[HN Gopher] Excess weight, obesity more deadly than previously b...
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       Excess weight, obesity more deadly than previously believed
        
       Author : CharlesW
       Score  : 70 points
       Date   : 2023-02-24 21:53 UTC (1 hours ago)
        
 (HTM) web link (www.colorado.edu)
 (TXT) w3m dump (www.colorado.edu)
        
       | gnicholas wrote:
       | > _Masters pointed out that a lifetime carrying excess weight can
       | lead to illnesses that, paradoxically, lead to rapid weight loss.
       | If BMI data is captured during this time, it can skew study
       | results.
       | 
       | "I would argue that we have been artificially inflating the
       | mortality risk in the low-BMI category by including those who had
       | been high BMI and had just lost weight recently," he said._
       | 
       | It's like the teetotaling bias -- a chunk of people who teetotal
       | do so because they have an illness that makes drinking very
       | unwise (or would conflict with medication).
        
         | cscurmudgeon wrote:
         | Reminds of the parachute study that was shared here recently:
         | 
         | https://healthjournalism.org/blog/2019/02/breakthrough-resea...
        
           | [deleted]
        
       | ehPReth wrote:
       | Man, food is so addictive and not like you can just stop eating
       | it like you can quit drinking booze or quit smoking!
        
         | nugget wrote:
         | For me, carbohydrate consumption and appetite are massively
         | correlated.
         | 
         | When I reduce carbs below 30g/day, my appetite is naturally
         | suppressed (or avoids over-stimulation). Food feels much less
         | addictive. It's easier not to snack in the face of stress. Keto
         | probably added 10+ years on to my life expectancy.
         | 
         | YMMV.
        
           | exfatloss wrote:
           | Cutting out carbs + protein worked even better for me:
           | https://exfatloss.substack.com/p/losing-43lbs-in-144-days-
           | on...
        
         | 8f2ab37a-ed6c wrote:
         | What's unique about food is that unlike smoking, drugs or
         | booze, a human will always have to go back to eating, it's
         | essential for day-to-day life unlike Jameson, Marlboro and
         | meth.
         | 
         | If you have a healthy relationship with food then you're fine,
         | otherwise every day you're faced with willpower checks that you
         | might struggle to consistently pass.
        
           | exfatloss wrote:
           | I don't think willpower has anything to do with it.
        
       | Someone1234 wrote:
       | This seems useful. However, some people, both inside and outside
       | medicine, believe that negative consequences' education can be a
       | solution to the overweight/obesity issue, even though after 40
       | years we've seen near no positive correlation. We've seen some
       | positive outcomes from interventions (e.g. mental health
       | treatments, actionable plans, etc.) but the funding/resources for
       | those continue to be scarce. So the trend keeps falling back to
       | education in the professional setting or bullying in the social
       | one as a "solution" because it is free, ignoring the lack of
       | efficacy.
       | 
       | I actually think our "personal moral failing" thinking is a large
       | impediment to _actionable_ solutions for society, because instead
       | of looking at WHY even 18-year-olds have gone from below 20 BMI
       | in 1879 to over 26 BMI in 2022[0] we just go around and around in
       | circles about how it is a personal responsibility issue not a
       | systemic one, while the data continues to show that it is across
       | all of society. We continue to subsidize sugar substitutes (corn
       | turned into HFCS) at the production side but sugar taxes to
       | offset the subsidies are seen as  "attacks on freedom." The US's
       | overproduction of HFCS has even lowered the international price
       | of sugar indirectly.
       | 
       | Because sugar is so cheap, and so addicting, in our capitalist
       | system the manufacturer willing to exchange other ingredients
       | (e.g. fats, proteins, etc) for sugars may be both cheaper AND
       | taste better, even if ultimately it isn't satiating. So we have a
       | bunch of foods which are high in sugar relative to historical
       | norms or that simply never existed since they exist to act as a
       | "sugar delivery system" (e.g. soda).
       | 
       | [0] https://www.calciumhealth.com/the-american-obesity-
       | epidemic-...
        
