4 ms·

Candidly, this makes me question whether we've correctly identified the "normal" weight.

JumpCrisscross 2y ago
> this makes me question whether we've correctly identified the "normal" weight Where did those questions lead you? A BMI above 35 (severe obesity) is "associated with significantly higher all-cause mortality" [1]. Regular obesity (30 to 35) is associated with higher morbidity, e.g. CVD, GERD and asthma. (Being underweight is more dangerous than being overweight [2].) [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC5401682/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5401682/ [2] https://www.nature.com/articles/s41598-023-29586-w https://www.nature.com/articles/s41598-023-29586-w
- imzadi 2y ago
  I don't understand why when it comes to weight critical thinking goes out the door. People always point to these things and say weight causes them, but no one ever considers these things may actually lead to people gaining weight. I say this as a person who has struggled with weight their whole life. I've spent 40 years having every issue dismissed by doctors with a "you just need to lose weight," while I sit at a dinner table with friends and family eating significantly less than everyone and still gaining weight. It's like people are so committed to the idea of weight gain being a moral failing, they won't consider for even a minute that people are gaining weight for other reasons.
  - JumpCrisscross 2y ago
    > People always point to these things and say weight causes them, but no one ever considers these things may actually lead to people gaining weight How did you conclude this? The evidence we have says obesity causes mortality [1]. > while I sit at a dinner table with friends and family eating significantly less than everyone and still gaining weight Yes, this is metabolic syndrome. There is increasing evidence that some peoples' bodies will reduce base metabolism to compensate for reduced calorie intake or exercise, sometimes to the point of permitting starvation despite food intake, in an effort to conserve body fat. Modelling nutrition thermodynamically is like trying to model flight with Newtonian dynamics. You can do it. But not in a practical way, and certainly not when it comes to edge cases. > people are so committed to the idea of weight gain being a moral failing Sorry you've experienced this. I've seen it too, in peoples' zero-information dismissal of e.g. Ozempic as a moral failing. (For disclosure, I've only dealt with weight gain as a cosmetic issue.) Sun exposure causes melanoma. That doesn't make the beach evil. It just means that causation is established. It's not perfect. But if you're at risk of melanoma, knowing that causation helps. In the same vein, obesity causes mortality. That doesn't make being obese (or overweight) evil. It just means the causation is established. It's not perfect. But if you're obese, you and your doctors knowing that causation helps. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC2765728/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2765728/
  - dgfitz 2y ago
    > eating significantly less than everyone I wouldn't focus on that, food intake relative to others will be misleading. Have you tried a food journal? For a week, take a picture of __everything__ you eat or drink. Go back and review it at the end of the week, a month would be better. If you review it and think "yes, this is a reasonable amount of food" you now have a months worth of data to shop around to a doctor who can help you. If you have the opposite reaction, now you have a baseline to work against. As an aside, do you drink a lot of soda?
    - imzadi 2y ago
      I don't drink soda at all. I have used food journals for years.
      - dgfitz 2y ago
        Yeah I mean I assume over 40 years you’ve tried IF, vegan, keto, gluten-free, etc. Good luck, your tone is defeatist and I don’t have the energy to engage any more.
    - Izkata 2y ago
      > Have you tried a food journal? For a week, take a picture of __everything__ you eat or drink. Go back and review it at the end of the week, a month would be better. I don't think this is sufficient. I started tracking calories a few years ago, and it turned out one of the meals I thought was high-calorie was actually low-calorie. Also with calorie tracking, only need to do it for a week or so and see if what you're eating is what you think you're eating. Something might add up to much more than you think.
      - dgfitz 2y ago
        I’m not saying track calories specifically, it’s just very enlightening to look at everything you ate over the course of a day, a week, a month.
  - lopkeny12ko 2y ago
    > eating significantly less than everyone and still gaining weight What I have learned time and time again is that people are at best inaccurate at counting their caloric intake or at worst just entirely dishonest about how much they at eating. You are most likely eating a lot more than you think you are and have normalized it after 40 years of doing so.
