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New Obesity guidelines for health care professionals


shootingstar
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All I know is a Body Mass Index of 30 is where obesity starts.

For me (male, 6'3"), that means less than 30 begins at 239 lbs.  Of course, that's an approximation based on avg. body build, etc. - but I'm close enough to accept it.

That's the goal, but water weight fluctuations due to more diabetic meds when sugar levels are high and winter weather limiting activity are making it hard to tell progress.  But I'm heading in the right direction.

image.png.c51ce9ab8583e42668ef311961ac34ea.png

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I could argue that my fattest relative, my Aunt Sally who was really fat as long as I could remember, lived to 99 3/4 years-young and missed 100 only because of COVID.

But, of course, that's too small a sample to argue fat doesn't kill and I'd be falling into the same trap as when I was young and pointed out that a 104 year-old farmer that smoked all his life was still plowing his land behind a mule.

Fortunately, my parents were the youngest of large families and I noticed my older relatives were living into their 80's and 90's if they didn't smoke and dying in their 60's and 70's if they did.

Maybe some people were not killed by smoking but my genetics were NOT likely to be among them.  I quit smoking in 1996.

Hopefully, I hit 239 by 2023.

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1 hour ago, MickinMD said:

that's too small a sample to argue fat doesn't kill

I think there is plenty of evidence that being overweight going into an illness is a GOOD thing - especially for things like cancer where appetite may be disrupted.  Fat is an essential part of a healthy body, but like everything, moderation is key, and obesity is generally when a person has stepped outside the "healthy heavy" and into the world of "new diseases and chronic problems" that non-obese folks are significantly less likely to encounter.  

But good genes are good genes, and bad genes are bad genes.  I'm going bald and there is relatively little I can naturally do about it.  Sure, drugs can fight that battle. Maybe surgery too, but otherwise, I will continue to lose hair on my head.  I could likely make that worse by having too much stress or having a crummier diet, but even with normal stress and a normal diet, I am doomed to lose hair.  On the other hand, some folks with crummy diets and lots of stress can keep their hair via good genes and/or a daily regimen of drugs (propecia or rogaine).

My mom is overweight (among other things), and it has a significant impact on her life now.  Things she says she always wanted to to - like revisit Bermuda or visit Nova Scotia - are completely off the books now as her semi-self imposed health issues have made her unable to comfortably fly or drive long distances, and her mobility, without a scooter, make her unwilling to even try a cruise to those places. "Too much walking" is her mantra. :(  If she lives to be 99, that's 25 more years of just watching TV :( 

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9 minutes ago, Razors Edge said:

My mom is overweight (among other things), and it has a significant impact on her life now.  Things she says she always wanted to to - like revisit Bermuda or visit Nova Scotia - are completely off the books now as her semi-self imposed health issues have made her unable to comfortably fly or drive long distances, and her mobility, without a scooter, make her unwilling to even try a cruise to those places. "Too much walking" is her mantra. :(  If she lives to be 99, that's 25 more years of just watching TV :( 

For  my mother it's other mobility issues. She wasn't obese. She lost weight. I would be happy if she could be motivated to walk half a block on her street. For her, one wonders just not walking often, one loses  sense of walking of balance, neurolocomotor coordination, and rhythm.

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I think it funny that my BMI at my military & PD weight had me at overweight.  At my current weight of 216 I’m obese but wear a 36” waist pant, size Lg shirt.  In my mind obese is a lot bigger than what I am. 

I think it’s a good guide but I don’t take too much stock in BMI.  

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3 minutes ago, ChrisL said:

I think it funny that my BMI at my military & PD weight had me at overweight.  At my current weight of 216 I’m obese but wear a 36” waist pant, size Lg shirt.  In my mind obese is a lot bigger than what I am. 

I think it’s a good guide but I don’t take too much stock in BMI.  