       | newaccount2021 wrote:
       | [dead]
        
       | WalterBright wrote:
       | > Excess weight or obesity boosts risk of death by anywhere from
       | 22% to 91%
       | 
       | A strange statistic, as the actual risk of death is 100% for all
       | of us.
        
         | inglor_cz wrote:
         | Could this be meant as "risk of death at certain age"?
        
         | qup wrote:
         | So far.
        
         | tshaddox wrote:
         | Strange in the same way it's strange that people might say that
         | playing Russian roulette increases risk of death by an easily-
         | calculable amount.
        
         | 2OEH8eoCRo0 wrote:
         | "I intend to live forever, or die trying." - Groucho Marx
        
         | exfatloss wrote:
         | What if you eat a lot of vegetables though
        
       | exfatloss wrote:
       | Previously believed by whom? Pretty sure we've been aware that
       | obesity is a huge problem for a generation now. I mean we
       | literally talk about an obesity epidemic.
       | 
       | Next, science is going to find out that water is wet.
        
         | saurik wrote:
         | The "science" has been saying for a long time now that there's
         | might even be a health _benefit_ from being a bit overweight,
         | and that --as this article carefully explained (which means I
         | guess you didn 't read it)-- there is a "U-shaped" distribution
         | of outcomes; in contrast, this study claims all that prior work
         | is wrong, and that there is a "straight upward line".
        
           | dkarl wrote:
           | The U-shaped distribution of outcomes has been discussed for
           | many, many years, and I've never seen it mentioned without
           | the caveat that most doctors and scientists suspect that it's
           | a misleading statistic attributable to serious illnesses that
           | cause weight loss. This definitely isn't the first study to
           | support that interpretation, either.
           | 
           | In other words, the longstanding conventional wisdom (at
           | least as presented in the media) is exactly what this study
           | set out to vindicate, not the opposite, like the press
           | release claims.
           | 
           | It's possible that this study is a significant step up in
           | quality from existing ones, and it's possible that their
           | method of considering past BMI is new and interesting, but
           | the framing of it as the first to challenge conventional
           | wisdom is pure marketing hype.
        
             | exfatloss wrote:
             | This. The U (or typically J as I've heard it described)
             | shape comes mostly from the fact that very many very
             | unhealthy people lose a ton of weight and end up with a
             | super low BMI.
        
         | netrus wrote:
         | The point is not that its deadly, but more deadly then
         | previously thought (as indicated by the title).
        
         | vanilla_nut wrote:
         | I don't believe this myself, but I do know a _lot_ of people
         | who believe being overweight is unfairly demonized and not as
         | harmful as TPTB would have us believe. Many point to BMI as an
         | inaccurate gauge of healthiness (there 's a fair point there
         | about eating disorders and ethnic predispositions towards
         | higher BMIs) and unhealthy obsessions with thinness (as opposed
         | to fitness). Look up "Fat Acceptance" if you'd like to know
         | more.
         | 
         | Personally, I don't think we should view fatness as a moral
         | failing; some people _do_ naturally tend towards higher
         | weights, especially as they get older. But I also feel that
         | fatness is really dangerous and unhealthy and the  "Fat
         | Acceptance" movement makes me a bit uncomfortable because, much
         | like smoking cigarettes, some people need a bit of a push to
         | kick bad habits like overeating. Obesity is very expensive,
         | both in money and lives, so if we can reduce it, we should.
        
           | exfatloss wrote:
           | > some people need a bit of a push to kick bad habits like
           | overeating
           | 
           | I think this is the real culprit - the idea that overeating
           | is the root cause and not a symptom, and that a little bit of
           | a push makes a difference.
        