  - s1artibartfast 2y ago
    metabolic health can be a factor in obesity, but the primary driver of metabolic dysfunction is also diet and exercise. It is possible that you may metabolize food slightly different from other people. What is not possible is that your body is defying conservation of energy and mass. I wont go into all the possible problems with using dinner comparison as a benchmark, because the charitable take is that you sharing a sentiment, not proof of anything.
    - JumpCrisscross 2y ago
      > What is not possible is that your body is defying conservation of energy and mass Your body has a lot of latitude in modifying its base metabolism. Folks with metabolic syndrome can reduce food intake to virtually zero and their bodies will still try turning off vital mechanisms before burning fat stores. Most people get into obesity through bad habits. But good habits aren't enough to get out. (The exception to my first statement are those with genetic or hormonal factors.)
      - s1artibartfast 2y ago
        Metabolic syndrome is a board classification, and what you described constitutes a tiny portion. For the vast majority of people with Metabolic syndrome, lifestyle change is both capable and necessary for reversing the issue. The challenge is that the syndrome is resistant to incremental change require a lot more than simply adopting what would otherwise be healthy steady state behaviors. That is to say, the syndrome goes away if you get back to a normal weight, it is just extremely hard to do it. Im hopeful GLP-1 drugs will help some people break through this wall.
- Izkata 2y ago
  You skipped right over what I think they were referring to: "overweight" (BMI 25-30) vs "normal" (18.5-25). Evidence there isn't as clear, I've occasionally but regularly for decades run across some that overweight could be healthier than a normal weight.
  - JumpCrisscross 2y ago
    Got it. And agree--that's the finding of the second source. "Possible explanations have included earlier presentation of heavier patients, greater likelihood of receiving optimal medical treatment, cardioprotective metabolic effects of increased body fat, and benefits of higher metabolic reserves" [1]. In summary, obesity (BMI > 30) is a health problem. 40% of Americans are obese [2]. I'd be curious to see what fraction of overweight Americans become obese versus normal weight become either obese or underweight--the presumption seems to have been that being overweight (particularly when young) is a risk factor for obesity. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC4855514/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4855514/ [2] https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity https://www.niddk.nih.gov/health-information/health-statisti...
dragontamer 2y ago
Why would the "normal" weight (or BMI) change between 2024 and 1974? BMI has been in usage for over a century. Its never been a perfect measurement (neck is also taken into account in Navy tests IIRC), but function(weight, height) is good enough for the basics.
deleted 2y ago
[deleted]
fallingsquirrel 2y ago
Considering: - a century ago a greater percentage of people were "normal" weight - human physiology has not changed much over the past century - our current definitions of overweight/obese correlate with negative health outcomes I think the classification is largely correct even if you can haggle over some of the smaller details. (EDIT: That said, people shouldn't be downvoting you just for asking the question, sorry that happened)
- JumpCrisscross 2y ago
  > people shouldn't be downvoting you just for asking the question I didn't downvote. But if you're asking a question, ask it. Don't phrase it as a statement while pretending it's a question. And if you're making a statement, substantiate it. Ending a question with a period is borderline intellectually dishonest.
- Izkata 2y ago
  > - human physiology has not changed much over the past century With improved nutrition, people are several inches taller than they were a century or so ago.
  - fallingsquirrel 2y ago
    That isn't a change of physiology, it's a change of our external environment. AFAIK there's no evidence to show humans living 100 years ago would respond any differently to modern nutrition than we do. If the cause of being taller were internal, such as genetic changes: that would be a change in physiology.
    - Izkata 2y ago
      There are only two inputs to BMI, and height is one of them.
      - fallingsquirrel 2y ago
        That's a complete non-sequitur. If you cut off your feet and get shorter, it doesn't mean the human species has physiologically changed. And if you eat more calories and get taller, it doesn't mean the human species has physiologically changed.