BMI is sort of BS, but likewise, we've now developed a feeling that by saying it is BS, we erase the fact that many many many folks with high BMI are, in fact, too heavy.  At the extremes of height and muscle, it all breaks down, but, most folks are neither too tall nor too muscular, yet will readily use that as a shield.  Honestly, I can tell without a scale and without a BMI chart when I am too heavy (or too light).  By the time I would be tripping the 30 or 35 limits, there could be no question that was not ideal for me in any way, shape, of form.

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29 minutes ago, Razors Edge said:

BMI is sort of BS, but likewise, we've now developed a feeling that by saying it is BS, we erase the fact that many many many folks with high BMI are, in fact, too heavy.  At the extremes of height and muscle, it all breaks down, but, most folks are neither too tall nor too muscular, yet will readily use that as a shield.  Honestly, I can tell without a scale and without a BMI chart when I am too heavy (or too light).  By the time I would be tripping the 30 or 35 limits, there could be no question that was not ideal for me in any way, shape, of form.

I would consider if I was 30 lbs. overweight, it would warrant significant attention.  50-75 lbs. overweight for me at my petite bone frame (which is genetic) and short height, it would absolutely not be acceptable for me. I am small, in every sense of  the word...and even, woman attributes.

My mother was at least 30 lbs. or more, overweight after 6 children. So I know what that means/how it looks. She has naturally a slightly bigger bone structure than I. She has had high blood pressure for past 3 decades (takes medication), tendency to gout, etc.

So I don't really care about  BMI as a benchmark. I know what creeping unhealthy in my small world would mean.

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While we argue that BMI is kind of BS and not absolute by itself, I would tend to agree with Razor, by saying it's total  BS for everyone, does not help if there are several family members with very high  BMI and clearly have several diagnosed negative health conditions.

Otherwise, how does a person surrounded by several family members with also very high BMI and diagnosed unhealthy conditions, know what their own family healthy reality even looks like?  I'm saying their own family healthy reality in the same country of residency for many years.  Not benchmarking against healthy thin model looking folks.

This is not about fat shaming. It is knowing the healthy norm for yourself and across many family members that you share genetically. I know what is healthy norm in my extended family because I see it and know the health conditions of various indivduals across multiple siblings, first cousins....here in Canada.

And it helps to understand, if the person is doing something to help control a health problem. We're never perfect, we can only try our best.

 

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19 hours ago, shootingstar said:

Otherwise, how does a person surrounded by several family members with also very high BMI and diagnosed unhealthy conditions, know what their own family healthy reality even looks like?  I'm saying their own family healthy reality in the same country of residency for many years.  Not benchmarking against healthy thin model looking folks.

This is not about fat shaming. It is knowing the healthy norm for yourself and across many family members that you share genetically. I know what is healthy norm in my extended family because I see it and know the health conditions of various indivduals across multiple siblings, first cousins....here in Canada.

NEVER benchmark against "models" - as they are often a HORRIBLY unhealthy group.

And anyone who visits Europe (particularly the white folks here) will see that their ancestors - Brit, German, Polish, Italian, etc., - are often very short and/or plump, yet live to some ripe old ages.  Polish folks have "adapted" over centuries or more to their diets, and likely they're fairly good with that by now.  But they also would have a LIFESTYLE that fit that diet - ie more physical labor, more walking for errands, reduction in calories in the winter, and similar.  So, if you eat like them, but don't live like them, you might run into issues.

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On 3/6/2022 at 8:36 AM, MickinMD said:

All I know is a Body Mass Index of 30 is where obesity starts.

For me (male, 6'3"), that means less than 30 begins at 239 lbs.  Of course, that's an approximation based on avg. body build, etc. - but I'm close enough to accept it.

That's the goal, but water weight fluctuations due to more diabetic meds when sugar levels are high and winter weather limiting activity are making it hard to tell progress.  But I'm heading in the right direction.

image.png.c51ce9ab8583e42668ef311961ac34ea.png

My BMI before chemo was 17.6, it is now 19.8 no wonder I feel better now.

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