
We’re in a new age of obesity. How did it happen? - NeedMoreTea
https://www.theguardian.com/commentisfree/2018/aug/15/age-of-obesity-shaming-overweight-people
======
beaconstudios
I suspect it's related to the "default" diet that we consume. You can be
healthy by eating a healthy diet, but that takes a conscious effort and we
know that the food that's most pushed in modern western countries is full of
sugars and carbohydrates. Most people eat the default diet, and for the modern
person that might be microwave meals or takeout. Presumably in previous
generations the default diet was more healthy, because people had to cook due
to the lack of quick-and-easy options like oven-ready pizza and chips.

Overall it seems like a fundamental issue with the "food ecosystem" we
surround ourselves with, and the types of food that it encourages us to eat.
You could even include in that the inclination to treat eating as a chore to
be performed instead of cooking and food as part and parcel of a fulfilled
life, leading to products like soylent that promote themselves as a least-
inconvenient meal.

~~~
craftyguy
Eating 'right' is only half of it. Many folks don't realize that they also
should exercise.

~~~
magicalhippo
They should, but the reducing energy intake takes the least amount of effort
by far when it comes to losing weight.

You don't even have to eat "right", just eating less would be enough. For
example I still love my pizzas and hamburgers, but I eat smaller portions so
the amount of kcals I consume is in line with what I need.

~~~
craftyguy
It's literally an equation, calories in = calories out. Any sustained
inequality will lead to either eventual obesity or a slow death by starvation.

~~~
1stranger
It's literally not. The human body is much more complicated than that.
Repeating this mantra is never going to help anybody.

The most important thing is for people to fix the kind of food they consume so
their appetite (hormones) self-regulates. Were people thin in the 1960's
because they were counting calories?

[https://www.healthline.com/nutrition/debunking-the-
calorie-m...](https://www.healthline.com/nutrition/debunking-the-calorie-myth)

~~~
d0lph
From the article, which does also mention the second law of thermodynamics.

> Saying that weight gain is caused by excess calories is true, but
> meaningless. It tells you nothing about the actual cause.

Most likely people were thin in the 60s because they consumed less calories
then we do now.

------
ericb
I think the most fascinating thing about this is the study that said it was
happening to lab animals with controlled diets, also.

Pet hypothesis: It takes a large amount of energy to maintain our body
temperature. What if one cause is the spread of climate control. AC and
affordable indoor heat mean we don't spend much energy on thermal regulation.

~~~
ihattendorf
I don't know, looking at this obesity map[1] I don't see much of a difference
between northern/southern states. If anything there are more southern states
with extreme (35%+) obesity. Doesn't mean it doesn't contribute partially
though. It's also very crude data.

[1]: [https://stateofobesity.org/adult-
obesity/](https://stateofobesity.org/adult-obesity/)

~~~
ericb
Here's a graph with the prevalence of AC by region. It could also be related
to the affordability of heat (my grandparents kept the house very cool). I
have no idea if there's something to this, but interesting to poke at.

[https://www.eia.gov/consumption/residential/reports/images/a...](https://www.eia.gov/consumption/residential/reports/images/acb_fig1_lg.png)

------
andrewmcwatters
I think what I'm worried about is approaching ketosis with skepticism. Are
people wrong on this? I hope not. Specifically, I remember growing up and
hearing about Weight Watchers, Atkins, and a number of other trendy diets, and
for some these approaches worked.

But it doesn't seem to be universal. And I don't know how much of it is
personal choice and commitment or dietary reality. Are people really
overeating and saying "no" less, or are our foods inherently more calorie
dense? I suspect maybe it's both? I'm not sure.

The latest talk on the Internet seems to be that to burn fat, rather than just
reducing caloric intake, a more effective combined effort would be to put your
body in ketosis.

That being said, I grew up on being taught out of outdated health textbooks in
charter school from the 70s with food pyramids. I remember the largest part of
the food pyramid from the 90s being bread, cereal, rice & pasta. All foods you
would religiously avoid by today's advice for weight loss.

~~~
wilsonnb3
All that matters for weight loss (and weight gain) is calories in and calories
out (CICO).

All of the "special" diets that people propose work on this principle. They
simply take different approaches to try to make "eating less" easier.

Certain foods make you feel fuller than others, so some people have success
changing their diets to include more of those foods. Other people have success
just eating less of what they eat now without changing their diet.

