Another reason not to go into the Stepford supermarket.

My state run health insurance will soon start charging the highest level of premiums for those employees (and spouses) with BMI over 32, or who continue to smoke after a grace period. IOW, they're offering a disincentive to stay overweight or to continue to smoke. Isn't that the same as what WF is doing?

Ah. Out here we call it "Whole Paycheck."

I've been inside the local one twice, once out of curiosity and once to see if they had bacala.

Didn't buy anything. Won't ever, now. Trader Joe's is just as easy to get to.

Hey, I've been to the Boulder Whole Foods... One of these days I'm going to go through the parking lot, find an SUV with a "Save Tibet" bumper sticker on it, and ask the driver to point to Tibet on a map.

And can someone tell me why Boulder doesn't yet have a Trader Joe's? Because I would totally shop there if I could.

But if the CEO were truly motivated by the health of his employees, wouldn't he offer the greatest discounts to Whole Food's supposedly-healthier offerings to those supposedly most in need of healthier eating habits?

This seems entirely backward: you are too fat (his take, apparently - I'm familiar with the problems with BMI), so you have to pay more for fruit and veg and organics.

Not to mention the level of company monitoring of individual health...

Open-threaded Obit - J.D. Salinger is dead at 91.

http://www.seattlepi.com/artandlife/1404ap_us_obit_salinger.html?source=mypi

Pardon me - wrong thread!

As far as Trader Joe's in Colorado goes, I believe I read in a newspaper article that Trader Joe's will not open a store in states in which grocery stores can't sell wine. In Colorado, grocery stores can sell limited-alcohol beer and cooking wine. We go to liquor stores for anything else. (Though we did recently get the ability to buy booze on Sunday. Go us!)

Wait - they're offering a discount on food if you're underweight? Isn't that a good thing, since if you're underweight you clearly need it badly?

Patrick, should you by some chance visit Edinburgh, remind me to show you round the best wholefood shop in Scotland, just to remind you of that lovely Brezhnev-era feel.

(Wholefood Market have a toe-hold in London. The rest of the UK is ... backward.)

Elaine @8: Trader Joe's will open stores in states that do not allow grocery stores to sell wine - TN forbids it, and we got a TJ's here about a year and a half ago.

And Massachusetts allows only 3 stores per chain to sell liquor in the state, and TJ's is all over Mass. Cambridge and Brookline do, I'm unsure if they have a 3rd.

Mackie clearly does not understand that a lot of his customers are among the people he's dissing.

There are Trader Joe's here in Blue Law Country (Pennsylvania), too. Right now you can only buy beer and wine in state-controlled shops, but they are trying to change the law. I do miss being able to buy Two Buck Chuck, however.

He just wants all his employees to be rail-thin. Not healthier, just thinner. It's aesthetic.

He's a stupid asshole.

BMI is stupid anyway. At 5'7" and 200 pounds (ha! I wish) I would have the same BMI whether I had 25% body fat or 10%—and in the latter case I could compete in bodybuilding competitions. NOT what anyone would call fat.

Now, it's possible that very muscular people have higher mortality rates, but I've never seen a discussion of BMI that even considered anything other than obesity as the cause of a high BMI.

I'm fat right now, but I'm also quite muscular. BMI doesn't help me figure out what I need to do at all.

Now, in my case I need to keep my weight low whether it's muscle or fat, to take strain off my artificial hip. But absent such considerations, it makes a huge difference where your weight comes from.

I don't suppose Whole Foods did this because people so skinny obviously need more food?

I didn't think so.

Xopher @ 15: "He just wants all his employees to be rail-thin. Not healthier, just thinner. It's aesthetic. "

Yes. Health science is just a pretext to act on an underlying distaste for fat people. That fact that it's taking place in a corporate environment (employees must conform to corporate-approved body types) and via restricting their food just makes it especially noxious.

And in Connecticut. Groceries can sell beer but not wine. And there are several Trader Joes stores in the state.

I live in a total food desert, and I've been so put off the local Food Bazaar by finding dairy products 30 days past their expiration dates on the shelves, I've been shopping at WF lately despite Mackey's WSJ editorial. But this annoys me so deeply I'm switching to Trader Joe's.

(Also? Monday I went in to get rice and beans and came out $60 poorer. I'm way too much an impulse shopper to go near them.)

So if I got a doctor's note to say that my extra 80 lbs was due to Hashimoto's that remained undiagnosed until the PCOS (which makes it really freaking hard to lose weight) kicked in, could I claim some sort of medical exemption from the lesser discount? Because as far as I'm concerned, 65 out of those 80 lbs is genetic.

If he were concerned about his employees being healthier, he might discount the healthier or less-processed foods at a higher rate. (yes, I know those cheezy-poofs are organic; it doesn't make them healthier). But it's clear to me this guy's got more in common with serial molestor and purveyor of female eyebrow guidelines and Abercrombie & Fitch than Alice Waters.

Funny, I could have sworn I put "D*v Ch*rn*y" in there between "guidelines..." and "...and Abercrombie".

Yeek. Here (Charlottesville, BA) WF is just one of the local chains. Alas, my neighborhood doesn't have a TJ's (there was a rumor...), but the local supermarket chains do have some organic produce and suchlike. Kroger's (more distant for me) is better, but even Giant has some.

This whole BMI thing is a bit silly, considering the recent study that showed that it's more important to be fit than thin.

Now, those are some pretty big flaws, but in the general sense, giving people incentives to have weight, blood pressure, and cholesterol not in the "OMG you're gonna die!" range is probably a good thing. It's also fairly good business sense, if you're going to give health benefits to your employees, since someone out of that range is going to cost you a lot more in the long run.

The real problem here is what nerdycellist @20 brought up - some people have medical conditions where it is very difficult to lose weight. If allowances are not made, I think this probably puts any policy of this sort in conflict with the ADA. So I'm not saying it's necessarily a bad idea to give employees incentives to be healthy, just that the WF idiot CEO is doing it wrong.

David Finberg @ 12 -- Newton's the 3rd licensed Trader Joe's in Massachusetts, I think.

Victor @24 : Unless things have changed since the last time I was home, that TJ's does not carry alcohol (I grew up in Newton).

I am very interested in seeing whether this would survive a complaint under the Americans with Disabilities act; as nerdycellist's example shows, he'd be punishing people for having medical conditions they can't help having--a healthy lifestyle may make conditions like Hashimoto's and PCOS more easily controlled, but it has nothing at all to do with whether or not you have those conditions in the first place. IANAL, and I don't know how far ADA can be carried wrt such conditions--but I suspect we'll find out soon enough.

Out here on LI, we're fortunate that we have Trader Joe's and, even better, our very own Fairway, which means that there's never a reason to go to Whole Foods.

I swore off Whole Foods ever since the anti-universal-health-care thing, and have rediscovered the pleasures of the co-op. I used to live in Davis, home of the Platonic ideal of grocery stores, the Davis Food Co-op (and the only slightly less awesome Nugget Market); when I moved to Los Angeles and found that the local co-op was the smaller and less comprehensive Co-Opportunity Santa Monica, it was all too easy to find myself at Whole Paycheck.

But no more, dammit. I exhort you all to check out your local co-ops, if you have them; unless you live within range of a Nugget Market, in which case I hate you.

Ben@25: A Trader Joe's that does not sell alcohol? What a peculiar notion.

Fairway is one of the things I miss most about living in NYC. (efficient public transit goes without saying)

But I am thrilled to live near so many Trader Joes.

FWIW, no amount of healthful eating or excercise will make your body start producing thyroid hormones once it stops. I may as well attempt to diet my gray hairs (also genetic) away.

I think he wants his employees to function as an implicit and inaccurate advertisement for Whole Foods. It's a Law of Contagion thing: if the people who are visibly associated with the grocery look healthy and attractive, the stuff they sell there must be extra extra good for you -- and thus worth the extra cost.

Teresa, is it stretching the definition unduly to call that implication a cargo cult?

Nerdycellist, liquor laws all over America are local, and thus wildly variable. In Pennsylvania, there are times when "drive to the next state" is a viable answer to "Where do I get a drink around here?" Arizona has 24-hour drive-through liquor stores that will cash your paycheck for you. New Orleans is strict on one issue: if you're standing out on the sidewalk, drinking a large lethal cocktail in the middle of the day, it *must not* be in a glass container. And so forth.

Almost all of them have laws governing the sale of alcohol by grocery stores. They can't sell it at all, or they can only sell certain items, or they can sell wine and beer but not on Sunday mornings, or they can sell cooking wine but only if there's enough salt in it to make it undrinkable. This is why NYC's Trader Joe's doesn't sell alcohol, but it operates a convenient wine shop right next door tot he grocery.

My husband John has lost fifty pounds in the last year due to cancer and various treatment side effects. He looks like a skeleton to me. His BMI is 22.

I went to high school in Colorado, trekked to Los Angeles for college, and came back to Colorado. It was very disconcerting at first to find rows and rows of hard liquor in the supermarket. Even more disconcerting to discover things like generic label vodka.

I also discovered Trader Joe's in L.A. I still miss it and am insanely jealous of every town that has one.

I would think that Boulder would be a perfect market for one, but maybe the competition with Wild Oats (which started here) and Whole Foods and Sunflower is seen as prohibitive.

#4: Colorado groceries can't sell liquor with the same level of restrictions as liquor stores, which is why Trader Joe's hasn't any CO locations. They're waiting for that law to go away, which the supermarket chains and liquor stores are fighting tooth and nail.

When the Co-op closed down in Berkeley, of all the supermarkets that moved into the old Co-op stores, Whole Foods was the only one that didn't hire old Co-op staff. The other stores mostly had union staff, Whole Foods was non-union. Fortunately Berkeley has alternatives such as the wonderful Berkeley Bowl produce market.

For a long time I thought Whole Foods, even if it is not up to Berkeley standards, must have been a good thing in other places that were not as well provided for. Then one day I was down in Austin town, home of Whole Foods, and I went to Central Market to shop for the con suite. Wow. It is a complete mystery to me how Whole Foods managed to even get started.

1. Trader Joe's is in 25 states right now. So they're lots of places, but the reason you may not have one may be as simple as "they haven't gotten there yet."

2. The worst part of the "extra special discount chart for health" is that it's based off your worst stat— which means your blood pressure and cholesterol can be great, but if your BMI is "too high" you're screwed.

3. BMI is such a crock. I have a mathematically-inclined friend who got a bone-density test and a body-fat test and calculated that to get his BMI below 25, he would literally have to be below 0% body fat.

Furthermore, there was a point in time at which I was literally not getting enough to eat. I didn't have a scale, so I can't give you exact numbers, but if I give a reasonable estimate of about fifteen pounds under my normal weight, I'd end up with a BMI of 22— which is considered healthy. But if you look at pictures of me at that time, I look overly thin— not model-thin (which is about 16-19 BMI, unhealthily underweight FWIW)— but definitely skinny. Still a size 10 or 12, though, because I've got hips.

4. They've been coming out with studies in recent years that show that it's fat distribution that matters, not total fat. Those of us lucky enough to have the thunder thighs are apparently far healthier than those with a bit of a belly. So is there going to be a body-shape penalty then?

5. Again, BMI is a crock. And medical professionals know it. I have yet to have my doctors look at my numbers and say, "Your BMI is too high, you need to lose weight." Instead, they look at me and my blood tests and work from that.

John L., way up at #2:

Your first invalid assumption is that everyone has complete control over his weight. Your second is that your state government's policy is necessarily laudable.

Consider: You work a low-paying job in a major metropolitan area, commuting 90 minutes each way to the nearest (remote, suburban) area with affordable rents.

What will you do with your remaining four hours of waking time each day? What will you eat for breakfast or lunch?

For the former, remember you will be fired if you're five minutes late, any 3 days in the year. For that latter, you have 30 minutes, same terms.

cgeye@35:

Discussion further up established that Trader Joe's exists in other places with restrictive liquor laws, and indeed there are TJ's that don't sell alcohol at all. So, there's gotta be something else going on.

OH:
http://www.denverpost.com/opinion/ci_13913017?source=bb

"Your first invalid assumption is that everyone has complete control over his weight."

Yes.

There are several factors that influence your weight. A big one is genetics. Lifestyle is another— the only one that can be controlled. And then some people just get screwed over by a medical condition— which is especially nasty if the condition comes with life-long maintenance.

If you are on a drug regimen, there is a good chance you will be unable to muck about with your weight at all. Thyroid conditions, diabetes, even asthma regimens can affect how your body processes nutrients.

#23 ::: Dave Fried: Even that 'general sense' is an unpleasant bit of body policing. It says that any other sort of chronic condition that could require doctor's trips and thus more insurance money is fine, but not those particular ones that just so happen to be corrolated with weight. It also says that weight in and of itself is a punishable condition, and people don't drop dead just because they're fat (despite that pearl-clutching label of 'morbidly obese' for the upper range of the BMI).

If employers are going to punish employees for having hypothetically correctible chronic conditions (aren't high blood pressure and cholesterol highly genetic? Weight sure seems to be), they might as well punish them all. It's nasty, yes, but it's no less nasty when it's restricted to sizeism.

John L @ #2, I'd be curious to know how high the taxes on cigarettes are in your state.

The state would be in an anomalous position if it were on the health hand encouraging people to quit while on the tax hand imploring them to smoke. Not that state departments are forbidden from having mutually exclusive positions on issues.

TomB #36:

Whole Foods began in 1980 or 1981. Central Market didn't open until 1992 or 1993.

We hit CM at least once a week, and have since it opened. We tend to save WF for times we feel like we can handle the parking hassle and want to be completely surprised by what we find--IOW, about three times a year. Sounds like that's going to shrink.

I wonder what would be the reaction to a sliding series of BMI-based discounts for customers?

http://www.seattlepi.com/sound/414761_sound82817997.html

This is what happens when people focus on weight instead of health.

TomB, #36: Yay, someone else who prefers Central Market! As for how Whole Foods managed to get started, they predate Central Market by a decade or so; CM is a competitor against WF, not the other way around.

Ohhhhhh, how much do I miss CM! Also HEB, CM's parent company--even the ordinary HEBs have a lot of CM-branded items. Like their organic chocolate truffles. Dammit, now I'm all homesick again!

Whole Foods lost my business (minimal at best, granted) with the WSJ article, but I find his philosophical stance fascinating, in a train wreck sort of way. Parts of it seem very similar to what the BBC reported as the Quaker's stance on business. Could work, if only everybody subscribed to the same philosophy which is exactly why it falls apart.

And then there's the homeopathic medicine aisle.

A Whole Foods employee commenting on Jezebel noted that her discount level pops up when she provides her employee card at the checkout counter. In other words, the checkout clerk--her colleague--gets to find out the extent to which she "meets guidelines". Very not okay.

Speaking of health food, I discovered recently that Randall's deli fried chicken tastes significantly better than HEB's similar offering.

According to Mackey, he's doing this to try to keep the company's health insurance costs down. Which means that, like most big corporate types who preach the libertarian gospel, he's perfectly happy with having powerful entities micro-manage the people's lives, as long as those entities are corporations.

Sadly, Whole Foods is an incredibly convenient place for me to get just-roasted-today-or-yesterday coffee beans in 4-to-8-ounce batches.

Anyway, given that there are people for whom weight, blood pressure, and/or cholesterol are difficult to manage for genetic reasons, I suspect Mackey's new policy is an ADA lawsuit waiting to happen.

#12, 24, & 25: I didn't know about Massachusetts 3-stores per chain limit on alcohol sales, but I do know that the Trader Joe's in Framingham sells wine.

On the Whole Foods front, I was disappointed to read about the BMI-based employee discount program. Last week, I visited the Whole Foods in Amherst for the first time and was delighted to discover they carry High Lawn milk, including High Lawn's whole milk.

Milk Composition. Compared to the other major dairy breeds, Jersey milk contains the highest levels of both protein and milkfat.

Jersey milk has over 18 percent more protein and 29 percent more milkfat in a given amount of milk compared to the average of all breeds.

So they're happy to sell extra high-fat products, but not to reward their fat employees at the same level they reward thin employees.

There's also the not-so-small repugnant practice of basing employee discounts on private medical information such as BMI and cholesterol numbers.

The whole thing is another small example of the problems that go with having employer-based health care system.

In the last couple of years, other employers have been requiring employees and their spouses to participate in various wellness programs in order to receive the lowest medical plan premiums.

Then there's the study reported in the New England Journal of Medicine showing that higher copays increase overall health costs for elderly patients in the US. (And here's the Reuters article about the report.) So much for the cost-savings copays are supposed to generate.

#28: Why, thank you. (Worked for DFC for 16 years, still live 4 blocks away.) Great place.

Dolloch (#50)

". . . Quaker's stance on business. Could work, if only everybody subscribed to the same philosophy which is exactly why it falls apart."

Excuse me? Excuse me??? The Quaker method has not "fallen apart"! It has transformed the business world. A fair, fixed price is now taken for granted everywhere, at least in developed countries. Prior to Quaker practice taking hold, everyone, everywhere, had to bargain every purchase. The fixed price took hold universally because fairness was a competitive advantage.

"The fixed price took hold universally because fairness was a competitive advantage."

I only wish it had taken hold universally. There are still a lot of vendors to businesses that use "talk to us" as a price. (A startup vendor to libraries recently drew some attention by actually posting fixed prices for their product.)

Fixed prices are more common when selling to individuals, but there are still areas where it's not common. You're usually expected to negotiate the price for a car in the US, for instance, unless you want to overpay.

And in practice, the price of groceries isn't reallly fixed either, initially because of coupons, and more recently because of the shopper-tracking cards (which give lower prices to some shoppers but not others), that are now prevalent in too many big supermarket chains. Whole Foods at least doesn't insist on snooping on your shopping habits to give you discounts, last I checked. (But then, neither does Trader Joe's, which I generally prefer to shop at.)

Somebody should send this to John Mackey at Whole Foods.

Lizzy, what interest would John Mackey have in a Medscape log-in form?

I have it on the best authority (a friend who works in the home office) that NO ONE passed the physical.

Including John Mackey.

Apparently no one was told to fast before the blood test, so everyone's cholesterol was sky-high, and all of the body fat readings were bizarre. So much for saving the company money, I suppose.

My source tells me it was an excellent team bonding experience, though, as everyone stalked around livid at being told they were too fat and unhealthy to get the discount.

Sorry Avram and everybody: I thought I was linking to a Medscape article. Here it is:

Current body mass index (BMI) thresholds for overweight and obesity may be overly restrictive for older people, according to the authors of a cohort study published online January 27 and in the February print edition of the Journal of the American Geriatrics Society.

"Obesity is a global epidemic that is prevalent in developed and developing countries; affects people of both sexes and all ages; and has negative health consequences (ill health, disability, and mortality), economic costs, and social implications," write Leon Flicker, PhD, from the University of Western Australia in Perth, and colleagues. "In industrialized countries, the prevalence of overweight and obesity in older people is a growing public health concern, particularly because sustained aging of their populations is expected to continue for many decades, and obesity and aging represent large components of healthcare spending."

The study goal was to assess all-cause and cause-specific mortality associated with underweight (BMI,

Another place to get groceries is Aldi. For me, Trader Joes is a long drive. Aldi is across the street from the YWCA where I swim. The selection is limited, and you need to bring your own bags, but the prices are excellent. And they have really good chocolate because the chain is based in Germany. I rarely eat American chocolate any more.

I'm a fan of Aldi, pending any sign of a TJ in Kansas City. Started shopping there because we were damn broke, but after I start getting paid (I start work Monday, Feb. 1) I'm probably going to visit them for the basics.

For those same reasons I don't shop at Whole Foods in general. Except last weekend we hit them up because they had $3.99/lb bison chuck roasts. Damn fine meat-we divided what we bought, had a crock-pot-roast Tuesday. Om Nom!

Otherwise, I don't shop there. I'm still mad that they bought and closed our Wild Oats markets, a chain that I have loved in KC since I was in college.

I'm a fan of Aldi, pending any sign of a TJ in Kansas City. Started shopping there because we were damn broke, but after I start getting paid (I start work Monday, Feb. 1) I'm probably going to visit them for the basics.

For those same reasons I don't shop at Whole Foods in general. Except last weekend we hit them up because they had $3.99/lb bison chuck roasts. Damn fine meat-we divided what we bought, had a crock-pot-roast Tuesday. Om Nom!

Otherwise, I don't shop there. I'm still mad that they bought and closed our Wild Oats markets, a chain that I have loved in KC since I was in college.

sorry for the double, it gave me a weird message when I posted the first one.

WF carries Soy Delicious coconut creamer (I find it much nicer in tea than soy creamer), and the co-op does not. Time for me to look elsewhere, or get used to drinking my tea black. I could ask the co-op if I can special order it by the carton; will have to remember to do that next time I'm there.

One of the other natural foods grocery options available to me has policies and a work envionment that tick me off enough to keep me from going there; adding WF to that list should not be too difficult for me.

I used to drop by the Whole Foods in Alexandria (VA) all the time on my way home from work, since it's right near the Metro stop. They seemed to have phased out their fantastic bulk foods section in favor of smaller, more expensive prepackaged foods, so I don't have any reason to go now. Can't say I'm too sorry. For anyone in the DC metro area, My Organic Market (MOM) is a decent local chain.

I stopped doing business with Whole Foods back in the 1980s, when I found out they were getting their employees together and giving them Randroid anti-union pep talks. I decided they were toxic then, and it seems they still are toxic. (reposted from my blog) I think Whole Foods is a fine example of what is wrong with the libertarian theory of market regulation of business. They satisfy their customers (rather fewer of them, now, thanks to the collapse of the middle class) and their investors, at huge costs to their employees, the environment, and ultimately, the world.

@ Teresa 32 Oh, yes. As a former bartender in Tennessee who grew up in Maryland, I can tell you about some weird likka laws.

Kroger is heavily pushing a change in TN law to allow grocery stores to sell wine. They already sell beer, and have forever. They push the Web site on every receipt, at least in Inglehood.

I don't go to Whole Foods because a) it's in Green Hills, the area of Nashville with the most heinous traffic; and b) can't afford it, anyway.

Sadly, our fair city's only TJ's is there, too, so I haven't been, though I've been to the store near my mom's in MD and love, love, love it.

But back to the OT: Mackey is a schmuck and an idiot. But we already knew that, didn't we? This is just the latest manifestation of his schmuckitude.

Older @ 53
Offering a fixed price was a competitive advantage because the Quakers were known to be fair businessmen. That's how you knew you were getting a fair price. Without the moral guidelines the Quaker's used, the price doesn't necessarily have to be fair, which is my problem with the Objectivist Libertarian mindset. It requires that everyone play fairly under the exact same set of rules in order to work. Call me cynical, but I like my system to account for the inevitable shrinkage, not believe that people won't abuse it because it wouldn't be in the best interest of the person somewhere down the road.

Consider this: when the price of crude oil goes down, the price of gas goes down. But does the price of goods that are also petroleum based go down? Or do the costs of transported goods go down? Granted there will be less flux of the price on the shelves because re-pricing things every day would be prohibitive, but the general price for goods don't really go down. Once the consumer is okay with paying a price it remains the same. Not surprising because it creates an increase in profit with no effort on the part of the seller.

Or better yet, what about the fountain drinks at the movie theater. When I worked at a theater, a 3 gal box of syrup which gets mixed 5 to 1 cost about $15 (1996 and a fairly major chain, so some discounts could be involved). Even with the CO2 tank rental, cups, and labor, it worked out to around 30 cents a cup. Yet $2.50 is a common drink price.

So, yes, a fixed priced has transformed the business world and for the better. As for a fair price - that's a perception of the consumer based on what they're told from the seller. In my experience, that's advertising and not really reliable as an honest source of intel.

I, too, am slow to boycott, and when I read this piece of ridiculousness, I said, "Guess I'm not going to set foot in one of those stores again, other than to grab free samples, for a while."

Not only is BMI broken - it fails to account for muscle and bone mass - but high cholesterol is often genetic. So I'm pretty sure this can be taken as in violation of actual anti-discrimination laws, as opposed to just the ones that should exist but don't.

Epic fail.

(OT - For those of you with Aldi, I've heard the chain actually owns Trader Joe's now.)

As I pointed out over at LGM, Campos' numbers are wrong - under Whole Foods rules, the lowest discount actually goes to the highest-risk group (the obese), not to the lowest-risk group.

Not to say that the policy isn't silly in other ways, but Campos isn't very good at science (math is hard!) and tends to e.g. ignore entire datasets and confuse "overweight" and "obese" in order to strengthen his arguments.

Apart from the general silliness of BMI -- how did they *get* the data? How often do they re-check? And why is it even legal for them to *have* this data?

Older: A fair, fixed price is now taken for granted everywhere, at least in developed countries.

Don't I wish. A few years ago, they made haggling legal in Germany. I try to avoid stores that have an "introvert surcharge": If I notice them giving discounts to obnoxious people, I leave.

A.J. Luxton: For those of you with Aldi, I've heard the chain actually owns Trader Joe's now

Yes, and the brothers Aldi are not exactly shining examples of progressive business practises. They know to keep their mouths shut, though.

37: Again, BMI is a crock. And medical professionals know it. I have yet to have my doctors look at my numbers and say, "Your BMI is too high, you need to lose weight." Instead, they look at me and my blood tests and work from that.

I wish this was the case here. Before I could be approved to volunteer for kidney donation i was told my BMI needed to be at the very least below thirty or it would be too much of a risk to undergo the operation. So I spent a year trying to get below it while my partner suffered, didn't make it anyway, but underwent the op after badgering the doctors enough -- no problem, back to work in half the time as the average.

Take that, fsckers!

My BMI is too high, they say, and for various sundry reasons otherwise, I do need to lose some weight. But the BMI shouldn't be more than a basic filter to focus the doctor's attention.

For most of my life, I've been doing regular heavy physical work. A lot of my weight has been the muscle needed to shift 50 kilogram bags of seed grain or fertiliser. (And that muscle helped when I fractured my spine: my back might not have been entirely sound, because of what I did in that past life, but it was well-supported.)

I'm afraid I'm still an example of those people who have been criticised for high BMI by young doctors whose experience of picking things up is limited to cute nurses. I am more careful now, but I still tend to snigger at some of the heavy object warnings in supermarkets.

Whole Foods is the best place near our house to buy decent fresh fruit and veggies when farmers markets aren't running. I have no idea why, but the local Giant and Safeway produce sections look like they hire enraged gorillas to stock their fruits and veggies, and unless you shop just after they've restocked, what little produce survived the enraged gorillas has long since been purchased by other people. We've shopped there a lot less since the store near us put in an in-store peanut butter grinding machine. (Our oldest son is allergic to peanuts, and walking past a machine that grinds them up seems like a very bad idea.)

