Talk:Obesity

Review of obesity in the developing world

Caballero B (2001). "Introduction. Symposium: Obesity in developing countries: biological and ecological factors". J. Nutr. 131 (3): 866S–870S. PMID 11238776. {{cite journal}}: Unknown parameter |month= ignored (help)

--Doc James (talk · contribs · email)

This article is horribly biased against the obese

If you read this article you believe obesity exist because lazy people eat too much. It makes no mention of changes in food production(such as the use of high fructose corn syrup)or analgesics(which slows metabolism). The idea that corporations are totally innocent or that this is just pure laziness is a spiteful argument. —Preceding unsigned comment added by YVNP (talk • contribs) 09:16, 3 July 2009 (UTC)

Doesn't read like that to me at all, and I'm what would be considered morbidly obese. If I disagreed with the articles POV I wouldn't have put my pics up to be used on here. - FatM1ke (talk) 11:43, 3 July 2009 (UTC)

I agree that these areas above need further discussion. They are however discussed somewhat under social determinants of obesity. I have not yet have time to add more of this content but will at some point. Thanks for the comments.--Doc James (talk · contribs · email) 18:29, 3 July 2009 (UTC)

Alright I'll add the information. I know from medical reports pain killers cause fast weight gain for one. I'll add themYVNP (talk) 18:54, 3 July 2009 (UTC)

Yes if it is well referenced please do. For medical stuff best to reference to a review. Cheers.--Doc James (talk · contribs · email) 23:56, 3 July 2009 (UTC)

I agree that it is a little biased. Specifically the word normal should not be used to describe people who are not overweight or obese. Who is to say what is normal and not? —Preceding unsigned comment added by 38.118.49.50 (talk) 21:44, 6 August 2009 (UTC)

Would you prefer it to be changed to healthy?Doc James (talk · contribs · email) 06:40, 7 August 2009 (UTC)

Uh... normal is simply a statement of majority. Most people aren't overweight. Thereby the definition 'overweight' and also the source of normality in this case. —Preceding unsigned comment added by 77.99.151.52 (talk) 23:12, 9 September 2009 (UTC)

USA

Why isnt obesity in USA discussed in this article? It is in the heart of this issue, as majority of americans are obese and majority of obese people are Americans.

This is a global issue. The USA is addressed under epidemiology.--Doc James (talk · contribs · email) 18:21, 11 August 2009 (UTC)

What?! The majority of Americans are obese? The majority of obese are Americans?? Are you retarded?? Serious question. —Preceding unsigned comment added by 69.26.122.162 (talk) 19:35, 4 September 2009 (UTC)

400 million people are obese worldwide, 110 million American are obese: 1/3 of American ( 330 million ). Therefore about 25 % of the obese people worldwide are American. Enough said.Doc James (talk · contribs · email) 18:17, 5 September 2009 (UTC)

Effect on the environment

You can´t blame the fat people for the global warming.

http://junkfoodscience.blogspot.com/2009/04/rejection-of-science-squared.html http://junkfoodscience.blogspot.com/2007/07/blame-fat-people.html

I think you should remove it from the Obesity article. —Preceding unsigned comment added by 92.73.223.55 (talk) 22:45, 21 August 2009 (UTC)

Feel free. I do not think it belongs either.Doc James (talk · contribs · email) 00:02, 22 August 2009 (UTC)

I can´t. {{editsemiprotected}}

I want to delete: Effect on the environment

Obesity may have a negative effect on the environment. A 2009 study concluded that if 40% of the population were overweight or obese as projected in 2010 it would require 19% more food. The energy required to generate this would create 270 million metric tons of greenhouse gas emissions. Transportation systems also would require more fuel to both accommodate and transport larger passengers.[225]

--Fisch4Fun (talk) 09:22, 22 August 2009 (UTC)

Done Doc James (talk · contribs · email) 18:27, 22 August 2009 (UTC)

The Morbidly Obese

Is it true that morbidly obese people have a mold that grows on their skin in the creases? I have heard this is true and would like it to be confirmed. The reason I asked is that my husband has become morbidly obese and he always has an unpleasant odor. There is also a yellow ring in the jacuzzi every time he sits in it that I can't explain. If there is a mold, are there any health risks to either one or both of us?

