Obesity

2009

2009-08-11-WP-Steinbock

Ready at Last to Start Running
by Martha Bair Steinbock
Washington Post Health Section, 2009-08-11

Last May, shortly before her retirement,
60-year-old Silver Spring resident Martha Bair Steinbock
started a blog, “My First Mile”,
about her determination
to use her new leisure time to get fit.
Here are some edited excerpts:

[The emphasis below is added by
the author of the current blog.]

---

May 16, 11:48 a.m.:

Somewhere in me is an athlete, albeit buried deeply under layers of fat.
I know I could run a mile.

This would not even have been a thought worth noting,
let alone writing a blog about, were it not for the fact that

I am 5 feet 3 inches and weigh 279 pounds.
[I am morbidly obese.
I do an management job and sit at a desk all day.]
I love to eat.
And I don’t walk anywhere, except when I absolutely have to.
I always take the elevator and avoid stairs.
I spend lots of time looking for those close-in parking spots.

This blog is the story of my attempt to make good on my pledge to myself:
to run a mile at some sort of organized track meet.

---

May 16, 12:43 p.m.:

Warning!
Before undertaking any new exercise program, always visit your doctor.
For those of us who are really fat, this is a huge disincentive.
We know that it will be implied, if not just not plainly said, that
we are lazy gluttons and that
our bad habits are killing us.

My experience was just about this bad.
I found out that I have diabetes (blood sugar 127) and, because of this,
need to reduce my blood lipids from a total cholesterol of 211.
My doctor said my blood pressure was high,
even though every other time I have had it checked recently,
it has been an acceptable 120/70.
I got in a huge fight with her, because she wanted to prescribe statins,
which seemed premature
since I am hoping my training will improve all these numbers.

I got the okay to begin an exercise program.
The nurse asked me what I intended to do,
and I decided not to mention running in a track meet.
“I will walk briskly,” I told her,
“and once I lose some weight I may jog.”

“Oh, no,” she said,
“Walking briskly is good, but don’t jog.
It’s too hard on the joints.”
I grabbed my passing report card, made my escape
and took the elevator down two floors to my car.

---

[Here is an excerpt from her blog, dated 2009-08-09.]

Its really important that I do my blocks because
yesterday we all ate at the Home Town Buffet.
It is all you can eat, and I ate all I could eat --

fried chicken, mashed potatoes, mushy green beans, and
two of the doughiest raised dinner rolls I have ever eaten
with a pat of butter each.
I followed this by a large piece of lemon pie.

Many of the fellow diners were also obese,
so I would have felt at home going for seconds, except, that I was stuffed.
I actually stopped eating when full.
That is good because driving here from San Francisco I ate compulsively:

a bag of beef jerky,
a small bag of BBQ potato chips,
ten or fifteen Hershy kisses and
three Milano cookies.

Let's hope that tomorrow, when I resume my exercise,
I will also resume healthy eating.

2009-08-13-Harbaugh

Here are some comments by the author of the current blog
on the situation described by Martha Bair Steinbock in the entry above.

Look, it is not my job, nor my place, to comment on her weight situation.
It’s a free country; if she wants to pig out, that is her right.

But what I do object to are the health care policies of this country,
which, so far as I am aware,
pay for health problems caused by her obesity without question.
What I would like to see is
a refusal by insurance companies, the government, etc.
to pay for health care costs clearly and directly related to obesity.
Why should the general public have to pay for
a person’s combination of gluttony and sloth?
In particular, in my area there are lots of people
who make a great effort to keep fit, to stay in shape,
by jogging, bicycling, working out, and other means.
Why should they have to pay for those who do not?

In particular, she has clearly said she avoids exercise and overeats.
Whose fault is that?

2010

2010-03-25-Cheng-Breast-Cancer

Up to a third of breast cancers could be avoided
Researchers say diet and exercise can go a long way to help prevent the disease
By MARIA CHENG, Associated Press
Salon.com, 2010-03-25

[1]

Up to a third of breast cancer cases in Western countries
could be avoided
if women ate less and exercised more,

researchers at a conference said Thursday,
renewing a sensitive debate about how lifestyle factors affect the disease.

[2]
Better treatments, early diagnosis and mammogram screenings
have dramatically slowed breast cancer,
but experts said
the focus should now shift to
changing behaviors like diet and physical activity.

