Weight Gain and Interviews

[tmn]

It's quite a jump to go from overweight to using heroine.

I was exaggerating for effect. I realize that it's much more nuanced than I let on.

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[tmn]

I'm not terribly overweight, but my BMI is in the 25-26 range. I recently gained ~20 lbs because of a medication I am on (that I have to be on because other meds don't work for me at all, and I am almost non-functional without the medication). I am not eating more than I used to eat, but this medication is messing with my metabolism. I'm in the process of finding a way to offset these effects with more exercise and healthier eating habits. This is by no means easy, and it's definitely much more difficult for me than average.

I can see how situations like this, which the average person might not understand or know about, could bring someone to say that I'm making "bad decisions." In fact, there are many more situations that could cause someone to be a bit heftier, and mine is just a single example. It's important not to make that snap judgement when you meet someone. You have no idea why they are overweight or obese, and they very well may have reasons behind it. As future physicians, we need to be sensitive to those reasons in order to help our patients the most.

I likely wasn't addressing someone with a bmi similar to yours. I probably wasn't even addressing OP as I don't know their specific situation. I don't think many (any) people would think twice about your bmi. I was more just making a general statement about health choices. For the vast majority of overweight people, they choose daily to not exercise and to eat garbage. That was the bad judgment I was addressing.

I agree that in reality it is a very nuanced situation, and certainly one that needs to be addressed with sensitivity and compassion. But compassion does not mean condoning everything someone does.

 

[reviliver]

For the vast majority of overweight people, they choose daily to not exercise and to eat garbage.

Unfortunately, the data isn't really on your side for this one.
http://www.ncbi.nlm.nih.gov/pubmed/24996961
One example of many where lifestyle interventions did not result in significant changes in biometrics (weight, HA1C, etc) despite showing appreciable differences in diet and exercise habits. By the time you're an adult, many complex hormonal and lifestyle factors are at play. "Those people eat junk and don't exercise" is a cop-out for real scientific understanding of the obesity epidemic that is killing many of our patients.

As for me, I didn't have the "upper middle class lifestyle" that someone else referenced earlier in this thread and am subsequently slightly overweight. I run every day and do not eat processed or fast food. I use myfitnesspal to keep track of everything I eat. No one in my home ever exercised growing up and we ate a lot of pasta and bread to beef up the more expensive produce and meat so that my 4 siblings and I could all eat. Change is hard. I make an effort. No one judged me about it at interviews but I'm sure that some of my classmates do. However, I know that I have a lot to offer my patients in the realm of lifestyle modification because I am fighting the good fight myself, every day.

 

[Goro]

Stinking of smoke? Yes.

Would an applicant who came to an interview smelling like cigarette smoke be looked upon negatively?

 

[Strudel19]

If you're actively working on it, I don't think you'll have much to worry about.

 

[tmn]

Unfortunately, the data isn't really on your side for this one.
http://www.ncbi.nlm.nih.gov/pubmed/24996961
One example of many where lifestyle interventions did not result in significant changes in biometrics (weight, HA1C, etc) despite showing appreciable differences in diet and exercise habits.

I never claimed that exercise and diet alone were effective management for prediabetes in obese African American women.

What I asserted (granted without any data) is that the majority of overweight people do not regularly exercise or eat healthy.

The corollary: Would you estimate that the majority of overweight Americans are regularly exercising and eating healthy? I think you would be lying to yourself if you said yes. Again, no data, just my estimation. But to me it doesn't even appear to be close. Honestly, I would love to see some data either way.

I agree and acknowledge that obesity (especially in middle-aged and older adults, and in people who have been chronically obese to the point that their body chemistry is significantly altered) is multifactorial and highly nuanced. The delicate interplay of body chemistry and related nuances of obesity are not easily understood or modified, but it is undeniable that there are two easily (read easily as "straight forward", not as "simple to execute") modifiable factors: activity and diet.

