Carbohydrate-Insulin Model and obesity

[Vorpal]

We are the fatest nation in Europe with all the health implications attached to that statistic,it didn't happen by chance or by freedom of choice,as all other European nations AFAIA have the same freedom of choice.....

Are you all that certain that being fat is such a problem? Yes, it is associated with some specific health issues, but it doesn't necessarily result in a worse outcome.

That beside the point, in hospitals in Norway or Denmark, the situation is a little different, in that there are fewer vending machines, and healthy food is offered alongside the junk food. But if you go into the shop in a hospital, you see an awful lot of people walking away with coke and crisps, or ice cream, rather than fruit and a yogurt, or a sandwich.

Where folks here seem to do a little better, is being outdoors and getting exercise.

[reohn2]

Are you all that certain that being fat is such a problem? Yes, it is associated with some specific health issues, but it doesnæt necessarily result in a worse outcome......

Being a little over weight isn't a big deal,but being obese or morbidly obese restricts movement and pleasure of life,whilst putting a greater strain on the body in general.
I'm about 6kg over what I like to be and 8 or 9 over what I'd call my fit for anything optimum weight,and I can feel it,people who've never been an optimum weight and fittness won't know any difference.
That said some sportsmen and women need to carry a little extra weight but most sports not as fat.

[ianrobo]

I'm about 6kg over what I like to be and 8 or 9 over what I'd call my fit for anything optimum weight,and I can feel it,people who've never been an optimum weight and fittness won't know any difference.

weight is one marker but plenty of others .... what is your BP like, your blood sugars, your trigs (cholesterol is a myth IMHO so not including that !) and inflammation markers.

and would say to anyone that we have a total obsession over weight when it is misplaced. Obviously if you have certain targets in cycling weight is important but then you balance that out.

[reohn2]

I'm about 6kg over what I like to be and 8 or 9 over what I'd call my fit for anything optimum weight,and I can feel it,people who've never been an optimum weight and fittness won't know any difference.

weight is one marker but plenty of others .... what is your BP like, your blood sugars, your trigs (cholesterol is a myth IMHO so not including that !) and inflammation markers.

and would say to anyone that we have a total obsession over weight when it is misplaced. Obviously if you have certain targets in cycling weight is important but then you balance that out.

BP is spot on and has never been high or low(I test it myself occasionally).
Last blood test showed spot on but on the crusp of anaemia I was prescribed folic acid.

[foxyrider]

I'm about 6kg over what I like to be and 8 or 9 over what I'd call my fit for anything optimum weight,and I can feel it,people who've never been an optimum weight and fittness won't know any difference.

weight is one marker but plenty of others .... what is your BP like, your blood sugars, your trigs (cholesterol is a myth IMHO so not including that !) and inflammation markers.

and would say to anyone that we have a total obsession over weight when it is misplaced. Obviously if you have certain targets in cycling weight is important but then you balance that out.

I've been around my current 85/7kg for quite a while, it gives me a BMI of @26 making me over weight. I'd like to be closer to 80kg - it would be less to drag up the hills after all but despite using all sorts of dietry plans I always settle about the same weight.

During my 'health scare' last year I was checked for just about everything, BP a bit low (well it always has been), heart rate low (I have been cycling for over 40 years so again no surprise) everything else, sugars etc all checked out aok and the NH staff were not concerned about the BMI as i'm quite obviously (with 24" tbighs and 16" calves, an xray revealed my thigh bones to be almost twice 'normal thickness too to hang all that muscle from) heavily muscled but otherwise quite lean, clearly not the verging on obese the BMI suggests.

So where does that put me in the model? BMI suggests i'm obese but a rudimentary body fat test (pinch an inch, I just about manage half of that) suggests not. Without the muscle mass i'd likely fall quite easily into the okay zones.

OTOH I see plenty of persons on the streets where the model may be appropriate - clearly carrying lots of 'blubber' with no real muscle development. They are quite clearly not anywhere close to being at a healthy build and may well be susceptible to health issues related to their physioloy. I think great caution needs to be taken when applying general health models to a more physically active group - ie sportsmen/women.

[ianrobo]

BMI is the biggest myth out, I am 5ft 10 85kg or so and around BMI of 30 - edge of obese ...

However my BP is usually 120/75

Resting Heart rate at 50

Trigs very low (despite high fat diet)

Blood sugars spot on

etc ...

so what is BMI telling me ? nothing ....

