Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

“Healthy obesity” doesn’t exist. It is unequivocally bad for you

bigthink.com

Post reply on HN
Print view View original

251–260 of 397 posts

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#251

Post by fnordpiglet »

I’m too fatigued right now to pull up my prior posts on the subject with compelling references but the linked article links survey research that says the same thing. BMI alone is a poor measure but when coupled with physical fitness and activity metabolically healthy overweight and obese type 1 tend to have similar health outcomes to physically fit and active normal BMI. The key is physical activity and fitness are key to health, and likely at some physical threshold aggregate size of body drags it down no matter what (inclusive of athletes with huge frames). BMI is a quicker to compute metric than metabolic and cardiovascular health, easier to measure in a doctors office than factoring reported physical activity, and therefore is probably a decent medical tool for providing advice. But the advice is going to be eat healthy and exercise no matter what the BMI is. So maybe BMI isn’t specifically useful, so maybe instead of telling an overweight person they’re fat (they probably knew) and therefore should exercise and eat healthy, likewise telling everyone else the same advice, just skip the “you’re fat” and give everyone the same advice as already happens. I don’t think anyone is surprised by “get fit eat right” is good medical advice.

Edit: as to why, I know a lot of obese folks that avoid their doctors because they feel harangued about being over weight. They know they’re fat and they’ve likely been working on it for some time, and the “you’re fat” + axiomatic health advice isn’t helping them vs simply axiomatic health advice. Psychologically it’s shaming, and shame is a powerful force in human psychology. Whether “you’re fat” is reducing their long term health or not is irrelevant since the advice is the same regardless, and it drives them away from their doctors from their shame. That’s not useful, and I’d hope utility is more important than reinforcing axiomatic medical advice with shaming. I know everyone will say “who cares if they’re ashamed it’s a fact,” but who cares in this is their doctor and the patient. That should have primacy over all.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#252

Post by tempsy »

coffeebeqn wrote: post #167
tempsy wrote: post #6

the only nuance i’ll add is that there’s a huge difference between subcutaneous fat (eg visible belly fat you can pinch) and visceral fat (the fat hugging your vital organs) visceral fat is significantly more dangerous than subcutaneous fat, and people who have a high ratio of visceral fat to subcutaneous fat can appear skinny but are as or potentially less well off that someone who has a more balanced ratio of visce…

How do I know if I have that?

dexa scan is the most accurate way. i’ve seen more pop up nowadays. they are a bit expensive though. have seen $150 or so per scan but can probably find cheaper.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#253

Post by marcellus23 »

bobthepanda wrote: post #110
8f2ab37a-ed6c wrote: post #76

I wonder what's going to happen long term to the recent trend of celebrating obesity in advertising. E.g. go to any Target and you will see overweight or obese models wearing the clothes they sell. On one hand you have to represent your current population, and with the majority of Americans overweight or obese, that's who your customers are. On the other, can this be seen as normalizing a disease?

Fat people exist, and they need clothes to wear.

The parent already acknowledges that: "On one hand you have to represent your current population, and with the majority of Americans overweight or obese, that's who your customers are."

The question is about whether this is normalizing an unhealthy disease, which your comment does not respond to.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#254

Post by somsak2 »

csa wrote: post #244
stametseater wrote: post #5

What interests me is how anybody could ever come to believe otherwise. The contrary belief flies in the face of all common sense, popular experience and medical science. It seems to come entirely from propaganda on social media telling fat people what they want to believe.

> What interests me is how anybody could ever come to believe otherwise. The contrary belief flies in the face of all common sense, popular experience and medical science. Did you read the article? I can give you two simple examples: Look at any picture of Dwayne “The Rock” Johnson when he has been ripped. Ditto with Arnold Schwarzenegger in his prime. BMI says these folks are either obese or severely obese. Extreme…

So two examples of individuals that are using huge amounts of anabolic steroids is "illustrative of the weakness of bmi?" Give me a break. All measures are going to have edge cases. And by the way, those two guys actually are pretty unhealthy -- your body is not made to carry around that much weight.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#255

Post by kennywinker »

etothepii wrote: post #231
manmal wrote: post #228

Earlier quoted context omitted.

That’s assuming perfect conversion of energy to body fat. That’s never the case due to losses, and everybody is _vastly_ different: > In response to 84 days of 1000 kcal/day of overfeeding, 12 pairs of monozygotic twins gained on average 8.1 kg, but the range was from 4.3 to 13.3 kg. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897177/

Your arithmetic does not support the use of the word vastly. It only diverges by mine on the line above by 25%.

The study was with 12 pairs of identical twins. Variation of 25% in IDENTICAL TWINS suggests that variation among genetically different individuals is probably going to be much larger.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#256

Post by Jtsummers »

otherme123 wrote: post #235
Jtsummers wrote: post #185

Earlier quoted context omitted.