The WF employee discount plan is a kind of paternalism about which American culture seems pretty mixed. Making life harder for smoking employees in hopes of pushing them to quit smoking doesn't seem to upset anyone (except smokers, but we've already decided they deserve whatever we do to them). It doesn't seem too much of a stretch to see employers (and governments, which do the same stuff with less flexibility and more straightforward coercion) extending that to other unhealthy lifestyles.

The stuff about weight and BMI is interesting--a nice demonstration of the fact that you can find a measure which is useful and predictive of problems in the population as a whole, but which can be massively wrong for a lot of individuals, and which may change over time for reasons not related to a change in what you're trying to measure. (This makes me think of IQ, SAT scores, and NCLB scores--all probably broadly meaningful measures of ability and performance, which appear to massively get it wrong for some fair fraction of the people who take them.)

One thing I think is important, though--medical data is often somewhat ambiguous, and many of us (like me) are pretty heavy. We have the same set of internal, subconscious incentives in reading that literature as a lifelong smoker[1] did in reading the medical literature of 1950, and it's much too easy to seize upon evidence that says we are okay or can continue as we are, and to ignore the more numerous evidence that contradicts it.

[1] One famous example of this was Ronald Fischer, the great statistician and geneticist who designed some largish fraction of the stuff you studied in that first-semester stat class you took in college, was one of the guys behind the "modern synthesis" (marrying genetics and evolutionary theory), and was involved in a lot of important research in agriculture. The guy became a spokesman for the tobacco industry in his old age, having convinced himself that the statistics used to show smoking's ill effects weren't really meaningful.

I am by all accounts obese. When I was forced to change doctors due to an insurance change at work, I ended up with one obssessed with everything-weight. At our first visit, he ordered a battery of tests that looked as if I were going to have major surgery, and told me that "when the results came back, we would discuss your stomach-stapling surgery." Except all the results came back.... normal. He couldn't believe it, ordered more tests. Same results. By the third visit, he wanted to go off my insurance and ORDERED me to pay for expensive tests that weren't covered, because he was certain there had to be something wrong with me.

I went back to my former doctor and paid for a review of the tests out of my own pocket. He took out my files and showed me that for at least the six years I had been with him, the numbers in all my tests: cholesterol, sugar, etc. had varied one or two points higher/lower. He called me the poster child for the median.

I fired the other idiot on the spot.

And I stopped shopping at WF more than two years ago when they took over one of our local shops and hiked the price to astronomical. Nice to know I was ahead of the curve for once!

Just thinking, making food cheaper for the hungry is a nice and charitable idea, but Mackey is at least 60 years late with his specific execution.

Sorry about the weird posts. I tried to get back to the Medscape article, but can't find it. It discussed a study whose conclusion was that elderly people appear to live longer if they are slightly overweight, as compared to those with low BMI.

Lizzy:

I gather there's an issue with BMI there, in that a lot of serious illnesses cause you to lose a lot of weight. So you might have a combination of:

a. Slightly higher mortality for heavier people as high BMI correlates with unhealthy arteries/blood chemistry.

b. Much higher mortality for very thin people, who are very thin due to some serious health condition.

This isn't my field, so maybe this is all wrong.

Albatross@73:

It doesn't seem too much of a stretch to see employers (and governments, which do the same stuff with less flexibility and more straightforward coercion) extending that to other unhealthy lifestyles. (Emphasis mine.)

Like being poor? Or perhaps that previous diets had the typical results on their metabolisms?

I admit, this is personal. I'm sick and tired to having my and other's fat asses be attributed to 'unhealthy lifestyles' regardless of what our lifestyles actually are or if the decreed One True Way Of Health is actually even financially or physically possible for us (chronically ill people; they exist). No, it's all about the automatic assumption that a fat ass must mean one spends all day sprawled on a couch mainlining fast food.

If employers and insurance companies were really and truly interested in people's health and not on the size of their rear ends, they'd be promoting Health at Every Size, which works better than diets at improving health, not punishing based on weight.

... it's much too easy to seize upon evidence that says we are okay or can continue as we are, and to ignore the more numerous evidence that contradicts it.

That was pretty patronizing. Also, cite please.

Dave, #72: young doctors whose experience of picking things up is limited to cute nurses

Mee-ow! *stores away for future use*

albatross, #73: Your first two paragraphs are oddly self-contradictory. You don't seem to have a problem with protecting your son from things to which he is allergic, but workplace policies that protect employees (and customers) who are allergic to cigarette smoke upset you so much that you mischaracterize them as "only done to make life harder for smokers"?

Emma, #74: I would fire any doctor who didn't try to discourage patients from stomach-stapling surgery -- I've known several people who have had it done (for reasons which seemed good to them at the time), and without exception their quality of life has gone straight to hell, including the rest of their health. I'm willing to allow that there may be extreme cases in which it would be the best alternative, but a doctor who actively pushes it is IMO a quack, and probably getting kickbacks.

I'll probably still be shopping at WF-- it's significantly more convenient than TJs, and has the only bulk section anywhere near here.

Essene (an independent health food store) is more expensive than WF.

Mostly, I'm waiting for the farmer's markets, but they're only sell produce half the year. It's so anti-locavorishly irresponsible to live in a temperate climate.

Anyway, I've been wondering how Mackey's discount system is likely to work out in practice. #57's account of no one getting the discount is more extreme than I expected, but even if the numbers were honestly measured, I don't think very many people would qualify for the best discount.

My guess is that there will be more theft by employees-- I'm assuming that feeling unfairly treated causes some people to try to even things out. And even if fat people can generally be convinced that it's their own fault, people with genetically high cholesterol and/or blood pressure know it's just bad luck.

Also, there's no allowance for being pregnant or having a weight which varies widely because of water retention.

This policy will tend to drive away older employees, I think. That is, the more experienced employees.

And to the extent that being more competent and having more energy leads to more choice of employer, the better employees will be going.

Any thoughts about CEOs being subject to the Brain Eater?

I've been avoiding WF for the past 6 months mostly because of the CEO comments after stopping there a few times per month for years. Broke down last week and had lunch from there and felt pretty bad.

Fortunately, I have local co-ops that are pretty good.

I have adjusted my (admittedly execrably nasty but cheap) diet with the goal of sodium abatement: I stopped using ramen flavor packets cold turkey a few weeks ago in favor of zero sodium bouillon powder. Also, I partially cook my ramen noodles with the canned chicken and veggies with no spices, then strain and drain the liquid (and, unfortunately, most of the flavor) and rinse under the tap for a bit, then add fresh water, bouillon powder (Herb Ox zero sodium) and spices, heavy on the black pepper, to finish cooking. Simple black pepper has long been my favorite salt substitute. This plan is not going to win me any awards, but it's better for me than my previous plan.

Bread and Circus sold itself to Whole Foods years ago.... Wild Harvest got bought ought by a supermarket chain or a Euro supermarket chain conglomerate owner, and the result was that sections of in this part of the USA there is packaged and frozen foods wich are semi-organic, at high prices, in Shaw's stores.

#73 albatross

I did a Teresa once from someone lighting up a particularly obnoxious brand of cigarette ten meters away from me. Poeple who have been smoking I see off choking fits in me in supermarket checkout lines, sometimes, from the miasma emanating from their clothing and bodies.

(Meanwhile there was an allergy sufferer who went to the extreme of going to Africe and walk barefoot through ground used for latrine purposes, to infect himself with hookworms. He did so, and his allergies went away.... the starving children of Africa do not have peanut allergies, etc.! )

I have a medically restricted diet -- and Whole Foods has for years been one of the few stores that reliably carried food that I could eat. You would think I was a "captured" client, however I would rather do without some of the food finds Whole Foods provided rather than support an organization that allows this man any power.

David Finberg @ 12: The third TJ's with Cheap Chuck is the one on Route 9 in Framingham. And you have just provided the answer to a long held debate in my house, as to why so many other stores don't have wine. Thanks!

Luckily in Oregon we have a million alternatives. Trader Joe's, New Season's -- heck, even the Fred Meyer's, Winco and Albertson's sell organic meat and produce, a lot of it locally farmed.

Renatus #78:

Do you need a citation for the claim that it's common for people to selectively find and remember things that make them feel better about themselves, or that confirm what they want to believe? Here are a couple Wikipedia articles on relevant known cognitive biases: Confirmation Bias and Cognitive Dissonance. It's a pretty overwhelmingly common phenomenon, I think.

As far as obesity having bad health consequences, this Merck Manual article describes some of them. Now, as I understand it, weight and BMI can be misleading in some cases, and my understanding is that the thing that's really unhealthy isn't being heavy, it's having the bad blood chemistry (potentially leading to type 2 diabetes and high blood pressure) that often goes with it. But it's a quick marker that often suggests some underlying health problems. (FWIW, I'm both pretty heavy and carry most of that weight on my belly, which is a really strong indication of potential health problems.) This article describes a link between obesity and cancer rates[3]. This is absolutely mainstream stuff, and it mirrors what my regular doctors and cardiologist have told me, and what I've read in various other places.

People do sometimes manage to lose weight, but it's damned difficult, and I gather that there are almost no non-horrible techniques[1] for losing a lot of weight that work on very many people[2]. My understanding is that you can improve your blood chemistry and blood pressure substantially with lifestyle changes, but that these mostly don't lead to dropping the extra 60 pounds--though they probably make you less likely to drop dead from a heart attack at 50.

[1] Stomach-stapling and liposuction strike me as horrible techniques. Also, I gather lipo makes you look better, but doesn't improve health outcomes.

[2] I've certainly had very little luck in this department.

[3] This paper's recommendations have the ring of "If only we could get practical fusion plants working, we could sure decrease our CO2 output in a hurry."

Obligatory link for this stage in a fat-related discussion on a progressive site: But Don't You Realize Fat is Unhealthy?

Linkmeister @ 43: "The state would be in an anomalous position if it were on the health hand encouraging people to quit while on the tax hand imploring them to smoke."

Er, I don't think that cigarette taxes are in place to encourage people TO smoke--generally when the government taxes specific activities, it's in order to discourage people from doing them. Or when they tax inflexible behaviors, like paycheck taxes, to raise revenue.

albatross @ 78: "b. Much higher mortality for very thin people, who are very thin due to some serious health condition. "

First, the increased mortality isn't among "very thin" people: it's among people with "normal" BMIs as compared to people with "overweight" BMIs. The lowest risk of mortality is among people with BMIs between 25 and 30. Platinum (BMI below 24) Whole Foods employees are more likely to die than Bronze (BMI below 30) ones.

Second, here are two refutations of that particular objection. The first responds specifically to the "smokers are thinner" criticism of Flegel's study, and the second to the wider "thinness is symptomatic of other serious conditions" critique.

I've been very good about living places where there are alternatives to Whole Foods, and I've probably spent less than $20 in them over my lifetime. Seattle has several Amazing markets (Central Market and its kin, Uwajimaya, the Farmers' Markets), so I don't even have to go to TJs.

I never liked WF because of price and it's easy not to shop there.

caffeine, thank you for the link. I've long been moderately interested in eating disorders* and I've come across that attitude as well. Including from people who should know better.

*Many of my well-educated friends from supportive families still have unhealthy weight obsessions. I'm one of the few females I know who doesn't, so the causes intrigue me.

What follows is a BBC summary of the information contained in the original Medscape article.

Moderately overweight elderly people may live longer than those of normal weight, an Australian study suggests.But being very overweight or being underweight shortened lives.

The report, which was published in the Journal of the American Geriatric Society, said dieting may not be beneficial in this age group.But the study of 9,200 over-70s also found that regardless of weight, sedentary lifestyles shortened lives, particularly for women.

The study by the University of Western Australia set out to find out what level of body mass index (BMI) was associated with the lowest risk of death in the elderly. Concerns have been raised about encouraging apparently overweight older people to lose weight.

For younger people, there is a well established health risk from being overweight or obese.

The team tracked the number of deaths over 10 years among volunteers who were aged 70 - 75 at the start of the study.

It found that those with a BMI which classed them as overweight not only had the lowest overall risk of dying, they also had the lowest risk of dying from specific diseases: cardiovascular disease, cancer and chronic respiratory disease.

The overall death rate among the obese group was similar to that among those of normal weight.

But those who were very obese had a greater risk of dying during the 10 year period.

Lead researcher, Professor Leon Flicker said: "Concerns have been raised about encouraging apparently overweight older people to lose weight.
Our study suggests that those people who survive to age 70 in reasonable health have a different set of risks and benefits associated with the amount of body fat to younger people."

The conclusion of this study, that being overweight may be less harmful for elderly people, corroborates the findings of previous research.

Sedentary lifestyles shortened lives across all weight groups, doubling the risk of mortality for women over the period studied, and increasing it by 25% for men.

Physical exercise "really matters", said Professor Flicker.

As well as helping to build muscle mass, it has broader health benefits for elderly people, he said.

The authors believe BMI may give a poor reflection of fatty mass in elderly people.

"It may be time to review the BMI classification for older adults," says Professor Flicker.

Professor Kay-Tee Khaw from Cambridge University agreed, noting that optimal weight appears to be higher in older age groups.

"This is important since under-nutrition is an important problem in older people. Waist circumference, which assesses abdominal obesity, appears to be a better indicator of health consequences of obesity" she said.

Right now, I've got a BMI that puts me in the Platinum level. Don't know my blood cholesterol, as I haven't had health insurance for years and thus I haven't had it tested. I know my BMI mostly because the Wii Fit is obsessed with it.

Here's the thing, though. Right now, I'm not in terrific shape. Slender but sedentary. If I started working out more regularly, I'd probably put on muscle mass. And if I did that, I'd probably go UP in BMI, enough to bump me into the next category.

And how is THAT healthier?

The local Wild Harvest section at Shaw's is pretty good for most of my Cooking For Picky Vegetarians needs. The one thing I consistently can't get at Shaw's that I do at Whole Foods is No-Chicken Broth, and there are times when my homemade veggie stock just won't do for the purpose. I may have to look into buying that by the case, online.

They also carry the one brand of yogurt that my Picky Vegetarian housemate likes. She buys that herself. That's on her head.

Albatross@89: That's a pretty disingenuous interpretation of why I asked for a cite. I noted that your statement had a patronizing insinuation, and then you made an unsubstansiated claim; I want a cite on that claim.

I'll also note that your wording in that claim has some really unpleasant implications that we--which seems to imply fat people--are not okay as we are, no matter what and in no case, and that if we think so we're obviously deluded. It reminds me of people who insist that someone who is fat must actually be unhappy and hate themselves, no matter what that fat person says about themselves (witness all the harping on Gabourey Sidibe).

Re: Merck Manual - I'm having trouble taking that seriously, respected source or not, because they actually start with the calories in, calories out trope. I also notice that the recommendations for diet are less than the calorie amount and the same in activity as what made the participants in the Minnesota Starvation Experiment go effectively crazy.

Re: cancer 'link' - I notice that predates when the CDC downscaled the mortality risk from obesity. It also blithely ignores that fat people, especially women, are less likely to get screened for cancer. Yes, I know your doctors have told you similar things, but doctors aren't immune from fat prejudice, either.

My understanding is that you can improve your blood chemistry and blood pressure substantially with lifestyle changes, but that these mostly don't lead to dropping the extra 60 pounds--though they probably make you less likely to drop dead from a heart attack at 50.

That would be what I was getting at with the Health At Every Size link, yes.

All this still goes right around to my original point--it's nasty to penalize* based on weight.

---

* Which is what I meant when I wrote 'punished', but I temporarily misplaced the word.

... not to mention breast cancer risks going up for fat women in part because the machines used for mammograms have problems with dense breast tissue.

When I first ran into the idea of fat acceptance, I found I was resisting it because I didn't want to think that my home culture was viciously crazy.

Then it occurred to me that my dreary 10 years of Hebrew school (to my mind, it was mostly a waste except for the songs and getting some very minimal knowledge of Hebrew) wasn't totally useless. If you learn anything in Hebrew school, it's that people's home cultures can be viciously crazy.

This, of course, doesn't prove that any particular prejudice is based in nothing but the desire to establish status and maybe get some extra money on the side, but it opens up the possibility.

In particular, why believe that being moderately fat is unhealthy? People keep saying so, but is there any evidence?

Recommended reading: Never Too Thin, Never Satisficed (both good, but I can't remember which is better), and Privileging the Hypothesis, about the importance of thinking about whether a hypothesis makes sense.

Rikibeth @95: I don't now if there is a Penzey's near you (http://www.penzeys.com) but they have veggie soup base, as well as several other kinds. And the most amazing selection of herbs, spices, etc.

I don't see a problem with providing incentive for health. Obesity, smoking, etc do, in fact, raise healthcare costs. And why should people who take care of themselves cover a share of that increased cost?

Jill, since we all fund things like roads and schools and the military, whether we use them directly or not, it makes sense. (Unless you're perhaps thinking that no one should pay for anything they don't approve of?)

P.S. I looked up the Flegal paper you referenced and the conclusion in the abstract is this:

CONCLUSIONS: Underweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category. The impact of obesity on mortality may have decreased over time, perhaps because of improvements in public health and medical care. These findings are consistent with the increases in life expectancy in the United States and the declining mortality rates from ischemic heart disease.

So basically the only reason the mortality is declining in these groups is because of improved (read: more EXPENSIVE) healthcare.

Also I don't see anything in the paper abstract about the mortality rate being higher in the "normal" range? Not sure how that conclusion was drawn by Mr. Campos.

The two most interesting statements (to me) in the article I just posted were this one:

It found that those with a BMI which classed them as overweight not only had the lowest overall risk of dying, they also had the lowest risk of dying from specific diseases: cardiovascular disease, cancer and chronic respiratory disease.

and this one:

Sedentary lifestyles shortened lives across all weight groups, doubling the risk of mortality for women over the period studied, and increasing it by 25% for men.

Jill, try reading the post before commenting. They're not providing an incentive for health. They're providing an incentive to be thin.

Go and play.

PJ: no, I'm all for spreading the wealth. But I also believe there's areas we can cut back, and for half the nation, it's our waistlines. America is sick. People literally eat/smoke themselves to death. That doesn't make you sad/angry?

Magenta Griffith @98: There's a Penzey's in the center of town, actually. But it's not just a veggie soup base I want; it's the uncanny vegetarian simulation of chicken broth that Horizon Organics' No-Chicken Broth provides, and that nothing else yet has managed. It's THE perfect solution, along with Quorn Naked Cutlets, for making the vegetarian version of "boneless chicken breasts in $pan_sauce." It makes Not-Chicken Piccata, Not-Chicken Marsala, and assorted other tasty dishes possible in my house.

Oh for pity's sake, Jill. Did you read the links? Do you understand that asserting something, even with an 'in fact', doesn't make it so?

And why should people who take care of themselves cover a share of that increased cost?

Oh wow, breathtakingly judgemental much?

It's called living in a society composed of fellow human beings. You help them, they help you, all in a bunch of little indirect ways. Optimally, you don't get to decide other people are undeserving because you don't like how their bodies look, anymore than other people don't get to decide you're undeserving because you're acting like a jerk, and that makes it much more pleasant for all of us.

People literally eat/smoke themselves to death.

CITE, PLEASE.

Renatus, yes I read the links. That's why I posted the study paper conclusion, which conflicts w/ Mr. Campos' conclusion. Who said anything about me caring about how people look? I'm talking about health. Xopher, I also read the WF press release. It's not just BMI. It's cholesterol, BP, and nicotine use. Did all of YOU read the links?

Jill -

Correlation does not equal causation. Many of us are fat because of genetic conditions, such as my thyroid disease, which caused me to gain about 80 lbs. before it was finally diagnosed. Rather than test my blood, the doctors lectured me on portion control. I do not overeat. I have never overeaten. Then I had no insurance. How then should I have been "more healthy" to avoid weight gain? Now that I have PCOS related insulin resistance which makes it near impossible to lose that weight I gained THROUGH NO FAULT OF MY OWN, how much extra money should I pay? I know not one fat person who is fat because they eat twinkies and mickeyD's all day. I know fat vegans and slow food advocates. I know people who are fat in part because of amphetamines they were prescribed when they were 11 years old.

African Americans also have higher incidences of diabetes - should those employees blessed with extra melanin be given lower discounts due to their effect on health premiums?

While I've been this fat for over 15 years, my blood pressure only went up (to "borderline") when I got a real, permanent job. The doctor attributed it to being fat, despite having my records of low blood pressure on file. I've had my bone density tested and I will likely never suffer from osteoporosis. I am genetically gifted, bone-wise, which also contributes to my BMI. My heart is similarly healthy. So, how is my mere existence as a fat person detrimental to society as a whole?

Am I unhealthy? Yes. Many people are unhealthy. Can I take the blame? Yeah, damn my inability to afford insurance. Curse my short-legged, stocky peasant ancestors, with their dense bones and failing thyroids, and for that matter, my mother for taking fertility meds to overcome the PCOS she passed on to me. But to anyone who thinks I should be punished for the "greater good of society", I show you the back of my hand.

Paula Helm Murray @ 61: I know I championed Aldi myself in a thread a while back, but this week I discovered this. Of course, then that also make Trader Joe's suspect. Blargh.

Jill, you read *a* link. You did not seem to read the rest.

Who said anything about me caring about how people look? I'm talking about health.

A health that's directly related to something visible that you can judge at a glance, and that judgement seems to be that fat = unhealthy lifestyle = eating themselves to death. (I still want a cite on that, by the way. You don't get to make sweeping assertions all tra la la like that and not get called on it.)

Carrie V., there is no competition between Whole Foods and Wild Oats in Boulder anymore. Whole Foods bought Wild Oats out a couple years ago. (I believe that's where the nasty financial sockpuppetry came from.)

And the co-op is gone, and the Vitamin Cottage is (I think) all vegetarian (which would suit neither myself nor the cats), and I am not shopping at King Soopers or Safeway more than I can help.

At least we still have Sunflower and, now, Sprouts. And the Farmer's Market in the summer.

But the Pearl Street Whole Foods remains the most convenient when I'm biking (and the only feasible when I'm walking) of these, and I genuinely like the staff there and wish my choices weren't "fail to support them by not shopping there" and "fail to support them by giving Mackey money."

And when I someday move back home to Metairie/New Orleans, I'm really not sure what other alternatives I have. But then I think once I got there my shopping morality would pendulum toward "shop local, whatever that will mean." And the farmer's market of course.

(As much as I'd like to be "good about living where there are alternatives to Whole Foods," I'm afraid I have other priorities when deciding where to live. Does that make me "bad about living where" etc.?)

Well now. I'm glad I checked the latest ML news before heading out to the grocery. I'm on the bike today, so Sunflower is quite feasible.

I have long steered clear of Whole Paycheck because they cost too mucking fuch. Now I have another reason.
I am really glad to see this issue--fat-bashing, fat-blaming and fat-shaming--kicked out into the daylight and stomped on. Nerdycellist, nice job. As one of those who take up more space than we used to, I feel that I have enough other crap to worry about already, I don't need yet another person--or group--telling me there's something wrong with me when I didn't even ask them.
For me it's Winco and Trader Joe's, and such items as go on sale at some other stores. Oh, and I am a union member too.
Don't get me started on the doctors.

Emma, #75, I weigh 319 at the moment and just had my four-week labs yesterday. The results came back today (Kaiser Permante puts them online for me to see) and the only labs that are unusual are those for my kidneys, which is reasonable since I have chronic renal failure (and I only weighed 135 before my first renal failure; a lot of people reverse cause and effect). My heart is in great shape and my other organs work well. Okay, my brain is a bit damaged, but that doesn't have anything to do with BMI.

I've never bought anything at Whole Foods; I get groceries at Giant because their employees have a union. That means I could buy at Safeway, too, but I like Giant better.

Jill: I don't see a problem with providing incentive for health.

Being healthy is enough of its own reward not to require incentives. Providing *opportunities* would be more helpful.

Jill, I've got moderator powers here. Let me tell you how things stand.

First, you're not a regular here. You aren't part of the established community. Therefore, you get very little slack. Your history here contains a total of four comments, all in this thread, all posted today. You're obviously here just to argue about this topic.

Second, you're a sloppy reader. Your very first comment looks very like trolling: You miss that the correlation between Mackey's criteria and actual health is in dispute; you assert a classic right-wing talking point about health care costs. Your comment on the Flegal paper makes sense only if you've missed the distinction Flegal, et al are drawing between the "overweight" and "obese" categories, and you don't seem to have noticed the relationships between Flegal's categories and Mackey's -- specifically, that the category to which Mackey assigns the greatest incentives is one which Flegal associates with greater-than-normal mortality risk, while the categories Flegal associates with the lowest mortality risks only get middling incentives from Mackey. And your reply to Xopher in ct #107 indicates that you either didn't pay attention to how Mackey's plan is supposed to work, or haven't thought it through. (Hint: Imagine that you work at Whole Foods. You don't use nicotine, you've got Platinum-level blood pressure and cholesterol, but you've got Bronze-level BMI. Which discount level do you get?)

What I'm saying is you need to shape up your discourse if you want to keep commenting here.

Nicole Leboeuf-Little @ 111... I'm afraid I have other priorities when deciding where to live. Does that make me "bad about living where" etc.?

Beyond bad.
Beyond evil.

The most important part of the link to Shapely Prose is this one:

9. In any case, shaming teh fatties for being “unhealthy” doesn’t fucking help. If shame made people thin, there wouldn’t be a fat person in this country, trust me. I wish I could remember who said this, ’cause it’s one of my favorite quotes of all time: “You cannot hate people for their own good.”

About stores: being up in the great foodie northwest, we have all sorts of choices: TJ's has finally come to our town, so we no longer go with a long list every two weeks. Fred Meyer's for some stuff, Top (also Haggen) for the best produce values, The Olympia Food Coop for others. When we get to Seattle or Beaverton, we make a point of hitting Uwajimaya (which is no relation to Central Market, and has been in the ID as long as I can remember) for goodies and for produce for the best possible stir-fries. We used to travel north to go to the late lamented Larry's Market. We grow a lot of our own food, and buy from the Farmer's Market when it's open.

We've gone to Whole Foods exactly once, when visiting in Austin, for shampoo that I'd forgotten to pack. The prices made my ears pop.

Rikibeth @ 105: We use a Kosher Parve chicken-flavour soup in recipes calling for chicken broth or stock. We get it from the Kosher specialist shops whenever himself goes to see his parents.

