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Old 10-04-2004, 01:57 PM   #1  
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Default NY Times Article 9/30/2004

I'm very interested in hearing your responses to this NY Times article, published September 30, 2004 and copied below. Discussing Medicare's potential coverage of weight loss surgery, this article by author Gina Kolata contains a grim view of the long-term efficacy of weight loss and it's accompanying health benefits.

The sections in bold are my own (fairly liberally applied) emphasis.

So what are your thoughts? I'll tell you mine. This reminds me of that other piece of horse**** Meg so kindly shared here not long ago. It's potentially destructive in its role as a weight loss deterrant, and I wonder where they get their data?? That said, regain statistics are what's the verdict? You guys are living it, so you're the experts.

__________________________________________________ ______
Weight Loss Surgery May Soon Be Paid by Medicare

Published: September 30, 2004

Carmen J. Pirollo expected his latest attempt to lose weight would take a while. At 5 feet 11 inches, he wanted to weigh 180 pounds, down from 260. A veteran dieter - "I've lost and gained a whole person in my lifetime" - he knew it would not be easy.

But while Mr. Pirollo, a 55-year-old sixth-grade teacher in Haddon Heights, N.J., says he is healthy, he worries that his excess weight might take a toll on his health. And, of course, he wants to look good.

"I'm an American," he says. "We live in a society where people have to be beautiful."

Who should pay for people like Mr. Pirollo to try to lose weight? For decades the answer has almost always been the patients themselves.

That soon may change.

At a meeting in November, Medicare's advisers will assess the safety, efficacy and cost of one increasingly popular method of weight loss - surgery - as a first step in a new policy that could lead to the use of federal money to cover a range of other obesity treatments.

Yet, at a time when coverage by Medicare and other insurers may increase, the evidence suggests that few obese people can lose significant amounts of weight in the long term. And some obesity researchers are also questioning the fundamental idea that losing weight improves health. Are weight loss programs, they ask, unnecessary medicine?

"No one wants to hear this," Dr. Jules Hirsch, an obesity researcher at Rockefeller University, said, "but I would ask where the data are."

None of the experts, however, are suggesting that people should abandon healthy eating habits and exercise, which have clear benefits.

At the moment, Medicare will pay for surgery for obesity when patients suffer other problems associated the condition, like diabetes. Now, Medicare says it may decide to cover treatment for those who are simply obese, meaning their body mass index, a measure of body fat, is at least 30.

The agency said that it would need to determine if obesity treatments help people lose weight and improve their health, adding that as yet it has no estimate on costs.

The insurance debate, for now, is aimed at the obese, not those who want to lose a few pounds here and there. But that still includes 61 million Americans, nearly a third of the adult population, and 9 million of Medicare age, 65 and older.

They include, for example, a woman 5 feet 5 inches tall and weighing more than 180 pounds, or a man 6 feet tall and weighing more than 221 pounds.

The immediate question is whether to cover so-called bariatric surgery, which costs $30,000 to $40,000 if there are no complications, and greatly reduces how much food can be consumed and the calories that can be absorbed. But commercial diet programs as well as many obesity doctors, including members of the American Obesity Association, whose sponsors include makers of weight loss drugs as well as companies like Weight Watchers and Jenny Craig, say they want coverage for other programs, too.

The obesity association said that it planned to use Medicare as a wedge to open the door for broader coverage for the obese and then, possibly, for overweight Americans.

Obesity, said Morgan Downey, the association's executive director, is a disease, and should be treated. Insurers pay for treating other chronic diseases, he added, although "there are very, very few cures out there."

Doctors, of course, have been telling patients for years that weight loss will greatly improve their health. But, in fact, there is only one long-term study following obese people who deliberately lost weight - in this case, with weight loss surgery - and comparing their health with those of similar people who did not lose weight. The results were a surprise.

The study of 692 patients by Dr. C. David Sjostrom of Goteborg University in Sweden, found, as expected, that the surgical patients lost weight - 68 pounds in the first year and 44 pounds after eight years.

