Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

The Consequences of Obesity

In the current social climate there is a reluctance to admit that obesity is a disease that requires treatment analogous to alcoholism.

While obesity is not a classical addiction it’s consequences are just as serious as those of alcoholism and its treatment is similar in that it involves a change in lifestyle choices. Ice cream, cheese cake, cookies, Twinkies, chocolate bars, potato chips, etc. are as addictive and as useless as alcohol. The incentive to make fight addiction is undermined by acceptance of the disease and by the moral hazard effect of lifestyle drugs.

The Internet is awash in sites like this that promote the idea that it’s OK to be obese as long as one is accepted and has self-respect. Here are some euphemisms used to avoid saying obese.

BBT – Big Beautiful Teen
person of size
BBW – Big Beautiful Woman,
BHM – Big Handsome Man,

Would anyone use these terms for an alcoholic?

DBW – Drunken Beautiful Women
person of ethanol
IHM – Inebriated Handsome Man

Here is a typical plea from a site, equating obesity with a clearly genetic characteristic like skin color:

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By Peggy Hoehne

Fat people are often considered to be a lower class of human being. They are ugly, scary because they show a lack of control, and obviously less intelligent than their thinner counterparts.

These attitudes are totally unacceptable these days when aimed at race or religions, but they are still being aimed at fat people each and every day. We all deserve the right to walk down the street without hearing derogatory comments, to go shopping without being insulted by the clerks, and to go out in public without being made physically uncomfortable because everything is too small for us to even sit down.

How do we change the preconceived notions of society? I don’t know, but I do have some ideas. We strongly support Hollywood when they cast people like Carmen Manheim, Kathy Bates, and even Roseanne in major rolls.

We can individually support local businesses that show that they support all people. If a business has taken the risk of hiring someone of size in a public position, let them know what that means to you. You can do this best by frequenting this business.

Support each other. You know you do not like to hear unpleasant comments about your size so be sure you are not making comments on anyone else’s size. I know all too often I have thought that I am OK because I see other people bigger than I am. That is not a good attitude. I am OK, because I am an OK person and so is that person who is larger. We do not need to find someone else worse off than us to make us feel better. Can I only be intelligent if I find others with less intelligence? Can I only be good at the things I do if I find someone who doesn’t do them as well? This is a very unprofitable way to determine our own self esteem.

Wherever we go, whatever we do we need to remember we are important individuals. I will remember to hold my head up high, look people straight in the eye, and be the best person I can be. I have no need to apologize to anyone for my size.

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Now here are the consequences of obesity that our society prefers to ignore at its peril. Everyone pays the price of the consequences of obesity. Regardless of whether one has public or private disease insurance one’s premiums are much higher because of the huge costs of treating the consequences of obesity. Even the cost of airline, train and ferry travel will increase because of the pandemic of obesity.

1. Type 2 Diabetes

By far the most serious. DM2 leads to many disabling conditions and shortens life expectany. Among the complication of DM2 are:
atherosclerosis
kidney failure
blindness
leg amputation
peripheral neruopathy

2. Osteoarthritis

If the population of North American all had a BMI under 25 orthopedic surgeons would be begging for patients.

Need for replacement hips, knees expands with obesity rates

BY HELEN BRANSWELL

THURSDAY, AUGUST 18, 2005

CANADIAN PRESS

A new report draws a direct line between alarming obesity rates and sharp increases in knee and hip replacement surgeries, a finding experts warn should be a wake-up call for Canadians concerned about the health of their joints — and the cost of their health care.

The report, from the Canadian Institute for Health Information, showed that people who were obese had joint replacement surgery at three times the rate of people with a healthy body weight. People who were overweight were twice as likely to undergo joint replacement as individuals with a healthy weight.