Renatus, #111: Also, notice that Jill seems to think that by citing the increased mortality risk due to smoking (which is well-documented), she can then casually link smoking and eating to make the same assertion about the latter, as if proof were contagious. There must be a name for that particular fallacy.

JESR @118, that quote has been attributed to Marilyn Wann.

Serge @117:

Heh. Possibly even light years beyond.

Lee @120: There must be a name for that particular fallacy.

It probably has the word "transitive" in there somewhere. Unless I'm confused and it's "commutative" I'm thinking of.

Angiportus @ #113 -

Thanks for the support. I posted then went home from work and felt a little bad for being so darned emotional and ranty. The last time I was "sensitive about my weight" I was 140 lbs, in phenomenal shape, had a working endocrine system and a nicotine habit. Now I'm nearly 100 more lbs, not smoking anymore and sensitive about complete strangers' perception of my health. I should have known the regulars on this board would not have let the crazy BS stand and just taken a step back.

I've had a bit of dinner, watched some Buffy and played with my dog now and my (un-related to weight) BP is better for it.

It's possible to have serum cholesterol levels that sound like you're walking dead and at the same time to not be seriously overweight (or to have clogged arteries: gallstones are an alternative side effect). And it's possible to do all of that on a long-term low-fat diet, too. (Been there, done that.)
Genes R Us.

"You cannot hate people for their own good."
"You cannot shame people into being thin."

Yes. My Nana died at what seemed to me then to be the advanced age of 74 (I knew about life expectancy charts, but I didn't know then that the longer you live, the longer you're likely to live.) She died primarily due to the side effects of life-long smoking and being overweight— the latter more because she refused to exercise than a direct result of diet.

Her doctors tried to shame her into taking better care of herself, and that never worked. She'd try to "cheat" and do the things she was supposed to do right before her checkup. Not one of them tried to be on her side about it. (It was— good lord— nearly two decades ago that she died, so medical thinking has changed a bit in the interim.)

A lot of her behaviors were in deliberate opposition to what people wanted, probably a reaction to her strict upbringing. I have to wonder: if she had gotten a sympathetic doctor, might she have changed her behavior? Might she have gotten outside and taken walks, tried to cut back on her smoking? Might she have lived longer?

Hi, Jill:

I don't see a problem with providing incentive for health. Obesity, smoking, etc do, in fact, raise healthcare costs.

Sure, to some extent. But the immediate situation prompting this thread is that the Whole Foods CEO chose a metric that is imperfectly correlated to health. Part of our discussion here is about the kinks in the correlation curve.

And why should people who take care of themselves cover a share of that increased cost?

Taking care of yourself is good. But as others have pointed out, that's not the whole story. There is some element of chance outside one's control. If not for unavoidable risk, we wouldn't even need health insurance (as opposed to something like a buyers' co-op).

So another subthread here is about whether it is proper for employers to make it their business. Well of course they can claim self-interest as long as they are paying part of their employees' health care costs. But that's something we've hashed out at length in other threads which I won't try to summarize here.

(Long libertarian rant omitted because it's rather off the topic of the thread. One sentence version: Federal tax law, not necessarily the free market, encourages the common US pattern of employers subsidizing health insurance, and in so doing the federal government favors big businesses over small businesses.)

Yes, @ #125. My parents tried, but it does not work. It did not help that I was a skinny, hyperactive child and they pushed food on me and caused all kinds of bad habits that did not help when my metabolism slowed down at adolescence.

I'm pretty good right now, about 40# larger than what is "ideal' but feeling fit, I can walk a long time, can do hard work without trouble and generally have no problem. I do pay attention to what I eat but am not psycho about it. I'm starting a new job Monday and hoping I can figure out how to work in some walking or something during my shift so I don't do much backsliding.

And smoking is a good/bad example for me. My grandma lived until 90 and until the last year of her life smoked approximately four packs of cigarettes a day. She wore out. On the other hand, of her four offspring, the three who did not quit smoking in their 40s died of lung cancer (all the males). My mom quit and is in her later 80s, still very active, with it and driving. Though I'm glad she moved to Lawrence, near my sister. (She used to live in b-f Kansas, where if you needed any kind of emergency services it could take 45 minutes to get to you...)

America is sick. People literally eat/smoke themselves to death. That doesn't make you sad/angry?

Jill @ 105, I have one small question: what do you think people should be dying from?

[Please note immortality is not an option. Humans are designed to die, just like every other organism on this planet (even Bristlecone pines and Californian Redwoods). If you believe this is inaccurate, I would like to see even a single medically authenticated example of a functioning, immortal human being. Do let me know when you find one.]

As for your comment at #100, all I can say is I hope your entire family is up to date with all of their immunisations, that you never go to work when there's the possibilty of you passing on any infection to others, and that you're the world's safest driver, worker and householder, who has never caused any risk (physical, social or psychological) of any sort to anyone, because otherwise that high moral ground you're standing on is looking extremely shaky indeed.

I've started multiple posts that boil down to me being a very mild example of unhealthy thin. Not as much so as I used to be-- my first idea of my adult weight was a BMI of 20ish-- but most of the things that my body cannot do or does poorly are the same things it couldn't do or did poorly back when I was right at the edge of 'underweight' and my mother kept trying to get me to drink protein shakes, lest I die of malnutrition.

None of my fitness issues will get better if my body is smaller. None of them. Losing forty pounds will not make me able to lift a bag of salt over my shoulder. Losing forty pounds will not make me able to run a 5k. Losing forty pounds will not lower my resting pulse, blood pressure, or cholesterol, it will not raise my hematocrit, it will not increase my vitamin intake. Losing forty pounds will, however, put me right at the minimum quantity of body to sustain me. And I still won't count as 'underweight' but as 'healthy' according to BMI.

Having those forty pounds doesn't do much for the health things I listed, but at least I'm less likely to faint these days.

Great discussion. My mom and I discuss the obesity does not equal unhealthy argument a lot because she is in public health trying to attack the corn syrup low activity diabetes/other disease vortex created by modern sedetary american life. One problem I see is the bumper sticker problem. The WF CEO fell into the trap set by the "obesity epidemic" frame.

Here is the problem. Very well intentioned people in public health talk about the obesity epidemic because (1) Doctors mean something specific by obesity and it is something distinct from just "fat" (yes, that is my mom's argument, and I don't entirely agree for all the correlation is not causation reasons people have posted above) and (2) The frame works. It is simple to explain "obesity epidemic!!" to the nightly news reporter doing a 5 minute story about why soda in schools is a bad idea. And why lots and lots of boring problems like unable to walk safely in your city, etc. are bad. The obesity epidemic frame is GREAT at getting mainstream media to focus on inter-related problems of our food system and transit system.

I like the "Healthy at Any Size" frame but it is a response to the arguments about obesity being bad for you. I think it comes really close but isn't as good as focusing the wandering attention of the news media. My question is: If we abandon the simple "obesity epidemic" frame then what can replace it to get mainstream focus on the food system/low activity problem for the nightly news? Simple, gripping, AND accurate is hard. Ideas?

In re "refusing to exercise": I've gradually increased my tolerance for exercise-- including that I now can mildly enjoy walking.

At far as I can tell, the reason I hated exercise was that I was so tense, I wasn't letting myself get nearly enough air. Exercise felt bad.

It's taken a lot of bodywork (Alexander Technique, massage, etc.) to get this far. I don't know if there are more efficient methods.

#130 ::: mea:

Maybe this is just a bad mood talking, but I don't know if there's any way to get the word out if it means giving up being nasty to large numbers of people.

A lot of fat-shaming is fat-blaming. The reasoning is that if people's weight is at fault for illness, then we have some control over whether we will get any of a range of unpleasant illnesses.

We do have some control, but not so much as we'd like to think. And the things we should be controlling, blood pressure, cholesterol and the like, aren't all visible. You can't look at someone in a hospital and say, "It's their fault for not controlling their blood pressure!" But people sure as heck do that about weight.

This is not unrelated to the idea that if we keep our noses clean, we will never be unfairly treated by the justice system or its agents. They're both a denial of the chaos (in the mathematical sense) and complexity of life.

@Rikibeth@106:
If you haven't tried the Penzey's Vegetable base... it's eerily like chicken stock, so much so that vegan sister #2 distrusts it. When I'm low on Penzey's chicken base and can't count on wrangling both our one car and time to drive 30 miles to stock up, I sub the vegetable base for almost everything. It's also far nicer in polenta -- just a richer variety of flavors, I think.

@mea@130:

I don't think the obesity crisis can be reframed because I think it's a symptom of a larger ill beyond framing in a sound-bite. The reframe means focusing on an interlocking set of Quality of Life issues upon which Americans are particularly intractable. (I won't comment on the rest of the world because I haven't lived outside of the US recently enough to speak with any vague confidence, and being expat isn't the same.)

I'm pretty certain that if as a culture we reclaimed a community based model of work/home/social life integration and incorporated our far better tech, we'd see many Chicken Little crises(1) diminish. (Sure, we'd get a whole new set, but we're human. We're not happy unless we're complaining about something.) After all, humanity has been living in some sort of communal symbiosis since we figured out a dozen eggs can be traded for a quantity of rice. We have a lot of lessons upon which to draw, and superior informational transfer and access tools.

A community possessing
-- transportation choices available to all members,
-- daily needs and workspaces within walking distance,
-- public spaces fostering cohesion and security,
-- housing that blends ages, classes, incomes and family structures,
has significantly lower crime, obesity, and community fracture that most of us not in an urban core experience today. (shamelessly paraphrased from: http://www.newurbanguild.com/NUG/SmartDwelling.html and drawing from this article on walkable cities: http://www.medicalnewstoday.com/articles/101790.php and a CDC report talking about walkable cities being safer, but I can't find the 2008 interim report, meaning it got rolled into something else and my google-fu is failing me.)

I am in love with the New Urban Guild's Popsicle test: a functional, sustainable neighborhood is one in which an eight year old can safely bike to a place from which zie can purchase a Popsicle, and where the 110 calories of sugar water make no difference because the kid burns it off. However, most suburban communities fail thanks to planning and zoning issues, and many urban communities are losing the mixed use character that made them functional.

That said, I think the bigger issue comes back into play because our current culture profits from fear. I'm 26 years from being the eight year old hellion on wheels who roller-skated to the closest Thrifty Drug, but Sister #1 will give birth to thirty flaming, pink gorillas before she'll let my eight year old nephew do so. The two neighborhoods and the distances are functionally equivalent; sidewalks, medium sized suburb, good safety record and a strong community. She's bought into the fear that if she lets Nephew #1 out of her sight for six seconds, he will be sold to Outer Mongolia, join a gang, or grow up to vote for the Guns 'n' Dope party. (This despite all statistics pointing to children being more safe now on every count save parental abduction, and the fact that she's happily married and my BIL would sooner diaper thirty flaming, pink gorillas than abscond with Nephew 1 or 2...)

The mainstream media, drug companies, insurance companies, food manufacturers, and probably twenty industries I haven't managed to think about are making a fortune off we poor mere mortals -- if crime or diminishingly rare random atrocity doesn't get us, then those same corps or the Death Fatz!!1! will.

It's much easier to shift the blame and the perceptual solution for the problem -- be it crime, obesity, terrorism, community fracture -- to the individual than to address the social ill. After all, if we just believe we're fat, unsafe, powerless in the face of crime, we can be convinced to do nothing. Fixing social ills, however, takes money and vision which most communities lack, and we the people are so allergic to taxes we won't approve them even if they're in our best interests. Further, the idea of a Walkability metric for a residence is still very new to the current generation of house hunters, and in a lot of places, a liability rather than an asset. Add in the Big Box profit model -- which works for low prices, but is rotten for sustainability -- and we're kinda stuck with the residue of several decades worth of poor urban planning and decision making before we can reframe that argument. (Told you it's not a sound-bite and I don't know how to break it down.)

@Nicole@112:
Sunflower is two blocks further south from Pearl Street WF. Wanna trade houses? (I'm not denigrating your circumstances -- I'm envious.)

I'm in Lafayette(2), and while it is a serious pain in my posterior to schlep my groceries on the JUMP(3), I'm consistently doing so from the Boulder Sunflower out to the slums of Boulder County. I admit I'd be sunk without Royal Crest Dairy and Door to Door Organics (4) and forced to pay danegeld to Soop's, but so far, so good. I'd sacrifice fingers to have Sunflower two blocks out of my functional range -- you can bet my range would expand in a hurry. (And apparently, sometime this summer, that's exactly what will happen, without the sacrificial digits. Hooray!)

(1) Chicken Little Crisis: one for which there is little to no reliable data to prove it is really an issue, but for which significant effort is spent not remedying it. See also: security theater, Stranger Danger, White Flight, Obesity-Deth Fatz!!1!, et cetera.

(2) Small town in Boulder County, CO. About 12 miles east of Boulder. (Footnoted for those lucky/unlucky enough to be unfamiliar with the intricacies of the People's Republic of Boulder. That said with all possible affection...)
(3) Local bus service, running from the east end of the county into Boulder, connecting to the major hubs.
(4) delivery services for milk and fruit/veg, and worth every penny... though not too many of them.

If you're going to look at who to blame for cranking up the fear level, the news media should be on the list.

Lee@120: You're right! I ran right past that in my REN SMASH PUNY ARGUMENT mode. Red herring? No, not quite... Analogic "syllogism"? Augh, thinking about formal logic before coffee makes me dizzy.

nerdycellist@123: I think your emotional rant was quite relevant and spot-on. Please don't feel bad about it.

125, 127: Yes, this. I started getting fat-shamed when I was 9, and it was in full swing by the time I was 10. I slid into adolescence feeling horrible, ugly, and out of control of my ballooning body.

My crime was beginning to develop a woman's body before I was 'supposed' to, and then packing on weight for future growth spurts on top of that. I was also weak; the shaming made me fearful to leave the house by myself or play in any sort of way that would make my shameful body jiggle, so not only was I fat, I was stereotypically fat with being unathletic, and clumsy too because I didn't know where all of my limbs went anymore.

When I miraculously slimmed down, it wasn't because the shaming made me do healthier things--it was because of growth spurts. The depression and self-hate stuck around for a good long while, though, and I didn't start to ditch them until... I started getting fat again.

mea@130: Trying to get the news to focus on actually helping seems to me like trying to fly to the moon by flapping one's arms. Or what CSEdwards@133 said.

This looks like a good place to drop the reminder that having time and safe places to exercise is a privilege. Being able to make exercise a primary concern is also a privilege. (See also my link labeled 'being poor', which is relevant.) I think the concern over how to make people get more exercises misses that many of those that could benefit from it don't have those privileges.

I'm trying to get our local Trader Joe's and froofy co-op to carry some of the vegan specality foods that only Whole Foods seems to carry. I certainly wouldn't qualify for a discount if I were an employee there so why, as a customer, pay a premium for specialty foods that subsidize a company that puts out such a progam?

Jill:

There's a large flaw in that claim that we are "smoking and eating ourselves to death." That claim is equivalent to "we are dying sooner because we smoke and eat too much and/or the wrong things" [1].

You are trying to explain a result that cannot be explained because it isn't true. If Americans' current eating and smoking habits are correlated to life expectancy, the logical conclusion is that those eating and smoking habits are good for us, because life expectancy keeps getting better.

You're in the position of someone coming in here and blaming drug use, or television, or religion, or alien Greys for the steady increase in the New York City murder rate in the last decade, while that murder rate has in fact been dropping steadily.

[1] Someone could, for example, be claiming that the problem is that beef is fatal and we should be getting all our protein from beans and duck. But yu aren't, as far as I can tell.

@CSEdwards at 133: yes, you've described what I'm talking about much better. I like the popsicle test -- which I've heard expressed as every child should be able to safely bicycle to school and back. I think that is a great way to talk about some of the bad infrastructure choices which are the default of too much American development. New urbanism is fighting the good fight.

The debate I have with my mom is about the fact that very good intentioned folks in the public health field are trying to get the wider public to recognize these infrastructure problems as public health problem -- THAT I think is a good idea, to have people connect that the public health problem is that we should have safe walkable communities and access to good food rather than encourage car-dependent sprawl and cheap food based on excess corn syrup. One way to discuss the problem is to focus on the increased amount of childhood diabetes -- an increase in a specific disease caused by these infrastructure problems. So I argue to focus on specific contributing factors to specific diseases rather than frame the discussion around "Obesity Problem!!". But the public health talks and campaigns (OK, the one's my mom is involved in and that we argue about) discuss the obesity epidemic because they want to discuss a wide range of issues (I guess). And I find myself having frustrating UR FRAMING IT WRONG discussions. With people who really ought to know better. Someone in our immediate family who used to be "the skinny one" gained significant weight as a direct result of necessary medications, but the discussion upthread about doctors internalizing the anti-fat messages of society is very true.

I love the links that folks are providing, and "Healthy at any size" is a useful nutshell summary. I'm just frustrated that very good intentioned folks in the public health field are pushing the obesity epidemic meme in a way that encourages things like this whole BMI stupidity.

abi at 132: You can't look at someone in a hospital and say, "It's their fault for not controlling their blood pressure!"

Actually, you can. Blaming is unhelpful, but educating people as to how they can affect their own health can make a big difference. I have high blood pressure. I control it with medication. I also exercise regularly, read food labels, avoid processed foods, pay close attention to my salt intake, own a blood pressure cuff so that I can check my blood pressure, see my doctor so that she can monitor my medication level, and so on. I don't smoke. I don't drink a lot of alcohol. I can't do a damn thing about my genetics, but there are things that I -- and anyone -- can do to make hypertension less of a chronic problem. The first thing anyone can do is his/her blood pressure checked. Many counties run free clinics to allow people to do this. If you don't know you have a problem, you can't address it.

Lizzy L @139:

I apologize; I misspoke.

What I was getting at is that you can't diagnose high blood pressure visually. So it's hard for someone other than the hypothetical hospital patient's doctor to say that they had control of the aspect of their health that brought them there.

This is in contrast to obesity, which people do quite freely diagnose visually, and then proceed to blame for all manner of ills in others.

Blood pressure can be controlled, and it's really important that people get theirs checked regularly to see if they need to work on the matter.

Lizzy L @ 139... also exercise regularly

So does this photo seem to indicate.

Serge: Taken by Gary Payne, world's finest photographer of Aikido events.

Jill: There are some good things for encouraging health, but a lot of bad things for an employer doing it. Worse, this isn't really encouraging health (IMO) so much as positing an ideal, and punishing those who fail to attain it.

Since the actual science seems to disagree (certainly there is no consensus) making an arbitrary decision about what rewards people get at work for how they live their ooutside lives (and basing it on such things as, "Core Values" which are 1: not core, and 2: heaps of motivational blather, aimed at making it possible to churn out press releases about what a caring company Whole Foods happens to be; while not actually seeming to make any real effort to actually carry out the sentiment) is offensive.

Are healthcare costs a problem? Yes. Is this the way to fix them? No. Is that rationale (healthcare costs are too high) a valid reason for an employer to intrude into my private life (and public, since the level of one's "fitness" becomes semi-public)?

What level of intrusion would you justify/accept for gov't in this regard? If it is different from that you accept for an employer, why is one privileged over the other?

Me.... I'd be platinum. It happens I am blessed with good blood chemistry, and don't gain weight (my BMI is about 17.6, at my heaviest I was probably less than 19; 5'9" and 136 lbs. To get to that I was eating something like 5,000 calories a day for 9 weeks, and doing insane amounts of physical exercise. When I stoppped doing that, and went to merely running 40-60 miles a week I dropped to 125, and when I stopped doing that dropped back down to 120. After my Reiter's manifested, and I went to 105 [not healthy] I came back to my present 116-ish). For me that's healthy. It's not for most people. From the history, there's not one bit of virtue in it. I've had the same waist for the past 25 years.

The bit about healthcare... that's disingenous on Mackey's part. His schtick is such that I can't take him as being making an honest argument. He is an advocate for maintaining the status quo, and he is hostile to workers being able to fairly negotiate with employers. In short, he favors a system which chains employees to employers (which is the idea which led to our present mess), and this plan of his encourages that.

Lizzy L @ 142... By the way, I rearrange the text below the photo so that Gary's name isn't off the frame of my laptop's screen anymore.

Terry Karney @ 143... I (...) went to merely running 40-60 miles a week

Merely, eh?

Obviously, you have better knees than most humans do.

Serge: I was younger then. I was making a point that, instead of about two hours of various calisthenics a day, and 5-10 mile of walking with 20 lbs on my back, and 12 lbs in my arms, I was doing not much more than running, and some push-ups and sit ups.

But yes, I did have pretty good knees, and a body which allowed me to not tear them up with running (which, btw, isn't as hard on the knees as one might think, if one runs well; jogging, on the other hand, will destroy them).

Terry Karney @ 146... jogging, on the other hand, will destroy them

Circa 1982, when I decided I should exercise more regularly (as opposed to being forced to do it in PhysEd in high school & college), I figured out that anything involving brutal use of my knees was not the way to go for me. I'm still exercising regularly at the gym, which was apparently sufficient to bring my blood presure down. I guess overall I got lucky in the genetic lottery.

Renatus @135 -- Anyone who has a safe place to sleep is really likely to have a safe place to exercise. It doesn't take up that much more space. Most yoga can be done, for example, in about a 3'x6'x8' (width, length, height) -- think about hallways, here.

Anyone who watches two hours of television a night has more than enough time to exercise -- just a different priority system.

Yes, space and time to exercise are privileges, in one sense. But they're pretty common privileges in this society.

I'm not advocating for exercise -- I don't actually exercise, myself, other than a certain amount of walking and what's involved in my work. That would be pretty hypocritical of me. What I am saying is that it's a choice and a commitment to do so. Many people who make it feel better about themselves, and statistically they tend to live longer; and exercise does not (as a great many people here have said!) control weight in itself, nor should it. Shaming people about not doing it doesn't help here either. But it's much more available than your comment would make it appear.

B. Durbin: A lot of her behaviors were in deliberate opposition to what people wanted, probably a reaction to her strict upbringing.

My teenage years were mostly spent finding ways not to do what people wanted from me, i.e., that I lose weight. I was ordered to do aerobic or jogging in my non-existent free time (I'm not built for jogging. Even less so in the age before sport bras.), put on 800 kcal diets, forbidden to wear short pants or short sleeves, forbidden to go places because I would impose my fatness upon other people. There is a point when the only thing you *can* do is refuse any demand and subvert all control. Even if it kills you at 74.

Tom--

Part of the problem is, most people dislike many kinds of exercise. And many have physical limitations that rule out at least some common exercise: knee problems can rule out jogging and running, for example.

If someone is going to stick with it, they have to find a kind of exercise that works for them. Suppose the only thing that you can both handle physically and bring yourself to do is swimming. You cannot do that in your small, safe sleeping space, or even in the nice, safe park across the street, if it doesn't have a pool. Few people manage to learn yoga on their own; you might be able to do it at home, once you'd had some classes, but maybe not from a standing start.

I'm lucky: I found something that does work for me, and I've been exercising regularly for a decade. Plenty of other people find the one that works for me unutterably tedious. That I don't is not a virtue, it's the same kind of luck as having inherited good cholesterol, like my mother, instead of bad, like her sisters.

You're also overlooking the reality of how crowded and noisy some people's homes can be; it's possible to manage to give your family a safe place to sleep, at the expense of extreme crowding. I'll agree that most if not all of the people on ML have space to do at least some kind of exercise, at least part of the year (depending on crowding, etc., that may mean outdoors and only be available when it's neither below freezing nor 90+ degrees Fahrenheit outside). But "most of Making Light" does not equal "most people."

Tom Whitmore@148:

Yes, space and time to exercise are privileges, in one sense. But they're pretty common privileges in this society. But they're pretty common privileges in this society.

I'm... boggled. Time? It's simplistic to act like time is a resource of invariable quality. People get tired at the end of their days, especially if they aren't young and/or healthy. Maybe my raised-by-a-single-working-class-mom is showing, but in my experience having enough leisure time to be willing to sacrifice it for another energy draining, potentially tedious activity is indeed a privilege.

By the way, yoga is an odd and poor example for an activity to be done in limited space when the discussion has a privilege component. Yoga is something that has to be learned, either by class (time and money privilege) or book (money or nearby well stocked library privilege). Never mind that a person has to know enough about it to look for it in the first place.

Vicki@150: Yes, yes, yes. And a lot of people have exercise ruined for them by mandatory PE in school--which can mean having to overcome the resistence to the very idea of exercise before they can find something they like. I was lucky; once mandatory PE was over for me I still had an interest in trying things on my own, and found I liked certain kinds of exercise when I wasn't under the scrutiny and judgement of other people.

If we are having an obesity epidemic globally, that affects our health, it's the food INDUSTRY that is to blame, with all the additives, corn syrup, pushing sodas and other junk food at us, making fresh produce really expensive, and often also hard to find.

That, and our work, almost all of which positions that pay enough to support ourselves, our cats and children, involve us being sedentary most of the day. Sedentary not just while doing the work, but getting to the job site, getting home aqain -- and driving our children around in-between for their school and social activities. If we're lucky enough to be employed ....

As well as the media driven consumer anxiety; we are all taught the indicator of our self-worth is what and how we consume.

All these things instead of what really provides us with substantial joy and pleasure, such as cooking great meals for ourselves and those we enjoy and love -- including wine and / or beer!, making and listening to music, dancing, walking and interacting with our communities, and so on. Who has the time for this? Not so many.

Not to mention the rotten to the core so-called health care industry ....

Love, C.

I'm in the process of attempting to decruft my office today, and came a across the previously-unread July 2009 issue of Saveur. It contains an article (bordering on a puff piece) on Whole Foods featuring this doozy:

"All the while, Mackey, who remains CEO. . . has waged a high-profile campaign to ensure an equitable workplace and ethical business practices."

Alas, I don't have the issues from the months following, so I've got no idea what sort of response the article got.

CSEdwards, #133, I would happily pay taxes to make things better, but we have a new Republican governor who promised no taxes in his run. I don't know if he can stick with that, but he thinks he can take care of our transportation needs by selling the liquor stores (all owned by the state) to other people. That much money would only work for one year -- how do we get more transporation money?

Personally, I know what I'd want to be taxed more: tobacco. Yes, we used to grow a lot of it and the leaf is on our seal, but we have one of the lowest tobacco taxes in the country (which is why there's so much smuggling out) and people who really want to smoke will still be able to.

Renatus, #135, my health plan encourages people to walk up and down their hallway, if that's the only way they can get exercise. Of course, on Tuesday, one of their podiatrists told me to walk even less because I keep getting tendonitis in my feet.

