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Hear, hear. One of the greatest failings of our "modern" healthcare system is that there's no plan to address this crisis. Obesity is the gateway to what seems

• midoridensha 4y ago
  >One of the greatest failings of our "modern" healthcare system is that there's no plan to address this crisis. Obesity is the gateway to what seems like an infinite amount of health complications What are they supposed to do? Obesity is caused by American's terrible lifestyle. Healthcare systems can only do so much to compensate for a bad lifestyle. Stop drinking alcohol, and start walking everywhere instead of driving.
  • remarkEon 4y ago
    >Healthcare systems can only do so much to compensate for a bad lifestyle. And this right here is my problem. Healthcare doesn't only begin when you get to the doctor or the hospital. There's no reason that healthcare officials/leaders/experts/whatever can't recommend baseline levels of fitness for Americans, and provide help for getting to that standard. I don't know, maybe Healthcare plans should include subsidies for gym memberships by law.
    • j-bos 4y ago
      This would be a beautiful dream
    • barbazoo 4y ago
      Imagine what half the population would say if an expert or an authority started telling people to walk more, eat less and eat better.
    • kredd 4y ago
      From what I’ve observed, even with free gym and advice, most of people will still ignore it. It’s simply not convenient, especially for people who haven’t gotten into a routine. I live in an extremely walkable neighbourhood of a fairly dense city, and honestly speaking, and just walking around to do my daily chores already helps with casual fitness. I do bike, swim and lift, but mostly for “fun” rather than for health. And before consistently working out, I weighed constant amount (+-4 pounds change depended on the season). Honestly, I want to blame the epidemic on cars and the convenience it brings to everyone.
      • remarkEon 4y ago
        I agree, and that was a glib suggestion of mine. It's a combination of cultural proclivities and the infrastructure. I was in the military, so I lift weights basically every day and either swim or run on the days I don't ... but that's because I've just had fitness culture inculcated in my mind since I was 18. I don't live in a city where I have to walk everywhere to get everything. But my fitness preferences do make me vote in certain ways (for candidates that encourage more public transit, bike lanes, and so on). Politics is downstream from culture, I suppose?
      • tomp 4y ago
        > From what I’ve observed, even with free gym and advice, most of people will still ignore it. It’s simply not convenient, especially for people who haven’t gotten into a routine. Maybe we should consider stronger incentives. Such as “exercise passports”, you can’t enter public spaces unless you did 30 minutes of exercise that day. Would solve the problem very quickly. Or obesity tax is another practical idea.
    • AlchemistCamp 4y ago
      > I don't know, maybe Healthcare plans should include subsidies for gym memberships by law. I can only imagine the level of added bureaucracy , certifications for gyms to qualify, and spiraling prices for gym users without healthcare plans through white collar salaried jobs. Just look at health care costs over the past 50 years as lengthier and lengthier laws have been passed in the hopes of shifting incentives and otherwise tweaking the system.
  • pmarreck 4y ago
    it’s not a lifestyle problem. neither willpower nor lifestyles have changed much. processed carbs being addictive, however… medication that treats it like the medical problem it is, instead of berating people for a lack of willpower that they were never missing to begin with, will fix it https://www.mounjaro.com/ https://www.mounjaro.com/
    • midoridensha 4y ago
      It's absolutely a lifestyle problem. Americans have a shitty car-based lifestyle that causes obesity. Go to Manhattan and see how many obese people you see; there aren't many. Or go to any other country where people walk a lot. This is uniquely a western, and especially American problem.
      • deleted 4y ago
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      • pmarreck 4y ago
        Correlation is not causation. Manhattan has many thins because thins are more likely to make more money and get better jobs in high-standard-of-living areas due to commanding more respect. (Which they mostly do not deserve, being mainly the beneficiaries of good genes, but I digress) Also, most people move out to the ‘burbs to raise kids, so Manhattan is strongly weighted towards the under-40 set. > any other country OK let’s pick Germany. (I’m German.) Most Germans are thin because they don’t eat many carbs at all. Orange juice is expensive and piss-poor compared to sugary American OJ. Breakfast typically consists of unleavened-style breads, mustard, and meats. Gas is super expensive so everybody walks or bikes. But guess what? Obesity is steadily rising there too! Gosh, I wonder why, with all that walking and biking? Wait, I know… They just need MORE walking and biking, that must be it!
    • switchbak 4y ago
      Lifestyles haven't changed? Come now, in just my lifetime I've seen kids go from being outside everywhere playing until dark, to being mostly inside all day. And I live in a very active community! With regards to changes in willpower, that seems like a strong assertion, got any sources on that? 100% agree that our diet (generally) has changed drastically. But I don't get your jump of why medication has to be the solution? Maybe undoing some of the changes that got us here? Sure, in many cases where they're already well down the road of obesity and experiencing its negative health consequences - yes medication can be useful. But that's far from the only option at hand here.