[fullupandslowingdown]

an idea:
Once upon a time humans walked around collecting food as they found it. Most of it was either animal origin that nutritionally means lots of fat and some protein and hardly any carbs. Or it was edible plants which had fibre, small amounts of protein, and some complex carbs. Seasonally berries and fruit would be available which tended to be more simple sugars, but most of the time these would be in short supply.
Humans would walk for long periods hunting for animals to kill. And there'd be the odd bit of running. maybe a wrestle with a bear too
Natural selection would mean that humans would develop systems for living off a low carb, high fat diet, with the facility to process occasional boosts of sugar.
Until a few thousand years ago that remained the case when sowing crops started to develop. Adaption takes a while though and as the human diet has changed the most in the last 50 years when consumption of sugar has skyrocketed, this is why we have such a problem with diabetes. A few centuries ago diabetes was a disease of the wealthy, those who could afford 'sweetmeats' and sugar rich food.
A co-morbid change has been in the timing of human meals. We now seem to have bigger meals later in the day.
More studies show that people tend to convert sugar taken later in the day direct to fat stored predominately around the belly. And in general, sugars taken during the day but not used for supporting exercise also get laid down as abdominal fat.
It's believed that abdominal fat impairs the function of the pancreas, liver and kidneys, as well as possibly harming the heart.
The pancreas is programmed to release insulin to enable blood born sugar to be used. However sugar in excess harms the mitochondrial that converts energy in food form to muscle energy. As this deterioration happens, the uptake of blood sugar by the muscles reduces which causes the pancreas to issue increasing amounts of insulin in an effort to get the energy across.
After prolonged periods if left unchecked, this ramping up of insulin production to counteract the reduction of insulin sensitivity of the mito whatnot, cause the pancreas to burn out. This is diabetes.
More and more studies are showing that high fat low carb diets stop diabetes from developing, and can (with care) reduce existing diabetes (type 2) possibly as much as stopping medication all together.
Fat must be good quality, not processed fats such as trans. Despite earlier concerns, dairy fats aren't that bad for you either. Certainly better than as many calories of high energy drink.
Clinical research also shows that the body is fooled into thinking that artificial sweetners are sugar, and so signals the pancreas to produce a dollop of insulin. This then finding no sugar to use, it messes around and you end up with even more fat shuttled off to storage around the abdomen.
.
Of course all this might be proved to be bogus science promoted by purveyors of 'healthy' and natural food. But the statistics really do seem to support the later theory

[random37]

Obesity is an emotional problem. People eat themselves to death because in the moment they do so it makes them feel good. This has all happened within the last 30 years, because food companies have been allowed to make foods which are addictive, and government advice has supported a diet based on things that doesn't work.

You can all sit there, judging people on their dietary choices and appearance, but think of it this way. Why are these armies of obese people a new thing? What has changed? OK, people are doing less exercise, but on its own that is not enough to become morbidly obese.

Approaches to weight loss based on diet and exercise are reductivist answers to a complicated problem, and the evidence shows that they don't work for most people. If they did, Weight Watchers would not be a massively profitable company owned by Heinz.

531colin, congratulations to your daughter for showing such self control, but is she really going to measure everything she eats for the rest of her life with an app? Measuring and logging everything you eat before you eat it is an eating disorder. I don't have the statistics to hand, but the evidence shows that Weight Watchers doesn't work in the long term. Is it any wonder?

We have a massive problem. The first part is accepting that we are getting it wrong by trying to make people change what they eat, we can only begin by helping people change the way they feel about themselves.

[fullupandslowingdown]

I can't fully agree. There is the definitive evidence of brain scans that show how the brain's pleasure centre is lit up with a dose of sugar, just it is with a shot of cocaine. So it can be argued that sugar has both emotional and physical addictive properties. But on a philosophical level, what is an emotional addictive behavior if not something born from the physical? Surely if we are deriving an emotional response to something other than a purely imagined thing thought out in our heads, surely then, there is a physical mechanism at work somewhere in the body. I know this risks straying into the freedom of thought and free will or predetermination.
I feel better when I have healthy exercise such as walking or cycling. If I was to go long enough without such exercise I would become increasingly depressed (I do have clinically recognized mental health issues) Now, if at some point I decide I MUST go out and cycle or walk to raise my mood, what is that mechanism at work here? Is it a degree of addiction to exercise, which is either or both to the endorphins, and/or the fresh air and sense of movement or connection to nature? Or my brain sensibly telling me to get off my lard posterior and jolly well do something fun!!!
Just throwing it out there... Is diabetes type 2 a result of addiction (probably not as some people who do eat healthy and exercise and aren't obese do get diabetes in midlife) But whatever the cause, we as a nation and as a planet, need to get to grips with this pandemic. It costs nations billions and individuals their life.