> this makes me question whether we've correctly identified the "normal" weight Where did those questions lead you? A BMI above 35 (severe obesity) is "associated with significantly higher all-cause mortality" [1]. Regular obesity (30 to 35) is associated with higher morbidity, e.g. CVD, GERD and asthma. (Being underweight is more dangerous than being overweight [2].) [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC5401682/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5401682/ [2] https://www.nature.com/articles/s41598-023-29586-w https://www.nature.com/articles/s41598-023-29586-w

imzadi 2y ago
I don't understand why when it comes to weight critical thinking goes out the door. People always point to these things and say weight causes them, but no one ever considers these things may actually lead to people gaining weight. I say this as a person who has struggled with weight their whole life. I've spent 40 years having every issue dismissed by doctors with a "you just need to lose weight," while I sit at a dinner table with friends and family eating significantly less than everyone and still gaining weight. It's like people are so committed to the idea of weight gain being a moral failing, they won't consider for even a minute that people are gaining weight for other reasons.
- JumpCrisscross 2y ago
  > People always point to these things and say weight causes them, but no one ever considers these things may actually lead to people gaining weight How did you conclude this? The evidence we have says obesity causes mortality [1]. > while I sit at a dinner table with friends and family eating significantly less than everyone and still gaining weight Yes, this is metabolic syndrome. There is increasing evidence that some peoples' bodies will reduce base metabolism to compensate for reduced calorie intake or exercise, sometimes to the point of permitting starvation despite food intake, in an effort to conserve body fat. Modelling nutrition thermodynamically is like trying to model flight with Newtonian dynamics. You can do it. But not in a practical way, and certainly not when it comes to edge cases. > people are so committed to the idea of weight gain being a moral failing Sorry you've experienced this. I've seen it too, in peoples' zero-information dismissal of e.g. Ozempic as a moral failing. (For disclosure, I've only dealt with weight gain as a cosmetic issue.) Sun exposure causes melanoma. That doesn't make the beach evil. It just means that causation is established. It's not perfect. But if you're at risk of melanoma, knowing that causation helps. In the same vein, obesity causes mortality. That doesn't make being obese (or overweight) evil. It just means the causation is established. It's not perfect. But if you're obese, you and your doctors knowing that causation helps. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC2765728/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2765728/
- dgfitz 2y ago
  > eating significantly less than everyone I wouldn't focus on that, food intake relative to others will be misleading. Have you tried a food journal? For a week, take a picture of __everything__ you eat or drink. Go back and review it at the end of the week, a month would be better. If you review it and think "yes, this is a reasonable amount of food" you now have a months worth of data to shop around to a doctor who can help you. If you have the opposite reaction, now you have a baseline to work against. As an aside, do you drink a lot of soda?
  - imzadi 2y ago
    I don't drink soda at all. I have used food journals for years.
    - dgfitz 2y ago
      Yeah I mean I assume over 40 years you’ve tried IF, vegan, keto, gluten-free, etc. Good luck, your tone is defeatist and I don’t have the energy to engage any more.
  - Izkata 2y ago
    > Have you tried a food journal? For a week, take a picture of __everything__ you eat or drink. Go back and review it at the end of the week, a month would be better. I don't think this is sufficient. I started tracking calories a few years ago, and it turned out one of the meals I thought was high-calorie was actually low-calorie. Also with calorie tracking, only need to do it for a week or so and see if what you're eating is what you think you're eating. Something might add up to much more than you think.
    - dgfitz 2y ago
      I’m not saying track calories specifically, it’s just very enlightening to look at everything you ate over the course of a day, a week, a month.
- lopkeny12ko 2y ago
  > eating significantly less than everyone and still gaining weight What I have learned time and time again is that people are at best inaccurate at counting their caloric intake or at worst just entirely dishonest about how much they at eating. You are most likely eating a lot more than you think you are and have normalized it after 40 years of doing so.
- s1artibartfast 2y ago
  metabolic health can be a factor in obesity, but the primary driver of metabolic dysfunction is also diet and exercise. It is possible that you may metabolize food slightly different from other people. What is not possible is that your body is defying conservation of energy and mass. I wont go into all the possible problems with using dinner comparison as a benchmark, because the charitable take is that you sharing a sentiment, not proof of anything.
  - JumpCrisscross 2y ago
    > What is not possible is that your body is defying conservation of energy and mass Your body has a lot of latitude in modifying its base metabolism. Folks with metabolic syndrome can reduce food intake to virtually zero and their bodies will still try turning off vital mechanisms before burning fat stores. Most people get into obesity through bad habits. But good habits aren't enough to get out. (The exception to my first statement are those with genetic or hormonal factors.)
    - s1artibartfast 2y ago
      Metabolic syndrome is a board classification, and what you described constitutes a tiny portion. For the vast majority of people with Metabolic syndrome, lifestyle change is both capable and necessary for reversing the issue. The challenge is that the syndrome is resistant to incremental change require a lot more than simply adopting what would otherwise be healthy steady state behaviors. That is to say, the syndrome goes away if you get back to a normal weight, it is just extremely hard to do it. Im hopeful GLP-1 drugs will help some people break through this wall.
Izkata 2y ago
You skipped right over what I think they were referring to: "overweight" (BMI 25-30) vs "normal" (18.5-25). Evidence there isn't as clear, I've occasionally but regularly for decades run across some that overweight could be healthier than a normal weight.
- JumpCrisscross 2y ago
  Got it. And agree--that's the finding of the second source. "Possible explanations have included earlier presentation of heavier patients, greater likelihood of receiving optimal medical treatment, cardioprotective metabolic effects of increased body fat, and benefits of higher metabolic reserves" [1]. In summary, obesity (BMI > 30) is a health problem. 40% of Americans are obese [2]. I'd be curious to see what fraction of overweight Americans become obese versus normal weight become either obese or underweight--the presumption seems to have been that being overweight (particularly when young) is a risk factor for obesity. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC4855514/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4855514/ [2] https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity https://www.niddk.nih.gov/health-information/health-statisti...