Kelco (talk) 16:32, 25 August 2009 (UTC)

Being overweight does increase ones risk of having Canadida ( which is a yeast ) grow between ones fold of fat.Doc James (talk · contribs · email) 16:55, 25 August 2009 (UTC)

Is there any evidence that weight loss in obese patients improves mortality or morbidity?

I found these answers:

Dieting

“ The few studies of mortality among people who voluntarily lost weight produced inconsistent results; some even suggested that weight loss increased mortality” (Kassirer JP, Angell M. Losing weight--an ill-fated New Year's resolution [Editorial]. N Engl J Med 1998;338:52-4. )

“The Cochrane Library holds a protocol entitled Weight reduction for reducing mortality in obesity and overweight (1) which is due to be published in Issue 1, 2002. In their background to the review they refer to a guideline produced by the National Heart, Lung and Blood Institute (NHLBI), USA, 1998, which states that "there have been no prospective trials to show changes in mortality with weight loss in obese patients. “ (Vlassov VV, Weight reduction for reducing mortality in obesity and overweight [protocol], The Cochrane Library, due Issue 1 2002. )

In the last 10 years evidence has been generated and is provided in the article.Doc James (talk · contribs · email) 23:12, 26 August 2009 (UTC)

Bariatric surgery

There is a review “Surgery for obesity“ from the Cochrane Collaboration.

http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003641/frame.html

• “Surgery is more effective than conventional management. “
• “Reductions in comorbidities, such as diabetes and hypertension, ”
• “Improvements in health-related quality of life occurred after two years, but effects at ten years are less clear. “
• “limited evidence and poor quality of the trials “

I think this means:

• Long term effects are not clear.
• The effects on the morbidities is unclear just “comorbidities” are mentioned.

Sandy Szwarc criticizes these kind of studies: http://junkfoodscience.blogspot.com/2007/01/junkfood-science-weekend-special.html

• “Extraordinarily high “lost in followup” rates are common ”
• “Most studies only report short-term outcomes “
• “The SOS Study, although its primary outcome measures were overall mortality, refused to release its mortality data in its latest 10-year report. “

I am not saying, that surgery is not healthy I am just saying, we are not sure.

So I think the answer is nobody knows if weight loss in obese patients improves mortality or morbidity. I think there is a huge difference between thin people an fat people, who lost weight.

http://www.youtube.com/watch?v=Q17NZNDjcBs

I know this is very sad news :(

But I think it should be part of the article.

What do you think?

-- Fisch4Fun (talk) 20:00, 26 August 2009 (UTC)

Do not have time for a complete response but a few things: comorbidities are the same as morbidities. Decrease in diabetes and hypertension is a decrease in comorbidities / morbidities. Therefore some long term outcomes are clear. Sugery improves morbidity.

Junkfood science and youtube are not great sources. Cochrane of course is a great source.

"Reductions in comorbidities, such as diabetes and hypertension, also occur. Improvements in health-related quality of life occurred after two years, but effects at ten years are less clear."

"A further systematic review of the long-term weight loss effects on all-cause mortality in overweight and obese populations (Poobalan 2007) concludes that there is some evidence that intentional weight loss has long-term benefits on-all cause mortality for women and more so for people with diabetes. However the long-term effects for men are not clear.Weight loss in obese patients with knee osteoarthritis has also been systematically reviewed and the results of meta-analysis indicated that disability could be significantly improved when weight was reduced over 5.1%, or at the rate of greater than 0.24% reduction per week (Christensen 2007)."

