[Closed] Is obesity really a disease?

play the game grips, you can't have it both ways, you go from people are individual and respond differently to food, or you make generalisations like that one.

Nono, it's not a generalisation - just an observation. I should have made that clear. I don't know if more fat people drink diet coke than skinny people; I also don't know if it's cause or effect, as in "Oh shit I'm fat, better switch to diet drinks".

I was thinking more of a conversational leader to see if anyone knows of research about sweetners, but given the context I can see how it would come across as the kind of crap logic I detest 🙂

However even if diet drinks do make you fat, it's not at odds with my previous comments about people being different. As a general rule, junk food does make you fat, but the amount of fat from a given amount of junk food ranges from 0 to loads.

What tyre for...

[img] [/img]

Stomm! Is being a comic-reading nerd a disease?

I also thought it was mostly in the US, but was shocked to see it listed on the can of a drink here in the UK recently. I'm going to have a snoop at a few labels when I'm next in the supermarket

HFCS contains glucose and fructose, and it's the high levels of fructose that are controversial. It is metabolised differently to glucose and there is some thought that it is more easily converted to fat, and that it may suppress the feeling of satiety by inhibiting leptin.
Of course this is not totally proven at the moment, but what is apparent is that more sugar is being consumed than before, given that HFCS appears all over the place.

Interestingly, lots of websites defending HFCS are appearing. Probably the food and drink industry?

Recently lost ~12kg and gone from being obese to just plain fat, perhaps being kind, no one I explain my weight loss to believes I was ever obese. I was though and feel much healthier now.

All I have done is stop eating the food I grew up being told was good for me- spuds and pies and stop eating the food they is heavily advertised- chocolate and biscuits etc and stopped eating any food unless I was actually hungry.

I seem to have cured myself of obesity perhaps I can sell it to the NHS.

With all due respect, as I know you've bad huge problems but why on earth do you have to self-medicate. Surely if they have now identified the problem, you should be treated within he NHS. Sorry if I missed part of he saga but I'm genuinely interested as my Mother is borderline under-active thyroid.

I know you've been cagey about it in the past c-g, but I really would be interred to know the name of the drug you are having to buy, as t4 and t3 are both available on the NHS.

OK, I'll try to explain. In the UK the thyroid is tested by means of the TSH (thyroid stimulating hormone)test and a measurement of over 10 is considered to indicate hypothyroidism.

In Europe and the USA, the measurement has been reduced to 2.5.

My TSH was under 10 and was told that I wasn't hypothyroid despite having many of the symptoms. Apparently I was depressed and I strongly disagreed with this. Then I was told I was menopausal to which my reply was 'check my records'.

Now to the science bit ... the TSH test has been questioned by many physicians who claim that this test will not show if you are converting enough T4 into T3, or your thyroid is being attacked by antibodies, or you have T3 receptor resistance, or you are suffering from adrenal insufficiency, or you're deficient in minerals and vitamins that are essential for thyroid health.

So ... despite at my worst sleeping for 12 hours at night and sleeping again during the day, walking up or down stairs exhausting me, having a croaky voice and brain fog being so bad that I couldn't string two words together, giving up riding, it was not due to my thyroid because the TSH test said my bloods were 'normal'. Clinical symptoms were completely ignored.

I knew I was hypothyroid and did persuade a GP to prescribe a month's supply of thyroxine but it was only the lowest dose. I actually felt worse then was informed that it definitely wasn't my thyroid, was pointless increasing the dose and taking it for longer.

Dr P - yes, thyroxine and T3 are available on the NHS but any Endocronologist has to follow NHS guidelines and that includes a maximum dosage level. I understand (from those bloomin' internet forums) that some GPs are not happy to monitor patients taking T3, let alone taking into account the high cost and do indeed refuse. I do buy my own T3.

Going back to the original topic, as can be seen from my comments I do believe that the reason for some of the obesity is undiagnosed thyroid disease.

My brain hurts now but do hope that this makes sense! Happy to answer any questions. 🙂

Can I just make the point that self-medicating was a last resort for me. This was only done following a (private) comprehensive range of blood tests that had been carried out together with considerable research and ongoing self-monitoring.

The estimate is that around 15% of thyroid sufferers do not do well on thyroxine.

Re the thyroid thing. I don't think anyone really doubts there are obesity cases caused by this. I think people are just wondering what percentage of obese people have their weight gain caused by a thyroid problem.

I have no figures, but anecdotal evidence suggests that the percentage is fairly small.

I don't think anyone is looking down on overweight people either. However classifying something as a disease when, for the majority of people, it is a lifestyle choice reduces their chances of ever doing anything about it.

....and a measurement of over 10 is considered to indicate hypothyroidism.

