our public parks but due to vandalism are now all gone. A lot of venues will not let people bring in there own food or water and then price gouge them for those essential items once they are inside and again the unhealthy items are cheaper. Most healthy foods for sale tend to also be far more expensive to by than the unhealthy alternatives. When it is far cheaper to eat and drink unhealthy, can you blame the poor for becoming fat?
Amanda Atkinson 5

16 December 2015 at 11:40 am

“When it is far cheaper to eat and drink unhealthy, can you blame the poor for becoming fat?” … Bullshit! …that is biggest myth told to, and excuse used by the poor. I’ll show anyone how to feed family of 4, with fresh healthy food for $25/day, giving them 3 meals. How do I know? We do it. Which fast food joint can you get 3 meals a day for $25? None. So stop talking shit and stop repeating the lies the media tells. Fast food is NOT cheaper than healthy food. If you want to be helpful, spread that message, and teach people (like I do), how to give their kids healthy food, for the less than they spending on junk food. You are part of the problem. Get your facts right.
- Lanthanide 5.1
  
  16 December 2015 at 11:43 am
  
  If you actually read the context of the comment, you will see they were talking about convenience food and food eaten away from the home.
  
  If your kids go down to the park to play, sure you can send them off with a drink bottle, but most families wouldn’t. There used to be water fountains they could use while at the park – now they can’t. So they buy something from the diary on the corner – and they buy a sugary drink because it’s cheaper and tastes better than water.
- Whispering Kate 5.2
  
  16 December 2015 at 11:54 am
  
  Amanda
  
  It would be far more helpful to give examples of how you feed your family of four for $25.00 for 3 meals daily. . That’s a productive attitude to have, we would be appreciative believe you me if you would do that. My days of feeding my family of four are gone now but I remember that I, like you, also fed my family wisely on healthy food. My kids never knew what a biscuit packet looked like in my pantry but would gets treats when they were due. They are now in their late 30’s and have never had a cavity filled in their teeth and I am proud that it was the effort that helped with that. We are not all clever clogs and can budget that well and I am sure they would love to get some help and advice.
  
  Write a blog page and give out of samples of your daily food ideas, I am sure people struggling with poor wages and high rents plus those unfortunates who through unemployment or sickness have to make ends meet on very low incomes would really welcome the idea. They are not, as I think,you think they are, lazy sods, not at all as I know people on very low incomes and not everybody is as clever as you. Be generous in your thoughts this Christmas and make a New Year’s resolution to share your ideas and get those ideas out to people who need them the most.
  
  Happy Christmas to you.
  - ICD 5.2.1
    
    16 December 2015 at 4:30 pm
    
    Kate (and Amanda), unfortunately there are no $-values attached to this cookbook, but it’s been put together by WINZ, so chances are it’s close and it’s full of useful info: http://www.workandincome.govt.nz/documents/brochures/the-great-little-cookbook.pdf
    
    Then there are, and yes I know, big supermarket chains etc., the Countdown’s of this world offering dinner ideas feeding 4 for $15. No doubt other services out there will provide similar guidance and ideas.
    
    None of it is a silver bullet, but by god, vege is cheap when bought in season and other items when bought in bulk. Team up with neighbours, family, friends. Buy bulk, save and split the goodies.
    
    Lanth, the idea of sending your kids out to play with a bottle of water is a no-brainer in my book. It’s healthy, cheap, i.e. virtually free and if you’ve not got much to go around, then preparing in advance is a must. It’s those impulse, away from home purchases that are putting utterly unnecessary strains on finances. Granted, some venues won’t let you, but taking bottled water/drinks and something to nibble on for the movies for example is doable, no need to purchase overpriced anything.
    - tracey 5.2.1.1
      
      17 December 2015 at 7:51 am
      
      Countdown’s $15 feeding 4 would not work well for a family where 2 were adolescent boys.
Bill 6

16 December 2015 at 11:54 am

I’m not going to find this link, but on the whole BMI thing, a study found that those determined to have a higher than optimal BMI were actually healthier than those who were in ‘the normal’ range. The conclusion was that people were being encouraged to be too thin and that it was damaging to health.