[random37]

...But on a philosophical level, what is an emotional addictive behavior if not something born from the physical?
Surely if we are deriving an emotional response to something other than a purely imagined thing thought out in our heads, surely then, there is a physical mechanism at work somewhere in the body. I know this risks straying into the freedom of thought and free will or predetermination.

This is interesting, though you have to wrap a towel round your head to read some of it:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380644/

I feel better when I have healthy exercise such as walking or cycling. If I was to go long enough without such exercise I would become increasingly depressed (I do have clinically recognized mental health issues) Now, if at some point I decide I MUST go out and cycle or walk to raise my mood, what is that mechanism at work here? Is it a degree of addiction to exercise, which is either or both to the endorphins, and/or the fresh air and sense of movement or connection to nature? Or my brain sensibly telling me to get off my lard posterior and jolly well do something fun!!!

Personally, I would say that your decision to go for a bike ride is self-care, and you excercise your own choice to do that. I suspect that you could decide not to go for a bike ride, too.

On the other hand, an addiction is a behaviour which which you have no control over.

Yes, you can say fat people are fat because they ate food that made them fat. But you can't say that fat people don't know eating the wrong foods isn't connected to their being fat.

Do you really think anyone would make a conscious choice to be fat? Being fat ruins your life. You become a butt of cruel jokes. No clothes fit you. You can't even walk properly anymore.

No one would choose those things, ever. A man who was addicted to gambling doesn't choose to lose his children's home, and drug addicts wouldn't choose to sell their bodies on the street.

Just throwing it out there... Is diabetes type 2 a result of addiction

I think you're trying to make this question binary. The answer, surely is that some people just end up with diabetes as they get older, but that others end up with diabetes as a consequence of addiction. My sister is on track for going blind and losing her leg because of diabetes. I've seen her try to not eat very sugary foods. She can keep it up for a while, but the strain is always unbearable.

But whatever the cause, we as a nation and as a planet, need to get to grips with this pandemic. It costs nations billions and individuals their life.

I agree. The way we need to start is by thinking about the way we, as individuals and as a society, look at each other. And governments need to accept that the dietary advice of the last 40 years has been terrible.

I found this book interesting, I'd love for you to pick up a copy and tell me what you think.

http://chasingthescream.com/

[Vorpal]

First of all, while it is clear that emotions and physical health are tied together, to suggest that 'obesity is an emotional problem' ignores scientific evidence tying it to gut bacteria, genetics, insulin response, metabolism, activity, sleep, and other things. For most people, there will be multiple factors involved. It's difficult to unwind them all, and medical professional are often unwilling, simply telling people to exercise more and eat less.

Second of all, the 'emotional problem' approach isn't necessarily helpful in finding a way to improve oneself. Whilst I am certain that a minority of obese people could find that a helpful model, and path to recovery, most would would simply feel worse about themselves.

I do think that it is disctinctly unhelpful for the medical profession to ignore that mental health aspects of obesity, it also cannot be looked upon as the sole or primary cause.

[random37]

First of all, while it is clear that emotions and physical health are tied together, to suggest that 'obesity is an emotional problem' ignores scientific evidence tying it to gut bacteria, genetics, insulin response, metabolism, activity, sleep, and other things. For most people, there will be multiple factors involved. It's difficult to unwind them all, and medical professional are often unwilling, simply telling people to exercise more and eat less.

Of course there will be multiple factors behind everyone's obesity. Sorry if I have not made myself clear. However, we nearly always ignore the emotional side of overeating because it is too hard to fix easily.

Second of all, the 'emotional problem' approach isn't necessarily helpful in finding a way to improve onesefl. Whilst I am certain that a minority of obese people could find that a helpful model, and path to recovery, most would would simply feel worse about themselves.

Why a minority? What are you basing that statement on?

My weight is falling off (13kg since January, from my all-time high of 143kg). It's purely down to eating good food at the right times, making sure I'm sleeping better, and doing things to make me feel better about myself. I haven't gone on a diet, and have no plans to do so. My blood pressure has gone from discussions of being on statins, to being a bit high.

I don't think I will ever be back at the weight I was when I was in my twenties, when I would ride 300 miles a week, had a resting heart rate of 48, and could reasonably have been called an athlete. Perhaps I could do it for a little while. But I'd never be able to keep it up, and the weight would pile back on. More to the point, I don't think I want to! It's too much focus on one part of your life, and it doesn't fit in with what I want to do now.