Otherwise, the results were mixed. The rate of diabetes among the surgical patients remained steady, at 10 percent, but tripled to 24 percent in the patients who did not have surgery and did not lose weight.

Blood pressure, however, was a different story. It fell in the first year after surgery but then crept up again. Eight years later, the blood pressures of the surgical patients were the same as those who did not have surgery.

For the minority of obese people who are surgical candidates, the operation can turn their lives around. But they risk serious consequences, like bowel obstructions and malnutrition leading to anemia and bone loss, as well as a 1 percent to 2 percent risk of death. What is not known is whether the surgery's health benefits outweigh its risks over the long term.

Dr. Russell Harris, an internist at the University of North Carolina who evaluated weight loss studies for the U.S. Preventive Services Task Force, an independent panel of experts that advises the Agency for Healthcare Research and Quality, said that when it came to surgery, the group decided, "we just don't know" what to recommend.

Other studies have focused on populations, trying to determine whether overweight or obese people who voluntarily lost weight were healthier. Some studies found that they were; some found no difference; and some found that they actually died at a greater rate.

The reason for the dearth of information on the long-term effects of weight loss, researchers say, is that very few people keep weight off. The National Institute of Diabetes and Digestive and Kidney Disease is now, for the first time, trying to get some concrete answers with an 11-year study of 5,000 overweight and obese diabetes patients.

In justifying the new study, its designers state the quandary: "Given the paucity of data on the impact of weight loss on morbidity and mortality, an increasing number of critics in both the lay press and professional literature have questioned whether obesity should be treated at all."

Another question raised by obesity researchers is whether a fat person who loses weight is as healthy as a naturally thin person of the same weight.

It is true that thinner people tend to be healthier, but studies have found that, biochemically, the formerly fat are like people who are starving: obsessed with food, needing fewer calories to maintain their body weight. Many - again the issue is with the obese, not those who want to lose a few pounds - have slow heart rates after they lose weight and always feel cold; women may stop menstruating, even if they are still relatively fat. Is that better or worse than remaining fat? No one knows for sure.

Another unknown should weight loss turn out to improve health: How much weight must be lost? Most obese people dream of being thin, but researchers say a more realistic goal is losing just 5 percent to 10 percent of their weight. That is the best that can be achieved in clinical trials lasting a year or two, they say, and over the short term, is associated with lower blood sugar and blood pressure.

As for other health benefits, Dr. Hirsch said, "the data get fuzzier and fuzzier."

While scientists ask questions, a robust weight loss industry takes in tens of billions of dollars each year and reaches into all aspects of society. It includes diet foods and beverages, weight loss centers, diet books and prescription medicines, diet supplements, visits to doctors, lab tests, and surgery. The Federal Trade Commission estimates that annual revenue from sales of diet foods and beverages alone reaches $40 billion.

Weight loss surgery alone has begun to hurt insurers. In Pennsylvania, the number of operations went from 674 in 1999 to 6,791 in 2003, and total charges went from $24 million to $242 million. Private insurance paid for 85 percent of the operations. In Florida, Blue Cross Blue Shield announced that it would not pay for the operation after this year, saying its costs nearly doubled in two years, to $17 million a year.

The problem with weight loss, researchers say, is that the advice so often given, eat less and exercise more, has not been much help.

Research studies at academic medical centers, providing intensive diet, exercise and behavioral therapy, result in losses of 8 to 12 percent of body weight in six months. But most people gain the weight back in a few years.

As for commercial weight loss programs, in a two-year study sponsored by Weight Watchers involving 358 people averaging 205 pounds, those assigned to the program lost 6.4 pounds. Participants who were randomly assigned to try to lose weight on their own lost nothing. Neither group showed a change in blood pressure or levels of cholesterol, blood glucose or insulin.

