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> Do you have resources on the scientific basis for BMI's efficacy as a health indicator? http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#R

by imagist 10y ago

> Do you have resources on the scientific basis for BMI's efficacy as a health indicator? http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Reliable http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/ind... http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Consequences http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/ind... > > > If you look at the statistics on weight loss success rates, asking a 500lbs person to lose 200+lbs before you're willing to treat their disease with actual evidence-based medicine—looking at symptoms, pathology, etc—is tantamount to outright denial of care. > > I'd like to see those statistics. > "Data from the scientific community indicate that a 15-wk diet or diet plus exercise program produces a weight loss of about 11 kg with a 60-80% maintenance after 1 yr. Although long-term follow-up data are meager, the data that do exist suggest almost complete relapse after 3-5 yr." This in no way indicates how many patients with knee and hip issues are able to solve those knee and hip issues simply by losing weight. > And that's 11kg… the situation described above is 90kg. You're essentially telling someone to go away and come back after 2+years of dieting to get medical care. Don't you think that seems unrealistic? No, I'm not telling someone to go away and come back after 2+ years to get medical care, I'm prescribing medical care that will take 2+ years. Weight loss isn't denial of care; weight loss is the care. There are plenty of forms of treatment that take a long time. If a doctor prescribes a course of medication that takes 2 years before trying surgery because it will solve the problem for most people and is lower-risk, you wouldn't complain about that, or call it denial of care. But in fact, weight loss is safer than most medicines--weight loss for an obese person has almost no negatives. I posit that the only reason you're objecting to weight loss as treatment is that you've formed your opinion based on identity politics rather than medical efficacy.

AstralStorm 10y ago
Weight loss is a result of a proper treatment. A result. Care is getting the obese person to lose weight. Which is hard, harder than dealing with hard drugs. Dieteticians, who are supposed to be specialists, fail hard at care. GP doesn't even know where to start. So let's fix what is broken. If a person cannot eat, they are fed, right? That is a task for a properly trained nurse. But I don't know of a doctor who wants to provide essentially more than daily care and effective one to begin with. And doctors do not like to feel like failures.
- imagist 10y ago
  I agree, we need better help for weight loss. However, that's not what most people here are arguing for. The specific case here is a complaint that people are denied surgery, and people feel that this is denial of care; that is, people are arguing that we should perform knee and hip surgeries on obese people, even though weight loss would be a much safer treatment.
  - AstralStorm 10y ago
    Well, I know a few people with damaged joints. Weight loss helps but does not fix the problem. The main thing is if your joint are damaged due to overload and not some other issue, surgery may be less effective or only temporarily effective. The joints can and do regenerate except from chronic problems. Unfortunately, obesity is one, just losing weight does not fix joints as quite a few long time former weight lifters can attest.
    - imagist 10y ago
      From the article: "The group concluded that heavy patients should first be counseled to lose weight because a lower weight reduces stress on the joints and can alleviate pain without surgery." (emphasis mine) I don't have any reason to disbelieve you about your friends, but your friends do not represent all obese people, and in losing weight does fix joints some percentage of the time. Given the alternative is surgery, which kills the patient some percentage of the time, I don't think there's a lot of debate to be had here.
      - AstralStorm 10y ago
        It is true. Counselling is not good enough though. Given how ineffective it is, it is essentially permanent denial. Moreover, there are other issues to verify, say, a person born with hip dysplasia should be treated regardless of weight as weight loss will never fix the underlying problem. Also aching hip joints quite effectively prevent many kinds of exercise, which does not help with weight loss at all. Without an effective alternative course of action, the surgery may be the one remaining effective measure.

by imagist 10y ago

AstralStorm 10y ago

Weight loss is a result of a proper treatment. A result. Care is getting the obese person to lose weight. Which is hard, harder than dealing with hard drugs. Dieteticians, who are supposed to be specialists, fail hard at care. GP doesn't even know where to start. So let's fix what is broken. If a person cannot eat, they are fed, right? That is a task for a properly trained nurse. But I don't know of a doctor who wants to provide essentially more than daily care and effective one to begin with. And doctors do not like to feel like failures.

imagist 10y ago
I agree, we need better help for weight loss. However, that's not what most people here are arguing for. The specific case here is a complaint that people are denied surgery, and people feel that this is denial of care; that is, people are arguing that we should perform knee and hip surgeries on obese people, even though weight loss would be a much safer treatment.
- AstralStorm 10y ago
  Well, I know a few people with damaged joints. Weight loss helps but does not fix the problem. The main thing is if your joint are damaged due to overload and not some other issue, surgery may be less effective or only temporarily effective. The joints can and do regenerate except from chronic problems. Unfortunately, obesity is one, just losing weight does not fix joints as quite a few long time former weight lifters can attest.
  - imagist 10y ago
    From the article: "The group concluded that heavy patients should first be counseled to lose weight because a lower weight reduces stress on the joints and can alleviate pain without surgery." (emphasis mine) I don't have any reason to disbelieve you about your friends, but your friends do not represent all obese people, and in losing weight does fix joints some percentage of the time. Given the alternative is surgery, which kills the patient some percentage of the time, I don't think there's a lot of debate to be had here.
    - AstralStorm 10y ago
      It is true. Counselling is not good enough though. Given how ineffective it is, it is essentially permanent denial. Moreover, there are other issues to verify, say, a person born with hip dysplasia should be treated regardless of weight as weight loss will never fix the underlying problem. Also aching hip joints quite effectively prevent many kinds of exercise, which does not help with weight loss at all. Without an effective alternative course of action, the surgery may be the one remaining effective measure.