“Essentially when you connect the dots, the reality is we have a choice here. Either we’re going to, as a nation, take some weight off or we’re going to have a lot more hip and knee replacements,” Michael Decter, head of the Health Council of Canada, said when asked to comment on the report. It has been known for some time that carrying excess weight puts individuals at risk of developing osteoarthritis, a condition that can lead to the need to replace knee or hip joints. And it has been known that the number of Canadians undergoing these operations has risen sharply in recent years. In fact, the report notes the number of these surgeries has doubled in the past eight years. That increased demand has lengthened waiting times for joint replacement operations.

A report this year said that Ontario patients waited an average of 33 weeks for knee replacement surgery and 24 weeks for a hip replacement. Olga Huk, an orthopedic surgeon whose practice is entirely joint replacements, said the correlation between weight and joint replacements is concerning when viewed in the context of the aging baby boomers, many of whom are approaching later life with more than a little excess baggage. “The big issue now is that the baby boomers, which represent a huge chunk of the population, are in this group of people that are progressively increasing their body weight over time,” said Dr. Huk, who practises at Montreal’s Jewish General Hospital. “And this is also the group of people that’s coming up to be in the age group that they’re going to require joint replacements, which is between the ages of 65 and 75. “When they get to that age . . . there’s going to be an epidemic rise in the need for joint replacement.”

The report, which is based on figures from 2003-04, showed that nine of 10 people who had a knee replacement were overweight or obese and seven of 10 people who had a hip replaced were in those weight categories. “If we reduce the prevalence of arthritis by addressing obesity, we could decrease the number of joint replacements required. This could in turn improve the quality of life for Canadians and at the same time could potentially shorten waiting times for these procedures,” said Margaret Keresteci, the institute’s manager of clinical registries. Forty-six per cent of people who had a joint replacement were considered obese, defined as having a body mass index of 30 or higher. (BMI is an approximation of body fat based on height and weight.) About 35 per cent of the joint replacement patients were considered overweight, meaning their body mass index ranged from 25 to 29.9. Only 18 per cent of the joint replacement patients had what was considered an acceptable weight, a body mass index of between 18.5 and 24.9.

Mr. Decter said the data show it’s time for an assault on the obesity problem similar to the successful campaigns that dramatically cut smoking rates in Canada. “If we don’t want another two decades of ramp [up] in total hip and knee joint replacements, we have to — as a nation — do something to, I guess, whatever the opposite of ‘supersize’ ourselves is, to take some weight off and be healthier.”

3. Non-alcoholic fatty liver disease

If you saw “Super size me” you saw a man get fatty liver disease in one month by eating excess calories and getting abdominally obese. One in four people with fatty liver develop serious liver dysfunction that may require liver transplantation. This consequence of obestiy is rapidly overtaking alcoholism as a cause of liver dysfunction requiring transplantation.

4. Transportation Expenses and Fatalities

Airplanes and ferries can only carry a maximum weight or they will crash or sink. As people weight more and more, the number of passegers per trip must be reduced and the cost per passenger increases.

How much we weigh

Nov 1, 2004

Talk-show host Jay Leno takes regular shots at the obesity of Americans. Whatever the news item — talking bathroom scales, refrigerators with see-through doors — he will begin this way: How fat are we getting in this country that we. . . ? Thanks to the Transportation Safety Board of Canada, Canadians know how fat we are getting. We are getting so heavy that the average passenger weights used to calculate whether an aircraft can safely take off will be increased as of next Jan. 20. The board called for the change, and Transport Canada made it official in a policy letter last month.

The board was spurred by its investigation of the crash last January of a Cessna Caravan. Shortly after taking off from Pelee Island, Ont., the plane hit the ice-covered surface of Lake Erie. The pilot and all nine passengers died. Investigators found that the aircraft had been overweight by 1,270 pounds (572 kilograms), almost half of which could be accounted for by the people on board. Their weight had been calculated the way airlines habitually calculate passenger weights, using the standard figure in the Aeronautical Information Publication, a manual handed out to all licensed pilots in Canada. By that measure, those aboard the Cessna weighed 1,833 pounds. Their actual weight, including their clothes, was 2,400 pounds.