I don't think there is a healthy road to being at the weight a chart says I ought to be, and unless there is some fantastical medical discovery(good luck, with the state of medical funding, Trump and Brexit) I don't believe "recovery" from obesity is possible for most people. Obesity is a health problem that needs to be managed, not something that will go away if you go on a diet for a bit.

Still, almost all the fat people I know make themselves miserable trying to chase external goals about where people have said they are supposed to be, and if they don't reach them they are judged as lazy and stupid. Apart from being mean, it doesn't work. Change needs to come from self-acceptance and kindness, not judgement and guilt. You don't guilt someone into a healthy relationship with food any more than you guilt them into heterosexuality, sobriety or anything else for that matter.

TL;DR: It's far more important to be happy and reasonably healthy than miserable and chasing the goals someone else has said you should aspire to.

[Vorpal]

I think that we have somewhat misunderstood each other. Or that we aren't too far off agreement...

I would prefer to think of it as mental health, rather than an 'emotional issue'. Mental health in general is badly managed by the NHS, and by Western society. Something like 'emotional eating' is just one part of that. It is a big part of obesity/overweight for many people, and often ignored. The medical profession needs to take a look at that, and people who want to lose weight and get out of poor food & lifestyle habits definitely need to pay attention to this aspect of it.

The reason that I prefer to think of it as a mental health issue is that to call it an 'emotional issue' goes dangerously close to blaming the victim, which tends to make people gain weight, rather than lose it (victim blaming, I mean). Furthermore, there is cultural baggage associated with that simple word 'emotional', as if someone just needs to stop being overwrought & emotional, and they can sort themselves out. Women, especially those who have recently had significant life changes (e.g. having a baby) trying to get various medical issues resolved are often told that they are 'just emotional'. Of course mental health has it's own baggage, but that at least has some attention in Western culture.

Mental health also encompasses a larger picture of self-esteem, depression, self-worth, and the thought processes that can make these worse, or help someone recover. As it stands now, however, people wanting to lose weight do not generally receive any sort of therapy or support unless they are diagnosed with an eating disorder, which seems to me to be unfair, especially as it would be far more cost effective for the NHS (or other health systems) to consider the whole person, and not just refer people to charities when they want emotional / mental health support for losing weight (or many other mental health issues, for that matter)

That said, I'm still not convinced that the medical establishment hasn't gotten alot of the the stuff on weight & what's appropriate worng. Sorry about all of the double negatives, but what I mean is that Western society has established a great deal of modern medicine on 'healthy' weight tables that were established in principle after WWII, when rationing was still in place, and most people did not have access to an excess of food.

If you look at recent studies on health outcomes according weight, people in moderately 'overweight' categories have as good as, or better outcomes as those in 'healthy' weight categories, and better than those who are considered underweight. Obesity is a different matter, but I suspect that if they threw away our preconceived notions about weight, and drew new tables based upon data and health outcomes, the range of 'healthy' weight (or BMI, if you prefer), would go much higher. Also, our natural body weights are somewhat heavier than what the tables & charts would tell us are 'healthy'

Being active, and getting plenty of exercise mean more to health outcomes than whether someone has a BMI of 22 or 32.

TL;DR: It's far more important to be happy and reasonably healthy than miserable and chasing the goals someone else has said you should aspire to.

I definitely agree with that!

[random37]

I think that we have somewhat misunderstood each other. Or that we aren't too far off agreement...

I see what you mean.

I suspect the way you and I use the word "emotional" is different. It never occurred to me but of course you're right; it's often used a put down, especially if you're a woman.

I am glad we have cleared that up, and sorry if I came across as a bit belligerent. I get so angry at the diet industry, and the casual labels put on people based solely on their appearance. Terms like "blimp" and "blubber" have both been used to describe people's appearance in this (very civilised) discussion. Imagine how it would read if people used slang to describe people's skin colour rather than the body fat they are carrying!

[ianrobo]

I think you're trying to make this question binary. The answer, surely is that some people just end up with diabetes as they get older, but that others end up with diabetes as a consequence of addiction. My sister is on track for going blind and losing her leg because of diabetes. I've seen her try to not eat very sugary foods. She can keep it up for a while, but the strain is always unbearable.

because sugar is as addictive as other substances, it takes an effort to get yourself off it and some people are unable to despite the damage it does.

Hence why I fully support the sugar tax, it should be larger and more wide ranging including fruit juices etc which are just as bad as Coke etc.

Also how many people really believe that being fat causes T2D and not the other way round ? I.e I firmly believe being fat is a symptom of T2D/insulin resistance which can be there for many years before it gets serious enough to go to the doctors and then they treat it all wrong.