  • knicholes 4y ago
    It's mostly about diet, not calories burned, unless you're burning a LOT of calories each day.
    • naravara 4y ago
      For most people weight creeps up on them slowly. Losing a lot of weight quickly does require radical changes to diet, but not putting on the pounds in the first place is generally going to be a matter of burning an extra few hundred calories a day. Also, just not being sedentary all day is associated with a ton of positive health outcomes (possibly mental even more than physical) independent of body fat percentage. So it’s worth it all on its own.
      • knicholes 4y ago
        Of course! Nobody can deny the panacea that is exercise. But it's still a widely misunderstood concept. Throughout many of these comments, people are claiming that the remedy to obesity is more exercise, but I hold that indeed a much larger component of combatting obesity is diet, not exercise.
        • naravara 4y ago
          I’d say on a population level exercise (as in more active, less sedentary lifestyles) will be a large factor. Though on an individual level you are right that diet will be the big thing. Though population level there is also a lot of food policy and incentive structures we could alter to improve diets in general as well.
  • californical 4y ago
    For one, we can start to treat city planning as a healthcare issue. Limit zoning restrictions that currently make driving everywhere the most convenient choice, stop all freeway expansion projects, and make as many walkable, bikeable, friendly neighborhoods as possible. If people want/need to go outside and walk or bike to accomplish their daily chores, they won’t need to think about exercise as much because it’ll just be an automatic part of their routine. The best kind of health outcomes are based on societal changes, not personal responsibility (“you need to go to the gym and punish yourself” has been failing us). And people will be happier too, if they are more connected to their community (after the initial grumbling about how “hard” it is). It’s so hard to walk/bike around in the US that I don’t blame people for not doing it more (as an avid walk/run/biker myself). That doesn’t mean we get rid of all current development and suburbs, but just eliminate the current restrictions which enforce that lifestyle, and let people’s communities start transforming slowly into healthier ones.
    • zepppotemkin 4y ago
      That would be nice but I don't see that happening outside of boutique cities like bentonville you really need to start fresh or force it before hitting the inflection point
      • californical 4y ago
        When things like tax revenue-per-acre starts adding up, it’ll also be more affordable to live in denser areas. By removing zoning restrictions, some communities will start becoming more walkable & mixed-use than others. Since it’s more cost efficient, it’ll be cheaper to own a townhome in a dense area than an equivalent townhome in a sprawling area (after the market equalizes & we can keep up with demand, because it’ll be sky-high for those walkable townhomes at first). But if zoning is reduced, supply will start to catch up. People in sprawling communities will start needing to pay more for taxes for things like road maintenance etc since they have much higher costs per person than a dense area, further starting to push people to favor dense areas. Are people willing to pay the actual cost of living in remote areas like suburbs? It’ll happen slowly at first, but just removing the current laws that prohibit that sort of development may actually enable those changes to happen automatically
  • switchbak 4y ago
    The way we design our systems is what made this mess, we can also design systems that lead to better health outcomes. We can also look around and see what other countries are doing right (and wrong).
    • midoridensha 4y ago
  • nu11ptr 4y ago
    For starters, they could stop encouraging unhealthy eating (cough food pyramid cough). We should be be eating like our grandparent's grandparents (or as I call it: 'A real food' diet) but instead they tell us to shun meat but feel free to eat all the heavily processed carbs with HFCS and canola oil foods you want. Don't eat red meat, but pizza and fries are just fine!
    • noduerme 4y ago
      This is true. There are also, though, other environmental factors that make it harder to maintain healthy weight in postindustrial countries than it was in the past, even if you eat no processed foods, cap your calories and work out regularly. Pharmaceutical and industrial waste in the water supply, Roundup in the grain supply, pesticides, hormones in the meat. Personally I'm swayed by the argument that these are at the root of other issues too, like gluten intolerance. I'm all for encouraging people to eat healthier but some of this is beyond what an average person can control unless you grow your own food and drink from your own well.
      • nu11ptr 4y ago
        Agreed, my suspicion is our problems are 'multi-causal' which is why it makes it so difficult to pin it down to just one thing.
      • worldshit 4y ago
        > unless you grow your own food and drink from your own well there was a post a few days ago about Australia: home-farmed eggs have 40x more lead than the industrial ones, because of unchecked pollution in non-agricultural areas...
        • dont__panic 4y ago
          I was under the impression that that "40x" argument" largely speaks to pollution in cities and suburbs. Curious how the rural/urban breakdown relates to that number.
    • deleted 4y ago
  • smeagull 4y ago
    Driving is legislated into city design.
  • c54 4y ago
    Average amount of exercise has gone up and average amount of alcohol consumed has gone down. Those two factors alone cannot explain the steady rise in obesity starting in the 1980s in the US and other developed nations. This[0] analysis points to environmental contamination, specifically three candidates: animal antibiotics, PFAs, and lithium. https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-part-i-mysteries/ https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-p...