I completely agree, Vicki @150. I've lived as one of three people in about 250 square feet for private space, 4 people in 800 for the total apt. That was a tight fit. And as I said, I haven't found an exercise that works for me.

Renatus, we all have the same amount of time. Some people choose to use time to exercise that others use for other purposes. People I know who exercise don't find it as an energy-draining activity, in general -- it's an energy enhancer. Time, I'll agree, is more problematic than space, in general -- but looking at the experience of those who do exercise seems more useful than looking at the expectations of those who don't. You're quite right that yoga was a bad example -- I wanted to mention something that required small space and absolutely minimal equipment. I'm sure folks could come up with other examples. And I don't say there's anything wrong with not exercising -- again, that would be hypocritical of me. I'm commenting that exercising or not is a choice.

Re: yoga, I just have to promote Sadie Nardini's vids here. I found her via YouTube and purchased her dvd thereafter (from Amazon, aish). She's a great teacher, and the poses and pace are genuinely strenuous. Here's a taste.

Rikibeth@106: Quorn Naked Cutlets

Oh MY yes. Never has not-chicken impersonated chicken so thoroughly.

Tom Whitmore @155:
Renatus, we all have the same amount of time. Some people choose to use time to exercise that others use for other purposes. People I know who exercise don't find it as an energy-draining activity, in general -- it's an energy enhancer. Time, I'll agree, is more problematic than space, in general -- but looking at the experience of those who do exercise seems more useful than looking at the expectations of those who don't.[...]I'm commenting that exercising or not is a choice.

Choice. Same amount of time. This makes me close my eyes and pinch the bridge of my nose.

You don't have kids, do you, Tom? Or the primary care of someone helpless?

My children are getting older, but a couple of years ago, my world looked very different to the one you describe.

And I have the good fortune to have a husband who does his share of the work, both in parenting and running the household, plus the tremendous luck to be in a profession that pays a living wage for a tolerable number of hours' work a week.

I bet things look even more different to a lone parent in a low-paid job.

Tom--Speaking as someone who does exercise, yes, it uses up bith time and energy. It is good for my moods, much of the time, and it makes me feel better about myself, but I am less likely to cook dinner or do other substantive things around the house on nights that I've been to the gym after work. That's partly time, and it's partly amount of energy. Lifting things is tiring, whether it's a nautilus machine for my health or carrying luggage or boxes.

I'm also not convinced that we all have the same amount of time in any relevant-to-this sense. If I need seven hours of sleep a night, someone else needs five, and a third person needs ten, we don't have the same amount of waking time in which to do anything other than sleep. That's before we account for stuff like work and health-related things other than exercise (e.g., doctor's visits and trips to the pharmacy).

"We all have the same amount of time" is literally true, but as useful as saying "the death rate is the same everywhere, because everyone dies once." People who don't exercise may not be choosing between exercise and television, but between exercise and cooking a vaguely healthy dinner, or between exercise and helping their children with homework, exercise and having clean clothes for work in the morning.

Tom Whitmore @ 155: "we all have the same amount of time."

That is unarguably true and utterly beside the point. The exercise time available to a doctor working a four day week and a waiter working double shifts is not equivalent for all that both live a twenty four hour day. Moreover, reread renatus' post: unspent time does not equal unspent energy. If your friends all agree that exercise leaves them more energetic, then I can only suggest that you have rare friends. Higher overall energy reserves certainly, but I never walk away from the gym with more bounce in my step than when I approached.

abi -- having kids, or being the caretaker of someone helpless -- those are choices too. Choosing them over exercise is a fine thing to do -- it's still a choice. We aren't disagreeing about that, I hope. Choices have consequences. I've made my share of choices that have been painful or damaging to me and others. Sometimes there's no good choice.

On a personal level, I find that looking at the world from the point of view of having choices gives me more flexibility in dealing with the world. I sometimes don't like the choices I'm constrained to by previous choices, but I still see choices.

Whoops--sorry about the pile-on, Tom.

Yes, my state (NC) has some of the lowest cigarette taxes in the nation. That's starting to change, primarily because politicians aren't as beholden to the tobacco industry as they used to, and also because the state needs money and taxing smokers more is considered a non-inflammatory issue.

As for the state health plan penalizing those with high BMI's or smokers, I'm not defending this at all. I feel it's a breach of doctor/patient privacy as well as believing that BMI is a bad indicator of health related issues. WF's decision sounds like it's more geared towards outer appearances and less towards more substantive health related measurements.

Tom, I know you're not into the automatic assumption of privilege, but you've accidentally drifted into sounding a bit like someone who does. Could you do me the favor of adding some consciousness of that to the mix? It will increase the general happiness, and help some of your readers focus more on your intended content.

Feorag, CSEdwards: thank you for the recommendations! In addition to the Penzey's in the town center, there's an independent supermarket on the north side of town with a strong kosher-foods focus, and I'll check there for pareve chicken flavor base.

Avram @116:

Jill, I've got moderator powers here. Let me tell you how things stand.

First, you're not a regular here. You aren't part of the established community. Therefore, you get very little slack. Your history here contains a total of four comments, all in this thread, all posted today. You're obviously here just to argue about this topic.

Second, you're a sloppy reader. Your very first comment looks very like trolling: You miss that the correlation between Mackey's criteria and actual health is in dispute; you assert a classic right-wing talking point about health care costs. Your comment on the Flegal paper makes sense only if you've missed the distinction Flegal, et al are drawing between the "overweight" and "obese" categories, and you don't seem to have noticed the relationships between Flegal's categories and Mackey's -- specifically, that the category to which Mackey assigns the greatest incentives is one which Flegal associates with greater-than-normal mortality risk, while the categories Flegal associates with the lowest mortality risks only get middling incentives from Mackey. And your reply to Xopher in ct #107 indicates that you either didn't pay attention to how Mackey's plan is supposed to work, or haven't thought it through. (Hint: Imagine that you work at Whole Foods. You don't use nicotine, you've got Platinum-level blood pressure and cholesterol, but you've got Bronze-level BMI. Which discount level do you get?)

What I'm saying is you need to shape up your discourse if you want to keep commenting here.

Nightsky @157: Whatever they use in the "Sesame Vegan Chicken" at the Chinese restaurant down the road with the extensive vegetarian menu is even MORE convincing than the Quorn Naked Cutlets. I am told it can be ordered from a place called May Wah, but I haven't done this yet. My friends who do have an auxiliary freezer.

Tom, it took me a while to figure out what bugs me about your choice theme. So far, all I have is that we judge people on their choices, but try not to when they're constrained. If 'exercise/don't exercise' is a choice, we usually look down on all those foolish inactive people and say they're just dealing with the consquences of their choices rather than acknowledging that they, like us, are rational people who clearly have a good reason not to work out and maybe figuring out a way to give them more options.

Granted, I'm coming at this with a tendency to remind myself that regardless of what choice I made, it was the right one, because otherwise I wouldn't have made it. I don't understand how gyms work, really, and the thought of going to one, or exercising at all, freaks me out a bit-- I just don't know the rules*. If I'd gotten the kind of constant harassment during gym class that the fat girl did, I doubt you'd find me willing to entertain the idea for more than the time it takes to walk away.

*this is not a plea for anyone to explain them.

Heresiarch @160: but I never walk away from the gym with more bounce in my step than when I approached

Back when I was exercising regularly, I left the gym exhausted, but by the time I'd showered and eaten breakfast, I'd recovered. And then I was more energetic for the rest of the day.

Why was Jill's moderator spanking done in public instead of via private email? It could send an unfortunate signal that it's ok to pile on now since the target has been marked.

Earl, please don't second-guess the moderators, especially when Teresa approves of the action taken so enthusiastically.

It never helps. Never.

And as someone who has been publicly spanked by a moderator, and recently, let me tell you it's effective. Plus the rest of us aren't left sitting there wondering why the mods haven't taken action on the Jill issue.

First, Earl, I usually do these things in public.

Second, tell me, what's Jill's email address?

Diatryma @ 168... this is not a plea for anyone to explain them

Curses!
Foiled again.

Actually, never mind that second bit. I've got access to Jill's email addy through ML's back-end.

Avram @ 169... I usually am more energetic after I'm done, even when I get up at 5am after going to bed at midnight.

I have to admit that the first response to Jill that I thought of would have been much closer to piling on. Fortunately I was at work and had to wait to comment.

I see lots of mainstream resources on exercising for weight loss, but few (if any) on exercising to enjoy that exercise. People who spent their formative years having incredibly negative experiences with physical activity, or who have ever looked for plus-size activewear at reasonable prices, are unlikely to try over and over to find activities they enjoy.

A great deal of the resources on small-space and low-cost exercise also focus on making everyday tasks harder and less efficient (e.g., put away each piece of laundry separately so that 25 trips across a room are needed rather than two). Given that the exercise/weight-loss industry is targeted primarily at women, and that women still do most household work, making this "women's work" more time-consuming and difficult is deeply problematic.

abi, #132: A lot of fat-shaming is fat-blaming. The reasoning is that if people's weight is at fault for illness, then we have some control over whether we will get any of a range of unpleasant illnesses.

Sounds very like thinking that if a woman's behavior is at fault when a man rapes her, then women as a class have some control over whether or not we are raped. In both cases, it's magical thinking pure and simple.

Renatus, #135: Re safety and leisure to exercise being a privilege -- we laugh at all the people on our street who pay someone else to do the yardwork, then climb into the SUV, gym bag in hand, to go work out at a place which costs them more per month than they pay the yard workers. Sometimes it's not just a privilege, but an active status symbol.

Lizzy, #139: You've completely misinterpreted what abi said. You can't "look at a person in a hospital and say it's their fault for having high blood pressure" because high blood pressure is not an immediately visible physical condition. Being fat, however, IS immediately visible, and generally the first thing a lot of people focus on.

Tom, #161: You are managing, whether intentionally or not, to continue to sound as though you are saying that anyone who does not choose to exercise has only themselves to blame. I submit that part of the problem is a misuse of the phrase "choices have consequences," in such a way that it sounds as if you are calling things bad choices when they are actually constrained choices.

Earl, #170: As no one has been piling on Jill in the wake of Avram's post, I would say that this is a moot point at best.

I wonder if an easy part of the health care savings needed could come from eliminating subsidies on corn ( for high fructose corn syrup) and eliminating any price support on sugar. That would be three or four birds with one stone. (or, three or four sacred cows, which is why it won't happen)

eric @ 179
Shift the subsidies from corn and sugar to fruit and vegetable production, especially the smaller growers. (Fruit growers need bees, and they cut out the subsidies for beekeepers some years back. That was probably a mistake.)

And as for excercise...

There was a time where I thought that anyone should be able to live without a car, just using a bike. I was riding 6k miles a year, in grad school, and living in the city. There was a grocery either 2 blocks from me or on my way home.

Then I bought a beater car, so I could get to bike races. I still rode more than I drove, or even drove + car passenger.

Then I got a job, and commuted via bike and bus. The weekday rides went away, the weekend rides got shorter, and I started thinking about buying a house. But I never drove to work, because it would be way too expensive to park.

Then I bought a house.

Then a car I didn't mind driving.

Then a job that had free parking. By this point, I'm probably down to 2000 miles a year. I still rode to work once in a while, but it was rare.

Then a relationship started. Not much riding till we got a tandem. Then we rode maybe 1k a year for a couple years.

Kid #1. Trailer for the tandem, we'll ride and he liked it. Down to a couple hundred a year.

Move to the country, less friendly drivers, Kid #2. Couple of short rides per year.

Move to my latest house, big garden, kid #3. Bike hasn't been out of the garage in 28 months except as a demo of how to ride for kid #1. I'm not actually sure I can get the trailer up any of the hills that ring the house either.

I've gotta change that...but not in January. I don't see how to get excercise in other than what I get chasing kids. But It's gotta change.

Lee at 178: you're right, I did completely misinterpret abi's point, as she explained upthread. My apologies to abi.

A comment about exercise: I do it regularly. I like it. It makes me feel good. I like martial arts and walking (not running, ugh), preferably with my dog and/or a friend, in the sunlight, and I've recently discovered I like Bikram yoga. I like weight training but no longer do it.

However, I absolutely feared and shunned exercise for quite a few years, until circumstances arose that introduced me to a demanding physical practice that fascinated, challenged, and engaged me. If a person dislikes or is afraid of exercise, for whatever reason, all the exhortations to do it, no matter how well-meaning, sound smug, insensitive, and even cruel.

Xopher #171: And as someone who has been publicly spanked by a moderator, and recently, let me tell you it's effective.

When it happened to me in 2007, it was public, extensive and traumatizing, and is something I think about every time I read ML. It's not something I would wish on anyone else, even if they're unambiguously in the wrong, as I was.

On the other hand, I recently participated in an unmoderated online political forum, and the reduced quality of discourse was dramatic.

TNH @165 -- you're probably right that I am sounding like that, and I apologize if so.

Diatryma @168 -- I'm trying very hard through my life not to judge people by their choices; I have enough trouble judging my own. I like to think about why people make choices, but it's not to judge the people. I try to do the same thing about my choices as you describe about yours -- the phrase I use is "I make the best choice I can out of the ones I see available at any time." I got harassed a lot around PE and it still affects me -- it's part of why I don't exercise. I did when I was Morris dancing, let me tell you!

Lee @178 -- that is indeed not the way I'm intending to sound, and please note that I've never said that any choice is a bad choice. Adding the word "bad" or "good" to my word "choice" seems to be being done unconsciously by many people in this discussion. Thank you for expanding it out to "constrained" choices". Sometimes, exercising is a very suboptimal choice; sometimes, it's the optimal one. In either case, it's still a choice.

Lizzy, your comment about exercise @182 is spot on.

Avram @ 169: "Back when I was exercising regularly, I left the gym exhausted, but by the time I'd showered and eaten breakfast, I'd recovered. And then I was more energetic for the rest of the day."

That hasn't ever been my experience--exercising leaves me tired and spacy for a good hour or two after I finish. I suppose different people react differently. Intensity and duration probably affects it too: my typical workout is 1.5-2 hours.

Exercising regularly does, however, make things like running up stairs feel effortless and fun, however.

caffeine @ 176: "People who spent their formative years having incredibly negative experiences with physical activity, or who have ever looked for plus-size activewear at reasonable prices, are unlikely to try over and over to find activities they enjoy."

I've been thinking a lot recently about how exercise has been made into an elite pastime in our culture. Just think of all the things needed to make exercise socially acceptable: a gym membership, appropriate sports clothes and shoes, the de rigueur iThingie--not to mention already having a fit physique. Lack any of those, and exercising rapidly becomes an exercise primarily of one's embarrassment gland.

Earl @170:

One of the reasons we address problems in public (I don't like the word spank; it's a terrible power dynamic in a conversation, even when talking about moderator action) is to control pile-ons. Note how few people felt the need to add to what Avram had said.

Now, as you can see a little later on here, if the matter involves a regular rather than a drive-by, a moderator's intervention doesn't always stop the attempts to address the problem. When it's someone we know from long association, we don't look to the moderator to do the complete job of mediating with them. I try to get people to control their tone and tempers and avoid really inflammatory comments, but I also know that some conflict is inevitable, and all I can do is keep it honest and help clean up the pieces afterward.

Members of the community (as opposed to drive-bys) are supposed to carry their own water, pursue their own relationships, own their own words, and make their own apologies. The moderators' job is to create an atmosphere where those actions are possible.

And Earl? I've gone back again and reread that sequence.

You were reprimanded and invited to apologize by a moderator*. The remainder of the community asked you to apologize, explained where you went wrong, did everything but sockpuppet you to write the apology ourselves. We got annoyed because you went from just a joke straight to you guys wouldn't accept an apology if I made one. It was some time before you stopped and simply said you were sorry.

And none of that matters now. That was 2007, and no one shuns you or treats you as some kind of pariah because in one thread you dug yourself a hole and jumped into it. Anyone who hasn't made an ass of themselves on the internet, ever, is probably not a very interesting or adventurous conversationalist. I've certainly done some dumbshit things from time to time.

What you need to do is move on from that moment. You have to forgive yourself for whatever in it is still bothering you. We already have.

Really, I'm somewhat upset that, like the monk in the koan, you're still carrying this matter. I'm not going to let that upset maneuver me into censoring the past, or changing the ways that I moderate threads. But I'm still bothered that you're troubled by it.

-----
* Avram is the only mod in that conversation, and he made only one very brief comment. It wasn't a comprehensive moderatorial smackdown, nowhere near his recent posting or what I did to Xopher that last time.

Here's something I hope will cheer you up:

Sometimes you feel like a monk
Sometimes you don't
Making Light's got monks
Fark's don't

Making Light's got rich discussion
Poetry and some doggerel, too
Fark's got deep dark craziness
Horrible flamewars ooh

Sometimes you feel like a monk
Yeah Yeah Yeah
Sometimes you don't
Oooh oooh
Making Light's got monks
Fark's don't

Internet Making Light's got monks
Internet Fark's don't

Because...

Sometimes you feel like a monk
Sometimes you don't

Earl @188:

Good one.

That koan has never been the same for me since I found out that some guys have a fetish about women with their cars stuck in the mud. Clearly it's one that predates the invention of the automobile.

abi @ 189... Wasn't there an XKCD comic about something like this? I think his involved young ladies taking showers while playing an electric guitar.

There's been something bothering me about the fat-acceptance links people have been posting. I agree with them all but entirely, and yet that "all but" has been niggling at me. I've been trying to figure out why.

I think the fat acceptance movement has a very powerful, very important insight into health: namely, that it is impossible to look at a person, fat or thin, and safely draw any conclusions about either their overall level of health OR about their personal choices. Along with with this insight come a number of prescriptive measures: stop trying to shame people into being thin.* Stop assuming that "thinner" means the same thing as "healthier." Stop relying on easy but inaccurate measures of health like BMI that occlude more than they reveal. And so on.

But I feel this insight is often raised in opposition to another insight that I also think is important and true: that the population as a whole is getting fatter, and that rise is associated with poorer overall health outcomes. That that rise is a bad thing, and can and should be fought at the society-wide level. (At the society-wide level, mind you, through social policy that encourages people to eat food instead of high-fructose corn syrup, not at the level of the individual.)

I think this opposition is a false one. I don't think there's anything incompatible with believing that it is ridiculous and malevolent to persecute social problems at the individual level and simultaneously believing that those social problems do exist and do need to be dealt with. I don't think there's anything incompatible with believing that different people will have radically different ideal weights and also believing that bombarding everyone with cheap calories will drive a lot of people up above that ideal weight, to the detriment of their health. I don't think there's anything incompatible between believing that the popular and even medical conceptions of ideal weight are too low and also believing that there's such a thing as too heavy too.

I don't know. Maybe I'm swinging at strawmen here. Maybe I'm missing something. Feel free to point it out if I am! But when you agree with someone 95%, it's the five percent difference that stands out.

*Not that fat-shaming really has anything to do with actually helping fat people, but moving on.

One thing I was thinking about in the shower last night was food choices, and the energy that goes into them. Not by the consumer, but by the supplier.

How many people have contributed their intelligence and energy, gotten paid for, made it their career to get a cheap, satisfying and energizing candy bar onto the shelves of a corner store?

How many people have done the same for a cheap, fresh and nutritious apple?

The whole supply chain is bent toward this. That's why someplace like Whole Foods can construct an entire competitive advantage (and price premium) on natural foods. (And suddenly we have people putting their time and talents into those foods, but "cheap" has gone out the window.)

Tom explained what he meant by his comment that people have choices, but I want to expand on the difference between encouraging people to recognize the choice already available in one's own life -- where I agree, Tom, it can be really useful for remembering we have choices and taking responsibility for saying "OK, now what?" and why it causes a pile on to bring that same approach into a public discussion of exercise options.

What I heard -- before Tom explained his meaning -- was "People already have choices SO WE DON'T HAVE TO TAKE COLLECTIVE ACTION." I read the all-caps phrase into Tom's original statement because the "you have choice" line has been used to destroy the American pension system, argue against health care reform, and the idea of choice is used all too often in all too many American discourses to drive back attempts at collective action to improve our society. So I'm a bit touchy about the phrase, and I bet I'm not alone.

The GOOD things that the public health people are doing under the obesity epidemic meme is to highlight just how different the choices are that we face in different parts of this country, and that collective action can make a difference. For example, women in Kettleman City in California's central valley were not going on walks because they were afraid of wild packs of dogs. It took a cooperative effort of different organizations to get the local community organized and to create the space for women to be able to take a walk for exercise. Something that I and probably many of the folks on this thread completely take for granted -- being able to chose to take a walk in safety-- wasn't an option.
Here are some links that better explain the lack of choice in California central valley that I'm talking about:

http://www.npr.org/templates/story/story.php?storyId=106061080

and the organization to foster exercise:
http://www.getmovingkern.org/

I think that the Kettleman City example was discussed in a previous thread on Making Light (I read 'em, even when I'm in my normal lurking mode) but I think it is important to highlight the huge difference between whether we are talking about constrained choices made by individuals in the environment which currently exists or looking around and asking how can we as members of our society make the choices better?

I also want to point out one more thing about the Kettleman City story. The women started walking as a group -- not lone individuals. Even when we drop back down to individuals who DO have choices, I think that it is important to ask why people are consistently not making certain choices which ARE available to them in their daily lives. In my case, I am not exercising enough because I hate to exercise alone. For me, focusing on what is the same between me and someone else who exercises more makes me feel guilty (and thus less motivated) but focusing on the differences (are you more stressed out? Do you hate to exercise alone? etc) helps to focus on the problem in a way that can encourage a workable solution.

heresiarch @ 191: thank you. You've put a lot of what I was thinking into words for me.

Leaving the weight arguments aside for a moment. Exercise. Exercise is good for you (general medical consensus). Moderate exercise, 30 minutes a day, five days a week. Can be broken into chunks. Could be e.g. walking up the stairs instead of taking the elevator or escalator, getting off the bus one stop early and walking the extra five or ten minutes home. There are ways which don't require e.g. gym membership or Lycra/Spandex clothing. But many people don't do this. Some have obvious constraints - they have a health problem which doesn't let them go for a brisk walk, or they would swim, but don't have anywhere to do so, or they would walk but it's not safe to go for a walk in their neighbourhood, or it's too hot/cold, or they are working long hours, looking after their kids and honestly don't have the time or energy: eric @181 gave a great example of how life can make exercising more difficult.

However there are also people who, by all those measures, could get their "30-minutes of moderate exercise a day" - but don't. They always take the elevator not the stairs; they get back in the car, drive to the other end of the mall and look for another parking space rather than walking through the mall; they spend their evening leisure hours watching the TV, or on the computer, or reading a book. There are lots of reasons why, but (sorry Diatryma) I don't think those reasons are always rational. If they were, it might be easier to do something about them. Laziness, inertia, a feeling that "exercise isn't something I do/isn't for me." Many of the underlying reasons are social, and we as a society should be looking at ways to make it easier and more acceptable for people to take that exercise. But in the end, people have to make the choice as well.

Heresiarch @191 -- one question for you in relation to what you're seeing there. Why do you say the "epidemic in obesity" is causing worse health outcomes? Is the average age at which people die going down? Are we merely finding and diagnosing more problems (is we even doing that?)? We're seeing increases in some diseases, decreases in others (I expect, without actually looking at the numbers). It's become accepted wisdom that fat is causing some of these increases, but is the overall health of the nation getting worse with this "epidemic"? And how would we know? Remember that you have to run this against the meme that we have the best health care system in the world here in the US, and use the same set of statistics to prove both if you want to prove either....

Good expansion, mea @193. One of the choices possible is clearly to take collective action to make it safer and more interesting to exercise! Another would be to work to change the ways people get treated around exercise in schools.

Tom, 195: Changing the way PE is taught in American schools will first require the elimination of bullying. Good luck with that!

heresiarch @ 191, I absolutely understand what you're saying, and I think you and the "healthy at any size" advocates are in strenuous agreement. The framing of the argument is all, once again.

The fat-hating and fat-shaming crowd with their talismanic BMI charts like to frame the question of size and health as a simplistic and purely individual matter because it relieves them of responsibility. If the issue is one strictly of individual choices and not of the constraints on choice placed on individuals by external factors, then they're excused from any obligation to advocate for changes in the socioeconomic conditions creating those constraints that would otherwise be imposed by their position of judgment.

Once one starts judging people for the results wrought upon their bodies by environmental degradation, the deteriorating sense of safety in our communities, the dismantling of walkable neighborhoods, a "food" production and delivery system that subsidizes dubious if not harmful foods and hinders reasonable access and pricing for wholesome nourishing fare, et cetera ad nauseam - and acknowledging that all these externalities make people's physical condition harder to control - one is forced to admit that any "blame" for their condition is distributed throughout society. And that moral high ground one was standing on feels a bit slippery under one's feet while shouldering a share of that burden.

How convenient for Mr. Mackey, that he can buff up his moral self-image at the same time as he relieves himself from any sense of obligation to use his economic and political leverage to make real improvements in society.

Tom @ 195, I don't recall heresiarch asserting that the US has "the best health care system in the world" - in the numerous health care threads we've had in the past year, the consensus seems to have emerged that our health care 'system' is very good at some things and absolutely dismal at others. It doesn't seem fair to insist that heresiarch defend a meme that he has not advocated.

Moreover, I question the relevance of the quality of health care to the matter under discussion. It is not inconsistent in the least to say that widespread obesity is increasing the rates of occurrence of a range of diseases, and also that advances in health care are improving longevity despite those increases. Indeed, anyone in the insurance industry (particularly long term care coverage) will tell you that over the past few decades mortality has decreased, but morbidity has increased.

...I think another root ambiguity about "you have choices" is whether it's tilted more toward a concrete past or a fluid future. The former is more like a bludgeon of "you got yourself into this mess; it's all your fault and you can't blame anyone else or expect them to help you out of it now"; the latter is a somewhat more empowering but still bludgeonable "however you got into this situation, you can still get out of it by putting extra effort into changing yourself in ways that no one else can."

Both of them can still go either way, of course-- when people lose their jobs because of an overall collapse of the industry they've been working in for decades, they theoretically *can* improve their job prospects by going back to school for retraining but won't necessarily have the resources or energy to do so... and even if they do, whether they actually get hired in the new field afterward isn't something they can really exert personal choice over.

Tom@155, 161, 184: What irritated me about your insistence about how everyone has a choice is that it was patronizing because as far as I can tell, neither I or anyone else were denying that people have choices. You kept repeating this, but my argument is that having choices does not make them viable choices, especially for people whose time constraints are because of something they had no choice in, like chronic illness and disability. The repeat came off as unhelpful harping upon.

