Depends on what you fill the glass with.

Subby may think it's obvious, but science is full of things that are "obvious" and are used to shape policy... but which turn out to be at best useless, at worst harmful. See for example the entire history of screening for early stage cancer, which is full of examples of screening that does more harm than good.

In this case, it's pretty reasonable to ask: do fat teens grow out of it by themselves, or are they saving up health problems for later? What about pre-teens? What about infants? How early should we intervene to prevent later problems? Where is it most cost-effective to spend limited healthcare dollars?

/We now return you to your regularly scheduled snark and mockery of fat kids

BronyMedic: As a Paramedic, I firmly support the rights of every American to indulge in any number of unhealthy behaviors, including obesity.

For me, it's job security. And a chance to test these nifty paddles on the Lifepak.

Why do you liberals hate job creators and American freedoms?

Meh, even if the trend begins to reverse itself, which seems doubtful, you'll still have plenty of time to play with that. Don't forget the Boomers, they should provide a good amount of work all on their own.

>anecodotal evidence

You do realize that those words don't go together?

LegoLewdite: WhippingBoy:
Exactly. It's just like my grandfather's situation. He smoked 2 packs of unfiltered cigarettes a day and lived until he was 97 (died in a car accident). Because smoking didn't cause *him* any health problems, smoking, in general, must not be bad for your health.

Well, not exactly. The articles I read weren't supported by such anecdotal evidence nor were they alluding to some sort of risk analysis. For a small but significant portion of the population, a larger body type simply has no negative health consequences. i.e. More weight does not necessarily correlate into coronary or cardiac problems or diabetes. The only drawback for them is it's probably harder to get dates.

From what I understand, however, most of the studies, while the subjects were overweight, they still had at least a moderate amount of daily activity, which I think most of the researchers emphasized was really the key to being healthy, and not a reasonable number on the scale. In fact, if you went too far the other way, being underweight, you were as much at risk for health issues as being obese. Also if your distribution of fat was more towards the stomach, versus the hips and thighs, your risk increased as well.

But, as a few people stated, getting people to realize when they are at risk and do something about it is the difficult part. Our neighbor's granddaughter always kvetches about her weight, she's 14, I'd guess she could feasibly drop about 30 lbs and still be within the normal range, and I offer to take her running, have her help me walk my dogs in the evening, etc. but to no avail. My husband's offered to get her on the swim team at his facility, but that hasn't been productive either. Her grandmother keeps telling her to take care of herself now, as she didn't when she was younger, or she'll be setting herself up for problems, but, she's a farkin' teenager, when does she want to listen to adults? Shaming hasn't worked, as she's been teased about her weight at school and she just shrugs it off.

WhippingBoy: I think the problem is that people don't have a lot of sympathy for people who:
- are dissatisfied with some aspect of their life
- apparently have the power to change it
- yet fail to do so

FTFY.

One of the strange things about obesity is the way that it leads otherwise perfectly intelligent and analytical people to make moral judgments: people are fat because they are lazy, greedy, or weak. I have no idea why that is; one guess is that all of us would love to chow down on pizza and cheesecake, and those of us that resist the temptation feel instinctively that those who don't should be "punished". It's a very deep instinct.

But the reality is that we are not nearly as in control as we like to think. That person eating too much pizza? They may simply not "feel" full the way you do.And the reason they don't feel full is because an enzyme that's supposed to be released in the stomach and signal "full" to the brain isn't being released. And the enzyme isn't released because key gut bacteria that mediate the signal were killed by all the antibiotics they took in childhood. And unlike you, they feel hungry all the time. Telling them to "eat less and exercise more" doesn't help them as long as their appetite is broken. Fixing their gut bacteria first might actually put them in a position to get better.

daniesmiley: Orrr they need to change what they eat, stop eating empty calories, drink more water and slowly shrink thier stomach so they aren't as hungry all the time.

It's all about self control and mind over matter, if someone really wants to change they will.

"For every complex problem there is an answer that is clear, simple, and wrong." -- H. L. Mencken

I assume you've met "them", and that's how you know that "they" eat empty calories, etc.? Feeling sated is a very complex phenomenon that requires a whole chain of connections to work right. And in many people, it doesn't. They may want to change what they eat, just like I want to win the New York Marathon, but their bodies overrule them. But hey, feel free to dismiss an incredibly elaborate physical mechanism if it helps you feel morally superior to the fatties. I'm sure there's nothing that your body ever wants to do that you give in to and feel ashamed about afterwards...

WhippingBoy: I think you're taking a possible edge case and assuming that it holds for everyone. Unfortunately, a lot of people will grab on to this and loudly declare that because they haven't lost weight, there must be some complicating factor that renders them incapable of losing weight. As far as I know, there's simply no credible reason to believe that the vast majority of overweight and/or obese people are incapable of losing weight through "regular" means (e.g. fundamental changes in their lifestyle).

If that is true, then why doesn't it work? Why do we have a huge diet industry, a huge exercise industry, and a huge obesity epidemic? Maybe it's time to give the whole "people want to but can't" reason a closer look... especially if it's fixable?

If you are open-minded you would probably enjoy the latest research on the interaction between gut bacteria and metabolism, appetite etc. There's a highly accessible article in the current Scientific American on the current thinking. For instance, it's beginning to appear that indiscriminately eliminating H. Pylori, implicated in stomach ulcers, might not have been such a good idea after all. It turns out it may also play a role in moderating appetite.

There's been a long-standing suspicion among researchers that something environmental is contributing to obesity, and screwing with our symbiotic microbes with repeated doses of antibiotics is beginning to look like much more than an "edge case".

And sure, some people will see this as an excuse -- just like a generation ago people claimed to have slow metabolisms, and before that to be big-boned -- but less so, perhaps, once they learn that once their gut microbes are fixed, they're out of excuses.

If you're going to ask people to eat less and exercise more, would it be such a bad thing to first ensure that their body will let them do so, especially if the fix is relatively simple?

daniesmiley: I do agree with you there are many different reasons that the population is overweight.
Giant portion sizes (drinks and food), high salt/sugar/fat ratios and cheap pricing on fast food makes for easy bad decisions.
But poor metabolisms, high caffeine intakes, and a sedentiary lifestyle isn't helping either.

And it's not an easy fix... even though it sounds like one. Everyone has an excuse why they don't workout or why they eat the way they do. But like you said there are sometimes underlying issues.
Medicines, depression, anxiety and horomones can play a part as well, its all about finding your presonal balance.

Yes to all those things. They all play together. For example, there could be a McDonalds on every corner and it wouldn't make me fatter, because I don't feel hungry all the time, and my tastes haven't been trained to crave salt and sugar hits. Conversely, having an ill-regulated hunger response wouldn't be such a problem for somebody were it not for the fact that they can get 2000 calories of sugar and transfat for a couple of dollars... and 30 minutes crave it again. Fixing appetite is just Step One: it's just like telling somebody "you need to exercise more, but first we need to fix that broken leg"... except that appetite is far less visible to outside observers, and therefore much easier to blame on "lack of self-control". It's all about giving people tools and taking away excuses.

I'm just starting school (again) to become a RD, I'm really interested in the field.

I can't wait to learn more

Good for you. I'm too old to be more than an interested observer, and the world needs people who take a more nuanced view than the "eat less/exercise more/apply willpower" approach.