
Obesity Is Weighing on Education, Productivity and the Economy - pseudolus
https://www.bloomberg.com/news/articles/2019-10-10/obesity-is-weighing-on-education-productivity-and-the-economy
======
nelblu
I have a friend and she believes that obesity is a made-up disease by doctors
to marginalise fat people (she calls it fatphobia). She refuses to acknowledge
that obesity actually causes health issues, instead she defends obesity by
citing that even "fit" people are victims of heart diseases etc. And then she
makes it sound plausible by talking about how we should focus on complete
health like mind + body. I went to one of her talks about it and almost all
attendees were obese. Just to be clear, I don't deny about her points on
fatphobia (i.e. how society rewards fit and good looking people more than fat
people), but she completely loses me when she talks about how nothing is wrong
with being super fat. (Btw I used to be very fat growing up and once i got my
first job i have stuck to a fit lifestyle so to me it is completely against
everything that I did to get rid of my obesity)

~~~
chrisseaton
Can she not see that very overweight people are literally just not able to get
around daily life as easily as physically fit people? She must be able to see
that other people do things easily that would make her very out of breath? And
can she not see that more physically fit people are more comfortable without
the extra weight? I would have thought you could see all these things plainly
even if you disbelieved all the things doctors told you.

~~~
goatinaboat
_Can she not see that very overweight people are literally just not able to
get around daily life as easily as physically fit people?_

Fat-rights people just take that as evidence of a conspiracy of “thin
supremacy”, similar to how some people see “white supremacy” everywhere they
look.

~~~
chrisseaton
You mean like the size of seats and doors and things? I can understand that
point of view.

But I mean things where there is no design being imposed. Like I can stroll
down the beach if I want to. An extremely overweight person cannot. Nobody's
imposed anything that makes that harder for them except their weight.

They must think to themselves 'it'd be nice to walk down the beach... I wonder
why I can't do that without being uncomfortable when these other people
can...' and realise that extra weight brings quality-of-life limitations.

~~~
javagram
Not everyone who is obese is at that level of being unable to do things, to be
fair.

I recently lost weight (~30 lbs) taking me from the threshold of obesity (30
BMI) to the threshold between overweight and normal weight (25 BMI).

While I certainly find it easier to be physically active now with less weight,
I was still able to do multi-hour hikes, bike rides, and other physical
activity before at the higher weight.

And if your lifestyle is such that you drive everywhere and don’t do much
physical activity besides short periods of walking I can certainly see not
really considering being even heavier to be too much of a drain on your
lifestyle.

------
ginko
I'm really starting to think there's some environmental factor going on that
at least in part explains the current obesity epidemic. A person in the 70s
who would have the exact caloric intake and exercise as a person today would
have been several BMI points slimmer[1].

[1][https://www.theatlantic.com/health/archive/2015/09/why-it-
wa...](https://www.theatlantic.com/health/archive/2015/09/why-it-was-easier-
to-be-skinny-in-the-1980s/407974/)

~~~
_4570
Probably to due with less calories spent in manual work. Like walking instead
of driving, washing clothes and utensils instead of using electronics, etc.

~~~
jimmaswell
Calories spent from exertion are generally negligible unless it's a very
intense focused kind of exercise done for a long duration. Run a whole mile
and all that gets you is one free apple.

~~~
thrower123
The difference in the amount of calories I burn on days when I go to work, and
am mostly sedentary, and days when I'm at home puttering around constantly, is
massive.

At least as tracked by my Fitbit it can be upwards of 2000 calories
difference, and 10-15k steps.

~~~
_carl_jung
It's unlikely that your TDEE is 4000 calories when you're at home puttering
around. These fitness trackers are extremely unreliable at estimating caloric
expenditure.

~~~
thrower123
Whether it is accurate in absolute terms is less interesting than what it
reports in differing trends. Every indicator that it reports is vastly higher
on the days when I am not in the office, chained to my desk. Just being on my
feet, walking back and forth all day, up and down and round and round, is a
night and day difference.

------
WalterBright
I try to take the stairs when I can. But the stairs in many buildings are
unpleasant fire escape concrete things. It'd be nice if the stairs were
expected to be used, and be part of the design rather than something the fire
code demanded.

~~~
imgabe
Fire stairs are like that because they have to maintain a fire rating between
them and the rest of the building. Some places have connecting stairs but
they're expensive to install and take up rentable square footage.

~~~
_carl_jung
Surely adding art to the walls and some nice flooring wouldn't negatively
affect the fire rating.

~~~
brudgers
Any flooring with low flame spread and low smoke developed and high slip
resistance as measured by standard tests by a qualified testing agency is
typically allowed by life safety codes. Other flooring isn't.