Or what mea@193 said. (Ninja'd! I wish I could think faster.)

Avram@169: I used to work that way, but now only short, light exercises boost me. Anything near enough exercise (where 'enough' is defined as enough to keep stiffness and aches away) depletes me, and sometimes wipes me out for the rest of the day, and sometimes into the next. It's rotten, but I make do with what I have.

heresiarch@191: Maybe I'm swinging at strawmen here.

Yeah, kind of. In my understanding, the fat acceptance movement is not trying to say that there aren't geniune complications that come with high weight--it argues that the complications may come at a higher weight overall than we've been led to expect and that that high weight may be the symptom of certain problems, not the cause, and that blaming fat and insisting on weight loss on a primary treatment for a wide range of ills is insulting, dehumanizing, and harmful. It argues that working with people's bodies as they are from the start will lead to better outcomes than insisting they must be a certain size and shape, first.

Above all, FA is a protest against how fat people are treated and an insistence on fat people being visible and treated as actual human beings.

(And what Mark@197 wrote. Rats, I'd better hurry up with this...)

Also, as per Tom@195, the epidemic might just be vastly overstated. Are you familiar with the term 'headless fatty'? It's a description of the stock photographs that tend to accompany articles about the obesity panic epidemic--a very fat person who would likely fall into the 'morbidly obese' BMI range in unflattering clothes, often taken from behind, and always only seen from the neck down.

Morbidly obese people are around 6% of the population, and yet their dehumanized photos are used to illustrate this 'epidemic'. Case in point, right there.

I'm 5'9", roughly 225, obese by BMI definition. Obese doesn't look like what the news media has led people to believe. (I hope that link works.) And I'm just one slightly crippled, chronically ill example; there are lots more at The BMI project.

Forgive me if I've forgotten to address something or missed something or, er, something. I'd better post before my brain turns to sludge for the night...

Er, damn! I did screw something up after all. Per that Reuters article, morbidly obese people are around 3% of the population. Right. Definitely going to bed now.

I have been working out on average of 3 times a week since I've was in my early 20's. Before that I lived on a farm and worked hard physically. I've owned a car one whole year of my life. When I lived outside NYC I rode a bike, now I walk or take public transportation. I dance a lot too. I like to work out, I enjoy it. Now that I have two sets of damaged vertabrae (due to a bike accident and early beatings by my father) I need to workout regularly to stay mobile and to manage the constant, chronic pain.

All that said -- I don't agree that anybody can simply make a choice to exercise regularly, that time isn't an issue and neither is space. Both are enormous considerations for a lot of people.

I workout at home, because the cost of gyms went sky high (when I first started going to health clubs my membership was $120 for a year -- and it was a very nice place -- in fact it was called a 'spa,' and included an olympic sized pool, sauna and steam room, and very fine shower rooms.). With all the books and paper and music accumulated in our place which is lived in by two working writers - historians (both of us), a working musician (just him), and now also teaching (both of us), space is at a real premium. I barely have room to put down my mat. Periodically I have to force HIM to remove a stack of cds so I can get down on the mat. It's like living in an Aubrey-Maturin era ship -- every inch of space matters.

And when you have children too -- holy cow! It's really hard. And you are exhausted, and I don't mean exhausted in the good way you are after a workout.

Love, C.

I miss exercising. There was a brief time when I lived in Milwaukee that I was able to take an excellent kickboxing (not cardio bs, but actual kicking and hitting stuff!) which despite my lifelong antipathy for exercise, fostered by the lousy way in which PE is taught, was a huge amount of fun. I loved working up a sweat in conjunction with getting my frustrations out on a heavy bag. I didn't have to worry about letting a team down when I f'ed up, the instructor didn't assume that screaming "...get moving you cow!" was effective motivation, and I discovered that a fat woman with a low center of gravity and heavy, muscular thighs was at a distinct advantage in this sport.

However, I didn't lose any weight. I might have even gained some. Exercise can be the key to fitness, but it doesn't necessarily follow that it's going to "cure" the obesity epidemic.

Now I'm in lovely LA, in a place I no longer feel safe walking at night, with no time or money for the gym, and no nothing-but-kick-boxing classes to be had. And yes, I have tried Tae Kwon Do, with the same awesome instructor as the kickboxing class, and I sucked at it. It was frustrating and not fun. I don't know - I'd love to live in an apartment where I could have access to a heavy bag, and then have about $100 to gamble on a sports bra ordered over the internet. Yes, it's true it incredibly difficult for a fat woman to find appropriate workout wear. I look forward to walking more once we've moved, but again - still fat. I'm lucky in that I don't seem to have any chronic knee or back problems yet, and I can get around fairly well, as pictures of me atop various castle battlements can attest. But hearing people talk about how exercise will make everyone thinner is seriously disheartening.

Thanks for the explanation, Renatus @200. You're quite right that I wasn't saying it as helpfully as possible. So perhaps the question I'd like to ask is -- how can we increase the number of choices people feel they can make? Because people don't make choices they don't see. And I see a lot of people here not seeing some choices as viable or reasonable. We're getting at a lot of the reasons why folks can't do things. The case of the folks who got together and created a safe walking space is one good example of how they can.

Not wanting to fall into the Prosperity Theology camp, but I do want to say that believing that something is impossible is an almost certain way to fail at doing it. Choosing not to try makes it a lot harder to get somewhere. Wanting or trying will not make it so in a lot of cases, but not trying is a pretty sure way to not make it so. In a technical logical sense, it's the converse of the prosperity approach, or the inverse (they're logically equivalent).

Tom Whitmore: In the US the life expectancy is about what it was a few years ago; so no, it's not dropping.

But... it's not rising either, and it's lagging behind (by a couple of years) the rest of the developed world.

Some of that (perhaps most, it's complex) is related to the various differences in healthcare (Cuba is almost the same as the US, Canada gets three years on us, and Macau comes in with an extra seven).

The real question is... how much of that is differential. Being a black male cuts about ten years off the life expectancy.

(Data drawn from the CIA Worldbook)

Tom, 204: believing that something is impossible is an almost certain way to fail at doing it.

OK, but now imagine that you were a fat kid. You've been mocked every single time you tried to do anything physical. Going into a locker room triggers a panic attack. Got it? Now tell me that nothing is impossible.

Optimism and faith in the indomitable human spirit are wonderful, but at some point you have to remember that people learn from experience. If you have never been treated as anything but a fat freak, you will not believe that you can find joy in exercise.

(This rant brought to you by a thin graceful person who was successfully taught that sports were not for her, only for cool people.)

I didn't say that "nothing is impossible", TexAnne. I'm in a very similar position to you around exercise.

What's been taught can be untaught. New learning can substitute for old. Expecting someone to go from where that kid is directly to enjoying exercise is about as likely as me getting to the moon tomorrow. And there are examples out there of kids just like that who have learned differently. It's a slow process, one where positive reinforcement techniques are much more likely to work than negative ones. And our society is not well set up around positive reinforcement. It's like what Terry Karney (and others in the field) talk about with getting intelligence -- positive reinforcement works a lot better than torture. And telling someone that something they *know* isn't true, and insisting on it, and trying to make them act as if wasn't true -- that's a form of mental torture.

As long as someone believes they can't exercise, they won't exercise. Simply telling them they can won't change the belief. Nor will forcing them to do it, in most cases. What it takes is making an environment in which they want to learn differently. Creating that environment requires a huge investment of time, thought, and often money. No quick fix.

I just had a great idea for a political cartoon. As I am no artist, I'm offering it up for anyone who wants to take a stab at it, for free.

Image: Parody of the Chik-Fil-A billboards with the cartoony cows. Except that, rather than saying "Eat Mor Chikin", this one says "Eat Mor Beef".

Caption: The American Tea Party

Lisa S @227: I think Amazon may have something in common with the underwear gnomes.

In fact, when that episode of South Park originally aired, over a decade ago, my reaction was "Hey, that's Amazon.com's business plan!"

Tom, 207: Oh, that's not at all what I thought you were saying. I'm glad we straightened that out!

#208:

Or cows helping change the tire of the truck "taking them to market."

Another thing the fat acceptance movement is pointing out is that in many cases, the healthiest weight isn't thin or even "normal," it's values that are classified as "overweight." So even if you can lose weight as easily as doctors would like to think, doing so may be bad for you.

The numbers that are used to classify people as underweight, normal [sic], and overweight are pretty arbitrary. Among other things, they are confusing a (majority, not inherent in the universe) aesthetic preference with a health issue: even if many men (and women) find thinner women more attractive, that doesn't necessarily mean that thinner women are healthier, any more than a preference for suntanned skin will prevent melanoma.

TexAnne @210: me too. Others had probably read it the way you did, so I'm glad you asked.

Tom Whitmore, 161: having kids, or being the caretaker of someone helpless -- those are choices too.

Oh, really? What exactly should someone like me "choose" to do when my only remaining parent turns up with Alzheimer's and other health issues, and can no longer care for himself? I am an only child, I am my father's only living blood relative, and somebody has to take care of the man. There really wasn't any choice involved, as he'd been living in another city from me, suffered pneumonia, was taken to the hospital, and after recovering from that, was placed in a convalescent home. Once his Medicare coverage for that ran out (it only covers a limited amount of time), he was moved into the home's assisted-living facility, but this was still at the other end of the state from where my husband and I live. I tried to get him transferred into an assisted-living facility closer to here and to the few family friends and ersatz relations still alive, only to have the facility he was in keep neglecting or refusing (depending on which functionary I spoke to on any given day) to forward his medical records to the new facility so that the transfer could take place. Meanwhile, they were trying to bleed his bank account dry by holding him as long as they could and bringing him checks to sign. In the end, since the other facility couldn't take him without medical paperwork, we wound up just going and putting him into the car and bringing him home to live with us. I had to stay home to look after him and take him to doctors to get him evaluated and stabilized, and by the time things looked to be in place to possibly get him into a different facility on the basis of his newer medicals, the recession hit and I couldn't find a job. So now we need his income just to keep the roof over all three of our heads until I have a decent job again (fortunately, that's in train now), which means he still lives with us. And no, I'm not arguing that I don't have time to exercise - I fortunately do - but rather I *am* arguing that not everything one is responsible for in one's life is the product of one's choices.

Constrained choice or no choice - and I pretty much feel that I had no real choice. Either way, I don't mean to pile on especially as you seem to have addressed most of the issues people were having with you, but I did want to point out that sometimes people really *don't* have a choice in some things.

Moving right along...

On exercise and one's formative years: how many of us were horrible at PE in school, but took great joy in running about the neighborhood after school, or riding bikes, swimming or just playing games like tag or kickball with friends? That's physical exercise too. I mstly sucked at PE (though I don't really remember being bullied in it, despite being bullied quite a lot otherwise). I wasn't any good at things like team sports, rope climbing, etc., but when they'd pull out the trampoline, I suddenly was one of the best in the class, because my next-door neighbors happened to have one in their backyard and all the nearby kids got to use it, which meant I was over there nearly all the time i good weather. We had fun, and it enabled me to have something thing in gym that I was actually good at. (And then in high school I had the option to take swimming instead of gym and found myself actually enjoying PE for a change, because I loved to be in the water.) I think sometimes the trick for exercise is to forget all about what PE class was like for us as kids and focus instead on finding some activity we actually enjoy and some way to incorporate that into our lives as adults. And no, I'm still not athletic, but I can certainly be active. Luckily, I happen to live in a very walkable urban neighborhood with an enormous city park a couple of blocks from here and the Cleveland Metroparks nature preserve only a mile or so away (though right now my local green space is *white* space, and likely to remain that way for another couple of months).

Tom #204: believing that something is impossible is an almost certain way to fail at doing it.

While a very improbable event (winning the lottery, discovering a talent one has not known about for 40 years, meeting the love of one's life while stuck in an elevator in the Empire State Building) is not impossible, one should consider its impropability when doing a cost/benefit calculation.

To keep people from regarding something improbable as "impossible" to preserve their piece of mind, the best way would be to lower the overall cost (time, money, opportunity, pride) of it.

E.g., I'm in a gym anyway for strength training, so I can put in some cardio (useless), and some yoga/pilates (painful), because I'm there anyway, the fees are paid, and the two hours more a week I can afford. If I had to start from scratch for things that are, so far, useless and painful, I would not consider that effort well spend.

So, yes, what you say, "creating the environment". Which would include IMO to teach people how to do something right. Because if you do it wrong, you need a lot more effort for a lot less effect. And teaching... that would start with respecting people and their goals, to even start to undo the damage of school sports and fat shaming.

Again to the example, I would be a lot happier if the yoga/pilates instructor told me either what I did wrong or confirmed that, yes, it's supposed to hurt. However, it is far better to be ignored in one's imcompetence instead of being mocked and called a fat cow.

SummerStorms: Constrained choice or no choice - and I pretty much feel that I had no real choice.

Sometimes choices present themselves as between the good, helpful and reasonable, and the evil/cynical, useless and stupid. In which case it might seem like there was no choice at all. Which makes "choice" a kind of academic point sometimes, IMO. Yes, it exists. So what?

I did want to point out that sometimes people really *don't* have a choice in some things.

You could have chosen to *not* take care of him; it was an option you did not/could not consider in all good conscience, despite all the difficulties entailed in going the other way. Other people can and have made the opposite choice with nary a qualm.

That choice has become such a loaded word (with "good" or "bad" automatically appended to it) is one of the reasons for the friction in the discussion, because every single thing* we do or not do (aside from the ones governed by involuntary physical mechanisms, like breathing) is the result of a choice**, and that's the point I understood Tom trying to make in his initial post. It's just that the majority of our choices are made pretty much on auto-pilot because we've already calculated the cost-benefit ratios in our heads very quickly.

The choices I've made that stand out are the ones that have had wider implications (more people, effort and/or resources involved).

That said, the dissection of the nature of choice at this micro level isn't useful for making progress at the macro level, which is what matters to us as a society. It's like the "everyone has 24 hours in a day" statement.

*And I mean things like taking care not to splash my hand with boiling water when I'm making tea—I could *choose* to, but I don't like wiping up spills or pain or third-degree burns or being unable to use said hand for a good number of days. Or not going to the supermarket to get eggs because I'd rather stay home where it's warm, and I can have the omelette for dinner tomorrow instead of today.

** No value judgments being made.

Summer Storms @ 214... I wasn't any good at things like team sports

I expect that many of us SF weirdos were like that in high school. Heck, if we had had the hang of this thing called fitting-in-society, we'd probably have figured out the more focussed interaction called team sport and we wouldn't have had our glasses fly off our faces because we didn't know when to grab the ball.

Renautus #79:

My grandparents on my dad's side did exactly this with regard to smoking, for their whole lives. Right up until he was diagnosed with lung cancer, right up until she had yet another stroke and lost the power of speech, they would say that smoking wasn't really all that bad for you, that they knew lots of old people who smoked, that the whole "smoking is bad for you" was all a conspiracy of media and busybody activists, etc. Nor is this unique. I have seen people buy into some load of self-serving bullshit often throughout my life--it's common as hell in political and social and religious discussions. Earlier, I linked to some identified patterns of mental biases that explain some of this kind of self-deception.

For this case: It would be very pleasant for me to believe that my weight doesn't matter for my health, and still more pleasant to think I could just eat and exercise as much as (and how) I wanted without consequences. Right off the bat, that makes me wary, because when someone tells me just what I want to hear, I know I'm inclined to want to believe it. There are a lot of other beliefs around medical issues which end up being self-serving in some way, and all wrong. Perhaps this belief is different. But exactly as I said in my first post on this thread: We have the same set of internal, subconscious incentives in reading that literature as a lifelong smoker did in reading the medical literature of 1950, and it's much too easy to seize upon evidence that says we are okay or can continue as we are, and to ignore the more numerous evidence that contradicts it. That doesn't mean we're wrong, or that we're behaving irrationally. It's patronizing only to the extent you believe that pointing out the possibility of self-deception in your beliefs is patronizing, because that's what I'm doing[1]. It makes me wary when I see some fringy medical theory which tells me and lots of other people basically what we want to hear.

When a claim about science is tied to a social/political movement (such as "fat acceptance,"), this makes me even more wary. It's amazingly hard to keep your reasoning about science separate from your beliefs about politics, society, religion, and your own identity. Go ask a young-earth creationist, or an antivaxxer, if you don't believe me.

None of this says anything about whether the claims about reality are true. How much I want a claim about reality to be true, or what incentives face those evaluating it, doesn't affect its truth or falsehood.

[1] I believe all human beings are very susceptible to many different kinds of self-deception, and that self-deception is extremely common. I have no idea whether this is behind your expressed beliefs here--how could I, when I barely know you? But I'm pretty sure you, like every other human walking this earth, are susceptible to such things.

heresiarch #191:

Yes.

Somehow, we need to separate the empirical questions (how does weight affect health, does weight reflect other lifestyle choices that affect health, how much control do individuals have over their weight, diet, and exercise level) from the moral or social question of whether or not it's okay to treat fat people badly.

Can we all just start with the acceptance that you're human regardless of your weight or physical condition? You have the same rights, you're entitled to the same courtesy and decent treatment, etc.? Just as in many other discussions, that moral question is independent of the empirical question of what the effect or cause of being fat is.

One problem here is that, if your choices affect your weight and health, it might be easier to blame you for your weight (or give you credit, if you're thin). Of course, that can't possibly tell us anything about the extent to which our choices do affect our weight--you can't reason from ought to is.

The specific policies of Whole Foods are an attempt to encourage people to make choices that will improve their health, by offering them financial incentives. Broadly, I've seen several different objections to this:

a. The targets are wrong, because (for example) BMI isn't really all that great a number for predicting health--low BMIs often indicate ill health, high BMIs can indicate lots of muscle, etc. (What you really care about, I think, is blood chemistry and the health of your arteries.)

b. It's discriminatory, because some people have bad measures of health (good and bad) through no fault of their own. Some kinds of thyroid problem, for example, make it really hard to keep your weight under control.

c. It's discriminatory, because the poor tend to be heavier than the middle class and rich, because hispanics (at least the racial subgroup sometimes called Mestizo) tend to be heavier than whites (and have more diabetes), etc.

d. Some (or most, or all) people will find it very difficult to improve those numbers, because of various constraints. For example, there aren't any well-studied diets (outside of surgery) that reliably help people lose an extra 60 lbs, so if that's what you need to do to get a discount, you're probably just out of luck. If you're working 60 hours a week and commuting another 20 hours a week, you may find time fr exercise a little hard to find.

And yet, we manage to impose a number of incentives with some effectiveness on smoking: We have high cigarette taxes, we make smoking as inconvenient as possible[1], we've done what we could through both social and governmental action to make it socially unacceptable. Those do seem to help. It's not nuts to think we can create incentives in other areas that encourage people to stay healthier, even if this particular set seems unlikely to work.

[1] This is part of reducing exposure to second hand smoke, which is an independent positive goal. But a lot of the measures you see to prevent smoking are explicitly done with the goal of encouraging people to stop smoking by making it inconvenient. Eliminating all smoking areas in a public place, for example, seems far more about making it inconvenient to smoke than reducing that last very small exposure of anyone to third-hand smoke.

Pendrift #216:

We all have choices, but many are pretty damned constrained. However, we also constrain our own choices pretty often, based on our own history, beliefs, desires, etc. IMO, a great deal of the success of positive thinking ideologies is not because it's a good strategy--if you are already a rational decisionmaker, positive thinking makes you a worse decisionmaker. Instead, it's that positive thinking helps you overcome some places where you've closed off your own choices incorrectly.

The problem is, just trying to use positive thinking doesn't give you better judgment. If you're irrationally pessimistic about some stuff, it will help you overcome that irrational pessimism. But if you're realistic or irrationally optimistic about other stuff, it will encourage you to be less rational, and to make worse choices. (This is a common pattern with all attempts to correct for biases in your thinking--the corrections tend to introduce errors in some places just as they correct them in others.)

It's useful to find some good sources of information about something you're trying to do. For example, losing weight is hard, which is why when your doctor tells you to lose weight, he gives you basically the same advice he's always given you, and it mostly doesn't work. OTOH, I think it's possible to significantly improve your cardiovascular health with exercise, improving your diet, and taking some fairly cheap medicine.

One question: Is it also hard to avoid gaining weight? If it's not so hard to avoid gaining weight, but hard to lose it once it's on, that suggests that the attempts to control weight ought to start before you're seriously heavy....

Tom@204: So perhaps the question I'd like to ask is -- how can we increase the number of choices people feel they can make?

Now that is a good question. There's a lot wrapped up in it that I don't know how to even begin approaching, but I think one of the big problems is that is that exercise culture is so dour. It's focused on suffering for a goal (like weight loss or big muscles) rather than having exercise as an end unto itself. There's very little fun to it and very little exploration of what one's body can do, very little permission to be slow and bad at something at first--it's very focused on fighting one's body to make it do something and doing it just right.

I'm certain that puts a lot of people right off from it.

inge@215: Ack! No, yoga should not hurt. Never ever. I'm told a good instructor will gently help a student keep proper form in getting into position but never force, and will help a student modify a pose if their body just can't do it. Not all bodies can do everything, not even thin ones.

albatross@218:

*pinches bridge of nose, sighs*

First of all, you're doing what our driveby did and trying to associate fat with smoking. I'm not interested in having that discussion all over again. Second, you're still being incredibly patronizing by pointing out that I might just be deluding myself, why haven't I considered that? after I asked you for a cite for your assertions. Which I note you've still failed to do. 'My doctors said so' is not a cite.

That combined with the scare quotes around fat acceptance, handwaving what I've linked as 'fringy' science without actually addressing what is so 'fringe' about it, and not addressing much of anything I've wrote except to insinuate that I'm fooling myself leads me to believe you aren't actually interested in having any sort of real discussion about any of this.

At any rate, I'm done with beating my head against your particular wall.

Albatross@218: "We have the same set of internal, subconscious incentives in reading that literature as a lifelong smoker did in reading the medical literature of 1950, and it's much too easy to seize upon evidence that says we are okay or can continue as we are, and to ignore the more numerous evidence that contradicts it."

This is true, but we can also look at what people are doing with their selections of evidence and their applications of it.

I admit, some fat-acceptance rhetoric makes me uncomfortable and feels like it's verging on justification for declining to change a situation that needs it...but it's also true that a lot of fat-acceptance argument is in fact grounded in the kind of precision and specificity that conventional wisdom about fatness isn't.

For instance: I was diagnosed with diabetes last year, coming out of several years' slump of depression and other stuff, a time in which I put on quite a bit of weight. I know folks working on fat acceptance, and not one of them has suggested I'm doing anything wrong in making a big commitment to weight loss. But they approve with pointers to specific data: for diabetics, there's a measured reduction in the risk of heart and vascular trouble and a measured improvement in the body's response to insulin that goes with weight loss, down to a threshold weight that's still well above "normal" in conventional wisdom. I'd like to be thinner than that, and they don't mind that, but they point out, and are correct, that demonstrable health benefits won't accrue if I do, except insofar (and it's a long far) my happiness at my self's condition would feed back into immune strengthening and the like.

Likewise, look up above and you'll find folks talking about the various lipid densities, heart rate and blood pressure stability, and other quite specific matters. This is the stuff health is made of.

One question: Is it also hard to avoid gaining weight? If it's not so hard to avoid gaining weight, but hard to lose it once it's on, that suggests that the attempts to control weight ought to start before you're seriously heavy....

Isn't this where forming good habits comes in? It's cheaper to prevent tooth decay by brushing teeth regularly than to fix them once they're rotten, but this assumes you were taught to brush your teeth early on. Same thing goes for food choices and exercise, assuming you have access to both (and this is where YMMV a lot.)

I'm pretty sure I'd have found it easier to avoid gaining weight if, as kids, we were taught to snack on fruit instead of chips and chocolates and cold spaghetti; if we weren't made to finish our plates even if we were full; and if our parents encouraged us to walk or bike places instead of taking the car for everything, even though walking was a perfectly feasible option. But we weren't, and all of us 5 siblings are less fit than we could be, are carrying extra weight that we don't have to (i.e. our choices are not constrained by considerations of time, money, or underlying disease conditions), and even though we have a medical incentive to pay attention (family history of hypertension, diabetes, arthritis and strokes).

The other thing about habits is that you don't really think about them. I grew up drinking water with meals, so it doesn't occur to me to wash down lunch with Coke. Meanwhile, my husband grew up in a soda-loving household, and it doesn't occur to him to do otherwise.

So yes, as heresiarch and dcb mentioned upthread, my siblings and I are among many people whose choices are not truly constrained in that respect, but who find it a real effort to exercise or pay attention to what we eat because we never got into the habit. (Most of us are trying to change it, with moderate and varying degrees of success.)

FTR my BMI places me at obese. I can walk for hours on a flat surface (inclined is another matter), and my blood tests are all boringly normal. OTOH, I get winded after a short run or climb, and bouts of knee and back pain would happen less frequently if I weighed less, for simple mechanical reasons.

I remember reading about the three-day rule for forming habits: if you can stick with it for three days straight, there's a greater chance you'll be able to stick with it in the long run.

albatross: I'm not complaining because of those reasons (or at least not those reasons alone).

I'm complaining because it's being done, so far as I can tell, for completely venal reasons on the part of Whole Foods.

1: The correlation to health posited in the announcement is, at best, in question; and seems to be be generally held to be specious (and I don't mean in the public at large. I am discussing medical literature. No, it's not filtered down to the public level yet; as it has with smoking, but that's in part because we have a huge bias against it, which is evident in all sorts of place, not least in places like the tabloid/magazine faceouts at the cash registers in the supermarkets).

2: A single factor (BMI) trumps all others.

3: Weight isn't the reason for the costs of healthcare for Whole Foods Inc. to be where they are.

4: I don't think, as a matter of social policy an employer ought to be able to dick with what I do in my off time. If I want to smoke, eat, drink, sleep, rock climb, ride horses, fence, fight heavy weapons in the SCA, do pottery, photography, etc. Whole foods is attempting this (not completely, but partly. I am not all that willing to let the camel's nose into the tent. Am I Chicken Little, perhaps but this is part of that eternal vigilance required to keep liberties).

This isn't an incentive to keep people healthy (see 1 and 3 above). What would really work, is increasing their paycheck. More money in hand means more options for food. It means more money for the gym. It might mean a car, and so an increase in available time to do things like take walks, join the gym, start doing yoga; aikido, fencing, etc.

