Fatist anyone?

[Nathaniel]

Whatever the other damage she does, it does seem a little unfair to blame the 600 pound oboid for her costs to the taxpyer without taking account of her (presumably) reduced life expectancy and thus lower costs. If she's already 42 and intends to continue her Intensive Guzzling Scheme it's really hard to imagine her living more than a couple of decades longer.

On top of that it's not like there's a digital choice between chomping her way to 1000 pounds and being a healthy weight. Someone enjoying her obesity this much (and even relying on her flab for her income) doesn't seem that likely to stop being obese even if she weren't deliberately blubbering up. She's still going to cause many of the obesity related healthcare costs.

Obviously this is all speculative and impossible to quantify, but from a public finance perspective her body-building quest may be the best solution.

[D.Turtle]

Except that she will incur a huge amount of additional costs before dieing. So yes, that will cost more over all than not being fat.

Exactly the same thing with people who smoke, etc. Yes they might die earlier, but they will cost a lot more before dieing.

[Marcus Aurelius]

This discussion reminds me of something I saw a few weeks ago:

Amusingly, this is from Fox and the article is quite happy enough to talk about how this astonishingly bad behavior will cost the taxpayers.

I can't understand how she can afford it. I followed the Slideshow link and this is what it said in one of the captions:

To achieve her goal of becoming the world's fattest woman, Simpson consumes up to 12,000 calories a day by eating fatty foods like pizza. Simpson said it costs her an estimated $750 a week to support her habit.

That makes $3000 a month, which is more than my net income after taxes. The Web business must really be lucrative.

People like her are very often suffering from an undiagnosed mental condition, most likely depression. A person in good mental health would not willingly give up her mobility in order to eat more. This is not to say that all obesity is caused by mental problems, although there certainly is a strong correlation. Over-eating may be even more common way to self-medicate depression than alcoholism.

[PeZook]

Jesus christ! I'd have to be forced to eat 12 000 calories of fat-drenched food a day, there's no way my natural apetite could support it.

[Nathaniel]

Except that she will incur a huge amount of additional costs before dieing. So yes, that will cost more over all than not being fat.

Exactly the same thing with people who smoke, etc. Yes they might die earlier, but they will cost a lot more before dieing.

That isn't necessarily true for smokers. According to this article smokers can have lower total healthcare costs on average depending on the rate of discount.

Similarly, this study concluded that:

"Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures."

Of course none of this can be applied directly to such an extreme case, but it does show that it's possible that the 600 pound lard depot will have lower total costs and at the very least it's something that needs to be taken into account before accusing her of costing the taxpayer money.

[D.Turtle]

Interesting studies.

One question about the first study: When discussing the overall costs of smokers, they pretty much conclude that it is dependent on the "discount rate" if a population of smokers is more expensive than a population of non-smokers. What is this "discount rate"?

One thing I have to note though about both studies (and the second one acknowledged this as a weakness of the study): They do not factor in the indirect costs. Obviously, old people are more expensive than younger people, so the increased cost during the younger years of smokers and obese people is offset by the increased number of healthy people getting old. However, being sick more during the younger years (aka when people are still working) immediately adds the cost of lower productivity in comparison to people who less often sick during their "productive" years. So an accurate study should include those costs as well, if it is looking at the total cost of a given activity.

[Steel]

Interesting studies.

One question about the first study: When discussing the overall costs of smokers, they pretty much conclude that it is dependent on the "discount rate" if a population of smokers is more expensive than a population of non-smokers. What is this "discount rate"?

A "discount rate" is linked to the concept that money now is worth more than money later.

£100 now is worth more than £100 in 5 years because if you had £100 now you could just stick it in a bank you would have your £100 plus the 5 years of interest. The discount rate is this, it is telling you how much less money in the future is worth than money now.

This is why if you buy a 10 year £100 bond (for simplicity it pays nothing till the end of its life) and interest rates are at 5% the 'fair price' of the bond is the discounted value: the quantity of money that gets you £100 at that rate of interest in 10 years time: £100/(1.05)^10 = £61.39.

[General Brock]

Ok, I have an obese female friend who seems to have cultivated a gaggle of similarly obese women as friends on Facebook. Lately they have been bitching about how their doctors have been really on them about their weight and other health related issues and they have begun throwing around a term I have not heard before. Fatist.