As of Jan. 20, males over 12 years old will be assumed to weigh 200 pounds (91 kilograms) in summer and slightly more in winter — an increase of 13 pounds from the previous standard. Females over 12 will be assumed to weigh 165 pounds (74.2 kg) in summer — an increase of 25 pounds. Carry-on bags will be assumed to be five pounds heavier. The revisions may cause headaches for the airlines, which must determine whether they can still carry as many passengers as before and still meet their weight limits. The new rules may complicate the lives of pilots of small aircraft, since Transport Canada is considering requiring flights with fewer than 10 passengers to weigh each person before they board. But it’s hard to argue with safety, and with the need to be sure a plane’s weight is within acceptable limits.

Even the increased weights may not reflect how heavy Canadians are. The figures were derived from Statistics Canada’s 2003 Canadian Community Health Survey, which interviewed 135,000 Canadians between January and December of last year. The survey relied on respondents to say how much they weighed and how tall they were. Trouble is, as Statscan notes, humans fib about such things; they underestimate their weight and overestimate their height. “This can lead to potentially substantial underestimates of obesity and overweight.” When a Prince Edward Island study went to the trouble of weighing and measuring 2,000 subjects, it indicated how big the deception could be.

In the June issue of the Canadian Journal of Public Health, the researchers concluded that the actual percentage of overweight Canadians is between 10 and 20 points higher than their statements would indicate. Statscan says its next survey, to be published next fall, will be based on real measurements. But the 2003 survey’s findings were worrying enough. Statscan used the international standard of body mass index (BMI), which divides a person’s weight in kilograms by the square of that person’s height in metres. This is a controversial measure, since it takes no account of a person’s level of fitness, which is a major indicator of health. But it does allow for a rough comparison across countries and populations. A BMI below 18.5 is considered underweight, between 18.5 and 25 is normal, between 25 and 30 is overweight, and above 30 is obese. The Statscan survey found that 14.9 per cent of Canadians were obese in 2003 — an increase from the 1996-97 figure of 11.9 per cent. That the United States is faring even worse is little consolation. Obesity can contribute to the onset of diabetes, to hypertension and to heart problems, and the fact of being obese in a society that inordinately prizes the skinny can cause psychological distress. The increase in obesity helps explain the increase in average weights. Though the year-over-year figures aren’t precisely comparable, the National Population Health Survey calculated in 1996-97 that Canadian men between 20 and 64 weighed an average of 183 pounds. As noted earlier, the 2003 figure for males over 12 is 200 pounds. Women in 1996-97 weighed an average of 145 pounds. The figure in 2003 is 165 pounds.

Yes, the statistics are imprecise. But given the other evidence compiled over the years about Canadians’ lack of exercise and love of high-fat processed foods and high-calorie drinks, as a society we delude ourselves if we think the numbers mean nothing. North Americans live in a convenience society that encourages overconsumption and underexertion. Now that even our planeloads have to be reconfigured to account for our weight gain, it’s time to look at our habits and resolve yet again to give moderation a try.

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Special ambulance handling obese in Vegas

LAS VEGAS (AP) March 31, 2006— An ambulance company has responded to oversize needs in southern Nevada by providing an ambulance equipped to handle patients weighing 500 pounds or more.

“We’re getting more and more requests to transport larger patients every day,” said Roy Carroll, operations manager at American Medical Response, one of two companies with Clark County Fire Department contracts to provide medical transport in and around Las Vegas.

Crews have called 75 times in the last six months for additional manpower to handle morbidly obese patients, said Chris Piper, a western regional spokesman for Greenwood, Colo.-based AMR. He said the largest patients weighed more than 500 pounds.

Carroll, in Las Vegas, called handling large patients difficult and unsafe for patients, paramedics and emergency medical technicians. “Not only does this person not fit, there’s a chance he or she could fall,” Carroll said. “Our job is to get that patient to where they need to be safely and in a dignified manner. Traditional ambulances can’t do that.”

