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not to mention the varying obesity rates - USA is almost double that in France - solve that problem and a lot of the health problems and costs will be solved as

by ejb999 3y ago

not to mention the varying obesity rates - USA is almost double that in France - solve that problem and a lot of the health problems and costs will be solved as well. Instead we as a country are glamorizing obesity, which has become a bizarre and deadly trend in the USA, we should attack it like we did smoking. Even my local doctors office is advertising how you can be 'healthy at any weight' - talk about gaslighting, no you cannot. Without a doubt the 'healthy at any weight' campaign is directly or indirectly funded by food companies and drug companies - neither of them which want thin and health populice.

efields 3y ago
Careful with “without a doubt” thinking when presenting a strong argument without facts to back them up. BMI is the foundation of a lot of health studies and it is increasingly called out as a bogus standard to base people’s healthfulness on. Science changes. The body positivity movement, plus sedentary lifestyles, plus the increasing cost of healthful foods, the time it takes out of your day to exercise, almost mandatory amounts of sitting in a car daily… there’s a lot of factors in modern American life that are just bad for our health. It’s not just the money spent on healthcare.
- ejb999 3y ago
  if you follow the money, it is pretty easy to connect the dots - ask yourself - who benefits the most, and makes the most money keeping people fat, and on lots of drugs?
- paulmd 3y ago
  it gets even more paradoxical when you consider total healthcare spending, and how the US system tends to weight this far more towards end-of-life care than other systems. in many cases, when looking at total life spending, things that kill you earlier actually can reduce total life spending (smokers are a great example) because it means you don't incur the three knee replacements and bouncing in and out of hospital for the last 2 years of your life and spend the last 2 weeks dying in an ICU. Having a heart attack and dying on the surgical table is pretty cheap in terms of total healthcare spending. Obesity is still cost-positive, but it's a lot less than you think from numbers like "X% of total medical funds spent on obesity" - you are going to substitute around 50-75% of that cost in cancer treatment and knee replacements instead (see table 2). https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.15116 https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/do... anyway, one of the problems is that obese people are massively stigmatized and shamed. they are already treated worse (and receive worse medical care, etc) than others, for every moment of their lives, they have constantly-reinforced negative body image, which is psychologically unhealthy to impose on people. And the point of "healthy at any size" (when not taken to an absurd extreme) is to get people to at least feel like they aren't so far gone that it's pointless to make better choices, because starting to make better choices are the foundation of starting to climb out. This is usually met (even here, in past discussions) by some variety of "good, they should feel bad", and "well, I was fat and it helped me!", but that's basically a riff on "my parents spanked me and I turned out fine". Not only is that probably not a medically-supportable opinion (stress and fear are themselves powerfully negative causative factors that place actual physical damage on the body over time), but not everyone's brains work the same in the first place. What inspires you to improve might just reinforce someone else's depressive spiral, a lot of obese people have very negative body image ("good", says the peanut gallery). Black Mirror wasn't wrong, people love having an underclass to look down on, and obese people are a very visible and very socially-acceptable underclass to punch down on. A "steelmanned" view of HAES, when not taken to ridiculous extremes (and I'm not saying nobody does!) is that it's simply asking that we not go full Black Mirror on shaming fat people, but frankly I think a lot of people don't even agree on that much, or that it would be a good thing. "It's for their own good" etc. The whole reaction to the idea of HAES, itself, is a microcosm of the social problems around obesity and self-image - how dare you feel good about yourself? Why aren't you going through every day in a haze of shame like you deserve to? It's for your own good!
tsimionescu 3y ago
Huge parts of the money are going to middlemen who do nothing productive at all (gigantic health insurance companies hiring armies of paper pushers that cause a need for more paper pushers in hospitals and pharmacies etc). Another large chunk is the enormous profits of drug manufacturers, who, entirely uniquely in the world, can set prices however they want with no government negotiation - ending up in madness like insulin being an expensive drug in the USA. While obesity is a huge issue and a huge cost factor, there are more obese countries with nevertheless a tiny sliver of the US medical budget - even after adjusting for life expectancy.

by ejb999 3y ago

efields 3y ago

Careful with “without a doubt” thinking when presenting a strong argument without facts to back them up. BMI is the foundation of a lot of health studies and it is increasingly called out as a bogus standard to base people’s healthfulness on. Science changes. The body positivity movement, plus sedentary lifestyles, plus the increasing cost of healthful foods, the time it takes out of your day to exercise, almost mandatory amounts of sitting in a car daily… there’s a lot of factors in modern American life that are just bad for our health. It’s not just the money spent on healthcare.

ejb999 3y ago
if you follow the money, it is pretty easy to connect the dots - ask yourself - who benefits the most, and makes the most money keeping people fat, and on lots of drugs?
paulmd 3y ago
it gets even more paradoxical when you consider total healthcare spending, and how the US system tends to weight this far more towards end-of-life care than other systems. in many cases, when looking at total life spending, things that kill you earlier actually can reduce total life spending (smokers are a great example) because it means you don't incur the three knee replacements and bouncing in and out of hospital for the last 2 years of your life and spend the last 2 weeks dying in an ICU. Having a heart attack and dying on the surgical table is pretty cheap in terms of total healthcare spending. Obesity is still cost-positive, but it's a lot less than you think from numbers like "X% of total medical funds spent on obesity" - you are going to substitute around 50-75% of that cost in cancer treatment and knee replacements instead (see table 2). https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.15116 https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/do... anyway, one of the problems is that obese people are massively stigmatized and shamed. they are already treated worse (and receive worse medical care, etc) than others, for every moment of their lives, they have constantly-reinforced negative body image, which is psychologically unhealthy to impose on people. And the point of "healthy at any size" (when not taken to an absurd extreme) is to get people to at least feel like they aren't so far gone that it's pointless to make better choices, because starting to make better choices are the foundation of starting to climb out. This is usually met (even here, in past discussions) by some variety of "good, they should feel bad", and "well, I was fat and it helped me!", but that's basically a riff on "my parents spanked me and I turned out fine". Not only is that probably not a medically-supportable opinion (stress and fear are themselves powerfully negative causative factors that place actual physical damage on the body over time), but not everyone's brains work the same in the first place. What inspires you to improve might just reinforce someone else's depressive spiral, a lot of obese people have very negative body image ("good", says the peanut gallery). Black Mirror wasn't wrong, people love having an underclass to look down on, and obese people are a very visible and very socially-acceptable underclass to punch down on. A "steelmanned" view of HAES, when not taken to ridiculous extremes (and I'm not saying nobody does!) is that it's simply asking that we not go full Black Mirror on shaming fat people, but frankly I think a lot of people don't even agree on that much, or that it would be a good thing. "It's for their own good" etc. The whole reaction to the idea of HAES, itself, is a microcosm of the social problems around obesity and self-image - how dare you feel good about yourself? Why aren't you going through every day in a haze of shame like you deserve to? It's for your own good!

tsimionescu 3y ago

Huge parts of the money are going to middlemen who do nothing productive at all (gigantic health insurance companies hiring armies of paper pushers that cause a need for more paper pushers in hospitals and pharmacies etc). Another large chunk is the enormous profits of drug manufacturers, who, entirely uniquely in the world, can set prices however they want with no government negotiation - ending up in madness like insulin being an expensive drug in the USA. While obesity is a huge issue and a huge cost factor, there are more obese countries with nevertheless a tiny sliver of the US medical budget - even after adjusting for life expectancy.