Never heard of it, but I understand where the National Association to Advance Fat Acceptance can have appeal to some people. Being fat doesn't mean one still can't be healthy and productive. However, some people will use it as an excuse to abuse their health, ignoring problems that cause them to lead unhealthy lifestyles.

"My doctor did my annual blood test and he gave me some doom and gloom about the numbers and what they mean to me."

"Honey, he's just being Fatist because some people are just naturally large and are just fine that way. My great aunt is obese and she's still alive and kicking despite what doctors have been telling her."

"That's right, and all this talk about bad numbers is just a way to keep us all on meds and line the pharmaceutical companies' pockets with money."

People do have an overblown concerns about being 'fat', as opposed to being poorly nourished. There are drugs sold to fat people to help them regulate their metabolism, as well as help them deal with health problems that come from being overweight. Its a win-win situation to pharmaceutical companies, as even people who are not overweight will freak at a little bulge.

Huh. Fatist. So, when faced with bad numbers that medical science has universally come up with to describe something out of sorts these people decide instead of accepting that things are wrong, conclude this must be some sort of conspiracy to keep fat people down. You're not being rascist, oh no, you're being fatist.

Well, there aren't to many put-downs to having a visibly robust six-pack. A little paunch is always teaseable. I'm not saying being obese isn't a problem, but the hostility to 'fat' in society distracts people from dealing with underlying causes. If you eat a healthy diet, exercise, and are in fact healthy, obsessing over being 'fat' can be damaging.

Now I am a large man. I also happen to have been diagnosed with diabetes two years ago. It was horrible and I was depressed for a few months and it was extremely tempting for me to look at that glucose meter and say "You know what, I feel fine. So what if ideally I should be at 120 and I'm at 200. That's just a number and some people are different so there has to be a wide range, right?"

You probably know about this diabetes natural treatment site, but I'll post the link anyway. There are lots like it, and I'm sure you have the tools to sort out the quacks. While it is doubtful that there is a natural 'cure' for diabetes, you can eat better food that can ease the condition.

Granted, I have no personal experience with diabetes, and reading about different diets is for fun; a lack of personal discipline rules out following any one. I myself only go by my waist hip ratio.

Waist-Hip Ratio Measures Heart Attack Risk

November 5, 2005

Waist-to-hip ratio, not body mass index (BMI), is the best obesity measure for assessing a person's risk of heart attack, concludes a global study published in this week's issue of the British medical journal The Lancet.

If obesity is redefined using waist-to-hip ratio instead of BMI the proportion of people at risk of heart attack increases by threefold, calculate the authors.

Previous research has shown that obesity increases the risk of heart disease. However, these studies have mainly been done in populations of European and North American origin. The evidence for other populations is therefore sparse.

In the latest study, Dr. Salim Yusuf, director of the Population Health Research Institute at McMaster University and Hamilton Health Sciences, and colleagues aimed to assess whether other markers for obesity, especially waist-to-hip ratio, would be a stronger predictor of heart attack than the conventional measure of BMI in different ethnic populations.

The investigators looked at BMI, waist-to-hip ratio, waist measure, and hip measure in more than 27,000 people from 52 countries.

Half the participants had previously had a heart attack and half were age and sex-matched controls (individuals who had not had a heart attack and were the same age and sex as cases).

The team found that BMI was only slightly higher in heart attack patients than in controls, with no difference in the Middle East and South Asia.

By contrast, heart attack patients had a strikingly higher waist-to-hip ratio than controls, irrespective of other cardiovascular risk factors.

The researchers found that this observation was consistent in men and women, across all ages, and in all regions of the world.

The authors state that compared with BMI, waist-to-hip ratio is three times stronger than BMI in predicting the risk of a heart attack. Larger waist size (which reflects the amount of abdominal fat) was harmful, whereas larger hip size (which may indicate the amount of lower body muscle) was protective.

The waist-to-hip ratio is calculated by dividing the waist measure by the hip measure. The cut off point for cardiovascular risk factors is less than 0.85 for women and 0.90 for men. A higher number denotes more risk.

Dr. Yusuf concludes: "Our findings suggest that substantial reassessment is needed of the importance of obesity for cardiovascular disease in most regions of the world."

In an accompanying published comment Charlotte Krageland of the University of Oslo, Norway states: "The main message from the new report is that current practice with body mass index as the measure of obesity is obsolete. For the assessment of risk associated with obesity, the waist-to-hip ratio, and not the body mass index, is the preferred simple measure."