Hmm.... Not strictly true c-g, though.
True it (TSH figure) won't show if you have auto antibodies, hence the TPA test.
T4 and free T3 are also very easily tested levels - I'm forever requesting them...
Plus, the TSH/T4/T3 feedback cycle can be seen as complicated, but a simple understanding of it demystifies it....
TSH can be elevated for a variety of reasons - hypo or hyper thyroid.

I'm not asking you to go into any more details about your health on here, though I really am interested as to the local failings in your management, requiring you to buy a drug prescribed (quite easily) by the NHS, unless the NHS/NICE disagrees with its prescribing in the first place?

DrP

I don't think anyone is looking down on overweight people either.

They are, just read STW!

TSH 10 mU/L or less

How should I manage someone with subclinical hypothyroidism who has a thyroid-stimulating hormone (TSH) level of 10 mU/L or less?

Confirm by repeat testing of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels, with the addition of measurement of thyroid peroxidase antibodies (TPO-Ab), 3–6 months after the original result.

Levothyroxine treatment is not routinely recommended.

Consider offering levothyroxine treatment if:

The person has a goitre.

Their TSH level is rising.

The woman is pregnant or planning pregnancy (see Scenario : Preconception or pregnant).

Consider offering a trial of treatment if the person has symptoms compatible with hypothyroidism.

Prescribe treatment for a sufficient length of time to be able to judge whether there is symptomatic benefit, see Prescribing information.

Only continue treatment if there is a clear improvement in symptoms.

If treatment is continued, once stable, measure TSH annually and alter the levothyroxine dose to maintain the TSH level within the reference range.

If treatment is not offered, it is still necessary to monitor thyroid function to detect progression to overt hypothyroidism.

If the person has serum TPO-Abs, measure serum TSH and FT4 annually, or earlier if symptoms develop.

Otherwise, measure serum TSH and FT4 approximately every 3 years, or earlier if symptoms develop.

Current NICE guidance.
I'd be testing T3 too.

Bear in mind this guidance ONLY applies if the T4 or T3 are low I.e. all figures need to be considered in relation to one another.
As mentioned, a high TSH and raised T4 indicatd HYPERTHYROID...

DrP

1. A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.
2. A condition or tendency, as of society, regarded as abnormal and harmful.
3. Obsolete Lack of ease; trouble.

2. A condition or tendency, as of society, regarded as abnormal and harmful.

Hmmmm - that one muddys the water a bit.

obesity is sometimes caused by a legitimate, underlying condition, eg underactive thyroid. no argument from me!

obesity is sometimes caused purely by being a coke-drinking, pie-eating lazy-bones.

by saying obesity is a disease, you are saying that the pie-eater has a disease. which they don't.

Therefore obesity is not a disease and if you say it is you are wrong. and an idiot.

notmyrealname and solo are correct. cinammon girl has valid points but is kind of missing the point. I suggest she rereads the question.

Try this one on for size

mickolas - Member

[s]obesity[/s] cancer is sometimes caused by a legitimate, underlying condition!

[s]obesity [/s]cancer is sometimes caused by smoking or other lifestyle choices

by saying [s]obesity[/s] cancer is a disease, you are saying that the smoker has a disease. which they don't.

It's all getting a bit Good AIDS/Bad AIDS this.

glupton - being obese is not a condition or tendecy regarded as abnormal. it is a measurement. overeating is a tendency. underactive thyroid is a condition.

by saying obesity is a condition, you are saying that most of those large, very fit rugy player types have an abnormal condition.

you could argue that being fit IS abnormal....or that being very fat is NOT abnormal, given apparently one third of the US population qualifies...

by saying obesity is a disease, you are saying that the pie-eater has a disease. which they don't.

Alcohol and (other) drug addictions are also classified as diseases, in both cases the solution is obvious: stop taking the drug(s). Somehow reality is a little more complicated.

by saying obesity is a condition, you are saying that most of those large, very fit rugy player types have an abnormal condition.

No, because noone is saying that professional rugby players are obese, it's commonly recognised that BMI scores aren't valid for certain edge cases. (Although their fitness levels are "abnormal", of course).

I used to be massively fat, this was because I drank and ate crap and was lazy and ill disciplined. I realised I was lazy and ill disciplined and sorted it out (I'm still overweight, but I'm still heading in the right direction). If obesity was classified as a disease I may have not been as motivated to find my own solution to the problem I had.

northwind - the pie-eater can fix their situation without recourse to any medication. Can the cancer patient?

anyway, cancer happens when the body is NOT functioning normally. obesity sometimes happens when the bodies systems are functioning perfectly - hence no disease.

unrelated, but there is a theory that cancer is simply a dietary deficiency. look up 'world without cancer'. just remember that it's not MY theory.

you are saying that most of those large, very fit rugy player types have an abnormal condition.