Hanging art on the walls of egress stairs is typically prohibited by life
safety codes. Egress stairs are required to be maintained as egress stairs.
The requirement isn't based on theory. It is empirically derived from
experience among fire fighting agencies encountering corpses and/or impeded
fire-fighting operations when egress stairs are adapted for non-egress uses
such as habitability and/or storage.

The blanket prohibitions exist because ordinary people ordinarily don't have
experience with emergency events and modifications to life safety systems may
effect the well-being of other building occupants, fire-fighters, and the
general public.

~~~
_carl_jung
Interesting, thanks.

------
blue_devil
I believe the original paper from OECD:

[https://www.oecd.org/els/41650997.pdf](https://www.oecd.org/els/41650997.pdf)

>> We provide comparable evidence on the patterns and trends in obesity across
the Atlantic and analyse whether there are economic rationales for public
intervention to control obesity. We supply new evidence on such rationales
taking into account equity issues as well as efficiency considerations, which
are organized around the following categories of market failures: productive
inefficiencies, lack of information or rationality and health insurance
externalities. We argue that there is support for intervention targeted
towards the young on equity grounds. While the evidence that the allocation of
resources is (or will be) significantly distorted by the rise in obesity is
less clear-cut, there are signs that this is the case due to time inconsistent
preferences and because of the resilience of product and labour market
imperfections, especially in some European countries.

------
lnsru
Obesity isn’t reason, it’s a result from other problems like loneliness,
anxiety or not very stable life circumstances. Fighting these will reduce
obesity. No proof of that, just my personal theory. Also in local supermarket
I could call minority of the products healthy. 600 grams of very unhealthy
cookies for 0,99€ should have sugar tax of another 2€ on it.

~~~
tomashubelbauer
I don't know about this. I don't think it is that uncommon to meet fat, but
also happy and well off people. Especially in office jobs, where you have to
actively fight free company snacks, sugar water and lack of personal time for
exercise. I do agree on your supermarket point though. I wouldn't go as far as
to punish eating bad, people should be able to do it if they want to, but when
you can split your average supermarket offering into 10 % actual food and 90 %
candy cosplaying as food, something's off IMO.

~~~
humanrebar
I think the point was that obesity is a symptom, not a cause. And then there's
the implication that "try harder to be thin" isn't an effective remedy, at
least not so far.

------
factsaresacred
That we're unable to exert enough self-control to avoid eating ourselves to
death paints a dim view of humanity.

The majority of people simply have no excuse not to manage their
health/weight.

Even more so for parents or anybody else with dependents. It's plain
negligent.

~~~
milankragujevic
Humanity is pretty dim already. This kind of situation is quite complex, from
socio-economic factors, education, access to healthy food (including taking
the time to cook), to medical issues that are often mentioned but usually
dismissed (as I've described in another comment, you can quite easily get
uncontrollably obese with an antipsychotic or antidepressive medication -- and
given the society's speed of development and ever increasing work
requirements, it's not hard to see why a lot of people would have mental
health issues) (not to mention actual hormonal disorders that can actually
prevent a person from being able to feel full).

In my opinion, it's helpful to look at the human body as a biological machine.
The mind itself is at the mercy of it's vessel, the brain. Thoughts are
electrical impulses enhanced with chemical neurotransmitters. A change can
quite literally cause a person to change their mind (literally, i.e. a hard-
vegan and animal rights activist having a stroke and becoming a caricature of
a meat eater, in worse cases a complete replacement of someone's personality
and memories).

The human body is not below the mind, rather, they work together. An incident
can initiate a never-ending cycle that ends in obesity and ultimately death.

Self control is not the panacea people think it is. The concious mind cannot
override most if not all built-in impulses. Can you choose not to have sex?
No. If you ask "why would I", that is already heavily influenced by the
impulses built into the structure of the nervous system. A basic part of human
existence. If you get over that part, sooner or later you will experience
mental health issues beyond your control and ultimately forget your initial
idea of celibacy. I have used this example and not eating, or excretion of
waste, as technically sexual activity has no influence on the body's
homeostasis and internal proceses.

Some people have a different priority list, including overeating. I do not
think that ANY obese person has ever conciously made the decision to overeat
and be miserable, sick and die earlier.

In any case, I agree with your part about parenting. It is incredibly
negligent. Not introducing a child to the concept of overeating will in a lot
of cases prevent obesity. However, some people are biologically predisposed to
have less self control. This does not have to imply obesity and overeating.