While Weight Watchers did not have much of an effect, "it's as good as most academic centers do," said the study's lead author, Dr. F. Xavier Pi-Sunyer, chief of endocrinology at St. Luke's-Roosevelt Hospital Center in New York.

It is almost impossible to tell the blunt truth about the success rates of treatments, some researchers said. "It is like resisting Mom, apple pie, and the flag," said Dr. Bruce Schneider, associate vice president for clinical research at the Association of American Medical Colleges.

Many said they know the data but encourage patients to continue trying to lose some weight, or at least stop gaining, especially those whose blood sugar level is elevated or who have joint problems that are worsened by weighing so much. Clearly, doctors have not yet given up on the idea that weight loss may improve health. Yet, they said, when they urge patients to lower their expectations about how much weight they can lose, some react with shock.

Dr. Judith Korner, an endocrinologist at Columbia University, tells obese patients that a 5 percent to 10 percent weight loss would be terrific. "Some of them look at me as though I'm crazy," she said.

Those few who succeed at weight loss may end up on what amounts to a permanent diet. People in a national registry of successful dieters - they maintained a weight loss of at least 30 pounds for at least a year - report consuming just 1,400 calories a day and walking, or doing equivalent exercise, for an hour a day.

Still, people who lost weight said they felt better, they looked better, and they found just moving around and going about their daily lives much easier.

That leaves a question, Dr. Hirsch said. "If it's all that good, why don't people maintain their weight loss?"

Mr. Pirollo, who lost 30 pounds since March, said he was confident he would reach his goal and that this time his weight loss would last. He would like insurers to pay but his latest treatment as a participant in a two-year clinical trial costs him nothing. Already, Mr. Pirollo reports, his doctor halved his dose of blood pressure medication.

But insurers have to make some tough decisions, said Dr. Madelyn H. Fernstrom, director of the weight management center at the University of Pittsburgh Medical Center.

"Let's say your weight went down 20 percent, but your blood pressure did not change,'' she said. "Your self-esteem may be better. But the payer might say, we're glad you're happy, but the bottom line is, Are you saving the company money?"
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Old 10-04-2004, 02:35 PM   #2  
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The truth is, it IS possible to be perfectly healthy and still be overweight by the charts, but many doctors & medical folks have become convinced somewhere along the way that ONLY people who meet the height-weight standards can possibly be healthy. I have had doctors tell me that the reason I was experiencing symptoms of one kind or another was because I was overweight. End of story. And they turned out to be wrong.

That's not to say that obesity isn't a potential health issue. But, a lot of the stats that are quoted -- that we're fatter than we used to be, that certain diseases are on the rise, etc. are not necessarily true, and no one has EVER proven cause-and-effect on any of it. There are countless factors that go into susceptability for diseases, including genetics, that currently we CAN'T say that losing weight is going to improve your health in a significant way. Did you know that there is not any definitive proof that high cholesterol is an actual factor in heart disease risk? Yes, my cholestrol is a good 50 points lower since I've been eating healthier and lost 150 pounds. But does this decrease my risk for heart disease? Who knows?

So I don't think that an article like this is necessarily a deterrent, but I do wish that science & health writers would point out the potential problems with any statistic. I respect Gina Kolata as a writer in general, but she has written more than a few articles on fitness / obesity topics that have a definite bias. She published a book recently that was quite one-sided about fitness -- she is a devotee of spinning and it's clear that she thinks there is one true path to health and longevity.