Like arguing a power lifter is normal

not sure either has a disease though

mogrim you are wrong. obesity is one of the classifications on the bmi scale. that is how it is defined!

as for your other point: addiction may or may not be a disease(mental); being drunk or stoned are certainly not diseases. I hope you understand the distinction.

mogrim you are wrong. obesity is one of the classifications on the bmi scale. that is how it is defined!

That's [b]part [/b]of the definition, not the whole definition, and it's widely acknowledged that BMI isn't directly applicable in all cases.

as for your other point: addiction may or may not be a disease(mental); being drunk or stoned are certainly not diseases. I hope you understand the distinction.

Being drunk or stoned every now and then are obviously not diseases, and I have never said they were. But that's not what I was talking about, I was talking about addictions.

(And incidentally, that "world without cancer" thing is a huge pile of quackery, as [i]I'm sure[/i] you knew).

mickolas - Member

addiction may or may not be a disease(mental); being drunk or stoned are certainly not diseases.

Liver disease caused by alcohol is a disease, regardless of whether you're an addict or not. The reason for the disease doesn't signify. Disease doesn't care what caused it.

mickolas - Member

northwind - the pie-eater can fix their situation without recourse to any medication.

Can they? Can the smoker just stop smoking? And why would you think it makes any difference? You can get better from many diseases without treatment.

Can they? Can the smoker just stop smoking?

Yes - but it depends on how strong willed the person is.

My wife grandparents smoked 60 a day for about 30 years, when one day they both decided to quit - and went cold turkey. Never touched a cigarette ever again. They admitted they did have some withdrawal symptoms for a month or so, but no worse than having flu.

Many family members were astonished by their ability to go cold turkey - their response was "It's all in the mind - and we're stubborn people"

So yes, people can "just stop" (this includes over-eating), if they have a strong enough mind.

===========

On a side note, I see another fan of The Wire! [b]mcnultycop[/b]

And that's exactly my point. Some people can just stop smoking, or drinking, or eating, or arguing on the internet. Some can't.

On a side note, I see another fan of The Wire! mcnultycop

I am a fan of The Wire, but I've been known as mcnultycop a good few years before The Wire was even concieved. A long story involving a strobe light and a late night Q&A session (and the fact I'm called McNulty).

Can they? Can the smoker just stop smoking?

Genuine lol at that... Why do we bother with all this support to quit smoking, when all that's really needed is for zilog to tell them to MTFU. Is this a service you offer on the NHS?

Nah, they couldn't afford me. 8)
In all seriousness though, that's what it often comes down to. Giving up something like smoking or binge eating is so much easier if you have support (partner, family, friends, etc) but that very often isn't there so you succumb to peer pressure. But either way anyone is capable of doing it. No, it isn't always easy, but getting the most out of life rarely is.

or arguing on the internet.

Goes off for MTFU therapy

mogram - okay I concede the definition thing. rugby players weren't the main thrust of my point, though. eating too much and doing to little will result in excess fat; this is not ABnormal. unfortunately, you did NOT understand the distinction I was referring to! unless you have underlying conditions, being fat is caused by poor lifestyle, just as being drunk is caused by consuming alcohol. being drunk/fat are not causes, but effects. addictions (to drink/drugs/food) may or may not be mental illnesses - that is beside the point I was making.

northwind - an overworked liver from slight overexcess would be a normal, healthy liver still. when liver disease is involved, normal functions have broken down. when a person is overweight through gluttony, normal functions (with respect to fat storage/burning) continue unabated. that is the difference. and yes, the smoker can simply stop smoking. it's called 'giving up' (although I'm not really sure what sacrifice is being made!) or 'quitting'. been there, done that. if someone has cancer from smoking, I don't believe simply quitting will help, though. if someone has fatness from gluttonyand inactivity, then simply quitting gluttony and inactiviy WILL solve their problem. don't see your problem with that one.

and yes, people will recover from some diseases without intervention. if a condition is irrevocable without intervention, then it almost certainly a disease. recovery from disease without intervention occurs in only two ways: by function of the immune system or by function of the bodies healing system (eg growth of new tissue etc). the curing of fatness through proper diet and exercise utilises neither of these; just ongoing normal functions of energy release. hence, not a disease

So yes, people can "just stop" (this includes over-eating), if they have a strong enough mind.

Hmm. Your mind is nothing but a collection of chemicals swilling around. By taking addictive drugs you are changing those chemicals, so you are changing how your mind works.