On my own example, I have never smoked a cigarette, taken any psychoactive
substance, or drank alcohol. I know that had I done any of those things, it
would become an obsession to me. My father is an alcoholic drug addict who
smokes a lot. My mother is just a heavy smoker. Some people cannot control
themselves, and the long-term success rates of drug rehabilitation and
AA/smoking quitters show that.

------
thrower123
Sitting kids in a chair for eight hours a day and feeding them three times a
day on refined carbohydrates has predictable effects.

School breakfast programs are good - many children would not eat anything in
the morning otherwise - but feeding them the kind of garbage that is typical
eliminates most of the potential benefits. No human being should eat cereal or
pop tarts, really at any time.

~~~
w0utert
>> _School breakfast programs are good - many children would not eat anything
in the morning otherwise_

Is there any scientific evidence that shows this would actually be a bad
thing? I know the amount of evidence that intermittent fasting like e.g.
16-hours a day without food has significant health benefits has been piling up
in the last few years. But I haven't seen any research that backs up the
'common knowledge' claim that 'breakfast is the most important meal of the
day'. As far as I'm concerned it's just a marketing trick from food companies,
just like the stupid idea that you need to 'feed your body' with small snacks
throughout the day.

~~~
javagram
Breakfast for adults without a medical condition is certainly unnecessary.

Not sure about kids though. They are still growing and modern nutrition has
helped kids grow taller and healthier than past generations who had
intermittent access to food.

Eggs and a glass of whole milk would probably be a lot healthier than pop
tarts and skim milk with cereal though.

------
ptah
yet again society pays the price whilst corporations selling sugary drinks
reaps the benefits

~~~
rimliu
Society is not forced at gunpoint to buy those drinks.

~~~
hannasanarion
Society was not forced at gunpoint to buy cigarettes either, but with
masterful marketing, corporations exploded cigarette smoking from
100/capita/day in 1910 to 5000/capita/day in 1960.

Humans are not random decision-making machines. The ease of manipulating our
consumption decisions is well documented. If you think your decisions aren't
affected by external manipulations, it just means you haven't noticed.

~~~
pandaman
Even 100 cigarettes per person in a day is not believable least 5000 - people
did not smoke more than 10 packs per hour in 1960 or ever.

~~~
hannasanarion
*per year

editing mistake from changing source from this graph

[https://ourworldindata.org/smoking](https://ourworldindata.org/smoking)

to this graph

[http://4.bp.blogspot.com/-p4ECPyex_cY/TzSalazW2XI/AAAAAAAAA2...](http://4.bp.blogspot.com/-p4ECPyex_cY/TzSalazW2XI/AAAAAAAAA2o/Wrgj5mSyGHA/s1600/Smoking+1900-2006.JPG)

~~~
pandaman
In this case it looks like merely switching between different methods of
tobacco consumption due to changes in the society. Cigarettes win vs pipes and
cigars both in price and in time requirements.

------
devoply
How does banning cars and making cities more walk-able effect obesity?

~~~
temon
I think in real life we have a lot of variables related to solve the obesity
problem. But I agree that reduce using a car and make everyone use a
bicycle/walking will reduce the percentage of obesity. We have to think more.

------
paulpauper
is it an obesity epidemic or humans converging to a biologically pre-
determined weight. it's not that people are overeating but that decades ago
they were undernourished. Maybe adult humans were meant to weight 200+ pounds

~~~
tonyedgecombe
We weren't "meant" to be any weight, we just evolved in an environment where
food was scarce.

~~~
paulpauper
right. and now with abundance, humans weigh more

~~~
Buttons840
I guess it depends on the definition of "meant". Depending on your religious
beliefs, you may believe humans were "meant" for this or that. Objectively, we
can't say that humans were "meant" for anything.

We exist. Our actions have consequences. Take control and perform the actions
that result in the consequences you want.

------
vfc1
Obesity is caused by food choices, it's an optional state you don't have to be
obese that's a fact, yet a lot of people think its a fatality and a bad draw
from the genetic lottery, when nothing could be further from the truth.

The only way to cure the obesity epidemic is public education, and inform
people. A whole food plant-based diet is the best diet identified by science
so far in terms of treating obesity, and even heart disease and diabetes yet
the public is still in 2019 going on 2020 largely unaware.

If you want to learn about this in a very relatable and none-formal way, this
YouTube channel Krocs in the Kitchen from an american couple is quite fun
(they lost 800 pounds combined) -
[https://www.youtube.com/channel/UC9vIrPTF0znhis-
gsFB8l8Q](https://www.youtube.com/channel/UC9vIrPTF0znhis-gsFB8l8Q)

~~~
dalore
> A whole food plant-based diet is the best diet identified by science so far
> in terms of treating obesity

Citation?