More to the point, this isn't really an incentive. If you lose weight, yes, you get a bigger discount, but if you don't everyone knows some aspect of your "health" isn't quite right. You are being shamed for failing to make the grade.

Not acceptable.

And the corrolary to smoking doesn't wash with me. I know lots of smokers who can't quit. I know a few who decided to quit because of cost (back in '87/88 when Calif. spiked a raise in the taxes). I know a lot more who didn't. I do think the place to intervene is at onset (because tobacco is addictive), and that cost is a reasonable stumbling block.

This isn't that.

Renatus, you asked for cites. I spent several hours looking stuff up over the weekend. The results of various studies don't agree exactly - that's messy biology for you. However, the largest, most recent study I can find is the following:
Lancet 2009; 373: 1083–96 Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies.
Prospective Studies Collaboration, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R.

"In both sexes, mortality was lowest at about 22·5–25 kg/m². Above this range, positive associations were recorded for several specific causes and inverse associations for none, the absolute excess risks for higher BMI and smoking were roughly additive, and each 5 kg/m² higher BMI was on average associated with about 30% higher overall mortality."

"Interpretation Although other anthropometric measures (eg, waist circumference, waist-to-hip ratio) could well add extra information to BMI, and BMI to them, BMI is in itself a strong predictor of overall mortality both above and below the apparent optimum of about 22·5–25 kg/m². The progressive excess mortality above this range is due mainly to vascular disease and is probably largely causal. At 30–35 kg/m², median survival is reduced by 2–4 years; at 40–45 kg/m², it is reduced by 8–10 years (which is comparable with the effects of smoking). The definite excess mortality below 22·5 kg/m² is due mainly to smoking-related diseases, and is not fully explained."

Other studies. To show the range of variation, here's one with a lowest mortality at about BMI 25:
Durazo-Arvizu et al. (1998) American Journal of Epidemiology 147, p739-749 Mortality and optimal body mass index in a sample of the US population
"The BMI of minimum mortality was 27.1 for black men (95% confidence interval (CI) 24.8-29.4), 26.8 for black women (95% CI 24.7-28.9), 24.8 for white men (95% CI 23.8-25.9), and 24.3 for white women (95% CI 23.3-25.4)."

On the other hand, there's the following suggesting below 21.9 is healthiest:
Field et al. (2001) Archives of Internal Medicine 161, 1581-1586. Impact of overweight on the risk of developing common chronic diseases during a 10-year period
""Compared with their same-sex peers with a body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) between 18.5 and 24.9, those with BMI of 35.0 or more were approximately 20 times more likely to develop diabetes (relative risk [RR], 17.0; 95% confidence interval [CI], 14.2-20.5 for women; RR, 23.4; 95% CI, 19.4-33.2 for men). Women who were overweight but not obese (ie, BMI between 25.0 and 29.9) were also significantly more likely than their leaner peers to develop gallstones (RR, 1.9), hypertension (RR, 1.7), high cholesterol level (RR, 1.1), and heart disease (RR, 1.4). The results were similar in men. CONCLUSIONS: During 10 years of follow-up, the incidence of diabetes, gallstones, hypertension, heart disease, colon cancer, and stroke (men only) increased with degree of overweight in both men and women. Adults who were overweight but not obese (ie, 25.0

I can put some others together for you if you want. But they pretty much all found higher mortality at the higher BMIs.

Of course BMI is not the be-all and end-all, and is not the only indicator to use in evaluating the health of a given individual. To give a very obvious example, if you're very muscular due to lots of weight lifting, you're going to have a high BMI due to high muscle mass and could have a normal or unhealthily low body fat level at the same time. But in population terms higher BMI is associated with higher mortality in most studies.

Also, that doesn't mean individuals can't improve their health, at whatever weight, by e.g. exercise and healthy eating. Nor does it mean that "shaming" people for being fat is either nice or helpful.

I know BMI doesn't really allow for things like having large breasts, but do people commonly adjust it for fewer limbs? Imagine how much weight could be lost with some clamps and a hacksaw. Fast, permanent, and just as correlated with an improvement in health as more common drastic measures.

I'm pretty sure I'd have found it easier to avoid gaining weight if, as kids, we were taught to snack on fruit instead of chips and chocolates and cold spaghetti; if we weren't made to finish our plates even if we were full; and if our parents encouraged us to walk or bike places instead of taking the car for everything, even though walking was a perfectly feasible option.

And even if you did all those things as kids - as I did - it still doesn't keep you from gaining weight later on. (It might slow that down, though.) I still prefer walking to driving, but having somewhat arthritic joints means I can't walk a couple of miles each way any more, and the supermarkets aren't close enough for easy walking.
YMMV, etc, etc.

albatross: It would be very pleasant for me to believe that my weight doesn't matter for my health, and still more pleasant to think I could just eat and exercise as much as (and how) I wanted without consequences. Right off the bat, that makes me wary, because when someone tells me just what I want to hear, I know I'm inclined to want to believe it.

I very rarely met anyone who was willing to believe, "It doesn't matter how you look, really. And thinness does not signify health." And those who were had worked long and hard on it.

Fat acceptance and Health at any Size is not about "being a binge-eating couch potato is just fine". It's about "You might never be thin. Stop angsting about it and do something useful.", resp. "Fat is primarily a shape. Stop drawing baseless conclusions and being an ass about it."

We have had decades of fat-shaming, medical scare stories, self-hate, useless diets, and ever-thinner models. We should by now all have a BMI or 18.5 or whatever is considered fasionable at the moment. After all, most people manage to get out of bed, brush their teeth, pay their bills and not crash their cars into lampposts. Most people are reasonably competent and have their act sufficiently together. So, if everyone who is not a total loser can be thin, they would be. If they aren't, the theory does not fit the data.

The choice is not, as you imply, between being thin and being fat, with fatties enthusiastically choosing disrespect, silly clothes, higher bills, bad medical treatment and what-have-you. It's between "have whatever body shape and daal" and "have whatever body shape and drive yourself crazy", resp. "treat people like crap for how they look" and "don't".

dcb @ 225... you're going to have a high BMI due to high muscle mass... Diatryma @ 226... BMI doesn't really allow for things like having large breasts

At least one of these isn't a concern of mine.

Man, I should have totally watched my weight before I allowed my thyroid to stop working. If only I had been 80 lbs to begin with, I wouldn't be so death fat today.

I'm going to back away from my standard argument because it's going nowhere. I'm interested in making PE a more pleasant experience for everyone. I was an unathletic, uncoordinated little kid. I enjoyed reading and making music. I was relatively good at both. Most of my spare time was spent doing things I enjoyed. When I had access to a bike I did ride it everywhere and I walked places, but otherwise I didn't get involved with team sports or competitions when I had time to myself. During recess, I'd stay in the classroom and read the encyclopedia when I had a sympathetic teacher. If not, I'd hope there was a jump-rope left, or sneak out with a book.

PE was pretty pointless up until Jr. High, when it became absolutely miserable. After one too many times of not having sports rules explained to me (of course everyone already knows the rules to softball/soccer/basketball - why would you need a handout or a book to explain it? I'm sick of your laziness!) and being very grudgingly picked last, I wondered what would happen if we made kids sing in a chorus or play in band with no particular training and then berated the tone-deaf and non-music readers, not to mention those who lacked the proper embouchure or finger strength? It would certainly be cruel, and I doubt many kids would grow up to enjoy even just listening to music, let alone playing it.

The problem of being fat is kind of a sore point for me. I was chunky all through high school, became the only freshman ever to lose 15 pounds, and then slowly bulked up again in the years following. My mom went from It's Just Baby Fat to I Was Heavy At Your Age Too to just getting on my case all the time about taking a walk at lunch and maybe not eating so much pizza. I don't actually know where she got the idea I lived on pizza and Twinkies, mind you.

When I started biking to work regularly, living on about 1200 calories a day (my normal diet, I might add) and still wasn't losing weight, I went to the doctor. They discovered I had PCOS and put me on Metformin. And over the course of a year or so, without changing anything, I lost 40 pounds.* That shut my mom up, for a while.

Now my BMI hovers around the Healthy/Overweight line, depending on whether it's a heavy biking season or not, instead of being at the low end of Obese. But Mum has started up on me losing more weight again, and I just don't know what to say. It's obvious that this is the weight my body wants to be, I'm happy with it, and have I mentioned that I'm a D-cup?

So I get a little snappish when someone starts up on how I could lose weight if I were just a little less lazy. I bike 40 miles a week; what more do you want? My blood pressure is so low sometimes they take it twice to be sure they're reading it right, and my cholesterol is smack in the middle of normal. I'm trying not to rant and rave, but sometimes it's so hard.

* Which I'm pleased about--I grew up in this culture, after all--but I'm much happier that I'm not so fscking tired all the time anymore.

Serge @ 229: Thank you for that. (Glad I wasn't taking a mouthful of tea while I read it).

I think there needs to be a distinction between the findings of epidemiological studies, and how an individual can or cannot improve their health.

Also, there's a big perceptual problem in the confusion between medical concerns and societal expectations when it comes to body weight.

I do get concerned when fat acceptance websites start insisting that medical opinion says there is no (epidemiological) correlation between very high weight (very high BMI) and higher morbidity/mortality. Partly because there's a risk that then, if that statement is discredited, everything else they say can be discredited by association. And I think a lot of what they're saying is very sensible. Focusing on weight loss appears not to be the most helpful thing to assist overweight people in improving their health. Focusing on e.g. finding a form of exercise they enjoy and can/will do regularly, healthy eating and so on (including accepting that yes, they are the shape they are and that doesn't make them a Bad Person (TM)) seems to be more effective. Also, if you're a relatively high BMI and healthily fit in terms of cardiovascular status, cholesterol etc. you may very well be in better health that someone who is of lower BMI, but does no exercise and has a high blood cholesterol. However, given the medical evidence, inexact and imperfect as it is, it may also be sensible to find ways for society to help more people avoid gaining weight in the first place, and also to stop obsessing with the image of the (unhealthily) very thin model as the shape to be.

And I've just realised that despite my best efforts, part of that last quote got cut off because of the "greater than" sign. It basically said BMI 18.5-21.9 was healthiest - the whole abstract is available on PubMed.

On the topic of incentives that might actually work - I've been thinking about this one recently.

Things that have actually worked for me:
- Discount on my gym membership costs ($20/month) if I go 8 times a month. What makes this work for me is that all I have to do is check in - there's no tracking or pressure to do a particular amount or level of exercise. (Especially since I'm slowly recovering from interesting exhaustion-causing problems.)

- My health insurance also has an online program with gift card incentives (up to $125 a year) for completing online seminar/quizzes, challenges, etc. Most of it's information I already know, but more money for books is always an incentive for me to check it out when I've got a little time to spare.

The tools no one seems to be offering:
- I have asthma, and the related frustration with exercise: every time I have a flare, my stamina drops back to zero, so I start building up again from nothing. I sometimes - because I believe in poking my health care providers about this - ask about specific support for combining exercise and chronic medical issues. They look sorrowful, and go "You know, that *would* be helpful" - but there's no mechanism to provide it, or even referrals, beyond "Do what you can, when you can" which doesn't actually solve my problems.

- I'm working on eating a better balanced, less processed food diet - but it's been surprisingly hard to find resources that a) involve minimally processed foods that b) can be cooked easily after work and c) make portions suitable for a single person who wants variety in their diet on d) a reasonable budget. I know the foods are out there, because I've worked some out - but it's lengthy and tiring to do all your own R&D on this kind of issue while also working. (I think there should be other variants, too, but this combo is my particular want.)

- Food tracking that focuses on types of food eaten, rather than calories or even nutrients. I'd love tracking systems that would let me input what I ate, and tell me "Ok, you had 3 servings of vegetables, but no servings of fruit yesterday - and you should really eat more green veggies today" (That's data I sometimes like to see, but only when I'm in the mood for it.) My dream version of this would let people adjust independently to handle preferences.

All three of these are things that would have a significant proven health impact for a lot of people, and they don't require new technologies or medical advances - but they're surprisingly unavailable.

I've used NHLBI's web-based menu planner, which focuses on the foods eaten rather than calories. NHLBI also has pages of information on the DASH diet, which was originally designed to help people with hypertension, and it ended up helping more than those patients.

You don't have a wide selection of actual food items in the menu planner, but there's usually enough of a choice to find a related item that you can use in place of what you actually have/had to eat.

For me, learning more about portion control was very helpful, as well as identifying good choices for meals over the course of the day.

Since it's online, there's no human to provide disapproving looks, which is another benefit. It has been easier for me to be honest in the past, when I was eating larger portions.

There are many medical reasons to gain weight and not be able to lose it. I was on beta-blockers to reduce the frequency of migraines (which worked for a few years); it also caused a weight gain that I have never been able to completely eliminate. Now I'm entering a metabolic-slowing phase of life, so it's even more difficult. If I can maintain my weight in a relatively decent zone, I'll be happy.

One question: Is it also hard to avoid gaining weight?

IME: Depends. If you really want to gain weight it's hard. If you do *not* want to gain weight, it can be anything from automatic to near-impossible. Probably still easier than *losing* weight, though.

It also depends on the point in your life. I might have gained less weight had I not been put on diets all my teenage years, because I were very active and had no bad habits to start with. Still, when you are a healthy 13 yo going into puberty, not gaining some weight is probably both rare and inadvisable. (Not that I would have accepted that with 13.)

Renatus #221: Thanks for the info on yoga. It seems I need to change something. Maybe the class.

inge #228:

The choice is not, as you imply, between being thin and being fat, with fatties enthusiastically choosing disrespect, silly clothes, higher bills, bad medical treatment and what-have-you. It's between "have whatever body shape and daal" and "have whatever body shape and drive yourself crazy", resp. "treat people like crap for how they look" and "don't".

Fair enough. I'm pretty sure I didn't imply any of that, though.

Jenett #233:

Trying to make cities/suburbs more walkable seems like a big win up front, but also one that's made much harder by the need to retrofit intentionally-unwalkable neighborhoods or communities. If it's pleasant and easy and safe to take a daily walk, lots more people will probably take it. If getting to the store or the coffee shop or whatever is practical on foot, again, lots more people will do it.

One problem there is time. Even if I could walk to a coffee shop and work from there, rather than working remotely from someplace I've driven to, I might have to spend an extra 40 minutes of my day traveling.

albatross, #219: WRT smoking bans, a lot of businesses have one very strong financial incentive for them -- it greatly reduces physical plant maintenance costs. This is why, for example, so many high-end hotels no longer have any smoking rooms at all. It's not because they want to make life inconvenient for smokers, it's because they're tired of having to completely renovate those rooms every 2 or 3 years to keep them from looking unacceptably shabby. Smoke residue stains, and it's very hard to remove. That's not just true about tobacco smoke, either -- there's a reason for businesses that specialize in removing smoke residue from buildings and objects after a fire.

Your continuing to harp on smoking (which is a side issue and a red herring in this discussion), plus your continuing argument that smoking bans are all directly and maliciously aimed at smokers, is starting to sound as though you've got a little victimization syndrome there on your own part.

(Side note: I continue to be amused by all the fired-up Libertarians I've met who run into a corporate-based smoking ban and suddenly WANT government intervention to prevent that business from doing what it likes with its own property. No, I don't think you're doing this, but I know a surprising number of people who do.)

Also, please notice that "It would be very pleasant for me to believe that my weight doesn't matter for my health, and still more pleasant to think I could just eat and exercise as much as (and how) I wanted without consequences" is a strawman. I haven't seen anybody here making that claim; what they are saying is that if your bloodwork, cholesterol numbers, etc. fall within the normal range at your current weight, there is no reason to order you to change that weight -- your health is FINE, by the measures that have genuine significance.

Terry, #224: I don't think, as a matter of social policy an employer ought to be able to dick with what I do in my off time.

Yes. This. When your employer can spy on your personal life to that extent, we're getting uncomfortably close to the cyberpunk universe.

Jenett @233:
on incentives: the one that kick-started me was the need to fit into a costume for an opera my choir is staging at the end of the month. The one that's keeping me on track is that I feel better overall (less tired, less prone to illness).

on food prep and planning: keeping it simple helps. I have a basic template for a 1200-calorie diet, which includes 3 meals plus 2 or 3 snacks. Sticking to it AND varying meals was much easier than I thought, although I needed kitchen scales and a notepad the first week. Most of it was visual: this much cabbage equals thismuch lettuce equals this much carrot; this size steak equals this many shrimp equals this much chicken. Now I don't have to think about it and just swap them around.

I realized my eating habits were changing when I had to go to the supermarket on Sunday morning because there wasn't any more fruit in the house, and I didn't want to eat the candies, cookies or chips that were in the cupboard. (Not in a "musn't break diet" way, but in a "need the taste of fruit" way—the way I crave chocolate sometimes.) That, and the fact that I feel full much faster than before.

Trying to make cities/suburbs more walkable seems like a big win up front.

This reminds me of an earlier ML discussion on biking, in that in some places people just don't bike even when the infrastructure's in place, and the difficulty of shifting that behavior when there isn't a large-scale effort to do it (and even when there is).

albatross @ 236: walkability is another one of those areas that's nice in theory and complicated in practice for me (and for various people I know). Not just for the reasons you state, but for ones that - again - often get passed over in these discussions.

I'm about a mile from my local library, post office, a grocery store, light rail, etc. and about three blocks from several bus lines.

However, I rarely walk to these places. Just because I'm able to walk somewhere doesn't mean I'm able to walk home. If the weather changes, or I run into an allergen, or I just misjudge my available energy, I can end up in a really bad state with few good options. Even on good days, I need to leave plenty of time for a rest in the middle, which doesn't fit well with a full work day. (Plus living in Minnesota, there's 3-4 months in the winter and a month in the summer where walking outside much is really not kind to my lungs.)

I live alone, so if I miscalculate on what I can manage, I don't have a spouse or housemate whose schedule I know who could swing by and get me. Busing back, getting a cab, and other options all involve complications that're tricky when I'm already having breathing issues. Going to the Y for my exercise (with people around in case there's a problem), or walking blocks near my home can be boring, but they're less likely to end in medical trauma.

(I have double-plus-ungood side effects to most of the long-term inhalers for asthma, so I only use them for acute problems, not chronic control.)

A health system that truly supports health, not just apparently-easy external measures has to take all the people like me (and many others with chronic conditions) into account.

We moved to our current neighborhood in part because of its walkability. With the economic downturn, the character of the neighborhood has changed just enough so that I have to actually take into account whether I feel "safe" or not. In broad daylight it's less of a problem and errands can be run with minimal fuss, but lately I've seen several loose dogs roaming around in the last couple of weeks that gives me pause when I'm walking Ardala. The sketchier aspects of the neighborhood does mean the mile between the Metro Station and my apartment becomes a serious deterrent to my using public transit/walking to evening events.

But speaking of choices, we will be not only calculating walkability to the usual restaurants, libraries and grocery stores, but the amount of comfort felt walking in the evening when finding our next apartment. And any apartment complex will get super-bonus-points if they have a heavybag in their vestigial "gym".

The drawback to living in this gorgeous, walkable climate seems to be the annual Shit's On Fire season and the couple of weeks of seriously fatiguing heat - both of which really crud up my otherwise excellent respiratory system. That and the insane a-hole drivers that make my biking anywhere kind of scary.

Pendrift @239 -- I've ended up making that same kind of shift away from sugar-sodas. Don't know why, but I now find the essence-flavored fizzy waters much more pleasant to drink. I've gone from liking two or three root beers a day to drinking probably that many in six months. And it wasn't from trying, or anything like that; it's just become what I like.

Now if I could harness changing my mind in that kind of way about other things, I'd probably be much healthier overall.

Carrie S. @ 231: You're getting a reasonable amount of exercise, your weight's fairly stable, your cholesterol's okay, your blood pressure is low, and you're okay with your weight at the high end of "Healthy"? Sounds fine to me. Mothers worry. My mother constantly worries that I'm anorectic (BMI 19.2, weight stable within a couple of kilos most of my adult life, with no history of rapid weight loss, food refusal or anything), oh, and iron deficient (because I've vegetarian).

Jennett @ 233: I suspect you've already seen the websites saying thinks like build up gradually, use your inhaler immediately before working out if your asthma is triggered by exercise, make sure you warm up and down properly?

Regarding food, I've found it helpful to cook some things (e.g. spiced lentils) enough for several meals, then freeze in one-person portions of either protein (which I can then easily add to e.g. pasta or cous-cous plus quick-cooking veg such as broccoli), or home-made-ready meals (protein plus carb. plus two veg). I then -try- to remember to get out a meal last thing at night and put it in the refrigerator to thaw (so at least it keeps the fridge cool and I feel less guily about all the electricity) then I can microwave it or heat it quickly in a saucepan. Of course, this depends on having freezer space for storage...

Lee @ 238: honestly, my reading of what albatross said was that albatross, personally, being overweight ("heavy"), would love to believe the articles which say that doesn't matter and ignore the ones that say it does. That's not a strawman argument, that's a personal example.

dcb @ 243: Yep, know all the standard stuff.

What I really want is someone with significant expertise who could coach through things like "I'd like to try biking, but I'm not sure how to handle these specific concerns" or "If I've had problems walking across the room for the last two weeks (i.e. serious acute attack), how do I build up again over time in a way that isn't going to completely frustrate me?" Or "Exactly where should I, given my own history, probably draw the line on outside activity based on weather/air quality?" and "Given the lung scarring makes exercise in certain positions tricky (leaning forward is a big one for me) what other stuff could I do instead?"

These don't seem like unreasonable things to have someone coach on (again, with specific experience and training about the condition) - but most coaching is aimed at people who are either reasonably able-bodied, or at people who are doing rehab, and I'm neither. I've obviously got solutions for some of them (yay, swimming), but there are times I feel like I could benefit a lot more with just a little more specific support from an expert in the field. Health care providers mostly don't have the exercise piece (except in very broad strokes), and exercise folks don't have the asthma piece.

And again, on cooking - yeah, that's mostly my solution (complicated by lack of microwave: tiny house.) but it seems stupid that in a world where you can buy cookbooks and find resources for pretty much every other combination of needs you might ever want, there's a real scarcity of ones that combine healthy, reasonably inexpensive low processed foods in serving sizes that suit one person.

(I do have an additional glitch with food - I mean, besides the parental disordered eating problem - which is that I work at a private school that feeds us a very nice lunch. That means leftovers mean I'm eating the same thing for 4-6 days, and also that if I'm out in the evening, or grab food on the way home, that perishables are more likely to go bad. So stuff that makes single servings is my friend.)

Jenett @ 244:

A range of single-portion sauces? Or two-person sauce portions that can keep in the refrigerator for a couple of days? That way you could maybe flavour the four days of leftovers differently on alternate days? Sorry, can't think of anything else.

dcb @ 245... two-person sauce

With a nice Chianti?

Serge @ 246: No, I'm vegetarian! And we tend to share a bottle of beer with dinner, rather than a bottle of wine.

Lee #238:

FWIW, I'm not a smoker, never have been, and don't much like the smell of cigarettes. I don't think smoking is a red herring in this discussion precisely because:

a. It's a hard-to-change behavior with a big impact on your health.

b. We as a society absolutely do feel okay about creating incentives to convince people not to smoke, or to smoke less.

So, when we're talking about the rightness/wrongness/workability of incentivizing healthier behavior, an example where both governments and employers are doing it right now, as an explicit policy, seems pretty relevant. Can this work? Well, here's an example where something like it apparently does work.

Smoking bans in public places have both the effect of making life harder for smokers and keeping everyone else from getting their second hand smoke. Complete smoking bans, in which public places not only ban smoking, but even eliminate all locations where smoking was formerly permitted and demand that all smokers move 25 feet from the doors, seem like they are much more targeted at encouraging smokers to quit by making the habit a hassle, and such smoking bans are sometimes justified in public with just that logic. Cigarette taxes are explicitly set high to discourage smoking, with no ambiguity about it. All kinds of related stuff, like antismoking ads, laws banning cigarette advertising, and formal or informal pressure on TV stations and movie studios not to show smoking in a positive light, are also attempts to discourage smoking.

Again, this is a worthy goal, because smoking is really quite bad for you. It is, however, an example of a big effort across a great deal of society to discourage a known-to-be-unhealthy behavior.

Should employers try to discourage smoking among their employees? Perhaps by offering a discount or bonus if they pass their mouth-swab tobacco residue test? If a company does this, would it be wrong, and would it be somehow illegal?

Among other things, this relates to the Whole Foods scheme because they do apparently base part of their discount on being a nonsmoker. More broadly, it's a kind of paternalism on the part of employers about which I haven't seen much outcry.

dcb #243:

Exactly right.

Albatross@248: moving smokers away from doors could well be because non-smokers, and especially people allergic to smoke, really really hate having to run that gauntlet to get into and out of buildings. (I say "could well be" because we are discussing the intentions of people not present; none of us actually know why certain policies are made at most companies.)

One point you skip over is that the use of BMI for health prediction is "controversial", i.e. there are recent credible studies (in "good" journals) challenging the orthodox position. That's very different from the state of expert opinion on smoking and health, and makes using BMI to measure healthy behavior rather questionable.

Mark @ 197: "I absolutely understand what you're saying, and I think you and the "healthy at any size" advocates are in strenuous agreement."

I certainly hope so. Yet, when I read things like this, I'm left feeling a bit disconcerted. Headline aside, that article isn't actually saying that weight is a product of genetics. Offhand, I can think of several non-genetic reasons that explain the same result:

*Developmental - their body has developed, in response to environmental factors, a fat reserve and works to maintain it.

*Psychological - their "natural" weight is a product of a complex mix of habits and attitudes they've developed over their lives, and putting them on a strict low-cal diet and then sending them back out does nothing to change those habits.

*Crash diets just don't work - sharp decreases in caloric consumption trigger anti-starvation mechanisms in the body that make retaining and regaining weight a priority.

Now, that's not to say genetics doesn't play a role--I'm almost certain it does (to a greater or lesser extent depending on the individual). But very simply, I'm pretty sure that there hasn't been a substantial genetic shift over the past fifty years. There has been an increase in obesity. There is a degree to which obesity is not purely a product of genetics, and that degree isn't being reported in Kate Harding's view of fat.

heresiarch @251, try this article, which addresses the question of whether there's been a major shift in weight in the last century.

Also, I can't find a cite right now (frustrating!), but in the late 90s the CDC revised its definition of obesity, instantly creating thousands of new obese people.

heresiarch @ 251 - One of the things I'd love to see a study on is whether there *has* been a genetic shift.