dragontamer 2y ago

Why would the "normal" weight (or BMI) change between 2024 and 1974? BMI has been in usage for over a century. Its never been a perfect measurement (neck is also taken into account in Navy tests IIRC), but function(weight, height) is good enough for the basics.

deleted 2y ago

[deleted]

fallingsquirrel 2y ago

Considering: - a century ago a greater percentage of people were "normal" weight - human physiology has not changed much over the past century - our current definitions of overweight/obese correlate with negative health outcomes I think the classification is largely correct even if you can haggle over some of the smaller details. (EDIT: That said, people shouldn't be downvoting you just for asking the question, sorry that happened)

JumpCrisscross 2y ago
> people shouldn't be downvoting you just for asking the question I didn't downvote. But if you're asking a question, ask it. Don't phrase it as a statement while pretending it's a question. And if you're making a statement, substantiate it. Ending a question with a period is borderline intellectually dishonest.
Izkata 2y ago
> - human physiology has not changed much over the past century With improved nutrition, people are several inches taller than they were a century or so ago.
- fallingsquirrel 2y ago
  That isn't a change of physiology, it's a change of our external environment. AFAIK there's no evidence to show humans living 100 years ago would respond any differently to modern nutrition than we do. If the cause of being taller were internal, such as genetic changes: that would be a change in physiology.
  - Izkata 2y ago
    There are only two inputs to BMI, and height is one of them.
    - fallingsquirrel 2y ago
      That's a complete non-sequitur. If you cut off your feet and get shorter, it doesn't mean the human species has physiologically changed. And if you eat more calories and get taller, it doesn't mean the human species has physiologically changed.