[3]
“What can be achieved with screening has been achieved.
We can’t do much more,”
Carlo La Vecchia, head of epidemiology at the University of Milan,
said in an interview.
“It’s time to move on to other things.”

[4]
La Vecchia spoke Thursday at a European breast cancer conference in Barcelona.
He cited figures from the International Agency for Research on Cancer,
which estimates that

25 to 30 percent of breast cancer cases could be avoided
if women were thinner and exercised more.

The agency is part of the World Health Organization.

[5]
His comments are in line with recent health advice that
lifestyle changes in areas such as smoking, diet, exercise and sun exposure
can play a significant role in risk for several cancers.

[6]
Dr. Michelle Holmes of Harvard University,
who has studied cancer and lifestyle factors,
said people might wrongly think their chances of getting cancer
depend more on their genes than their lifestyle.

[7]
“The genes have been there for thousands of years,
but if cancer rates are changing in a lifetime,
that doesn’t have much to do with genes,”
she told The Associated Press in a phone interview from Cambridge, Massachusetts.

[8]
Breast cancer is the most common cancer in women.
In Europe, there were
about 421,000 new cases and nearly 90,000 deaths in 2008,
the latest available figures.
The United States last year saw
more than 190,000 new cases and 40,000 deaths.

[9]
A woman’s lifetime chance of getting breast cancer is about one in eight.

Obese women are up to 60 percent more likely to develop any cancer
than normal-weight women,

according to a 2006 study by British researchers.

[10]
Many breast cancers are fueled by estrogen, a hormone produced in fat tissue.
So experts suspect that
the fatter a woman is, the more estrogen she’s likely to produce,
which could in turn fuel breast cancer.
Even in slim women,
experts believe exercise can help reduce the cancer risk
by converting more fat into muscle.

[11]

Yet any discussion of weight and breast cancer
is considered sensitive
because
some may misconstrue that as
the medical establishment
blaming women for their disease.

[What insanity!
We have no qualms about discussing how
obesity is a strong risk factor for a variety of gender-neutral syndromes,
such as diabetes, hypertension, and coronary disease.
We have no qualms about making the well-researched correlations known,
and pointing out the obvious conclusion that
you do, indeed, determine a considerable part of the probability
that you will develop those obesity-linked syndromes.

Then why on earth should women be “sensitive”
if obesity also correlates with a problem largely confined to women?
What kink of psychological sickness is that?

I suggest to the psychologists that,
rather than searching for problems such as “sex addiction”
(which no doubt will be discerned far more in men than in women)
to label as pathologies,
that they start doing a responsible, gender-neutral job and look at
how pathological much of the ideology of feminism is.
But of course that won’t happen because
so much of our society is conditioned on “keeping the women happy.”

As to the significance of this to the general public,
note that the costs of treating breast cancer
are spread across the general public via the health insurance system.
Those who deny women the information
that they can reduce their risk of developing breast cancer
are denying them the opportunity to reduce that risk.
This, in turn, directly raises the overall national health care bill.]

[12]
Tara Beaumont,
a clinical nurse specialist at Breast Cancer Care, a British charity,
said her agency has always been careful about giving lifestyle advice.
She noted that three of the major risk factors for breast cancer --
gender, age and family history --
are clearly beyond anyone’s control.

[13]
“It is incredibly difficult to isolate specific factors.
Therefore women should in no way feel
that they are responsible for developing breast cancer,” she said.

[14]
Yet Karen Benn, a spokeswoman for Europa Donna,
a patient-focused breast cancer group,
said it was impossible to ignore the increasingly stronger links
between lifestyle and breast cancer.

[15]
“If we know there are healthier choices,
we can’t not recommend them
just because people might misinterpret the advice and feel guilty,” she said.
“If we are going to prevent breast cancer,
then this message needs to get out,
particularly to younger women.”

[16]
That means avoiding becoming overweight as an adult.
Robert Baan, a cancer expert with the international cancer research agency,
said it isn’t clear if women who lose weight
can lower their risk to the level of a woman who was never fat.

[17]
The American Cancer Society Web site says
the connection between weight and cancer risk is complex.
It says risk appears to increase for women who gain weight as adults,
but not for women who have been overweight since childhood.
The cancer society recommends
45 to 60 minutes of physical activity five or more days a week
to reduce the risk of breast cancer.