Dr. John Kelton, dean of the Michael G. DeGroote School of Medicine and dean and vice-president, Faculty of Health Sciences, McMaster University, said: "The results of this study will change, on an international scope, how we evaluate patients' risks for heart disease. Being able to easily identify the risk will have a beneficial effect on awareness and treatment."

No scales, no mirrors, just an honest number to keep an eye on that's not part of the fatist industry. Its simpler than the BMI and as yet has no industry built up around appearances over actual substance.

It was tempting but I overcame that little bit of self delusion and while I struggle daily with diet and taking care of myself I have embraced that there are certain things that are immutable and these numbers don't lie. You see you might feel fine now, but 20 years from now your body will be a mess if you don't try to keep these numbers low. This goes back to the analogy of the frog in the slowly boiling pot from and inconvenient truth.

The Danny Finckleman school of diet goes, "If it tastes good, eat it". So while scarfing down a cake or bag of Doritos, I stop and ask if I am enjoying the food itself. In many cases, its just eating out of habit or stress, but not actually tasting and savouring the meal. So I stop and find something I really can enjoy. Healthy meals made from scratch - with real and whole foods - tend to be more satisfying than junk and processed food. Personally, I don't count calories; eating is for nutrition; vitamins, minerals, that sort of thing and when eating 'whole' foods, calories tend to be there by default.

A simple exercise routine from boxing or yoga and that's about all most people need in addition to a reasonable diet to stay healthy.

This whole fatist idealogy strikes me as fully embracing the siren song of "I can't be sick, screw them." It seems to be also related this growing movement I see amongst the fat and obese to try and potray themselves as some sort of victims.

"McDonald's supersize menus made me fat." NO. Your mouth did. Ronald wasn't shoving those burgers down your throat.

Has anyone encountered this sort of Fatist idealogy? It's really weird to see otherwise perfectly rational people just do an about face when it comes to their health and relationship with their doctors.

Not by name, but its a mix of half truths. Fatists are victims, in a sense. The entertainment industry condemns the 'endomorph' to forever desire endo or mesomorpism, and you can never be endo or meso enough. The food processing industry happily and profitably caters to people addicted to artificial additives, sugars and salts, and gosh darn, there is the pharmaceutical industry and the doctors it educates right there to pick up the pieces. There's always a value-added solution to value-added problems.

So yeah, if my doctor told me I needed to lose weight, I might ask for tests on vitamin and mineral levels before I went on any kind of diet or started popping pills and I really wouldn't appreciate being bugged about my weight alone. Hunger means the body wants something and if its getting fatter trying to meet it, the diet may not be providing it resulting in more hunger signals.

[jegs2]

It's a good thing I'm in the Army, or I'd shun physical training altogether and probably be a blob. Have always disliked physical training, but it's so engrained in me now that I'll most likely stick with it after retirement out of habit. Have also mostly laid off sugar and high-carbohydrate foods.

My uncle is a doc, and he said it's simple: Eat more than you burn, and you'll get fat. Eat less than you burn, and you'll lose weight. My dad seems the sole exception: The man eats four plates of food and doesn't gain a pound.

[jegs2]

Found this gem online:

Huntington, West Virginia, is a small city nestled along the bank of the Ohio River. It has five parks, a famous college football team, dozens of churches, countless fast-food restaurants, a population of 49,000 and a mayor, Kim Wolfe, who rides a horse and delivered all of his eight children himself.

It has also been recently crowned the fattest city in the U.S., which is the developed world’s most unhealthy country.

Everywhere you look in Huntington, there are oversized people — in the cinema complex, outside Starbucks, squeezing into booths at Buddy’s All American Bar-B-Que.

A few are just large, but more are properly obese — bulging out in all the wrong places and too big to run, jog, ride a bike or even walk without wheezing in pain.
It isn’t just grown-ups. Grossly overweight children waddle about clutching huge bags of crisps, their legs chafing at the tops and their tummies straining beneath stretched T-shirts.

Huge teenagers slope about on street corners, smoking and drinking fizzy drinks from enormous containers. More shocking, though, is that no one’s staring. Not even covertly. Because fat is normal here. Almost half the population is clinically obese.

[General Brock]

Good grief. The Hillbilly Hotdogs cooks and serving guy are normal sized. Its a conspiracy!

Gosh darnit those sandwiches look good. If only I were a little younger and dumber again and could take the abuse...

[Akhlut]

Good grief. The Hillbilly Hotdogs cooks and serving guy are normal sized. Its a conspiracy!