But yes, alcohol (sugar), grabbing take-a-ways for lunch (carbs and sugar and fat), eating out, buying from ‘chemical central’ isles in the supermarket (sugar and fat), not eating at optimal times or timings and not eating optimal amounts (rush down lunch in 10 min, load up at night when we’ve slowed down)…I agree it’s systemic ie, imposed on us by work environments or environments of poverty, environments demanding ‘fast’ living etc.
- David 6.1
  
  16 December 2015 at 12:37 pm
  
  There is a correlation between being slightly ‘overweight’ and better health. That drops very rapidly once you pass into obese territory.
Colonial Viper 7

16 December 2015 at 12:23 pm

Is “stress and poverty” really major drivers of obesity?

Then the question is:

How is a Labour led government going to make peoples lives less stressful and hard, and more meaningful? Labour doesn’t believe in giving beneficiaries any more money but does believe in giving beneficiaries more difficult hoops to jump through.

3 terms of the fifth Labour Government did nothing but level off child poverty at Ruthanasia levels.
- weka 7.1
  
  16 December 2015 at 6:07 pm
  
  Half a day and nobody bit 😉
  
  Write a post mate, and we can all hash it out.
Mrs Brillo 8

16 December 2015 at 12:25 pm

What’s a poor National government to do?

Put curbs on junk food purveyors, including in schools?
Not Pygmalion likely. (We couldn’t wait to reinstate them, it was our first act when we took office.)

Put curbs on supermarket chains?
Wash your mouth out with soap.

Put curbs on TV channel owners’ right to wax fat, er, sorry, rich on junk food advertisers’ money?
We’ll wash out your mouth for you, this time using a loo brush.

Put stricter rules around alcohol sales and advertising?
You’re kidding, right? Would that mean we had to pay retail?

Take GST off fresh fruit and veg?
That’s not funny.
Because then we couldn’t pay for the flag neverendum, or give tax bribes to our corporate backers.

What do those frigging experts know about endocrinology anyway? If we don’t like their science, we can always find a second opinion.

St Ayn of Rand (our expert of choice) said that the best solution was to put the whole thing back on Personal Responsibility. Blame the afflicted. It’s very cost-effective, too, saves us a packet.
- Psycho Milt 8.1
  
  16 December 2015 at 1:39 pm
  
  In the sense that National won’t do any of the things in paras 2 to 5, it’s fortunate we have a National government and not a Labour one. All of those actions would impose additional regulatory complexity and compliance costs, for a net reduction in obesity of somewhere between zilch and fuck-all. The fact that National won’t do those things is one of its few good points.
  - Colonial Viper 8.1.1
    
    16 December 2015 at 4:47 pm
    
    Let’s start fining people with a BMI over 25. It won’t help them lose weight but it will help the Crown to a surplus.
    - Ad 8.1.1.1
      
      17 December 2015 at 2:47 pm
      
      Wow that’s dark!
Naki man 9

16 December 2015 at 8:46 pm

Nice work CV
A fat bastard tax.
Benoni 10

17 December 2015 at 12:59 pm

The article mentions how there are large numbers of obese children from the lower socio-economic groups. We could kill two birds with one stone here….by saving money on the cost of excess food for these obese children we can reduce obesity and put money in the pockets of the poor. This is a win-win situation.
- McFlock 10.1
  
  17 December 2015 at 1:42 pm
  
  Because obesity is related only to quantity of food… oh, wait. It’s not.
- Draco T Bastard 10.2
  
  17 December 2015 at 1:51 pm
  
  IIRC, obesity is more due to poor diet than excess food. The poor diet is brought about by good food costing too much.
  - David 10.2.1
    
    18 December 2015 at 2:13 pm
    
    The laws of thermodynamics say that isn’t correct. To be obese, you need to eat excess food.
    - Draco T Bastard 10.2.1.1
      
      18 December 2015 at 2:53 pm
      
      http://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/
      
      An article I read a few years ago pointed out that a lot of people eat excessively due to poor diet. Basically, they eat more because they’re not getting the vitamins/minerals that they actually need from the food that they ate meaning that they always felt hungry.
      
      Put them on a good diet and that feeling of being hungry goes away.
      
      http://www.sciencedaily.com/releases/2015/10/151027074759.htm
      
      “When we took the sugar out, the kids started responding to their satiety cues,” said Schwarz. “They told us it felt like so much more food, even though they were consuming the same number of calories as before, just with significantly less sugar. Some said we were overwhelming them with food.”
      