As far as I know, the keto diet is designed to treat epilepsy in children.
There is no current scientific consensus that keto helps with weight loss
compared to any other diet with a similar CICO.

I'm sure people are researching it right now so that could change, but we know
enough about how the laws of physics and the human body work to know that
whatever is happening, CICO is the basis of it.

------
wilsonnb3
I'm a little confused about their numbers - they say we currently consume an
average of 2,130 kilocalories a day, but in 1976 the average was 2,590
kilocalories.

Unless people were doing an absurd amount of additional exercise in 1976 (like
running multiple miles every day), how is it mathematically possible that
people are more obese now but eat less on average?

The article seems to imply that it's because we eat differently than people in
1976 (more sugar and what not), but as far as I know calories in -> calories
out is the only factor in weight gain/loss aside from uncommon hormonal
issues.

~~~
mayoff
His current number (2130) comes from the UK's “Family food datasets”. The
first thing you see when you open up the UK nutrient intake spreadsheet is
this message:

> It is a widely recognised characteristic of self reported diary surveys such
> as Family Food that survey respondents tend to under report their purchases
> (and any derived nutrient intakes based on purchased quantities are also
> likely to be underestimates). Empirical comparisons of sales and duty data
> for alcohol in particular suggest that reported alcohol consumption could be
> 40-60 per cent lower than the reality. For other food and drink, reporting
> is likely to be closer to actual purchases, but underreporting is likely to
> feature and some food types may be underreported to a greater extent than
> others.

Here's a paper that critiques the survey results in detail:
[http://38r8om2xjhhl25mw24492dir-wpengine.netdna-
ssl.com/wp-c...](http://38r8om2xjhhl25mw24492dir-wpengine.netdna-ssl.com/wp-
content/uploads/2016/08/16-07-12-Counting-Calories-Final.pdf)

~~~
weiSev5h
Hahaha so that research is one big collective "I don't even eat that much"
self-delusion. I did want this article to be correct and to have a quick fix
for obesity, but I guess I have to go back to my diet :(

------
EngineerBetter
Ex-fat person here. 14 stone at 14 years of age.

I stopped eating so much and took up regular exercise.

I am no longer fat.

~~~
ikeyany
Out of curiosity, what is the socio-economic level, education level, and
relative health of your parents? That is statistically a stronger contributor
to a child's health than the desire to simply lose weight.

------
Hockenbrizzle
Hi folks,

I am a bit confused about a citation given in this opinion piece and ask for
your help. In paragraph 5, the author mentions the effect of manual labor and
cites an article published in the International Journal of Surgery Oncology.
In this article they state that:

"Adults working in unskilled manual profession are over 4 times more likely to
be classified as morbidly obese compared with those in professional
employments",

and they show a graph to support this. However, the graph seems to show the
opposite. I looks like males who perform manual labor have a lower prevalence
of obesity than those of non-manual labor. Am I reading this wrong?

~~~
mayoff
You're not wrong. The graphs (figures 7 and 8) don't match the numbers. I
think the graphs are mislabeled.

~~~
Hockenbrizzle
But even if the graphs are mislabeled, the numbers don't agree with the
statement. The 2010 data for prevalence of obese men shows an increase from
27% to 29%... without error bars given. In what world does that translate to
"over 4 times more likely to be classified as morbidly obese"?

------
SubuSS
I wrote a blog about addressing this a while ago:
[https://www.subu.io/post/176259843689/one-step-from-the-
farm](https://www.subu.io/post/176259843689/one-step-from-the-farm)

Granted I have a greater than normal calorie burn right now, it still has been
an amazing switch to move away from highly processed stuff. Keto was too
painful for me to try (I need the carbs for cycling), So this one. It has been
great while giving me enough energy to keep my habit!

------
phobosdeimos
Really simple. Humans weren't made to sit on their ass all day. Obesity used
to happen to the nobility too. Physical labor is niche now.

~~~
tabtab
Indeed. We can tinker with diets and nag people to eat less until the cows
come home, but humans are engineered to do physical activity at least half the
day and that's not easy to replace.

------
fulafel
> More alarmingly, according to a paper in the Lancet, more than 90% of
> policymakers believe that “personal motivation” is “a strong or very strong
> influence on the rise of obesity”.