[18]
Drinking less alcohol might also help.
Experts estimate that having more than a couple of drinks a day
can boost the risk of breast cancer by 4 to 10 percent.

[For some reason omitted are certain other actions
that decrease the risk of getting breast cancer:
bearing children at a (relatively) young age
and breastfeeding them.
That reference, as of 2010-04-06, contains the following
(emphasis is added):

• The younger a woman has her first child,
  the lower her risk of developing breast cancer during her lifetime.
• A woman who has her first child after the age of 35
  has approximately twice the risk of developing breast cancer
  as a woman who has a child before age 20.
• A woman who has her first child around age 30
  has approximately the same lifetime risk of developing breast cancer
  as a woman who has never given birth.
• Having more than one child
  decreases a woman’s chances of developing breast cancer.
  In particular, having more than one child at a younger age
  decreases a woman’s chances of developing breast cancer during her lifetime.

Obviously, by controlling her weight and child-brearing,
a woman has a great deal of control over
the probability that she will develop breast cancer.]

[19]
After studies several years ago linked hormone-replacement therapy to cancer,
millions of women abandoned the treatment,
leading to a sharp drop in breast cancer rates.
Experts said a similar reduction might be seen
if women ate healthier and exercised more.

[20]
Holmes, the Harvard expert, said changing diet and nutrition
is arguably easier than
tackling other breast cancer risk factors.

[21]
In the 1980s and 1990s, breast cancer rates steadily increased, paralleling a rise in obesity and the use of estrogen-containing hormones after menopause.

[22]
La Vecchia said countries like Italy and France --
where obesity rates have been stable for the past two decades --
show that weight can be controlled at a population level.

[23]
“It’s hard to lose weight, but it’s not impossible,” he said.
“The potential benefit of preventing cancer is worth it.”

--
International Agency for Research on Cancer: http://www.iarc.fr/



[In a remarkable display of not reporting significant news,
the Washington Post as of 2010-03-31
has not reported at all this story,
aside from putting the AP story on its website.
Do a search here to see the current status:
http://www.washingtonpost.com/ac2/wp-dyn/NewsSearch?st=breast%20cancer%20barcelona.]

2010-06-06-NYT-Obese-mothers

Growing Obesity Increases Perils of Childbearing
By ANEMONA HARTOCOLLIS
New York Times, 2010-06-06

[1]
As Americans have grown fatter over the last generation, inviting more heart disease, diabetes and premature deaths, all that extra weight has also become a burden in the maternity ward, where babies take their first breath of life.

[2]
About one in five women are obese when they become pregnant, meaning they have a body mass index of at least 30, as would a 5-foot-5 woman weighing 180 pounds, according to researchers with the federal Centers for Disease Control and Prevention. And medical evidence suggests that obesity might be contributing to record-high rates of Caesarean sections and leading to more birth defects and deaths for mothers and babies.

[3]
Hospitals, especially in poor neighborhoods, have been forced to adjust. They are buying longer surgical instruments, more sophisticated fetal testing machines and bigger beds. They are holding sensitivity training for staff members and counseling women about losing weight, or even having bariatric surgery, before they become pregnant.

[4]
At Maimonides Medical Center in Brooklyn, where 38 percent of women giving birth are obese, Patricia Garcia [who recently weighed in at 261 pounds] had to be admitted after she had a stroke, part of a constellation of illnesses related to her weight, including diabetes and weak kidneys.

...

Ms. Garcia, 38, a former school bus dispatcher, is 5 feet tall.
She said she had tried diets, weight-watching groups and joining a gym.
She was 195 pounds before her pregnancy (B.M.I., 38)
and ballooned to 261 pounds,
which she attributed to water weight and inactivity.

“I’m the smallest one in my family,” she said.
Her older brother weighed more than 700 pounds
before having gastric bypass surgery.

...

The hospital estimated that the cost of caring for [Ms. Garcia] and baby
would be more than $200,000,
compared with $13,000 for a normal delivery.

[Some points this article omits:
Is Ms. Garcia married?
Who is paying the hospital's bill?