The company recently put into service a $250,000 bariatric ambulance, which looks like its other 80 ambulances, but is extra-wide and has a larger gurney, a winch and ramps capable of loading up to 1,600 pounds. Clark County spokesman Bob Leinbach called the need for the larger ambulances obvious. “If you don’t think it’s needed, all you have to do is look around,” Leinbach said. “Americans are heavier.”

The county’s other ambulance provider is awaiting delivery of a bariatric ambulance and recently bought four electric gurneys capable of handling patients weighing up to 750 pounds, said Matthew Cox, a spokesman for MedicWest Ambulance. “There’s less stress on the paramedics’ backs and it’s a better stabilizer for the patient,” Cox said.

Of Nevada’s 1.7 million adult residents in 2004, the federal Centers for Disease Control and Prevention and the state Health Division estimated that 21%, or about 357,000, were obese.

5. Obstructive Sleep Apnea

OSA was almost unkown 30 years ago. It is now epidemic in North America.

To quote the Mayo Clinic site: A fat or thick neck tends to narrow the airway in your throat. A possible indicator of obstructive sleep apnea is if the diameter of a man’s neck is larger than 17 inches, or if a woman’s neck is larger than 16 inches around. Fat deposits around your upper airway may be a factor in obstructing your breathing during sleep.

6. Pulmonary Embolism

Blood clots in the veins of the legs are much more common in the obese and can cause death when the clots dislodge and block blood flow to the lungs.

7. High Blood Pressure (Hypertension)

One Response to “The Consequences of Obesity”

  1. Obesity is now declared a disease! If so, it is a disease of affluence and most people afflicted by it, are obsessed about the difficulty of losing weight, whereas I believe the solution is quite simple.

    As a kid I grew up in New Zealand during the 2nd world war, when food was scarce and rationed. I remember only 2 kids at primary school who were overweight. One lived on a farm and ate dairy and other foods which were obviously not rationed or at least, were hard to ration by the authorities. The other had no interest in physical activity, but loved eating, particularly fatty fried food. Overweight adults were a rarity, as they are still in poorer societies.

    I walk along the streets of Balmain in Sydney after schools are out and most kids are eating ice creams, or consuming sugary drinks, bought for them by their mothers! When I grew up, the standard of living was much lower, but an ice cream or lemonade was a special treat, bought for me rarely.

    Today, in the 1st World, the majority of adults are overweight, many grossly and hideously obese. During my frequent business trips to the USA in the nineties, I was taken once to dinner by an obese company representative to Ur Cooks in Houston, Texas, where we selected our own steaks, cooked them and added cooked vegetables. The concept was ideal for feeding yourself a healthy nutritious meal. My host selected an enormous steak about 2 inches thick, covering most of his plate, cooked it and added copious vegetables that almost fell off his plate. I selected the smallest steak available – still large in my view, added vegetables, ate my meal, feeling I probably could have eaten more, but pleasantly satisfied.

    The answer to obesity is common sense. If anyone is overweight, they must stop being be so greedy, but select nutritious food of a quantity that doesn’t make them feel (and look like) like a stuffed pig.

    Most obese people blame everyone but themselves – they have tried everything, they say – their genes are wrong (if so, they are lucky, they have an efficient metabolism and don’t need much food to remain functioning and healthy – would have been great in the ‘hunter/gatherer’ days) – they love sweet things – fast food is so tasty (lots of salt and fat!). There were no fat people in those horrendous concentration or POW camps during the 2nd world war.

    Has old fashioned, self discipline just gone out the window? For goodness sake, can’t humans stop putting food in their mouths! They don’t need a fad diet. In the blog on my site, ‘Lose Weight’, (See http://fitnessforum.us), I specify how to live a life that will banish obesity – to live longer and enjoy the years much more – obese people must simply resolve themselves NOW – only they can do it and it is simple.

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