Indeed, especially the 22 BMI target. For me (5'10") that would mean 155lbs, I'd have to shed (going by my scale which estimates body fat percentage) around 28 lbs of fat (I'm at 15% fat right now, so 28 lbs would get me to 0% which is unhealthy) and 7lbs of other weight to hit that target. Could I lose some weight? Sure. But I won't. Back on the exercise habit after a few months off and I'm getting slimmer but my we…

I'm 185 cm (6'1") and 73 kg (161 lbs), for a BMI of 21.3. I still have more than 0% fat, but I'm certainly slim. I don't have to fight at all to keep my weight as it is, and I'm healthy. You say 30 BMI, but in my experience unless you are lifting a lot of weights 25 is the upper limit. Ten years ago I hit 25 BMI, and despite feeling "normal" there were already the first signs of being fat: thights always red, sweaty…

I think you're agreeing with me but I'm not sure. I said you have to know your body, which you seem to. For your body 25 BMI is an upper limit, for my body 25 BMI is a lower limit unless I'm losing muscle mass or going to unhealthy body fat percentage levels.

Which is why I also said BMI is a poor target. 22 BMI, for me, would be an awful target. I'd be gaunt and have to lose a lot of muscle mass, not just fat (which I don't have a lot of to lose). Even bringing body fat percentage from 15% to 10%, which is still healthy, would only get me down to about 180lbs. That would leave me 25lbs over the target for a 22 BMI. That's my body, not yours, not anyone else's. I've learned what is healthy for me and have set goals and expectations around that. I wouldn't expect yours, or anyone else's, to be the same. You've realized that 25 BMI is too high for you, great. Now you know, but that doesn't apply to everyone. And the original poster in this thread claiming everyone should be at 22 BMI is clearly also speaking about a particular experience which is not applicable to everyone, but writing as if it is.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#257

Post by triyambakam »

karmicthreat wrote: post #58

Yea, being obese isn't health in any way shape or form. Unless you have some sort of exceptional physique that takes you out of the common medical model. You probably don't have that. I fucking hate it. I have at least managed to get under a 40 BMI its a huge slog to even get try to get down to only overweight. And even then in realistic terms even if I do, its 100% impossible to stay there over your lifetime after b…

Great work and keep going! I recently heard a good motivator is to think about something as just the "next thing to do" rather than a challenge or problem. Anyways, I don't it might feel like getting advice in an elevator, but I wish you well.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#258

Post by dogma1138 »

mtlmtlmtlmtl wrote: post #232
dogma1138 wrote: post #220

Earlier quoted context omitted.

I’m not sure that is true, it seems like the preference was always for small highly calorically dense meals. The 3-4 meals + the constant availability of food is definitely new.

Yeah, humans are evolved to go long periods without food and then to have massive feasts and gorge on food when a prey is caught, say. The human brain's ability to use ketones(byproducts of fat metabolism) for energy is actually unique to humans, suggesting a selective pressure towards surviving starvation in our evolutionary past.

Looking at a more recent history last 3-5000 years it seems that having 1-2 large meals a day even if simple ones and very highly caloric dense food.

You aren’t marching in a legion, working in the fields or building a giant monument without proper food.

Since food preparation took much more time and the logistics were complicated the number of meals and choices were limited but pretty much every meal was packed with carbs and often with fat too (lard, oils etc).

Sweeteners whether it’s honey or other sugars were also quite common and very much so not limited to the ruling classes.

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#259

Post by bialpio »

varjag wrote: post #178
kennywinker wrote: post #118

Earlier quoted context omitted.

> I get to eat what I want and sit around all day? Hell yeah! I am naturally thin. That statement ("i get to eat what i want and sit around all day") is true of my body. Is it such a strange idea that there are as many people who are naturally thin as there are that are naturally fat? Those people aren't making a choice to be fat any more than i am making a choice to be thin. Why should they feel bad about their body…

I was naturally thin too until I started driving to work.

Adulthood was what did it for me. : - ) I'm theorizing that it's at least 2 factors: lack of PE (2.5h a week of forced exercise - gone), & reaching legal drinking age (I lost the most weight when pausing drinking for a bit). There were also random occasions for physical activity that now require more effort to set up that were handled by adults in my life or otherwise organized by someone else (skiing trips, hiking, kayaking).

Re: “Healthy obesity” doesn’t exist. It is unequivocally bad for you

#260

Post by remarkEon »

csa wrote: post #244
stametseater wrote: post #5

What interests me is how anybody could ever come to believe otherwise. The contrary belief flies in the face of all common sense, popular experience and medical science. It seems to come entirely from propaganda on social media telling fat people what they want to believe.

> What interests me is how anybody could ever come to believe otherwise. The contrary belief flies in the face of all common sense, popular experience and medical science. Did you read the article? I can give you two simple examples: Look at any picture of Dwayne “The Rock” Johnson when he has been ripped. Ditto with Arnold Schwarzenegger in his prime. BMI says these folks are either obese or severely obese. Extreme…

I’ll criticize the crudeness of BMI as a yardstick for fitness as much as the next guy, but absolutely no one is looking at Arnold’s BMI and thinking “huh, BMI says the terminator is obese therefore it’s okay for me to be obese”. They’re getting this idea from somewhere else, and that somewhere else is a nexus of social media and bizarre fat positivity propaganda that’s leaked out from obscure corners of society and into the mainstream.
Post reply on HN