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Are there still healthy obese patients?

Discussion in 'Break Room' started by NewsBot, Aug 17, 2012.

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  1. NewsBot

    NewsBot The Admin that posts the news.

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    Are there still healthy obese patients?
    Blüher M.
    Curr Opin Endocrinol Diabetes Obes. 2012 Aug 13
     
  2. twirly

    twirly Well-Known Member

  3. Admin2

    Admin2 Administrator Staff Member

  4. wdd

    wdd Well-Known Member

    The negative effects of the sumo lifestyle become dangerously apparent later in life. Sumo wrestlers have a life expectancy of between 60 and 65, more than 10 years shorter than the average Japanese male. They often develop diabetes, high blood pressure, and are prone to heart attacks.... Recently, the standards of weight gain are becoming less strict, in an effort to improve the overall health of the wrestlers.[18][19]

    The above extract from Wiki 'Sumo' seems to contradict the assertion re-healthy sumo wrestlers at least.

    Bill
     
  5. wdd

    wdd Well-Known Member

    What does healthy mean?
     
  6. Bill Bird

    Bill Bird Active Member

    World Health Organisation, definition of Health

    Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

    The correct bibliographic citation for the definition is:

    Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

    The Definition has not been amended since 1948.

    Another definition that creates a different perspective with respect to orthotics and footwear is: 'Health is the ability to adapt.' In other words someone can appear to be healthy simply because they have not been put in a situation that challenges their physical, mental and social wellbeing.
    Some people can wear any old thing on their feet and be happy. Others... things have to be just so, one millimetre here, another there or the pain is so great they have to sit down. When you finally get it right, are they then healthy?
     
  7. wdd

    wdd Well-Known Member

    Thanks for the definitions Bill. The first one is good enough for me and the fact that it hasn't changed enhances its value as it suggests that they got it right first time and that the nature of health hasn't changed in the interim period and therefore they haven't needed to modify it? Of course it might be that no one has looked at the definition since 1946 and that in contemporary terms it's nonsense?

    The answer to the question Are there still healthy obese patients is almost by definition NO. If they are patients they must be ill?

    If the question was Are there still healthy obese people. My answer would be that they may not be manifesting disease but will be, because of their obesity, sooner and more severely than slim people. This is probably covered by the first of the definitions proposed by Bill B. The word 'still' in the question suggest that at sometime in the past there were healthy obese people. The most healthy response is that there never were and never will be healthy obese people, it's a contradiction in terms.

    It would be better for the health of the world if the idea of healthy obesity is laid to rest here, once and for all but I bet it isn't.

    Bill
     
  8. efuller

    efuller MVP

    The definition of obesity as a BMI over 30 is problematic and I would disagree with the assertion it is unhealthy by defintion. In my training I was at the marine corp recruiting depot and they brought in this guy for a medical exam because he was "obese". From just looking at him, with his shirt off, you could tell that he was easily less than 10% body fat. So with the BMI definition, there will be people that are quite healthy and catagorized as obese.

    I will agree that most people with a BMI over 30 have a problem, but the BMI is an imprecise instrument.

    Eric
     
  9. wdd

    wdd Well-Known Member

    http://www.nature.com/oby/journal/v19/n5/abs/oby201138a.html

    The above article looks at an alternative to the BMI the BAI (Body Adiposity index) which looks esentially at the hip circumference to height ratio and adjusts it so that can be read as a fat percentage.

    The authors suggest it is better than the BMI. They describe it as 'reasonably accurate but not terribly accurate'.

    Why are so many American baseball players obese? I am sure that in part if reflects increasing national obesity but is there something within the culture of baseball that makes being overweight a status symbol?

    Bill
     
  10. efuller

    efuller MVP

    What percentage are obese? By what measure? True, there are not many that look like marathoners. I'd bet that carying an extra 20 pounds doesn't effect their performance that much. A good question is how much does that slow you down when sprinting, or starting from a sprint. Being 20 pounds overweight might shave only a couple of points off of your batting average. The real skill is being able to hit a 90 MPH fastball. That's a skill where extra pounds probably don't matter. If you look at middle infielders, they tend to be more lean. Diving quickly to one side or the other, with quick accelerations, will be affected by body mass. Pitchers, especially with the designated hitter rule, rarely have to run at all. You could make the case that trowing fastballs might be easier if the body has more inertia. I guess the point is that they can perform at an elite level for their sport with some fat. Maybe the status symbol is that "I can be this good without being in shape." I don't see a lot of people saying they want to be like their idol because he's fat.

    Eric
     
  11. I agree with Eric. The BMI is neither a valid or reliable indicator for body fat percentage in a great number of individuals (Prentice AM, Jebb SA: Beyond body mass index. (Obesity Reviews, 2:1-7, 2001). I would imagine the Body Adiposity Index is just as poor of an indicator of actual body fat percentage. Measuring body fat percentage is best done using underwater weighing....BMI is basically a mediocre guesstimate of body fat percentage and, in my opinion, is much overused in today's medical world as an indicator of body fat percentage.
     
  12. wdd

    wdd Well-Known Member

    I am sure that you are right kevin, re- the validity and reliability of BMI but I don't think we should throw out the baby with the bathwater. The problem isn't so much the BMI but its use as the single factor leading to a possible diagnosis of obesity. As Eric said, 'From just looking at him with his shirt off, you could tell that he was easily less than 10% body fat.'

    Add together BMI, Looking at the subject stripped to the waist (the subject of course and not the examiner although it might add an interesting dimension) and asking a few questions such as - What kind of work do you do? What kind of exercise do you take each week? As these are questions that could be asked at the same time as measuring the BMI there would be no extra time cost involved in doing so.

    Are there any photos on the web showing people with different and the same BMIs?

    Bill


    Bill
     
  13. wdd

    wdd Well-Known Member

    There are some BMI visual graphs online including one which illustrates Eric's point, re-same bmi different body composition, nicely.
    All the bmi visual graphs that I saw seem useful but they look as if they could be improved , at least by including a profile view as well as full face.

    Bill
     
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