BTW, in Thin for Life, Anne Fletcher talks about the much-quoted regain statistics, and she shows that they are flat-out wrong.
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Old 10-04-2004, 07:07 PM   #3  
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Medicare says it may decide to cover treatment for those who are simply obese, meaning their body mass index, a measure of body fat, is at least 30.
Oh wonderful. Does this mean if your BMI is 29, you need to eat like a pig in order to be "acceptably obese"? Isn't that what this would lead to?
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Old 10-04-2004, 07:54 PM   #4  
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I'm not in a real good place food-wise right now to answer this, but it did strike a few nerves.
First, I find it appalling that bariatric surgery would be considered for someone with a BMI of 31. It is drastic, irreversible, life-changing surgery and I really don't believe that it should be considered for someone in that range. Yes, there has to be some measure used and I don't know where I'd put the cut-off, but even with co-morbidities the amount of excess weight carried by the slighly over 30 BMI person shouldn't make that much of a difference. I'm 5'3" and at my highest weight would have qualified. It was not that difficult to lose 45 pounds. With a BMI of 31, I was running daily, skiing, biking and leading an active, healthy lifestyle. I just ate way too much and too much of the wrong foods. I certainly didn't likethe way I looked or the size of the clothes I had to buy, but invasive surgery was not the answer. With a BMI of 51 I might think differently.

It is true that thinner people tend to be healthier, but studies have found that, biochemically, the formerly fat are like people who are starving: obsessed with food, needing fewer calories to maintain their body weight. Many - again the issue is with the obese, not those who want to lose a few pounds - have slow heart rates after they lose weight and always feel cold; women may stop menstruating, even if they are still relatively fat. Is that better or worse than remaining fat? No one knows for sure.
I found this to be true. I reach goal almost exactly 3 years ago when I was 47. I went through a fairly instant menopause although I'm nowhere near the 9-11% body fat range where younger women lose their periods. I am obsessed by food, and usually cold. As we've discussed several times on this forum, the rule for calorie usage based on BMR and activity don't seem to apply to me. I must eat the same way I ate while losing and do at least the same amount of exercise to maintain.

Healthwise, there has been a pay-off for me. My blood chemistry was never an issue to begin with, but I have fibromyalgia and chronic fatigue syndrome. Since changing the way I eat and live, I haven't had a flare-up. There are too many factors in my lifestyle change to say that it was due to simply weighing less. I eat healthier foods. I get more regular, structured exercise. I take megadoses of vitamins. Any or all of these could be the controlling factor.

Those few who succeed at weight loss may end up on what amounts to a permanent diet. People in a national registry of successful dieters - they maintained a weight loss of at least 30 pounds for at least a year - report consuming just 1,400 calories a day and walking, or doing equivalent exercise, for an hour a day.

Still, people who lost weight said they felt better, they looked better, and they found just moving around and going about their daily lives much easier.
Yep, that's me. And since I'm one of the people in the registry, I'm not surprised. I didn't expect it to be this way, but 9/10th of the time it's worth it.

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Old 10-04-2004, 10:08 PM   #5  
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Wow. I'm amazed that they would offer surgery as an option to people that really aren't that much overweight, of course it is all relative. I think surgery is quite drastic and should be considered in life threatening situations.

Personally, I think insurance companies should offer nutritional programs and exercise programs instead of just saying "you need surgery". My insurance company has a weight loss program which cost me extra to enroll in and it was very limited. It would be much much cheaper for them to help people lose weight by learning about nutrition and helping them out with an exercise program.
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Old 10-05-2004, 08:58 AM   #6  
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Asides from the feeling cold all the time, I haven't really had any problems due to losing weight asides from some "head" stuff... My periods aren't as heavy as they used to be(they were very heavy) but they're more regular than they ever were before (and I am not on the pill anymore) and they still are far from being considered light. I probably eat less than what charts would say to maintain and to lose, just the way my body is made. My heart and blood pressure is great... I have been diagnosed with low blood sugar, but I suspect I have had this my whole life.

I read an article about 6-7 months ago where a woman about my age was trying to gain 40lbs to qualify for WLS (so she'd have a BMI of 40 or whatever they consider the cutoff). I didn't understand why she would do that though since WLS is not an easy path by any means.

The fact is I am starting to view maintenance as obesity management. I know I could easily become obese again, so I have to manage my food and my life in a way to control my weight. My dad is diabetic and manages his eating fine... So I am using him as an example.

I think as more people have dramatic weight losses there will be more research on how to maintain one's body weight... Books like Thin for Life and Master's on this board offer such great advice. We can do this, just believe it. Humans can acheive so much. Remember that.