Here is the SOS data on mortality "Cumulative overall mortality The SOS 1997-2007 study reported cumulative overall mortality

during a period of up to 16 years (mean 10.9 years follow-up).The hazard ratio of the surgery group compared with the control group was 0.76 [(95%CI 0.59 to 0.99) P = 0.04)]. There were 101 (5%) deaths in the surgery group and 129 deaths (6.3%) in the control group. Table 8 displays the causes of death; the most common causes of death were cancer (surgery 29 cases, control 47 cases), sudden death (surgery 20 cases, control 14 cases) and myocardial infarction (surgery 13 cases, control 25 cases)."

The p on that last one is just barely significant for decreased mortality with surgery.

So inconclusion the Cochrane paper basically supports what is already in the paper.

No one is saying surgery is healthy. It is a final measure after all others have failed. Weight loss via diet and exercise is better but most human are not able to do this well living in an obesogenic environment were exercise is not required / discouraged. That obese people are somehow different than thin people has been disproven in well done in hospital feeding trials. Cheers Doc James (talk · contribs · email) 22:26, 26 August 2009 (UTC)

Conventional:

I think these are the points where we agree:

• intentional weight loss has benefits for people with diabetes.
• long-term effects for men are not clear
• ”benefits of weight loss on all cause mortality for overweight/obese populations is meagre.” (Poobalan 2007)

I think this should be changed: “There are significant benefits to weight loss. In a prospective study, intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality.”

Surgery:

I think these are the points where we agree:

• ” No one is saying surgery is healthy. It is a final measure after all others have failed.”
• Long term effects are not clear.

I think the last point should be added in the section “Reduced mortality and morbidity”(Bariatric surgery)

--Fisch4Fun (talk) 17:48, 27 August 2009 (UTC)

Yes I agree. With respect to diet and exercise what has been shown is that very few people are able to maintain long term weight loss. Therefore finding benefit from diet and exercise is not very significant as no one does it. Benefits at 2 years for surgery have been shown. ( in other areas of medicine 2 years is refered to as long term ) Adding that quality of life at 10 years is not yet determined would be good.

Feel free to make the above suggested changes.

Doc James (talk · contribs · email) 19:08, 27 August 2009 (UTC)

Poobalan

The problem with the Poosbalan study is they looked at both overweight and obese people combined. Weather being overweight causes heath problems BMI 25 - 30 is questionable. At greater than 30 no one disagrees. Need to look at it in more detail but not sure if it is appropriate on this page.

I am not sure. -- Fisch4Fun (talk) 19:24, 30 August 2009 (UTC)

Even still they found benefits in women, in diabetics, and possibly those with intentional weight lose. I do not find the new wording very good at this point. Will look at it further.Doc James (talk · contribs · email) 17:41, 29 August 2009 (UTC)

The benefits in women, were based on just one study. But if you want to include it feel free to do so. Please don´t hesitate to change the wording -- Fisch4Fun (talk) 19:24, 30 August 2009 (UTC)

Weight loss in the severely obese was associated with a substantial survival benefit. http://journals.lww.com/annalsofsurgery/pages/articleviewer.aspx?year=2007&issue=12000&article=00016&type=abstract Now if this weight loss were achieved by diet and exercise there is no reason why it would lead to different outcomes. Improves frailty in the elderly obese http://archinte.ama-assn.org/cgi/content/abstract/166/8/860 <st likely better outcomes. pan style="color:#0000f1">Doc James (talk · contribs · email) 20:45, 29 August 2009 (UTC)

I think, we shouldn´t start to write our own reviews. Knowledge from reviews is more reliable, than single studies. On the other hand, the obesity debate "is so political, so rife with misinformation and disinformation," ( Dr. Friedman dicoverer of leptin). So sometimes one has to question a review.

Exercise is good for everyone even if you don´t loose weight. So if you want to produce positive effects for in weight loss just combine it with exercise. This is an old trick. ;-) --Fisch4Fun (talk) 19:24, 30 August 2009 (UTC)

This was a previous argument that one could be fat yet fit and have no back health outcomes. A recent study found this not to be true. That about half of the detrimental health outcomes are from obesity and half from inactivity. This is just one of many reviews on the topic.

My concern is that the Pooblan dilutes obesity with overweight. Being overweight does not seem to lead to poor health outcomes in many people. Therefor losing weight would have not benefit.