 

[tmn]

Stinking of smoke? Yes.

Bingo

 

[jakeislove]

Why couldn't a smoker be working on quitting?

 

[tmn]

If you're actively working on it, I don't think you'll have much to worry about.

I very much agree that actively working on achieving a healthy weight is important for its own benefits. However, I do not know that someone (an adcom or otherwise) can tell at first glance if an overweight person is making strides or not. Like it or not, first impressions and snap-judgments do happen and do matter. Is it always fair? Probably not.

 

[Strudel19]

I very much agree that actively working on achieving a healthy weight is important for its own benefits. However, I do not know that someone (an adcom or otherwise) can tell at first glance if an overweight person is making strides or not. Like it or not, first impressions and snap-judgments do happen an do matter. Is it always fair? Probably not.

I agree to a certain degree (see what I did there?) But in all seriousness, I wish the OP the best and hope he/she gets the results they're looking for come interview time. Good luck with everything - you can do it.

 

[tmn]

Why couldn't a smoker be working on quitting?

Very good point, and very true. But it is the same as with obesity: first impressions do happen and do matter.

Actively working to overcome nicotine addiction, obesity, over-eating, sedentary lifestyle, etc. are extremely important, commendable, and worthwhile pursuits. I think our culture (and more focused, our physicians) should really go out of our way to celebrate and commend people who are working so hard towards these goals. All I'm suggesting is that we could also be less approving of people who choose to not pursue those goals.

 

[jakeislove]

Very good point, and very true. But it is the same as with obesity: first impressions do happen and do matter.

Actively working to overcome nicotine addiction, obesity, over-eating, sedentary lifestyle, etc. are extremely important, commendable, and worthwhile pursuits. I think our culture (and more focused, our physicians) should really go out of our way to celebrate and commend people who are working so hard towards these goals. All I'm suggesting is that we could be less approving of people who choose to not pursue those goals.

It's okay to judge smokers because they aren't a protected class.

 

[tmn]

It's okay to judge smokers because they aren't a protected class.

Agreed. Is obesity a protected class?! I surely hope not. If so, it reflects the cultural view that I have been describing.

 

[SkipJunior]

I think we all know that, and I was writing under the assumption that people reading my post would realize that I know that as well. My fault for assuming. I am obviously addressing people who do not have a pathological reason for being overweight. If you disagree with what I said, please address the substance of my post and not some unimportant detail.

It's definitely not an unimportant detail because a significant proportion of overweight & obese Americans are the way they are because of underlying medical conditions or side effects of medical treatment. Another hefty chunk of overweight Americans are overweight due to severe emotional trauma and scarring that occurred earlier in their lives that led to them overeating as a coping mechanism. How do you plan on differentiating these people from the people who "deserve" to be shamed and humiliated so they can lose weight? Will you go up to them and ask them why they are fat and then humiliate them accordingly? What about the people who are overweight but have been losing weight for a significant period of time before you meet them? You think your shaming or the adcom members refusing admission based on weight will help that person lose weight? I'm quite surprised that you are a medical student and I hope you gain some compassion and maturity before you start treating patients, god forbid you may meet someone who is overweight.

 

[LAtoDavis]

I'm pretty sure that studies have shown the affects of being overweight on interview success. Going into the medical profession makes being overweight that much bigger of an issue, no pun intended.

That's stupid. A 6' 183lb male would look small to me assuming that they don't lift... seems extremely inaccuruate to label them as overweight. 220lbs would be a fair size to have at 220lbs if you do indeed lift.

Do you even lift, bro?

And another thing... I had a ligament problem in my foot, and couldn't exercise for like 6 months. I got pale and kind of pudgy. I do a lot of free personal training, and I noticed a huge difference in the way my advisees reacted to me. Especially the women.