I think the best diet science has identified in treating obesity is cutting
out processed foods. Whether it's processed plant or animal food.

Heart disease and diabetes comes from sugar and carbs, all of which are plant
based.

~~~
vfc1
The key is word Whole, a whole food plant-based diet is the only diet
documented to reverse the progression of heart disease.

The reversal of heart disease with this diet has been proven decades ago -
[https://nutritionfacts.org/2011/10/14/heart-disease-there-
is...](https://nutritionfacts.org/2011/10/14/heart-disease-there-is-a-cure/)

No one knows the exact cause of diabetes, there could several causes.
Processed foods are not whole foods. White flour, marguerine, processed sugar,
cheetoes, that's a not a whole food it's not comparable to potatoes and
bananas.

Here is the opinion of one of the leading experts in Diabetes, Neal Barnard -
[https://www.youtube.com/watch?v=S51D07bvlPY](https://www.youtube.com/watch?v=S51D07bvlPY)

He mentions that diabetes seems to be linked to an excessive consumption of
fat, that inhibits the absortion of sugar.

He has studies published showing that a whole-food plant based diets in some
cases has made the person stop taking insuline altogether.

~~~
dalore
Low carb is the only diet know to reverse diabetes. Previously type 2 diabetes
was thought uncurable and only a managed disease. But Dr Unwin has been
helping to change NHS policy and reverse type 2 diabetes. Over 60 patients to
date!

[https://www.diabetes.co.uk/in-depth/whats-at-the-heart-of-
he...](https://www.diabetes.co.uk/in-depth/whats-at-the-heart-of-healthy-
eating-dr-david-unwin-discusses-low-carb-and-its-cardiovascular-benefits/)

We know the cause of diabetes, it's elevated insulin over time. We know what
elevates insulin, it's carbohydrates. We know fat doesn't raise insulin.

That website, nutritionfacts.org is quite wrong in several places. I read some
of the articles, it's not that good I'd avoid it.

------
tomohawk
I'm tired of subsidizing people who are so intent on harming themselves, while
at the same time blaming everyone/everything else for their behavior. I get
that people need to be the hero of their own narrative, but requiring the rest
of us to subsidize and approve is just too much.

Obesity should automatically put a person into a different risk/cost pool for
health insurance. The price of procedures should be higher to reflect the
higher cost and risk of treating people who are obese.

~~~
milankragujevic
> Obesity should automatically put a person into a different risk/cost pool
> for health insurance

That already happens, though.

> I'm tired of subsidizing people who are so intent on harming themselves

Fair point, however you also subsidize smokers, drug addicts, etc.

I find your comment to be overly negative, instead of trying to solve the
problem your propose to punish people financially, which won't work for two
reasons, one of which is that poor people on average weigh more, and second is
that you will reinforce bad behavior (i.e. overeating) and conspiracy theories
that the world is out to get fat people.

My opinion is that a significat number of people who are overweight have a
psychiatric condition, that can either directly cause overeating, or
indirectly (i.e. medication such as antipsychotics, including "modern" ones
like aripiprazole, drastically increase appetite).

As a fat person myself, I find it helpful to criticize obesity, as a complete
fat-acceptness state of society would be very harmful. However, please, do not
settle on punishment that at most could benefit normal-weight people
financially, as we do with the justice system. Instead, try education and
constructive criticism. Also, some fat people need healthcare to be able to
lose weight -- like me (Coushing's disease).

Had your plan to deny me health insurance (by making it too expensive) been
implemented, I would not only be fat forever, it would ruin both my life,
lives of people around me (a stupid example: people in a bus being
uncomfortably close to a obese person who is simply too large), and in the end
achieve nothing.

As a software developer, I can provide more value to the society alive and
healthy than sick and possibly dead, even including the additional cost of
health insurance, adrenal gland surgery and medications and care.

Think before you ostracize. What you're proposing is not healthy and helpful
criticism, it's a totalitarian conspiracy against a group of people, some of
whom need your help.

~~~
tomohawk
The non-obese are the ones being punished. They are having to foot the bill
and subsidize. Putting the cost onto the people who make the lifestyle choice
is just being fair.

I fully support the choices people make, but these choices come with costs
that people need to take responsibility for.

~~~
milankragujevic
You seem to have skipped most of my comment, only replying to the first
paragraph.

Have a look at this comment that may further illustrate my point about your
assumption about "choices people make" being incorrect.

[https://news.ycombinator.com/item?id=21214124](https://news.ycombinator.com/item?id=21214124)