So once you've made that change, you have to change your brain back. This is a hell of a lot harder than just stopping, for many people. It's more fundamental than just 'don't do it'.

So you believe that all smokers can just stop without intervention? Excellent. People who try and fail, they must be pretending?

mickolas - Member

if someone has fatness from gluttony and inactivity, then simply quitting gluttony and inactiviy WILL solve their problem. don't see your problem with that one.

I don't see why you think I have a problem with that? Of course they [i]may[/i] be able to do that, and if they can then it will resolve it. It's just not relevant to whether or not it's a disease.

on seeing the smoking debate has started while I was typing:

it's not MTFU at all. willpower has nothing to do with it! otherwise it would be the weak-willed who quit due to public/peer pressure. it is a mental state though. your head has to be right. if you quit through 'willpower', you are effectively denying yourself something that you actually want. this means you will never be free, or will forever have those 'weak moments', whether you cave to them or not...

the correct solution is not to give the smoker reasons to quit (health/wealth mostly). if that worked, there would already be no smokers left!

the correct solution is to remove the reasons FOR smoking, which when examined properly can be seen to be false constructs, erected by the action of the drug itself. im effect, the smoker has been brainwashed by the nicotine to believe they achieve some sense of tension relief or other pleasure, when in fact the tension is implanted by the previous cigarette. once the smoker is 'unbrainwashed', they will not feel any desire to light up. hence no willpower will be required.

I heartily recommend 'the only way to stop smoking permanently' by Allen Carr. it's awesome. forget patches and gum etc, they are just the latest ploy by the tobacco companies to make money from you (where do you think they source the nicotine?); how do you expect to break a drug habit by taking the self-same drug - it's patently nonsense and it's a travesty that it is supported on the NHS!

Oh dear. Would you like to post some youtube videos to prove the conspiracy? Nicotine alternatives are effective for quitting- it separates the habit from the addiction, which means you can work on one part of the problem in isolation- makes things easier. This is a very simple concept!

(in the same vein, it's been demonstrated that going through the motions of preparing a dose can reduce the cravings even if the dose isn't taken, or if an alternative is used.)

Also, let's just state the obvious, you don't need to quit nicotine to quit smoking.

From IFLS on Facebook ("I F*cking Love Science" is the group name!)

These two pictures show body scans of two women approximately the same age and height. The one on the left weighs 113 kg (250 lbs), while the one on the right weighs 54 kg (120 lbs). Accumulated adipose tissue is not the only difference between the two; the obese woman has an enlarged heart and her lungs are somewhat restricted.

Obesity has recently been declared a disease by the American Medical Association. While this does not have any legal ramifications, it may encourage doctors and insurance companies to take more steps in treating and preventing obesity. However, not everyone agrees with the AMA's definition, citing that obesity is a complex issue with multiple causes and treatment options.

Obesity is defined as having a body mass index over 30 kg/m^2. It greatly increases the risk of Type 2 diabetes, heart disease, and osteoarthritis.
[img] [/img]

(There's a photo at the end, of two women (one 250lbs, the other 120lbs), and full body scans showing the difference of the organs)

northwind, I will try again: obesity due to sloth and gluttony is NORMAL. it is achievable without there being any malfunction. in those cases, therefore, there is NO disease.

therefore obesity itself is not a disease, but may be caused BY a disease.

I hope your happy now - that's far more capital letters than I like to use.

northwind...please be honest..are you trolling?

mickolas - Member

northwind, I will try again: obesity due to sloth and gluttony is NORMAL. it is achievable without there being any malfunction. in those cases, therefore, there is NO disease.

Typing it in capitals doesn't make it any less wrong. Obesity is not normal, that is the entire point.

Disagreeing with you is not trolling. Pointing out factual errors is also not trolling. This [i]was[/i] trolling though:

"Therefore obesity is not a disease and if you say it is you are wrong. and an idiot."

Hope that helps clear it up

it is perfectly normal if you eat too much and do too little. it goes away if you reverse this trend. that is not true of any of the other cases you have put forward in support of your argument.

mickolas - Member

it is perfectly normal if you eat too much and do too little.

It is often a natural consequence of eating too much and doing too little. This still isn't normal.

Bleeding is a natural consquence of banging your head against a computer screen. That isn't normal either.

smoking is not addictive - nicotine consumption is. so quitting smoking by using them is not really quitting any addictive behaviour. studies showing that people will quit smoking more readily by using alternatives only prove the same thing as saying people could quit injecting heroine if only they could get it in pill form. it doesn't mean anybody has been helped out of their addiction.

and again, bleeding is not helped by stopping banging your head. it relies on your bodies specific healing mechanisms. yet another fail by you.

and yes I know you were being facetious.