This article is however about obesity not overweight. Doc James (talk · contribs · email) 21:49, 30 August 2009 (UTC)

"My concern is that the Pooblan dilutes obesity with overweight." Yes that´s true. Perhaps you should mention it in the arcticle.

"In a prospective study, intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality", but only for midel aged white woman who had with obesity-related health conditions. "In women with no preexisting illness (n = 28,388), intentional weight loss of > or = 20 lb (> or = 9.1 kg) that occurred within the previous year was associated with about a 25% reduction in all-cause, cardiovascular, and cancer mortality; however, loss of < 20 lb (< 9.1 kg) or loss that occurred over an interval of > or = 1 year was generally associated with small to modest increases in mortality." This are not a significant benefits in mortality. I would like to remove it. --Fisch4Fun (talk) 16:39, 31 August 2009 (UTC)

Made some clarifications. I am not sure how a 20 and 25% reduction in mortality is not clinically significant? Especially when it involves a potentially free treatment ( diet and exercise ).Doc James (talk · contribs · email) 15:27, 2 September 2009 (UTC)

Let´s take a look at the authors interpretation: ". The association between intentional weight loss and longevity in middle-aged overweight women appears to depend on their health status. Intentional weight loss among women with obesity-related conditions is generally associated with decreased premature mortality, whereas among women with no preexisting illness, the association is equivocal." That´s more or less, what the review says. The sentence "Some studies have found significant benefits in mortality." leads the reader into a wrong direction and is without evidence. --Fisch4Fun (talk) 20:44, 3 September 2009 (UTC)

Agree and clarified further.Doc James (talk · contribs · email) 21:34, 3 September 2009 (UTC)

Sorry but I think this is to complicated for the reader. If you want to keep in the article at least put it behind the results of the review and cite the conclusions aof the authors: "The association between intentional ... whereas among women with no preexisting illness, the association is equivocal." -- Fisch4Fun (talk) 16:06, 7 September 2009 (UTC)

Seem straight forward to me.Doc James (talk · contribs · email) 18:54, 7 September 2009 (UTC)

How can it be straight forward, if even you (with your huge knowledge) thought it suported weight loss among women with no obesity-related conditions? Let´s do an experiment: Send this text to a friend:

"Some studies have found significant benefits in mortality in certain populations. In a prospective study of obese women, intentional weight loss of any amount in those with other weight related diseases was associated with a 20% reduction in all-cause mortality, well a weight loss of greater than 9 kg ( 20 lb ) was associated with a 25% decrease in mortality in those with out obesity related illnesses."

Then ask him "Is it good for woman to loose weight?" The answer should be: "Intentional weight loss among women with obesity-related conditions is generally associated with decreased premature mortality, whereas among women with no preexisting illness, the association is equivocal." You won´t get it. --Fisch4Fun (talk) 15:31, 8 September 2009 (UTC)

Clarified it. Also can you provide a ref to the Cochrane collaboration paper. Unable to find it on their site.Doc James (talk · contribs · email) 22:22, 8 September 2009 (UTC)

The Cochrane paper has been withdrawn, "due to inability of authors to continue work with this review" (8 July 2009) http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003203/frame.html. If you want to know more about the old version, please contact me via email. --Fisch4Fun (talk) 16:00, 9 September 2009 (UTC)

Since it was withdraw from publication it is no longer verifiable and thus I have removed it.--Doc James (talk · contribs · email) 16:27, 9 September 2009 (UTC)

World map of Energy consumption and Yugoslavia

Hi,

I think there is a mistake about Yugoslavia in the World map of Energy consumption 1979-1981

It's impossible they ate more than 3600 kcal/day, more than any country in the world (even more than USA lol) ! Yugoslavia wasn't that poor but was not very rich too...

And the other map (2001-2003), ex-Yugoslavia republics (Serbia, Bosnia, Kosovo, Macedonia, Montenegro, ...) HAVE THE LOWEST consumption in Europe !

Obviously, 1979-1981 map must be changed

Thanks