 

[tmn]

It's definitely not an unimportant detail because a significant proportion of overweight & obese Americans are the way they are because of underlying medical conditions or side effects of medical treatment. Another hefty chunk of overweight Americans are overweight due to severe emotional trauma and scarring that occurred earlier in their lives that led to them overeating as a coping mechanism. How do you plan on differentiating these people from the people who "deserve" to be shamed and humiliated so they can lose weight? Will you go up to them and ask them why they are fat and then humiliate them accordingly? What about the people who are overweight but have been losing weight for a significant period of time before you meet them? You think your shaming or the adcom members refusing admission based on weight will help that person lose weight? I'm quite surprised that you are a medical student and I hope you gain some compassion and maturity before you start treating patients, god forbid you may meet someone who is overweight.

Presumably, organic causes for obesity have been around for some time. How then do you explain the dramatic increase in obesity over the last 100 years or even last 20 years? An increase in pathological causes for obesity? Or an increase in sedentary lifestyle and poor diet?

Who said anything about walking up to random people and asking why they're fat? As someone's physician (especially in primary care) you will presumably inquire/know about your patients' diet and activity. Clearly patients who are overweight because of uncontrollable circumstances are in a different category than those who choose to not exercise and eat poorly. I don't think "shaming" is the right word, but I will mince no words expressing to an unhealthy patient that their choices will kill them. In no way am I making a commentary about their value as a person or their self-worth or their right to be respected. It's not a value judgement, it is a matter of fact. I guess I'm confused as to how a medical professional could think otherwise.

Our culture's acceptance of obesity certainly contributes to some obese people's complacency with their health.

Who said anything about adcoms refusing admission based on weight? Nice non sequitur. All I said was that obesity will likely have a negative influence on an applicants chances of admission. Whether that results in acceptance or rejection is impossible to determine.

I appreciate your concern for my compassion and maturity. Compassion does not mean that you have to condone every bad decision a person makes. Perhaps it would take some maturity to take responsibility for your patients' health and to have a difficult conversation with obese patients about how their decisions aren't sustainable.

Anyway, it seems that you have missed the sentiment of my posts. I must not have been effective in conveying what I meant to say. I'd like to keep this going, but I'm behind on studying. I'll probably check again maybe in a few days.

 

[Aerus]

I think we all know that, and I was writing under the assumption that people reading my post would realize that I know that as well. My fault for assuming. I am obviously addressing people who do not have a pathological reason for being overweight. If you disagree with what I said, please address the substance of my post and not some unimportant detail.

Even if it wasn't a pathological reason and the sole reason for their being overweight was strictly diet and exercise, it still isn't a choice for many people. Being obese is correlated with socioeconomic status.

 

[tmn]

Even if it wasn't a pathological reason and the sole reason for their being overweight was strictly diet and exercise, it still isn't a choice for many people. Being obese is correlated with socioeconomic status.

How so? Correlation ≠ causation. All you have said is that people of lower socioeconomic status have a tendency to make poorer health decisions. Their decision making is obviously influenced by a great number of things but that doesn't change the fact of what it is: a decision.

 

[Aerus]

How so? Correlation ≠ causation. All you have said is that people of lower socioeconomic status have a tendency to make poorer health decisions. Their decision making is obviously influenced by a great number of things but that doesn't change the fact of what it is: a decision.

Have you ever heard of food deserts? People who live in these places have very little, if any, choice in what they eat. Moving to another place with healthier options isn't viable because of their financial status. Exercise isn't very possible if you're working 70-80 hours a week trying to pay for rent, food, and preparing to send your kids to college, and what not.

 

[tmn]

Have you ever heard of food deserts? People who live in these places have very little, if any, choice in what they eat. Moving to another place with healthier options isn't viable because of their financial status. Exercise isn't very possible if you're working 70-80 hours a week trying to pay for rent, food, and preparing to send your kids to college, and what not.