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Old 10-05-2004, 09:06 AM   #7  
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Ali- I really like your term "obesity management". Although it makes little difference in the day to day actions, it does seems to be a more pro-active approach than "maintenance". Thanks

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Old 10-05-2004, 11:58 AM   #8  
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One thing I have to remind myself whenever I read articles like this is that, unfortunately, science is often (always?) informed by the culture in which it is practiced. While I do think we have a problem with weight/obesity in American culture, I have been skeptical for a while of the hysteria about an "epidemic," which I think often is colored by an irrational fear and disgust about fatness. Data used for these studies are usually sketchy at best -- for instance, one of the studies cited used only diabetic patients who lost weight -- not the best indicator of the overall population.

I think the "cutoff" for surgery at a BMI of 30 is appalling. In fact, I wonder if a lot of the "epidemic" talk about obesity could even be tracked to the exclusive use of BMI as a measure of overweight/obesity. I'm sure everybody here knows someone very athletic whose BMI is in the overweight range because of muscle mass. While WLS can save lives of people who are severely overweight, it just hasn't been practiced long enough or studied enough to warrant its use on a third of the U.S. population (who might not need it anyway)!

I think the general thrust of the article -- that it's damned difficult for most people to lose and keep off a substantial amount of weight (don't I know it) -- jells with what I've heard on here. But that said, I know from personal experience that even 30 pounds lost has made a huge difference to my physicial and emotional health. I know "fit and fat" is not the optimal place to be, but it sure beats fat and sedentary.
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Old 10-05-2004, 01:09 PM   #9  
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Great post, Jen.
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Old 10-05-2004, 03:15 PM   #10  
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I'm with y'all who feel that a BMI of 30-31 in order to be considered for WLS is way too low - but then again, I don't think that the article really stated that Medicare was going to pay for WLS for people with a BMI that low.

And it IS possible to be heavier than the 'traditional' charts and still be healthy - I'm a prime example of that. At 5'4", I currently weigh 146 lb (as of last week) with a medium frame. According to many sources - height-weight charts, etc. - I should lose 20-25 pounds to be at my "ideal weight". However, at this weight I'm wearing a (loose to comfy, depending on clothes manufacturer) size four. So there ya go.

IMO, since obesity is a condition (disease, if you will) brought on by lifestyle and environment for the vast majority of 'sufferers', what the government should do (not that they asked ME, but here ya go) is tackle this the same way that tobacco use was tackled - concentrate on educating the NEXT GENERATION. When I was in Jr. High and High School (I graduated in 1981, BTW) smoking was still considered pretty darn 'cool'. Our high school had a large smoking area to accomodate the 'cool kids' who needed a cigarette between classes. I don't remember if Joe Camel was being used at that time, but I do remember seeing a lot of kids wearing Marlboro T-shirts and such. (I was a nerd, so I didn't generally hang out with that bunch).

Nowadays, judging from my nieces and nephews, cigarettes are SO uncool that if they even see someone with a pack of MATCHES, there's a HUGE outcry.

If a similar sort of campaign could be formulated to make overeating and underexercising uncool or what have you...focusing on kids and their parents...and if the food industry can be, um, motivated to assist in this effort by (for example) stopping the marketing of food as 'fun' (i.e. Happy Meals with toys, cartoon characters advertising sugary cereals, etc.) which IMO encourages 'recreational eating'.

Anyway, on that Medicare issue, here's a recent article from Michael Fumento's website you might find interesting...

Medicare Help Obesity? Fat Chance
By Michael Fumento
Scripps Howard News Service, July 22, 2004
Copyright 2004 Scripps Howard News Service

Since I'm the author of the first book warning of America's disastrously growing weight problem and have helped popularize the term "obesity epidemic," you probably think I support Medicare's decision to essentially classify obesity as a disease so that it can spend money on treatments. Well, you're probably wrong.