Some questions for the Democratic Party,
which just passed their expansion of healthcare coverage
which, as I understand it, ended limits on coverage:

Do you care about this situation?
What is to stop Ms. Garcia, and women like her,
from having one baby after another,
each costing responsible Americans $200,000 per childbirth?
Is this your idea of responsible economic management?
How high might healthcare expenses go under your bill?]

2010-07-07-WP-Givhan-Full-Figured-Fashion-Week

Full Figured Fashion Week draws plus-size crowd
By Robin Givhan
Washington Post, 2010-07-07

[Some excerpts; emphasis is added.]

In the past two years, a vigorous storm has been kicked up
among plus-size women and their advocates.
[Who on earth would advocate for obesity?]

...

The women have little desire to be slender.

They are uninterested in preventative weight loss
to stave off diabetes, high blood pressure
or any other disease linked to obesity.
Some are even unconvinced
that their weight predisposes them to such conditions.

...

So stop telling them to lose weight.
...
They don’t want your condemnation, but they don’t need your approval.
As one size-24 woman with a cascade of dark hair and Hollywood sunglasses
shouted out to her plus-size comrades,
“I have always been fabulous.”

[Yes, I have read in the past of such activities.
There is, for example, a “National Association to Advance Fat Acceptance”.

My attitude:
If obese people want to feel “fabulous”,
who am I to argue them out of that feeling?
But when their self-caused health problems
start running up the nation’s healthcare bill,
it’s time to stop burdening the general public
with the expenses of those self-caused problems.

You know, when I was a kid back in the 1950s (that Dark Age :-),
fat people were not exactly accepted.
In fact, when the circus came to town, on the sideshow,
one of the “attractions” was typically the “Circus Fat Lady”. (E.g.)
Circus-goers would pay (a small sum)
to enter the tent in which she was up on the stage,
revealing rolls of fat.
Now you can see such sights for free, just walking down the street.

I wonder what those advocates for the obese would think (and say!)
if today’s circuses had such sideshow attractions.]

2010-08-04-NYT-obesity-rates-rising

Obesity Rates Keep Rising, Troubling Health Officials
By DENISE GRADY
New York Times, 2010-08-04

Americans are continuing to get fatter and fatter,
with obesity rates reaching 30 percent or more in nine states last year,
as opposed to only three states in 2007,
health officials reported on Tuesday.
...

2011

2011-09-25-NYT-Junk-food-not-cheaper

Is Junk Food Really Cheaper?
By MARK BITTMAN
New York Times Sunday Review, 2011-09-25

THE “fact” that junk food is cheaper than real food
has become a reflexive part of how we explain
why so many Americans are overweight,
particularly those with lower incomes.
I frequently read confident statements like,
“when a bag of chips is cheaper than a head of broccoli ...” or
“it’s more affordable to feed a family of four at McDonald’s
than to cook a healthy meal for them at home.”

This is just plain wrong.
In fact it isn’t cheaper to eat highly processed food....

2012

2012-03-25-WP-Wise-out-of-shape-athletes-who-are-weighing-down-teams

Andray Blatche among out-of-shape athletes to weigh down D.C. teams
by Mike Wise
Washington Post, 2012-03-25

[Perhaps this is too far back for Wise to want to mention,
but he could have included former Washington Bullets center Kevin Duckworth,
who oddly died of heart failure at the age of 44,
in his list.
Must all be due to white racism and the lingering affects of slavery and Jim Crow,
right?]

2012-05-06-NYT-Randall-why-black-women-are-fat

Black Women and Fat
By ALICE RANDALL
New York Times Review, 2012-05-06

...

[T]oo many experts who are involved in the discussion of obesity
don’t understand something crucial about black women and fat:
many black women are fat because we want to be.

2014

2014-09-04-WP-the-states-where-americans-are-the-most-and-least-obese

The states where Americans are the most and least obese
By Roberto A. Ferdman
Washington Post, 2014-09-04

...

What might be most disconcerting, however, is
how quickly and completely
the obesity epidemic has overtaken the country.

In 1990,
not a single U.S. state had an obesity rate above 15 percent,
but by 2000,
only two, Arizona and Colorado, had obesity rates below 15 percent,
and by 2010,
not a single state had an obesity rate below 20 percent.

...

The problem is such that nationally,
obesity has leveled off at just over 35 percent,
which has earned the United States the unenviable distinction as
the world's most obese major country.