My mother's side of the family is Eastern European (Jewish and non) but fairly small-framed, but with experience of famine in the previous handful of generations. My father's side of the family is English, much larger boned, and has less recent famine in the immediate prior generations. He tended to be larger but was able to maintain it with very moderate exercise - my mother has to work much harder for that same result. (I'll note that he died in 1990, so my data is not current, obviously.)

I got my father's bone structure, and my mother's height and tendency for my body to go "Let us store that food for you in case of emergency" in a way that makes me think I wouldn't be this particular size, shape, or weight, if my parents hadn't come from two relatively different gene pools that combined in this particular way (even though they're both European.) My actual body shape is quite different from grandparents on both sides (though very similar to my sister's)

My actual weight, like many people's, is also complicated by past medications, health issues, stupid choices in dieting due to parental pressure, etc. etc. etc. But even when I was in my teens, eating extremely healthy, and getting 6-8 hours of activity a day, I was still well into the 'overweight' line on the charts, which made me start wondering about the mixture in my genes in the first place.

caffeine @ 252: "Also, I can't find a cite right now (frustrating!), but in the late 90s the CDC revised its definition of obesity, instantly creating thousands of new obese people."

According to Wikipedia, NIH moved the line between "normal" and "overweight" down in order to match WHO's definitions in 1998--is that what you are referring to? Regardless, this study by Flegal et al shows an increased prevalence of overweight of ~8%, and of obese of ~9% in the 1990s. She is using a constant BMI in measuring that change. Rates of "extreme obesity" (BMI above 40) increased from 2.9% to 4.7%.

Jennett #233, re: incentives. Kind of.

Last March I bought trousers one size too small because they were not available in my size. No problem, I'd be going on a three week vacation in May, and I *always* lose size (don't know about weight) on vacation, even when I'm driving through Italy to try out restaurants and wine.

So I lost that size on vacation. And then continued. And continued. I can now get out of the trousers without opening them. I didn't gain size over the holidays. Neither when visiting a friend and splurging on junk food. It's quite scary, actually. When my mother started to lose serious weight for the first time in her life she was diagnosed with cancer a year later.

I eat more meat and less chocolate than I used to, and I have given up on trying to cram three meals into a day. (The meat thing bugs me).

Cooking for one: I often come home after 11 pm, so I have several bags of frozen, minimally processed (cleaned, peeled/sliced) vegetables, herbs and thin meat cuts in the freezer. Slice the meat, add a cup or two of veggies, some herbs, spices, and a little oil or butter, eat with bread. It's done in the time a pot of tea takes to brew and cool to drinking temperature, and works fine for me.

albatross: Two things in your #218/#219 postings gave me the impression that you set up choices in a way that I felt was very wrong, and both were caused by smoking parallels: First that a theory that BMI isn't the be-all and end-all of health indicators (which is what we had been *talking* about -- no one was making a point that it would be healthy to lie on the couch all day and eat Belgian chocolates) is similar to a theory that smoking has never hurt anyone. And second the "disincentives work" (wrt. smoking) part What has that to do with fatness -- except if you *mean* to hint that there need to be more disincentives to being fat.
If that wasn't the impression you meant to create, I misunderstood.

heresiarch @254, that's it exactly, thank you. No wonder I couldn't find it, since I was searching for CDC stats.

albatross219: Eliminating all smoking areas in a public place, for example, seems far more about making it inconvenient to smoke than reducing that last very small exposure of anyone to third-hand smoke.

(emphasis added)

I guess "that last very small exposure" wasn't minimizing enough, you refer to "third-hand smoke." Sorry, it's still second-hand smoke, unless you mean smoke exhaled by someone who got it second hand. That's not what it's about, and you know it. Second-hand smoke is any (tobacco) smoke inhaled by a non-smoker.

If you meant something different, and weren't just trying to be dismissive of this problem, please say so, because right now I'm kind of mad at you for attempting this cheap trick.

About third-hand smoke

Summer Storms, #214, talk to your father's doctor. If he brings your father back into the hospital for three days, then he gets another batch of time in a skilled nursing home for a related illness. I don't know if your dad has the Medicare & You 2010 book, but this is explained on page 20. You can probably find it online, too.

Earl: still doesn't mean what albatross was talking about. To eliminate the threat of third-hand smoke you'd have to segregate smokers completely.

Hmm...

heresiarch #251: But very simply, I'm pretty sure that there hasn't been a substantial genetic shift over the past fifty years. There has been an increase in obesity. There is a degree to which obesity is not purely a product of genetics, and that degree isn't being reported in Kate Harding's view of fat.

There's a few other possibilities you've missed:

1) Environmental factors -- I'm thinking expecially of the problems with "artificial estrogens".

2) Viral involvement

3) Epigenetic effects from prior "feast" or "famine" generations such as Jenett alludes to. (Briefly: Cells have other places besides their DNA sequence in which to retain and pass on information, even between generations.)

Marilee @ 259: He was last hospitalized over three years ago. He doesn't have anything acute going on at present that would result in hospitalization, and he now has a Medicare Advantage plan. He also has no desire to be back in either the hospital or a convalescent facility (and I don't blame him). Also, his Social Security and pension are what is paying a sizable portion of the rent and bills around here at the moment because I have not gotten back to work yet. Things at the moment are as under control as they can be.

David Harmon @ 261: "There's a few other possibilities you've missed:"

Are you agreeing with me? Because my point wasn't that any of the explanations I suggested are The Truth, but that the genetic explanation is by itself insufficient. I'll entertain the possibility that there are any number of other factors involved, as long as they explain the rise in obesity in the US over the past two or three decades.

DD-B, #250: Your speculation is absolutely correct at least where hospitals are concerned; my ex worked at a hospital and was familiar with the reasons behind that policy, and it's not far-fetched to think that other hospitals would reason similarly. And I'm not allergic to cigarette smoke, but I sure as hell don't like running that gauntlet either.

caffeine, #252: Down in the comments on that article, I found a statement that BMI is calculated by dividing weight by the square of height. However, weight increases as the cube of height, other factors remaining the same. So taller people are going to have a higher BMI than shorter ones who have exactly the same physical proportions. That makes the BMI junk science from square one, if the initial assertion is true.

Lee @ 264: "So taller people are going to have a higher BMI than shorter ones who have exactly the same physical proportions."

Yes, but tall people do not have the same physical proportions as short people: A twenty-five percent increase in height does not usually translate into a twenty-five percent increase in shoulder width. Nor are very short people proportioned the same as taller people: they tend to be wider relative to their height. Thus the well-known preference for very tall models; it makes them appear proportionally slimmer.

heresiarch @ 251 and David Harmon @ 261

There is also a theory that the great increase in consumption of high fructose corn syrup over the last couple of decades may be a factor in increased obesity. Not just the extra calories, but there is something about how HFCS is metabolized that causes it to be harder for the body to burn, and easier to store as fat. I don't have any citations for this, sorry.

albatross: Should employers try to discourage smoking among their employees? Perhaps by offering a discount or bonus if they pass their mouth-swab tobacco residue test?

No. See above: My life, my choices, my time. They may prohibit me from smoking on the job/the property. That's it.

If a company does this, would it be wrong, and would it be somehow illegal?

Yes it would be wrong. As to illegal, that depends. The Supreme Court has held that blanket drug tests are not overly intrusive (mostly because Blackmun thinks it's not an inconvenience to be made to piss in a bottle).

If you were to ask me: it's a moral wrong to have an employer intrude into my personal life (very much a social liberarian). Having unprotected sex is risky. It increases the risk of increased health costs.

Does an employer have a right to intrude into that?

If not, why not? Where, why, and how, do you draw that line?

As to not seeing the outcry... I've been arguing this point for decades. I am not alone. That you haven't seen it is, perhaps, my (our) fault, but it's not been not happening, and it's not all my fault, because I've said it on ML, and I've said it in this very thread.

(catching up on some stuff I didn't reply to before due to lack of time)

albatross @ 218: "It makes me wary when I see some fringy medical theory which tells me and lots of other people basically what we want to hear. "

Substitute "popular" for "fringy" and you have precisely the reason why I'm so wary of the fat haters: as Mark said so elegantly @ 197: "If the issue is one strictly of individual choices and not of the constraints on choice placed on individuals by external factors, then they're excused from any obligation to advocate for changes in the socioeconomic conditions creating those constraints that would otherwise be imposed by their position of judgment."

Which is to say: that rule of yours isn't necessarily cutting the direction that you think it is.

@ 219: "There's a lot wrapped up in it that I don't know how to even begin approaching, but I think one of the big problems is that is that exercise culture is so dour. It's focused on suffering for a goal (like weight loss or big muscles) rather than having exercise as an end unto itself. There's very little fun to it and very little exploration of what one's body can do, very little permission to be slow and bad at something at first--it's very focused on fighting one's body to make it do something and doing it just right."

Yes, just so. There are two great thefts that have been perpetrated against us by modern society: the first is the theft of the joy of work, that doing something challenging and meaningful ought to be more thrilling than the most hedonistic of leisures; the second theft is that of the joy of motion, that being a physical being moving through a physical world can and ought to be a pleasure rather than a burden. Modern exercise culture manages to rub our noses in both thefts at once.

Oops--@ 219 is Renatus, not albatross.

--aaand, it's @ 221, not @ 219. Can you tell I'm tired? I'm quite tired, by the way.

Magenta at #266 Thanks for bringing up the "how does high fructose corn syrup metabolize" issue because it got me looking for a citation and brought me to this article which looks like the one I originally read:

http://www.grist.org/article/draft-new-research-links-high-fructose-corn-syrup-and-diabetes-heart-diseas

Sorry for being clueless about links but that should take people to the article at Grist - and it is extensively updated and corrected from the original article since the UC Davis scientist who did the study showed up in the comments. The study was about fructose versus glucose and not HFCS but the bottom line is that fructose and glucose can be metabolized differently and that the way our bodies handle fructose might increase signs leading to diabetes in ways that glucose doesn't. Fructose is in corn syrup, and juices, and we as a society eat too many sweets but the type of sugars we eat might matter more than we thought before. At least that is the bottom line I got. I'm going to have to read it again more carefully. I am by chance not a heavy consumer of HFCS but what does this mean for my maple syrup addiction? Is maple syrup better or worse than sugar in my hot cocoa? Oh how I wish I had a better science education. Must. Read. Slowly.

I also like the Grist article because it has strike thru corrections that show how the popular media got the story wrong and somehow that makes my head spin less. If you are trying to figure out the high fructose corn syrup argument, I recommend it.

Dunno why, but I grew up calling it "maple surple". In my opinion, it goes really well with peanut butter (it mixes much easier than grape jelly does).

Earl Cooley "maple surple" My mother used to quote a piece of doggerel that went, "Roses are red, violets are purple, sugar is sweet, and so is maple surple." I suspect an original source in a comic strip (Pogo?) or movie.

OtterB @273, my father used to say the same thing. I thought it was nonsense he'd made up, but a quick Google says an artist named Roger Miller used the phrase in a song. Neat.

#271 mea

High fructose corn syrup is made in factories with lots of chemical processing.
Maple syrup production tends to be "tap maple trees for sap, sap goes into "sugar shack" into container which get heated to evaporate the water out of the sap, until what's left is syrupy. Bottle the result." For maple sugar, continue the evaporation processing.

Archer-Daniels-Midland and conversion of starch into sugar, isn't involved. Farm supports aren't that I am aware of involved, other than tax benefits for farming.

Back in college, I did a thesis study on body image and eating disorders. One of my sisters got annoyed with me because "there's an obesity epidemic, and you're saying it's okay to be fat?" At the time, I didn't know how to answer her.

But now I do.

1. Our perception of fat in this culture is very badly skewed towards the thin end of the scale, which means we perceive thin as average and average as fat. This is a cultural problem.

2. There are many factors to eating disorders, of which weight is only a part. This is a psychological problem.

3. There are people who are unhealthily obese due to various factors. For some, it's a medical problem. For others, it's a lifestyle problem. This latter category is not nearly as big as the sensationalism would attest.

4. Many kids are, in fact, getting unhealthily fat and sedentary. This seems to be related to two things: improper eating habits and the growing fear of letting kids out of the parents' sight, with the latter having a much greater impact. This is a societal / cultural problem.

In other words, eating disorders are not even on the same continuum as weight problems. And talking about them isn't going to sabotage efforts to make our kids healthier— quite the contrary.

—

I found out several interesting things when doing my thesis. One is that there are distinct, trackable risk factors for eating disorders. There's the obvious ones, such as the family harping on weight, but there's some subtler ones, such as a daughter achieving academic excellence at a higher level than her mother, or in contrast to brothers in a family that does not value female intelligence to the level of male intelligence.

There's also the fact that simply viewing advertisements with models (especially photoshopped ones, these days) drops women's esteem in their own bodies (lovely double-blind studies, those.) In other words, women's magazines are horrible by their simple existence, not just because of the articles.

And as for the assertion that "women do it to women, men have nothing to do with it?" Well, that's true... but the connotations of "so it must be okay" are false. Many women are so invested in the idea, much more than men, because they're the ones who have suffered for it, and if it's false, their suffering has no meaning.

Women who promote the beauty industry have spent their lives eating dire foods, exercising beyond pain, poking and prying and doing makeup and buying torturous garments. They're invested. When people come along and say, "You know, that's really not necessary," they turn on them because the foundations of their lives are under attack. They've spent years doing these things, and if they didn't have to, that sacrifice is meaningless.

Hmmm. It may be time for another look at the queen in Snow White.

#276 B. Durbin
Women's magazines don't -have- to be evil.... I don't think that e.g. Women's World is, for example--but then its advertisers get included in articles by, "Canola Oil such as [brand name]" and it's not selling literally women have had their toes cut off or trimme to fit into stinking high pointy toe hells shoes (paid for by the those paying healthcare insurance premiums... and the pain medications, and the tendon surgery for when the women need surgery to continue to able to walk...)....

The advertisers determine the content, the public has the choice to buy or not buy the magazine, not control over content.... the same is true for TV. The content exists for the purpose of attracting and growing revenue for publishers of products which contain advertising and networks and TV stations, maximally, and to hell the with public interest and the well-being physically and financially of the public.

When was the last time anyone saw a woman on TV who wasn't thin, or even of average weight and body type? Christina Hendricks is considered "fat", while someone like Jessica Alba is considered 'normal', means society's perception of what a normal woman ought to look like. It's a constant bombardment from TV, printed media and film, directed at both men and women, and it can't help but shape everyone's perceptions of what is healthy and what isn't.

B Durbin, I know what you mean about just seeing extremely thin models. I haven't had a TV since I went to grad school-- no, since senior year of college, because that's when my roommate also didn't have a TV. I have gained some weight and know that my body is shaped a bit different for it. But instead of thinking I am fat (and therefore worthless) when I go home and watch TV, I am a little put off by all the tiny arms and waists on the women. My idea of 'normal' is based on the people I see most, and now, that's the people around me rather than the people on TV.

That's actually my only idea for making exercise more appealing: make it a Thing People Like Us Do. I still don't think people like me exercise. We don't go to gyms. We don't lift weights. That's for *other* people. This in spite of lots of evidence.
However, I also have the fairly healthy People Like Us Don't Diet.

Diatryma @ 279... We don't go to gyms. We don't lift weights. That's for *other* people.

You rang?
:-)

My goal in life is to look like Hugh Jackman. Unfortunately that requires, among other goals difficult to achieve, my getting younger. Taller too.

I'm much happier with companies, such as the one my father works for, that offer incentives for employees to do physical activity. Or the one my fiancé works for, which subsidizes his gym membership.

Individual BMI is not a good measure of someone's physical health. But increased physical activity will improve someone's health, even if they do not reduce their BMI much or at all. If you want to make your employees healthier, and reduce your insurance costs, offer them incentives to exercise.

We can usually control the inputs to our bodies -- the quality of our diets, the length and intensity of our physical exercise, the amount of sleep we get. But we don't have very good control over what our metabolisms do to our weights using these inputs. Metabolisms are complicated and pretty much black-box. These inputs have more predictable results on other things, like resting heart rate, blood pressure, cholesterol.

Weight is the measure we have the least control over. Of course it would be the measure everyone is most obsessed with controlling.

I'd be interested in seeing how BMI correlates with measures of strength, stamina, flexibility, cardiovascular health. I've found studies concluding that physical fitness measures are correlated with reduced occurrence of cardiovascular disease, while BMI is not, but haven't found any direct discussion of how well BMI is correlated with physical fitness measures.

Serge #280: My goal in life is to look like Hugh Jackman. Unfortunately that requires, among other goals difficult to achieve, my getting younger. Taller too.

Second Life will eventually get you to the point where you can cast aside the crude flesh of meatspace and accept luminance. I figure it'll take perhaps another decade or so for the tech to improve to that point.

Earl Cooley III @ 282... The problem is that ladies seem to prefer the aforementionned crude flesh of meatspace.

John L @ #278: Kirsten Vangsness, one of many reasons I love "Criminal Minds".

#278 I also submit Miracle Laurie, of the late and moderately-lamented Dollhouse. She's smoking hot in an entirely plausible way.

Renatus @ 221

one of the big problems is that is that exercise culture is so dour. It's focused on suffering for a goal (like weight loss or big muscles) rather than having exercise as an end unto itself. There's very little fun to it and very little exploration of what one's body can do, very little permission to be slow and bad at something at first--it's very focused on fighting one's body to make it do something and doing it just right.

Interesting. In my visits to running websites, I've found lots of articles and forum threads on beginning running, on the fact that running should be fun, that you should enjoy it, that it's perfectly okay to start by walking, then walk-run; that it doesn't matter where you come in a race, if you decide to do one, etc. Lots of larger people and older people who have started running. Yes, some of the larger people wanting to lose weight (but, you know, wanting to lose weight because you think you'll be healthier and feel better if you do isn't a crime), but with a focus on enjoying running (and becoming fitter). Of course, there's also a lot on how to get faster and stuff but that's not -all- there is there.

B. Durbin @ 276. Like Diatryma, I've not had a TV for ages. I've never followed fashion or the glitterati (I just Googled to find out who the women mentioned by John L. @ 278 were and what they look like). I've never bought into the size zero culture. I'm genuinly happy with me as me. I forget how much pressure there is to be stick thin. That when many people say "fat" they mean anyone over a UK size 10 (US 6, I think?) - even if they're five foot ten. At the same time, I do think, medically speaking, there are more people carrying more weight than is really healthy for them. But the two (social "fat" versus medical "harmfully overweight") get confused - which isn't helpful. And setting the "ideal" at an impossibly (and unhealthily) low level is (IMO) counterproductive.

dcb @ 221... exercise culture is so dour

Based on my own experience, people have been known to smile at the gym, even when it's 5am.

Jeremy @ 285 -

Miracle Laurie is gorgeous. Her character was meant to be the "... well of course some people hiring dolls want a Fat Woman", as if she would appeal to the fat fetishist. Having seen her at an event or two, I can say she is probably between a size 4/6 misses, which is to say, quite realistically pretty thin. In TV terms, non-visible skeleton + frumpy wardrobe = grossly obese.

Joss Whedon had mentioned how he had not initially thought that Tara (in BtVS) would be "large", but after seeing Amber Benson, decided it would be interesting to see how a "large" woman might behave. Amber Benson is also probably a 4/6.

Many actresses have wardrobe so small it cannot be put on a "child" mannequin.

Caroline @281 -- I think it's because we have so little control over weight that attempting to control it is a major commercial industry. If it's difficult to get results, somebody must know how, and we should pay them lots of money to tell us how.

Even if they're actually as clueless as we are.

B. Durbin @ #276, "perceive thin as average and average as fat"

'Tis true of American politics, too. "Center-right" is average; "center-left" is skinny.

IIRC, Jewel Staite had to gain weight for the role of Kaylee in Firefly; Joss Whedon wanted the character to be attractive in a girl-next-door kind of way.

My former employer offered an employee incentive of up to $100 a year towards a gym membership, exercise program, or other "activity that makes you sweat". I probably should have at least tried to get them to apply that towards cycling equipment.

Summer Storms, #262, okay, I knew you needed him there now, but it sounded like he needed care in a skilled facility. I have a Medicare Advantage Plan, too, plus private disability paid for by the company for which I was working when I got too sick to work.

caffeine, #274, an artist named Roger Miller Urk.

#278 John L
Oprah, Star Jones, and Roseanne Barr.
But generally, I agree with you. I'd have to have surgery along with a starvation diet to get anywhere close to TV personality height/width ratio.

#288 nerdycellist
Some female European models died from essential starving themselves to death, in the past two or three years.... there were some, er, cosmetic changes made regarding fashion shows and such--but no real underlying attitude changes made.

I keep wondering when the next Karen Carpenter-type entertainment industry tragegy hits....

Fortunately none of us have fallen into this trap.

B. Durbin at 276; I love what you say here. I am constantly surprised and angered at what our culture has decided to call "fat." Because I am a human being, not a tailor's dummy, I don't actually fit into any "size" -- I can wear size 6 or 8 jeans, but I wear medium or large, size 10 or 12 tops, depending on the cut.

I know grown women who honestly believe they are "fat" when they need to buy a size 8 pair of pants: this strikes me as completely nuts.

I am curious: in your examination of the current American obsession with inordinate and unrealistic thinness, did you follow the money? i.e. did you look at all the ways that profit is made from this obsession? There are so many different avenues in which individuals and corporations make money off of distorted body images: clothes, food, cosmetics, beauty salons, the "diet" industry, books, therapies, gyms, magazines (as you said), medical procedures, drugs (legal and illegal) -- I could go on.

JohnL @278, Callie on Grey's Anatomy is large, as is Bailey. And besides, TV always gets the aspect ratios wrong; none of those thin people really look like that in real life.

Serge @287, yes, there probably are smiling people at the gym at 5am, but they are Morning People, not normal humans beings. Many of them were grown from pods.

296
The other thing is that ready-to-wear sizes are smaller than the same dimension of clothing in sew-your-own - I wear 8/10 in RTW, and it's more like 14 in patterns. That's part of this same thing - if you're wearing a smaller size, you must be skinnier, yes? (Psychological tricks. It doesn't change your physical size at all.)

Bill @ 297... they are Morning People, not normal humans beings. Many of them were grown from pods.

Sean Bean, for example?

I'm a computer programmer and, in my line of work, it's quite useful not to be normal. When your cell phone goes off at 2am because the system failed, you have to be able to think on your feet, especially if the problem was caused by someone who wrote code with his feet.

Who was the actress in Boston Legal (I remember her from "The Road to Wellness). Large, and hot as blazes.

Terry, 300: Camryn Manheim. I think she was in that TV-movie loosely based on a Connie Willis story, too. (Good story, good actress, lousy movie.)

Marilee, #292: no, he doesn't need care in a skilled home (now/yet). The reason he was released into one from the hospital after the pneumonia was because he needed rehab. Once that was complete and the benefit ran out, he was still not capable of living alone and caring for himself. He lived in Cincinnati at the time, and I lived nearly four hours away in Cleveland which meant I was not available on a daily basis to help him. Hence the choice to put him in assisted living, but we wanted to have him in one that wasn't in Cincinnati where we have no other family. D and I didn't have space for him in our (2nd floor of a triplex) apartment at that time this all started, either; however, you already know what a hassle we had with trying to get Dad transferred from Cincy to an assisted living facility in our hometown, and while I was going round in circles on that, the apartment below ours became available, so we gave up and moved him in there. We have since moved all three of us into a 3-bedroom apartment on the first floor of a different triplex to save money.

Eventually, he will need to go back into either assisted living or a skilled care facility catering to Alzheimer's patients, but by that point I hope for D and I to be earning enough money to manage this place without Dad's income, since we don't really fancy moving again until we actually leave Cleveland.

Lizzy L. @ 296: Oh yeah. I basically had my thesis as a website (in 1999, on Geocities, so I've archived it now) and there was a whole section on why the money is so important. Frame it as a need and it gets higher priority than a want. If you "need" to be thinner and more made up, you'll spend more money on it.

Diatryma: I suggest that if you do watch television, watch the Food Network. They have real-sized people, Giada deLaurentis aside.

P.S. FWIW, my normal jeans size is 12, and my hips poke out. If I lost weight I might be able to fit into a size 10. No smaller; my skeleton won't shrink on me. But hey! They say thigh fat is healthy now!

TexAnne @ 301... Mannheim as Snow-White was the best thing in 2000's miniseries The 10th Kingdom, especially when she talks about her own birth having killed her mother, and blood spilled on the snow.

Lizzie L #296: One size fits none. Going by my measurements, I need (German) size 48. Or 52. Or 42. Which is why I do not order from catalogues.

Serge #299: I'm a computer programmer and, in my line of work, it's quite useful not to be normal.

Tell that to my boss who wants me in at 10am *g*. I am more awake at 2am than at 10 as my "normal" day-and-night rhythm fits a place about six time zones west of where I life.

Serge @ 287 Hey, I like running (and I really enjoyed judo and archery while I was at university) - it was Renatus I was quoting who thinks exercise culture is dour. In the picture my husband took of me just after I finished my first half-marathon in October, I'm grinning widely (and not looking too red in the face, either).

Yes, there are days I don't want to get out of bed and turn on the treadmill while it's still dark outside, but there are more days when I come back from a run in the park feeling relaxed, happy and full of energy: which is how I ended up tweaking a tendon over the winter holiday period once the pavements/sidewalks were no longer skating rinks - running outside was feeling so good, and I was bursting with life and energy - and I bumped up the mileage by more than 50% in one week: bad idea!

dcb @ 306... Oops. I was sure I had quoted renatus, whose remark I noticed when you referred to it. Am I red-faced. Not that difficult to do at the gym. I remember once being done with some situps and someone asked me if I was ok. I was. I used to get red when I'd find myself with my head closer to the ground than my hips are.

inge @ 305... In my case, the timezone difference is quite litteral. I live in the Mountain timezone while most of the group I work with are in the West Coast timezone. Oh, and our computer center is in the Central timezone.

I'm not sure I'm more a day person than a night person, but at least I can function 'round the clock, provided I've had some sleep at some time. Some times, said sleep has me sitting upright on the couch.

Serge: no problem.

P J Evans @ 298: when I was looking for a wedding dress I tried on my usual size and it fell off me. The next size down, I still had to have taken in. Friends explained this was normal - they make them large so everyone can go down a dress size for their wedding. My reaction was Huh? You're not leaving the size lable hanging out, so who are you fooling? What's the point?