This is just an opportunity for the diet industry to get fatter, for the already-anorexic Medicare fund (government health insurance for the elderly) to grow even thinner and for "horizontally challenged" seniors to remain so.

The problem is the nature of the beast, the intractability of obesity. If preventing or treating it were as simple as "regularly taking long walks and keeping your mouth shut," as Rick Berman of the Center for Consumer Freedom told a reporter, two-thirds of us wouldn't be overweight. The CCF is funded by restaurants and food and beverage companies whose advertising and T-Rex-sized food and drink portions encourage us to cram our craws with the most caloric stuff on earth.

On the other hand, personal responsibility cannot be ignored. After all, somehow a third of us have managed to stay thin. While Big Food encourages gluttony, I've yet to see a Keebler elf threaten somebody's life if he didn't down another E. L. Fudge Peanut Butter Double Stuffed Sandwich Cookie. Nor can you blame the industry for the American Way of Sloth.

And don't even think of blaming genes. They might have a slight impact on individuals, but genes didn't turn us into the United States of Adiposity.

Significant and permanent weight-loss is achievable, as the ever-growing 4,000-member National Weight Control Registry shows. These people have lost 30 pounds or more and have kept them off for at least one year. The question is: How can Medicare help?

Well, the cheapest program would be to buy all fat seniors a paperback diet book. No, diet books don't work; I just said it would be cheap.

Then there are commercial plans. A 2003 study in the Journal of the AMA found that after a year dieters on one such plan had lost significantly more weight than a comparison group relying strictly on self-help. But after two years, the difference was almost gone.

Not for nothing do major companies like Jenny Craig and LA Weight Loss Centers keep no records of long-term results. And have you seen former Jenny Craig spokeswoman Monica Lewinsky lately?

Further, most commercial plans essentially operate by selling members pre-portioned food – at extraordinary prices. Should Medicare be paying for meals?

Elderly obesity is serious, but what can Medicare do about it?

Of course stomach reduction or "bariatric surgery" does work. And it's reserved only for the direst cases, right? Not exactly.

Such surgery has increased eight-fold during the last 11 years because more people (including the parents of obese teens and children) no longer see it as a last resort. It's terribly expensive, at $15,000 or more a pop. And while it's clearly the most successful method of long-term weight-loss, it's no panacea.

Bariatric surgeons seem reluctant to publish detailed results, but some who did reported that while 90 percent of their patients lost a fourth of their excess poundage, only 8 percent "attained normal weight." Further, some weight regain is almost inevitable because what remains of the stomach stretches and people often compensate for smaller stomachs by eating more frequently.

Pills? It's rare to lose more than 5 percent to 10 percent of your weight with them. Ultimately only drugs will end the epidemic, but it's hard to find an area of medical research that has produced more failures and there's nothing exciting on the horizon.

Meanwhile, Medicare spending is busting its own pant seams. Partly because of the new drug coverage adding an estimated $534 billion, outputs from the taxpayer-funded portion have already begun exceeding revenues. What will happen if we expand coverage even further?

All that said, a study in Obesity Research this year pegged annual U.S. obesity-attributable medical expenditures at $75 billion with Medicare and Medicaid (health insurance for low-income people) paying half the tab. So when we do get effective treatments, some form of Medicare coverage might actually pay for itself. But until then, expanding the coverage an already-overextended program will do nothing to prevent elderly waistlines from expanding.
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Old 10-05-2004, 05:09 PM   #11  
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At least in NJ you have to have a BMI of 40 to qualify
30 is almost normal They are out of their minds!
and a word about language if I may
While words like epidemic and victim are quite popular in relating to obesity right now
they are downright wrong to use
Yes the #s of people who are obese have gone up
But I feel ( being a writer) the word epidemic leads people who are obese to feel they are helpless against a tirade of donuts or indeed adipous (i butchered that spelling) tissue
They should be workign to mobilize people to do something
I would love if insurance paid for an actual weight loss program or at least something to help empower the person in themselves
ok i'm off my soap box
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Old 10-05-2004, 09:24 PM   #12  
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Many insurance companies do have limited "paybacks" for going to the gym. I know a lot of the members at my gym key in a PIN as they enter, and after 120 visits in a calendar year, receive around $120-150 back from their insurance companies. Doesn't pay a lot, but it's something.
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Old 10-05-2004, 11:07 PM   #13  
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I've talked before about what motivated me to lose weight, and it's mostly the location. I moved far enough from family clutches and a lifestyle that promoted bad eating and laziness to an area that is big on exercise, organics, and natural medicine.