This is the "calories in, calories out" meme. It's very bad.

~~~
_mhr_
Can you suggest an alternative theory for the rise of obesity, other than
prolonged caloric surplus?

------
maxharris
Sugar: The Bitter Truth
[https://www.youtube.com/watch?v=dBnniua6-oM](https://www.youtube.com/watch?v=dBnniua6-oM)

------
mayoff
Dietary caloric surplus is a solid, time-tested explanation for rising obesity
that people, like the author of this article, just don't like. There are a
variety of reasons that people eat more and move less now than previously, but
ultimately it's the caloric surplus that causes obesity.

From the article:

> So here’s the first big surprise: we ate more in 1976. According to
> government figures, we currently consume an average of 2,130 kilocalories a
> day, a figure that appears to include sweets and alcohol. But in 1976, we
> consumed 2,280 kcal excluding alcohol and sweets, or 2,590 kcal when they’re
> included.

On the other hand, the UN's Food and Agriculture Organization data shows a
very clear upward trend in per capita calorie supply in the US (since 1961)
and the UK (since 1982).

[https://ourworldindata.org/grapher/daily-per-capita-
supply-o...](https://ourworldindata.org/grapher/daily-per-capita-supply-of-
calories?country=GBR+USA)

[https://ourworldindata.org/food-per-person#the-global-
perspe...](https://ourworldindata.org/food-per-person#the-global-perspective-
on-caloric-supply)

Per capita calorie supply means the calories delivered to the household for
each person. It doesn't account for food not eaten.

From the article:

> I have found no reason to disbelieve the figures.

Meanwhile, I clicked through the “government figures” link in the article and
downloaded the “UK - household and eating out nutrient intakes” file. The file
itself tells you to be skeptical of the numbers therein:

> It is a widely recognised characteristic of self reported diary surveys such
> as Family Food that survey respondents tend to under report their purchases
> (and any derived nutrient intakes based on purchased quantities are also
> likely to be underestimates). Empirical comparisons of sales and duty data
> for alcohol in particular suggest that reported alcohol consumption could be
> 40-60 per cent lower than the reality. For other food and drink, reporting
> is likely to be closer to actual purchases, but underreporting is likely to
> feature and some food types may be underreported to a greater extent than
> others.

> Although such surveys are completely confidential, respondents may under
> report for a range of reasons, from self consciousness to simply forgetting
> to record purchases. 'Top up' and eating out purchases are probably more
> likely to be missed than the main household shop. There is no evidence to
> say whether levels of underreporting have changed over time but it is
> plausible that changes in household shopping and eating patterns may have
> contributed to increased underreporting.

> Users should bear this issue in mind, when considering trends in estimated
> intakes and the values for individual years. For example the downward trend
> in energy intake estimates can appear counter-intuitive at face value given
> other evidence on the prevalence of obesity. Factors affecting obesity and
> other health issues are complex. Family Food trends are broadly consistent
> with other sources, such as the National Diet and Nutrition Survey, which
> also show reported energy intake in decline, although NDNS intakes are also
> known to be underreported.

Furthermore, obese subjects are more likely to under-report intake and over-
report activity. Example:
[https://www.ncbi.nlm.nih.gov/pubmed/1454084](https://www.ncbi.nlm.nih.gov/pubmed/1454084)

From the article:

> A paper last year in the International Journal of Surgery states that
> “adults working in unskilled manual professions are over four times more
> likely to be classified as morbidly obese compared with those in
> professional employment”.

“International Journal of Surgery” links to this paper:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673154/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673154/)
The paper cites “UK Parliament. Select Committee on health—third report.
2004”, available here:
[https://publications.parliament.uk/pa/cm200304/cmselect/cmhe...](https://publications.parliament.uk/pa/cm200304/cmselect/cmhealth/23/2302.htm)

The committee report says (§1 ¶38):

> 38\. In common with most public health problems the impact of obesity
> mirrors many other health inequalities. Men and women working in unskilled
> manual occupations are over four times as likely as those in professional
> employment to be classified as morbidly obese.[28] The Health Survey for
> England has shown that in 2001 amongst professional groups 14% of men and
> women were obese, compared to 28% of women and 19% of men in unskilled
> manual occupations.[29]

I'm unable to track down the text of references [28] and [29].

But please note this other very interesting thing that the committee report
says (§2 ¶67):

> It is certain that obesity develops only when there is a sustained imbalance
> between the amount of energy consumed by a person and the amount used up in
> everyday life.

I wonder why the article doesn't quote that?

Occam's Razor says that obesity comes from eating too much and moving too
little, and that articles like this come from wishful thinking and ignoring
the evidence.