           | swatcoder wrote:
           | * * *
        
           | rootusrootus wrote:
           | > I do know a lot of people who believe being overweight is
           | unfairly demonized
           | 
           | Because it is. As you yourself allude to later...
           | 
           | > I don't think we should view fatness as a moral failing
           | 
           | It clearly is not. I suspect the only people who believe that
           | are the folks 'born on third base' as it were.
           | 
           | > some people need a bit of a push to kick bad habits like
           | overeating
           | 
           | Some people? The vast majority of people are overweight.
           | Anyone who isn't fit & trim has no business commenting on
           | anyone else's bad habits and moral failings. None. Got a
           | little bit of a spare tire? Shush. Got some love handles?
           | Shush. Skinny fat? Shush again!
           | 
           | > if we can reduce it, we should
           | 
           | 100% agree.
        
             | tekla wrote:
             | > Because it is. As you yourself allude to later...
             | 
             | No its not. Its nowhere near demonized as it should be.
             | 
             | > It clearly is not. I suspect the only people who believe
             | that are the folks 'born on third base' as it were.
             | 
             | It's a failure of self control.
             | 
             | > Some people? The vast majority of people are overweight.
             | Anyone who isn't fit & trim has no business commenting on
             | anyone else's bad habits and moral failings. None. Got a
             | little bit of a spare tire? Shush. Got some love handles?
             | Shush. Skinny fat? Shush again!
             | 
             | Untrue. The vast majority of people in rich countries are
             | overweight.
        
               | exfatloss wrote:
               | > It's a failure of self control.
               | 
               | Disagree. The root cause of the problem is that you can't
               | apply to more willpower if you don't know how to actually
               | fix it, and we don't.
               | 
               | There are currently 0 known methods to lose fat
               | sustainably. Yea, you can starve yourself for a few weeks
               | in a thousand ways, but none of them lead to lasting fat
               | loss. Neither does any kind of exercise.
               | 
               | We need to find the true root cause, or this will not
               | change.
        
         | Someone1234 wrote:
         | > Previously believed by whom?
         | 
         | The previous data/methodology. The whole point of the study was
         | to look at three untracked externalities[0] in BMI-outcome
         | research. They used historical NHANES data combined 2015 data
         | on mortality data.
         | 
         | > (1) confounding bias from heterogeneity in body shape; (2)
         | positive survival bias in high-BMI samples due to recent weight
         | gain; and (3) negative survival bias in low-BMI samples due to
         | recent weight loss.
         | 
         | https://www.tandfonline.com/doi/abs/10.1080/00324728.2023.21...
        
         | 8f2ab37a-ed6c wrote:
         | https://asdah.org/health-at-every-size-haes-approach/ - and
         | similar efforts have sprouted like wildfire these last several
         | years in the name of inclusivity. Claiming or hinting that
         | obesity is bad for one's health is considered highly gauche in
         | polite company.
        
       | thriftwy wrote:
       | There was an article[1] about two gene mutations which cause (a)
       | lose fat, lose muscle, and (b) lose fat, gain muscule.
       | 
       | If you could build a selector between these three models (normal
       | human, (a), (b)), you could solve HALF OF HUMANITY PROBLEMS. For
       | real.
       | 
       | That's not a joke. I see a lot of people around whose lifes are
       | crippled by the fact they're not in the body mass which would be
       | most productive/healthy for them. People are losing a decade of
       | life and another decade of productivity due to this. A lot of
       | interpersonal problems are also due to this, more than you can
       | imagine. Half of world's perceived social injustice go away once
       | you fix BMI.
       | 
       | We do not even realize the amount of self-humiliation humanity
       | suffers by not being able to control something so fundamental.
       | 
       | Disclaimer: My own body weight is normal, though I would perhaps
       | accept additional muscle; but it pains me seeing people who
       | suffer from this every day, people who are better than me in most
       | other respects.
       | 
       | 1. https://davidepstein.substack.com/p/the-diy-scientist-and-
       | th...
        
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       (page generated 2023-02-24 23:00 UTC)