    • Denvercoder9 4y ago
      > Average amount of exercise has gone up Exercise is not the only thing that matters. If you eat twice as much, but exercise only 1.2x as much, you'll still get fat.
  • godelski 4y ago
    > and start walking everywhere instead of driving. This sounds nice until you actually look at most of America. Cities are designed around cars. I'm in a rather walkable city and the nearest grocery store is a mile away. That's not too bad, but other places I've lived it is 5+. Buses are bad (hour+ between pickups) or non-existent. It gets difficult to do all kinds of chores, visit the doctor or whatever. Even using a bike my grocery store shopping becomes a multi-hour experience that I have to do more than once a week where a car is 30 minutes and once every week because I can carry more. The experience is completely different in a city where I would rather actually walk than take a car. I don't think this is an uncommon experience either. What I'm trying to say is that it isn't great to just tell people to start walking but rather to recognize the design and incentives places by that design. The burdens that it creates. If you want people to walk more for their commutes then you need to design cities for walking. I've lived in many places in America where sidewalks are non-existent. If you live in these places and walk you either have a death wish or a DUI. But rather, build it and they will walk.
    • EVa5I7bHFq9mnYK 4y ago
      You can walk/bike/bus to a store and then order uber back to carry all the bags.
      • wildrhythms 4y ago
        Have you visited the U.S.? Suburban sprawl has made it a 1-2 hour walk one-way to a grocery store in many places (if you can walk there at all). In many places there isn't even a sidewalk.
        • EVa5I7bHFq9mnYK 4y ago
          I lived in CA, AZ, NV, NC, FL, NJ and NY, and visited a dozen of other states. There was always a large grocery store I could walk or bus to.
          • godelski 4y ago
  • LoveMortuus 4y ago
    They could also try obesity tax, where you're taxed more of you're obese.
    • LoveMortuus 4y ago
      Money is quite a good motivator, especially when it's being taken away from you.
  • deleted 4y ago
    [deleted]
• bluedino 4y ago
  We're just ordering meals in and staying our homes more. Yay.
• Barrin92 4y ago
  obesity isn't a crisis of the healthcare system, it's a cultural crisis at a macro level. You don't need 'healthcare advice' as if giving individual people recommendations has any meaningful impact, you need to tackle it a social level. Living designed around movement rather than cars, prices up on high calorie foods, nationwide exercise programs in schools, put a ban on all ads for sugary drinks like Singapore did, etc.
  • voidfunc 4y ago
    Or you know we can just let people live and die as they want to. Inform them of the risks but we don't need to go to draconian levels to prevent this.
    • barbazoo 4y ago
      Do people want to be obese? I doubt it.
    • vasco 4y ago
      Nobody likes to be obese or genuinely thinks it's better, they just post-rationalize it to feel better about a situation they deem to hard to change, in the same way some deaf people rationalize it's actually better to literally not hear. Humans will tell themselves anything to cope, and the only hope we have is that other humans call that out instead of enabling it. Or we just let society crumble from a health crisis that is totally preventable. Health care money is limited and obesity kills people with other illnesses by taking away resources.
  • barbazoo 4y ago
    I'd like to see all those things.
• mushbino 4y ago
  Poor health is extremely profitable in the US. From the food industry to healthcare. Drug addiction is profitable. There's little incentive to do much about it at a public level.
• anovikov 4y ago
  Obese people are simply a market for healthcare system. They have totally no incentive to do anything about it - will mean leaving tons and tons of money on the table. Preventative healthcare kills repeat business.
• seper8 4y ago
  Guess politicians are afraid of scaring away their voter base by telling them to lose weight
• lm28469 4y ago
  > One of the greatest failings of our "modern" healthcare system Healthcare has nothing to do with it. There is no medicine or medical treatment to cure obesity, it's a lifestyle issue
• npteljes 4y ago
  >One of the greatest failings of our "modern" healthcare system I'd rather put the "failings" in quotes, instead of the modern. Contrary to it failing, it seems to be working rather excellently as business.
• tomjen3 4y ago
  Obese guy here, we know. We don't really need the health system to tell us to drop weight (though of course, as a doctor inform us anyway). What we need is a sufficiently strong reason. Food is great and tasty, so we need a really good reason. Mind you, everything is also more difficult as an obese person, so convincing me to lose weight so that I can e.g run better is really kinda pointless. Doctors and the medical system can help with the issues around it, and manage the effects, but they are really the wrong place to solve it. And no, the answer isn't making the streets more walkable (the streets around where I live are pretty walkable), or more places to exercise, since obesity is a diet thing. And there is the issue, I think. The modern world is outstanding at solving wants by adding things. The problem is here you have to solve a problem by removing things. I don't think this problem is solvable in the modern world at all, unless you are willing to institute calorie ration cards.