The differences here from there, most office here have showers because many employees jog on their lunch hour. And my company here has an insurance plan that gives discounts if you join a health club, take yoga, dance, get discounts on exercise equipment too. They provide incentive here to live a healthy lifestyle. There's no incentive where I was raised. You get none of those things, and you don't see a lot of people living a healthy lifestyle there either.

I was amazed at the number of joggers I saw when I first moved here. And the people who walk their dogs? I mean, they don't just dump them out into the fenced in yard like back home, they actually take them for a walk, even in the dead of winter and 5 foot of snow. LOL Just so much difference. And I really think that's the motivator. You know what you learn, what you see. And I was able to see and learn something different than I'd been taught all my life.
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Old 10-06-2004, 06:36 AM   #14  
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I had a chance to meet Barry Sears, author of The Zone diet books, this week and talk to him about weight loss and lifetime obesity management (I LOVE that phrase!). I told him all about 3FC and all of you guys (he wants to do a live chat with the site; we’ll see if we can work that out).

Anyway, I started off my question by saying that many of us who have lost weight think it’s just as hard to keep it off as to lose it and he interrupted me to say: “no, it’s harder to keep it off”. (I could have hugged him at that point since not many people understand! ) Why? He said that it’s not that our bodies are different NOW that we’ve lost weight; it’s the way we were born. It’s that old cave man survival thing — how we’re the people who are exquisitely evolutionarily adapted to live on very few calories. He cited those same NWCR statistics that are in the article about the 1400 or 1500 calories and hour of exercise per day and says it’s because we’re the survivors. In other words, it’s in our genes -- it is was it is (too bad it sucks ).

I’ve read other articles that seem to point to hormonal changes due to weight loss caused by our bodies attempts to get us to regain weight. Perhaps that’s part of the whole cave man syndrome — when you lose a lot of fat (deliberately or by starvation), your body tries to get you to pack on some more fat for the winter or mastodon shortage or whatever?

I also asked why, in his opinion, 95% (or whatever) of people who lose weight regain it and he said it's the failure to realize that this is for the rest of your life. It's a cliche, but it truly has to be a lifestyle and not a diet.

I really agree with KO that the language that writers are using to sensationalize “the obesity crisis” sends a huge message of defeat to anyone who is losing or has lost a lot of weight. Look, we all know it’s not easy, right? Those people who are still in the honeymoon phase of weight loss and think that once you reach goal, you’re “done” are going to have to wake up to the realities of obesity management or be doomed to regain the weight. BUT … we all know it can be done. Look around here — we’re doing it, people! Look at Karen — it’s been close to 15 years for her! We may moan and groan and have bad days but we’re doing it, day by day, meal by meal. No writer can take that away from us.

I personally don’t care what the statistics say — this is MY life and I don’t ever choose to be obese again. I know what to do to keep the weight off and even if I have to do it 24/7, 365 days a year for the rest of my life, it’s totally worth it.
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Old 10-06-2004, 10:31 AM   #15  
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well meg. now you've done it. i'm printing this out. and i'm linking it from the WLS forum as well.

your post should be required reading for every single member of this forum. and expanded into a magazine article.

thank you!!!!

i haven't posted my comments about gina's article because i'm too annoyed and i have to wait until i can be more rational in my response. it's taking longer than i expected!!!!
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