Apparently, people now tend to have a larger waist relative to hips than they used to. A survey in the UK a few years ago found that, over the last 50 years, average waist measurement for a woman went up 6.5 inches from 27.5in to 34in, the hips were 1.5in wider at 39in and the bust increased by 1.5in to 38.5in. Women were also 1.5in taller at an average of 5ft 4.5in, and there was a similar pattern in men. In response to this, my favorite outdoor clothing store has (unfortunately for me) changed its way of sizing clothes - so now if I buy something with the correct size hips, the waist is way too large for me: I still have a waist 10 inches smaller than my hips, which puts me far away from what is now the norm.

There's a really good paper on this available online: http://www.ajcn.org/cgi/reprint/85/2/419.pdf) - if you just look at Table 7, and the text in the first paragraph of the discussion, as well as the paragraph in the left hand column just above where the discussion starts in the right hand column, you'll see that they've also found that women in the USA and heavier, and larger on the waist and hips, than women in the UK despite being shorter on average. However, a recent CDC study found that the rate of rise in bodyweight in the USA is now levelling out (I can give you the cite if you want it).

Xopher #257:

I meant "third hand smoke." My guess is that most of the exposure to cigarette smoke eliminated by, for example, eliminating dedicated smoking lounges in public places, is the smell of smoke coming off the smokers' clothing, which I think would be classified that way. I may be misusing the term slightly, but there's a pretty big difference between the exposure you get being in a room full of people smoking, and the exposure you get being in a room full of people who have been smoking somewhere else.

309
It's not so much the change in shapes, as that retail clothing sizes have been reset so that the nubmers no longer match the old sizes - I remember that they used to be closer to the sizes on patterns, and that there was a general resizing/standardizing of pattern sizes back in the 60s, when they all still more-or-less matched.

(Check the dimensions given on ready-to-wear in catalogs and those given on patterns.)

albatross, 310: Speaking as an asthmatic, no, there's no difference. Well, okay, technically there's a difference between two days of misery and only one. But the fact remains that stealth smoke causes me to have asthma attacks. On the other hand, if I'm warned in time to use my inhaler, I can usually get by. (Also, if I'm warned, I can decide whether the company is worth the lack of oxygen to my brain--and so far there's only one person I can say is worth it.)

TexAnne, #312: The people I know who are allergic to tobacco smoke say there's no difference either. Outgassing smoke residue is every bit as bad as fresh smoke WRT allergens.

Michelle Obama declares war on childhood obesity, puts daughters on a diet

dcb: Great. Another reason I'll never be able to find jeans that fit. I basically have three sizing oddities: 1) My waist is a full size down from my hips; 2) My rise* is petite; and 3) My legs are "tall." Every time I see one of those magazine articles where they show "how to find your perfect jeans," I want to take part and really mess with their minds.

*"Low-rise" pants are actually low-waist, as they're designed to fit around a woman's hips. Paper bag is one way to describe what happens on me.

As for wedding dresses, I went to a bridal warehouse instead of a salon. That means instead of ordering a dress in "your" size, you buy off the rack. The really nice part was that they racked the dresses according to their actual size rather than their stated size, which means I tried on everything from size 6 to size 12 and they fit exactly the same.

Nancy @314:
...puts daughters on a diet

AAAAARGH!

Reading the article, I see that she changed their diet, but why would headline writers make that distinction when they can imply that they're starting yo-yo dieting now?

Head. Desk. Head. Desk.

P J Evans @ 311: I wasn't disagreeing with you - I know zilch about pattern sizes. My anecdote about my wedding dress was just giving an example of the phenomenon you mentioned: "That's part of this same thing - if you're wearing a smaller size, you must be skinnier, yes? (Psychological tricks. It doesn't change your physical size at all.)".

The rest of my post was only tangentally related, but your post made me go look up the survey I vaguely remembered, so I was just noting that recent large-scale surveys do show an overall (population level) increase in weight and measurements (including height, but with a disproportionate increase in waist measurement) and that the weight and girth increases are greater (so far) in the USA than in the UK. Back upthread I'm sure someone asked for proof that there was a trend of people getting fatter. These surveys show this, including people in the USA being heavier than those in the UK despite being (to my surprise) shorter, on average, so it's not just due to increasing height.

B. Durbin: Sympathies with the fitting problem. I loath low-rise/low-waist trousers. I want the waistband to reach my waist! I'm just really glad I managed to buy some jeans back before the present several-year-long fashion for "low waist" trousers came in, and have enough of those and other trousers to wait until the fashion goes away again. I got my wedding dress from the own-brand "eveningwear" section of a department store - none of the bridal stores had anything nearly as plain as I wanted.

abi @ 316: yes. Sounds like she's actually encouraging them to change to healthier eating choices - rather different from the implication of the headline. I suppose "Michelle Obama encourages healthy eating, starting with her own family" would get less attention?

dcb #309: Apparently, people now tend to have a larger waist relative to hips than they used to.

Were those measures taken naked or with underwear on? 50's underwear had these corset-like things...

That said, if I want to improve my hip/waist ratio I *should* sit on the couch all day and eat chocolates.

abi: AAAARGH seconded.

317
Apologies for misunderstanding you.

There are patterns I buy because I like the dress, not because I ever expect to fit into it. (Some things are not achievable, like being skinny again. But these patterns - Vogue 1079 and 2237 - make me feel like I am. Slinky, slinky, slinky!)

inge @ 318... I *should* sit on the couch all day and eat chocolates

Is that what's called a waisted effort?

A couple of years ago Lane Bryant overhauled their jeans and offered three distinct shapes symbolized by colors. This was great in theory; in practice, some brain genius decided to change sizing info. While I appreciated being able to choose between hip/waist and rise options, I couldn't just go in and try on a size 20 red, I had to be measured (poorly, since the saleslady was sure I was a "yellow" - no hip/waist difference, and those created a massive butt-gap) and then given some other arbitrarily numbered pants. I believe I wound up as a 3 red.

The nice saleslady asked (rhetorically, I'm sure) "isn't it great to be a size 3 instead of a size 20?" I answered, "Oh my, it certainly is! Now that I'm not fat anymore I can purchase my jeans anywhere in the mall! I'm not just stuck with Lane Bryant!"

I think they may have gone back to traditional sizing. FWIW, I am too old to care what arbitrary number or designation is on the tag of my clothes. They are welcome to call my size "SuperElephant Fat-Ass!!!" so long as the clothing fits my body. The high synthetic fiber content of the LB jeans, which made them sag sloppily within about 6 minutes of wear, combined with the fact that only "flare" and "bootcut" were available in my color pretty much meant I didn't buy any.

Formal wear - a few years ago I ordered a formal gown off the internet (I didn't want to be in one of the 4 dresses available off the rack for fat ladies) and was warned about sizing. "It may be different for formal wear! You may have to go a size up!" I scrupulously checked the sizing chart, determined I was exactly a 22 by the manufacturer's standards, and wound up having to spend more than the dress on the alterations to take it in pretty much a full size. I hardly buy without trying on anymore.

inge @ 318: Sorry, no info. provided in the source I've read on the stage of undress at the time the measurements were made back in 1951, but I would doubt they would have been made while the women were actually wearing corsets - although habitual wearing of same may have affected measurements?

PJ Evans @ 319: No problem, glad we're able to communicate.

Low fat isn't necessarily healthier, does it make sense to think that those girls are so heavy that they need to adjust what they're eating, and what do you think Michelle will do if they don't fit where they're supposed to be on the charts?

dcb@225, thank you for providing a cite. I've gotten a bit out of my depth here, so I'm going to conceed your point.

Focusing on e.g. finding a form of exercise they enjoy and can/will do regularly, healthy eating and so on (including accepting that yes, they are the shape they are and that doesn't make them a Bad Person (TM)) seems to be more effective.

Yes, this. This is the main thrust of what I've been writing about (although perhaps not as concisely as I could have).

dcb@286:

The culture I'm talking about is the sum of influences from books, tv, magazines, websites, popular beliefs, and common experiences, all over a period of time--say, a few decades. This includes things such as how we were treated in gym class as children, which got a bit of discussion above.

Phrases like No Pain, No Gain, Pain is Weakness Leaving the Body, and Feel the Burn are sayings I've encountered frequently (the former and the latter especially when I was a child) and don't exactly say 'fun'. For all they're meant to be inspirational sayings (at least in the contexts I've found them in), the message is one of suffering for gain.

This is especially so where diet culture intersects exercise culture--which, when you're fat, is very very often. When I was a child and teen, exercise was something a fat person Should Do to not be fat--and we're talking running laps and aerobics. I frequently read or saw on tv that it was aerobic exercise that had to be done, because activities like swimming or strength training weren't acceptable because they didn't meet the all-important target heart rate for fat burning. I got a very strong impression that if one is fat, one should be working when they exercise, not having fun. Fun is for people who are not fat.

I think it's awesome that the sites you encountered were so encouraging for people of all types. I wish such encouragement were and had been more common.

Please keep in mind that I don't think of any of what I've written as excuses not to exercise, but as not uncommon obstacles to exercising. Even people who exercise with a grim determination to not be fat/be a good fattie might be happier if they know, really know, that it's okay to do something they like rather than something they Should do. Or so was my personal experience; YMMV.

abi@316: This is a headline in the Daily Mail. Any resemblance to medical fact is purely coincidental. (Readers of Ben Goldacre's "Bad Science" column will undoubtedly recall his comments about their "ongoing ontological project of dividing all the world’s inanimate objects into those that cause or cure cancer".)

Nancy: The article just said the girls were made to eat fewer burgers, drink low-fat milk (I assume rather than whole, or rather than sugary soft-drinks), and eat fruit and drink water rather than soft drinks. That all seems pretty healthy to me. 2% or 1% milk is better for nearly everyone (except children younger than Sasha) than whole. Milk is more nutritious than soda pop, and burgers aren't really all that healthy a meal. To me it sounds like Michelle merely made her daughters' diet healthier than it was, which is a good idea to tackle in childhood and the pre-teen years. After all, if you grow up accustomed to burgers, fries, soft drinks, sugary snacks and highly processed foods rather than healthier fare, once you hit puberty and then adulthood and your metabolism suddenly stops burning up every calorie you eat, you can have a real problem adjusting to the healthy foods that you probably should have been eating all along.

On the topic of jeans sizing, rise, low-waist and whatnot: I would dearly love to reliably find jeans that fit, too. I'm only 5' 2 1/2" but my legs are of average (not petite) length and I'm short-waisted. Jeans sold as low-rise, meant to come to the hip, often *do* come to my waist. Jeans sold to reach the waist often come to within an inch or two below my bra, if not right up to it. Don't even get me started on the 80's craze for high-waisted jeans that some say is making a comeback.

I may have to simply learn to make my own jeans. Oh yay, something else to spend time on.

abi @ 316: "Reading the article, I see that she changed their diet, but why would headline writers make that distinction when they can imply that they're starting yo-yo dieting now?"

There seems to be some law that headlines MUST reinforce whatever the common wisdom is, even when the article is in direct contradiction to it. Also, the change in the meaning of "diet" from "the type and amount of food regularly consumed" to "a short-term reduction of caloric consumption in order to effect a long-term change in weight" is one of the more pernicious word shifts in the English language.

Singing belly buttons, a strange alternate Denimworld reality.

Renatus @ 324. Re. the cites - that's what I do (research stuff). And I'm really pleased we're managing to communicate.

As for "Please keep in mind that I don't think of any of what I've written as excuses not to exercise, but as not uncommon obstacles to exercising." well, again, we're in violent agreement there. I think it's a shame that children, in particular, have less freedom to just go out and play/be active in whatever way they like than they used to. And most school stuff is useless if you're unpopular and have bad hand/eye coordination, because nobody wants you for their team, and you know it. Fun-with-exercise should be for everyone.

Regarding "target heart rate for fat burning" - forget it, not important. I can (if you are interested) point you towards various websites that explain (as you probably know) that that really doesn't matter, it's the total energy output that counts, for weight loss. And if your aim is primarily to get fitter, I'd totally ignore anything about calories used, and just concentrate on exercising, in whatever way suits you, increasing the amount gradually so it doesn't hurt (a bit of muscle ache maybe, but not more than that).

"Even people who exercise with a grim determination to not be fat/be a good fattie might be happier if they know, really know, that it's okay to do something they like rather than something they Should do." Violent agreement, again.

AND, one doesn't have to choose the single "best" thing to do. Much better to find something that's reasonably effective that you'll keep doing. For example, several studies have indicated that the "best" way for older people to stay both mentally and physically active is to go dancing. But (not that I need to worry about it yet) that's not something I enjoy. So, I'd rather find a physical activity I do enjoy and a mental activity I enjoy, and do those instead.

While I've got no problem exhorting the use of wholesome foods, I really dislike the way women's bodies are offered up for public scrutiny. Mrs. Obama's use of her own daughters' bodies as examples seems pretty gross to me.

Renatus: addendum. This has been a really useful discussion for me. I'm "naturally" quite slim, although I discovered, when I dislocated my shoulder, how easy it was to put weight on if you vastly reduced your daily activity level and continued eating what you'd been eating before - and how much more difficult it was to get rid of the extra weight again. For me, it's always been a fairly simple thing, an understanding that being overweight was, in general terms, less healthy and made it less easy to be active, so I didn't want to get that way (and I do have in-family examples of high weight/low fitness to compare myself with).

This discussion, and the websites suggested up-thread, have helped me remember how complex the issues are, how society's obsession with "size zero" culture fuels unhealthy yo-yo dieting and puts a real (psychological, but no less real for that) obstacle in the way of people of all sizes being both physically and mentally healthier.

Nerdycellist, #330: Would you feel any differently if the First Family had sons rather than daughters, but everything else in this story were otherwise the same?

Serge@287: Based on my own experience, people have been known to smile at the gym, even when it's 5am.

There are three really obvious possible explanations, and no doubt many others as well:

• Bizarre facial grimaces could result from the torment they're undergoing, which looked briefly like smiles
• At that time of day, they may not have been functionally in control of their own bodies, and random expressions could result
• Can we really rely on your impressions of things happening at such extreme times?

For myself, as I've gotten older, I find myself in bed asleep by 5 nearly all the time.

Shorter David Dyer-Bennet @333:

It's just gas.

David Dyer-Bennet @ 333... I certianly hope that those smiles were not bizarre facial grimaces that could result from the torment they were undergoing, especially as some of those smiles began only when I came within visual range.

Summer Storms @ #332 -

It would probably be nearly as icky - they are minor children after all - but not as problematic. I'm sure I'll live to the day when we as a society are as concern-troll upset about "husky" boys as chubby girls (and that's sad) but as of right now, there are no diet commercials on showing "after" shots of men in speedos.

Nerdycellist, I'm as squicked as anyone over the unrealistic expectations for women's bodies today. On the other hand, I don't feel that the Obama girls were misused in this incident. I don't see anything of "concern trolling" involved, either. What I do see is a First Lady attempting to set a good example for other parents. In order to do that, her children do have to be mentioned. If the Obama family dynamic is anything like what it has been made out to be (by the President himself, no less, and by the First Lady), my guess is that the children were consulted regarding their willingness to serve as examples before the story was ever told to the public. The Obamas do appear to have a great deal of love and respect for their daughters.

So I'm really not too worried.

as of right now, there are no diet commercials on showing "after" shots of men in speedos.

We're watching different cable channels, methinks. I've seen them. Watch Logo for a while. If you watch late at night you can even see commercials for "Guys Gone Wild."

I agree, I'm probably not watching as much Logo as I could, but the chicks in bikinis meme is pretty much everywhere else. I did see an alternately hilarious and depressing ad in ESPN awhile back, advertising shapewear for men. Hilarious because it had typical "As Seen On TV!" production values, depressing because as much as I'm sick of the disparity between how we treat women's bodies vs. men's, I feel the wrong answer is "OK, now we start treating men's bodies as if they are indicators of moral character too." (see also, the hash that was made of Clive Owen in a recent men's cosmetics campaign - they airbrushed all his cragginess!)

I don't doubt the Obamas care for their kids health and I appreciated her mentioning that she noticed "something was off-balance", but I still object to "I noticed them getting chubby" (so unusual around puberty!)and don't think it would be an issue if the kids were boys.

See, where we differ is that I think they'd have noticed it if the kids were boys, too. And probably would have done the same thing.

Or, at the very least, I'm not going to make the assumption, absent evidence, that they would not.

Oh, I think they'd have noticed. I don't know that they would have talked about the huskiness of their boys to the press. I'll give Michelle the benefit of the doubt if people stop acting like having a chubby Surgeon General is a crime. Because C.E. Koop was so svelte.

#310 albatross

Some some smokers breathe OUT smoke, even if they haven't been smoking for the past half an hour or more. The miasma sticks around inside their lungs and had all sorts of disgusting substances accreted apparently.

Just published in Nature: Rare genetic deletion linked to morbid obesity.

I eat yogurt by the bucket, but sometimes I'll scarf up a whole bag of faux-guacamole chips. And keep me away from cheese.

Summer Storms: I have found the quickest way to describe a petite rise is to say, "Those normal-height jeans? They're highwater jeans on me." Or a quick demonstration— I get Eddie Bauer loose-fit jeans and wear them riding a bit lower than they're intended. If someone asks why I hate jeans shopping, I simply pull up the waist until it hits my ribcage and say, "This is why."

I have gotten a bit better luck when buying shorts, because normal shorts length is a bit too short for my long legs. I've bought petite capris and they fit on me like cargo shorts. :D

Way upthread, someone posted a link to MetLife's chart to calculate your "frame" using your elbow measurement. Much to my surprise, I have a large frame. (The surprise is because I have narrow bones; my wrist is only about eight inches around.) Which puts me right in the healthy category for my size according to their charts, while BMI says I'm overweight. Well then.

Didn't someone say they would love an adult-size playground? Well apparently someone has thought of providing them for pensioners - see http://www.goodgiftsshop.org/ - Gigantic Good Gifts
The Pensioner's Playground is right in the top row, and they talk some more about it as a place for people to meet etc.

B Durbin @ 345... my wrist is only about eight inches around

Only?
Mine is 7 inches.

B.Durbin, #345: I can't stand to wear jeans riding lower than intended, because then the crotch is lower than intended too, and it doesn't feel right. Also, it makes the legs too long. Besides, there's this slight problem with my having largish hips and thighs...

As for frame size, I measured my wrist and it puts me in the "small frame" category (where I've pretty much always assumed I am). I tried measuring my elbow, though I'm not completely sure I understood the instructions (a picture would be nice) but if I did it right, then it puts me right on the cusp between small- and medium-framed.

My wrist measurement, btw, is only 5.75" and I'm just barely 5' 2.5" in bare feet.

Summer Storms @ 349... ...while I'm 6 feet tall. That's another reason I'll never achieve my goal of looking like Hugh Jackman: there's no room for me to fit the darn claws in.

Wrists: 5.5 inches, height 5ft 2 inches and small frame, yes.

Pendrift @ 343. Note how low a percentage of obese people they say this genetic problem is found in.

dcb@329: And I'm really pleased we're managing to communicate.

I'm stubborn and curmudgeonly, but I try not to be totally unreasonable. *g*

Thank you for the info and advice. I appreciate the reinforcement of what I've been stumbling toward re: exercise, that it's getting it regularly that's important, not the specific kinds or rigid schedules, and that it's okay to take it easier than I did when I was in my teens/early 20s, when I had a lot less damage and wear and could ignore that I'm also a bit of a cripple.

I've made a lot of progress on that in the past year (coinciding with me finally, finally getting treatment for my bipolar diorder), and that's helped a lot in me recovering from a few years of severe stress, injury, illness, and poor mental health.

AND, one doesn't have to choose the single "best" thing to do.

This is very true. I get bored and antsy if I have to do the same thing all of the time so I've found it's really important for me to mix things up. It's been hard to allow myself permission to not worry if I don't do any given activity as often as I'm 'supposed' to, as long as I'm doing something regularly.

I've recovered enough that anymore my biggest obstacles toward being active are SAD (I didn't think I had it until I moved to Southern Finland... oops) and my faulty brain chemistry.

This has been a really useful discussion for me.

I'm glad I could contribute to that. It's been useful for me, too.

dcb @351: Yes I did. I also checked the abstract on the Nature website. 0.7% of morbid obesity cases is tiny.

CSEdwards @133 (Ah, those good ol' days) - Howdy neighbor!

Thank you for clarifying that you're not denigrating my choices/circumstances because otherwise I probable would have thought you were. As it is, those X amount of blocks (I'd quibble with you over the exact number; the corner of Canyon and 28th is 2 blocks from the corner of Pearl and 30th but both groceries are in the middle of the fairly deep retail parking lot clusters which abut those corners, but so not the point, sorry, the point being that those X amount of blocks) do make a big difference to me when contemplating walking home with a very big grocery bag in either hand, believe it or not. Maybe I'm not in as good shape as I thought I was? And the biking logistics are much simpler for getting to WF than to Sunflower, because I'm already on the 30th Street corridor where there's a lovely bike lane and a straightforward parking lot and lots of bike parking. With Sunflower, there's a lot of sharing lanes with cars especially around some squiggly curves that they always take too fast and scare the bejeezus out of me at that corner by the Marriot and the McGuckins where the Bennigans used to be because no one's clear on who gets right of way when there, and there's limited bike parking, and REST OF SOB STORY REDACTED

Point being: Trust me when I say the difference is non-trivial, K? I'm glad it would make little difference to you, though. Good for you.

Also, having made good on my intention last week, I still had to make a trip to WF for some things that Sunflower simply doesn't carry, and at Sunflower I frankly almost went back to WF after seeing the grossly dripping packages of not quite the meat I wanted but had to settle for at Sunflower -- apparently they would prefer to deal with less people face-to-face at that tiny meat counter, so they package things up and set them on the fridge shelf instead. Where they get a lot drippier and grosser than what WF prepackages and shelves, not sure why. Also, I bought my fruitcake supplies this winter at Sunflower and discovered that the candied papaya they carry is hella bitter, probably because it uses inferior coloration additives. Yuck.

What I'm saying is, faced with higher quality at WF and an easier walk/bike commute to WF, I am very likely to fail at boycotting WF. And boycotting WF would mean I wouldn't get to interact with WF staff, who are tops and friendly and lovely people.

So when I say I'm torn, it's not just whining. Seriously. I'm torn here. I don't want to support Mackey's abuses with my money, but I really love my neighborhood WF for reasons which I think are valid. So. Seriously torn here.

I do congratulate you on your impending move. It sounds from what you said that you'll be happier. But seriously: slums of Boulder County? Really? ...I guess my slum-recognition calibration is set a bit differently from yours? Should we compare slums in Lafayette CO with projects in New Orleans LA?

And I damn straight wish Royal Crest would deliver to me. They don't do apartment units. Suxxors. I was happy to see Sunflower carry them under their supermarket branding, if I remember correctly. (Haven't checked out Door2DoorOrganics; I've been doing farm shares with Abbondanza, so that's taken care of. Don't they have a pick-up at the Thomas Open Space?)

"B Durbin @ 345... my wrist is only about eight inches around
Only?
Mine is 7 inches."

Oop. I meant six inches. Or thereabouts, maybe a bit smaller. (Women's watches are invariably too loose, so whatever that means in terms of length.) The reason this is weird is because I have a nine-inch handspan AND I can fit my hand into an eight-inch diameter pipe (collapsable hand, family trait.) So I've got these giant hands on tiny wrists, and I can grab things from garbage disposals. Please keep them off.

And on topics that are much less dated:

albatross: My guess is that most of the exposure to cigarette smoke eliminated by, for example, eliminating dedicated smoking lounges in public places, is the smell of smoke coming off the smokers' clothing, which I think would be classified that way.

But you were originally talking about how terrible the "X feet from door" rule is, and how it could only possibly be put in place to inconvenience smokers, before the argument about "third-hand smoke" broke out.

My answer is NO NO NO NO NO.

There are cafes I cannot go to because the smokers go on break right outside the door or only about 5 feet down (I do not know whether there is a ban that isn't being enforcing, or in fact no ban at all, but for my experience it doesn't matter) and every time the door opens to admit another customer the entire dining area, customers and non-smoking employees alike, gets a lungful of second-hand smoke. And the places where the doors are propped open on sunny days while the smokers smoke close to the door, they're even worse.

That's above and beyond the "running the gauntlet" problem, which is bad enough.

I imagine that sometimes public smoking lounges are too close to bathrooms everyone must go to, or too close to the working spaces such that second-hand smoke goes wandering whenever it's let out. And some places even have a non-smoking lounge which you have to go through the main (smoking) hall to get to, which is dumb. With doors that don't close. (Bingo parlors of Colorado, where Sweet Adelines members, singers for cripes's sake, sometimes work monthly shifts to help pay for the chorus, I am looking at you.

--

As for fat shaming and media having to push the popular message:

Not long ago I was up watching the 10 o'clock news. (The Saints had just beat the Cardinals and I was looking for the Channel 4 sportscaster to gush about it. But this did not happen, sigh.) AND ON THE NEWS there was a story...

...about a young woman (late teens? early 20s?) who was by any objective measure shockingly obese (to the tune of 400, 500 pounds, I forget the exact number). She had begun shutting herself in her room, not going to class, because the embarrassment just grew and grew. Eventually she wouldn't even stand up, because it shamed her not to be able to see her feet.

Finally she braved the shaming she expected her doctor to give her, and went to the doctor. And the doctors found that she had a tumor in her abdomen roughly the size of an elephant. Which was, incidentally, why no matter how much she ate she was malnourished; the tumor was getting all her the nutrition, not her.

And I thought, Awesome! A story emphasizing that you just can't make safe assumptions correlating someone's size and sin indices, nor yet even your own. Finally!

But what did the news spot close with? That's right. A quote from the young woman that she would "urge everyone to eat right and exercise often."

LIKE, MISSING THE POINT MUCH, DENVER CHANNEL 4 NEWS???

I can only see one possible reason to include that soundbyte, which I suspect they manufactured via leading questions: They felt for some reason that they had to bring the story safely back to the popular message that "It still might be brought upon you by your sins, so sin less!"

Urgh.

abi @186: Members of the community ... are supposed to carry their own water, pursue their own relationships, own their own words, and make their own apologies.

What a splendidly succinct recipe for being a grownup!

http://www.tnr.com/article/politics/childhood-shmomesity

Update on Michelle Obama's diet for her daughters--She banned the girls from watching television on weekdays, put them on low-fat milk, replaced sugary drinks with water, largely eliminated hamburgers from their diet, and monitored portion sizes at meals carefully. The next time she took them to the doctor, she reports, he was amazed. “What on Earth are you doing?” he asked.

Much more drastic than the earlier article reported, and arguably more dangerous.