Of course he is; imagine how much of a workout he gets making goddamned enormous sandwiches and lifting those monstrous portion sizes.

[Alerik the Fortunate]

Those giant hamburgers actually look like they would be fun as party food delivered like pizza and cut into wedges to feed a whole family. But for individuals? Eeew. The image and descriptions of the common people remind me of the slines from Neal Stephenson's Anathem. (In the world in which that story takes place, all the scientists, mathematicians, and philosophers, collectively called "avout," live in monasteries and only have contact with the outside world once every 1, 10, 100, or 1000 years depending on which order they join. "Slines" are a term they have for the uneducated lower class trash in the outside world, who are always described as enormous and out of shape, drinking flavored sugar water from large tubs, and thuggishly dressed.)

[Darth Wong]

Good grief. The Hillbilly Hotdogs cooks and serving guy are normal sized. Its a conspiracy!

Gosh darnit those sandwiches look good. If only I were a little younger and dumber again and could take the abuse...

Tell me you're joking. Those sandwiches look utterly disgusting.

[Rye]

The most haunting image of the Jamie Oliver thing is the "king sized" coffins. I've never even thought about how obesity would force the shapes of coffins to change to accommodate larger corpses. It makes total sense, though, and it's a powerful image.

[TithonusSyndrome]

My aunt had to be buried in one such coffin. I can't tell you the kind of unyielding terror it is to see a loved one barely squeezed into a box that makes their face look like some kind of a John Carpenter piece of latex affixed on top of a formless blob that is evenly distributed throughout the entire box like some kind of clay or other near-liquid.

[LaCroix]

This coffin shows what I first thought when I read about that 600 pound woman. "How many plots will they deed to bury her? Will they charge extra for that?"

Or maybe a cremation - since fat burns, a single urn might suffice...

[Akhlut]

This coffin shows what I first thought when I read about that 600 pound woman. "How many plots will they deed to bury her? Will they charge extra for that?"

Or maybe a cremation - since fat burns, a single urn might suffice...

The article says that cremation's not much of an option. The fat burns too hot in their ovens.

The burial process isn’t very dignified either. Because oversized coffins won’t fit in hearses, they have to be transported in the back of a cargo van. Cremation isn’t an option — with all that fat, the bodies burn hotter and longer, like human candles.

[Mayabird]

I think they also have issues with fitting massive obese bodies into the cremation chambers, though that might be a product of, "We're not going to burn people larger than X because they'll burn too hot, so we won't make them large enough to fit those people."

[Akhlut]

I think they also have issues with fitting massive obese bodies into the cremation chambers, though that might be a product of, "We're not going to burn people larger than X because they'll burn too hot, so we won't make them large enough to fit those people."

Although, now I'm curious about a post-mortem liposuction then having the cremation.

Of course, that would cost a ton extra, as then the funeral home has to find some use for 200+ pounds of rotting fat.

[Alerik the Fortunate]

New source of biodiesel, perhaps? Though really, the extra large coffins should be part of an anti-obesity educational campaign.

[UnderAGreySky]

I don't know about you, Wong, but I wouldn't mind eating about a third of that (the Hillbilly Hot dog) for dinner. I'm with Alerik here, it looks like something I'd order with a few friends and then eat wedges out of. Pizza with a difference, I guess.

That said, the coffins are.... creepy? Sad? Disheartening? I'm running through a gamut of emotions here.

[CaptainChewbacca]

The hillbilly coffins (what I'm calling them) are the most depressing thing I've seen in a while. Makes me glad I've already gone from BMI 34 to 29% and I'm still on my way down.

[LaCroix]

This coffin shows what I first thought when I read about that 600 pound woman. "How many plots will they deed to bury her? Will they charge extra for that?"

Or maybe a cremation - since fat burns, a single urn might suffice...

The article says that cremation's not much of an option. The fat burns too hot in their ovens.

The burial process isn’t very dignified either. Because oversized coffins won’t fit in hearses, they have to be transported in the back of a cargo van. Cremation isn’t an option — with all that fat, the bodies burn hotter and longer, like human candles.

How about outdoor funeral pyres, Indian style, then(and without the wife burning)? A concrete 'tub' where the coffin is lowered into, which has an open top and some gas burners to start the fire - an outdoor crematorium. Just don't use it on a windy day...

[CaptainChewbacca]

I think generally you can't get permitted for outdoor cremation, because you can't reliably contain the emissions.