      The cheap food on the market has huge amounts of added sugar.
      - David 10.2.1.1.1
        
        19 December 2015 at 1:01 pm
        
        “Put them on a good diet and that feeling of being hungry goes away.
        
        http://www.sciencedaily.com/releases/2015/10/151027074759.htm”
        
        That ‘study’ doesn’t deserve to be anywhere near anything that calls itself science. No control for a start, so there is simply no way of knowing what has changed at all. As well as that do you really think that cutting sugar (if they really did) and replacing it with the following;
        
        “The food choices were designed to be “kid food” — turkey hot dogs, potato chips, and pizza all purchased at local supermarkets,”
        
        Is improving nutrition in any significant way? 43 kids and 10 days, and no control makes for a worthless waste of time as a study. On top of it all, it’s a self-reported study! Anyone who has done any work in nutrition knows that self-reporting is very inaccurate when dealing with people with food problems.
        
        His last claim is that “This study demonstrates that ‘a calorie is not a calorie.’ If he actually proved that with some actual science he would be up for a Nobel. He isn’t, because it’s junk science, junker than the food he was feeding those kids.
        
        It is possible to be overweight and malnourished, but that doesn’t change the fact that to be overweight you have to be eating too many calories.
        
        Draco T Bastard 10.2.1.1.1.1
        
        19 December 2015 at 2:35 pm
        
        That ‘study’ doesn’t deserve to be anywhere near anything that calls itself science.
        
        Have you got anything to back up your assertion?
        
        Because I’m pretty sure that the University of California crossed the t’s and dotted the i’s. And the article even says that it was controlled.
        
        Basically, you seem to be talking out your arse because your beliefs are being proved wrong.
    - Psycho Milt 10.2.1.2
      
      18 December 2015 at 3:07 pm
      
      The laws of thermodynamics express no opinion the matter. The human body isn’t a closed system, its ability to extract calories from food depends on the efficiency of the chemical pathways involved in digesting it, and the question of whether excess calories get stored as fat involves processes that don’t reduce to “calories in vs calories out.”
      
      To be obese, you need to eat excess food.
      
      To be obese, you need to be storing excess blood glucose as fat, which requires surplus quantities of both glucose and insulin in your bloodstream. “Excess food” may or may not be involved.
      - David 10.2.1.2.1
        
        19 December 2015 at 1:15 pm
        
        For the vast majority of people, it does boil down to a calories in vs calories out equation. If excess food isn’t the source of the fat being stored for the 31% of the New Zealand population that is obese, where exactly is it coming from?
- Colonial Viper 10.3
  
  17 December 2015 at 3:38 pm
  
  Coke cheaper than milk etc.
  - alwyn 10.3.1
    
    17 December 2015 at 4:49 pm
    
    That is, as always, a ridiculous comparison.
    Coke is an alternative to water, not milk. One is a drink to quench your thirst. The other is a food.
    Water is, for all practical purposes, free in the quantities anyone is likely to drink. A litre/day would cost, even in Auckland, only about 1 cent per week. (If I got the decimal point correct). It also has some other benefits such as strengthening your teeth via the fluoride rather than, like coke, rotting them.
    - Draco T Bastard 10.3.1.1
      
      18 December 2015 at 2:56 pm
      
      Coke is an alternative to water, not milk. One is a drink to quench your thirst. The other is a food.
      
      What a load of bollocks. Coke is food as the huge amount of sugar in it shows never mind all the rest of the BS in there.
      - alwyn 10.3.1.1.1
        
        18 December 2015 at 7:31 pm
        
        If you regard Coke as food because it is largely sugar I hate to think what the state of your health is.
        I hope you don’t sit down to breakfast and have a couple of hundred grams of sugar and regard that as healthy
        
        Draco T Bastard 10.3.1.1.1.1
        
        18 December 2015 at 8:20 pm
        
        Sugar is a food no matter how much you want it not to be. Sure, it needs to be taken in moderation but that doesn’t stop it from being a food in the first place.
  - David 10.3.2
    
    18 December 2015 at 2:11 pm
    
    Of course coke is cheaper than milk. Milk requires refrigerated transport from source to consumption as well was far more complex processing.
    
    Coke is water with some sugar and bubbles, and water, sugar and bubbles are all very cheap.