"We always have a choice." - Jax Teller

 

[tmn]

Have you ever heard of food deserts? People who live in these places have very little, if any, choice in what they eat. Moving to another place with healthier options isn't viable because of their financial status. Exercise isn't very possible if you're working 70-80 hours a week trying to pay for rent, food, and preparing to send your kids to college, and what not.

Again, correlation ≠ causation. Difficult ≠ impossible. It is incredibly unfair that some people get dealt a bad hand in life. All that can be expected of anybody in any aspect of life is that they do their best with the situation they are in. I suspect you're using the socioeconomic status data (even though it is just correlation) as a distractor.

Do you estimate that the majority of overweight Americans are trying their best to live a healthy life?

I would still guess that my original point is true: that the majority of overweight Americans are overweight because of the unhealthy choices they make daily (lack of exercise, poor diet) and because of their lack of desire/effort to improve their health. People do not prioritize their own health.

I'm suggesting that physicians attempt to redirect American priorities toward personal health over comfort/convenience.

 

[Aerus]

Again, correlation ≠ causation. Difficult ≠ impossible. It is incredibly unfair that some people get dealt a bad hand in life. All that can be expected of anybody in any aspect of life is that they do their best with the situation they are in. I suspect you're using the socioeconomic status data (even though it is just correlation) as a distractor.

Do you estimate that the majority of overweight Americans are trying their best to live a healthy life?

I would still guess that my original point is true: that the majority of overweight Americans are overweight because of the unhealthy choices they make daily (lack of exercise, poor diet) and because of their lack of desire/effort to improve their health. People do not prioritize their own health.

I'm suggesting that physicians attempt to redirect American priorities toward personal health over comfort/convenience.

I'm NOT saying that it is 100% impossible for them to change their weight. What I am saying is that a "choice of changing diet and exercise" is grossly oversimplifying the case and ignores a lot of the sociological factors that affects weight. Sure, people normally work as hard as they can to be as rich as they can. Being a millionaire is a choice after all right? Obviously, to some degree, there is a factor of freedom, but in a realistic sense, this isn't the case.

No, correlation does not equal causation, but we must extrapolate what that correlation means. Why are SAT scores correlated with how many pots you have in your kitchen cabinet? We can extrapolate that correlation to mean that it's likely to be wealth that leads to increases in SAT scores. The same is done for here. Ignoring the fact that there is a correlation would be foolish, since correlations don't happen just because.

 

[SkipJunior]

How so? Correlation ≠ causation. All you have said is that people of lower socioeconomic status have a tendency to make poorer health decisions. Their decision making is obviously influenced by a great number of things but that doesn't change the fact of what it is: a decision.

You say weight loss is merely a decision. I challenge you to make the "decision" to lose 10 pounds right now, regardless of whether you are overweight or of a healthy weight. Lose the 10 pounds and then get back to us on how "easy" it is to lose weight and how shaming and humiliating fat med school applicants and patients will make them lose weight.

 

[tmn]

You say weight loss is merely a decision. I challenge you to make the "decision" to lose 10 pounds right now, regardless of whether you are overweight or of a healthy weight. Lose the 10 pounds and then get back to us on how "easy" it is to lose weight and how shaming and humiliating fat med school applicants and patients will make them lose weight.

Nice reductio ad absurdum.

I never said anything about easy. In fact I said the opposite: that achieving a healthy weight is contrary to comfort and convenience. I said that it is about a realignment of priorities.

 

[jakeislove]

I never said anything about easy. In fact I said the opposite: that achieving a healthy weight is contrary to comfort and convenience. I said that it is about a realignment of priorities.

Most obesity is related to lifestyle. Why is it such a big deal to say what we already know?

 

[tmn]

I'm NOT saying that it is 100% impossible for them to change their weight. What I am saying is that a "choice of changing diet and exercise" is grossly oversimplifying the case and ignores a lot of the sociological factors that affects weight. Sure, people normally work as hard as they can to be as rich as they can. Being a millionaire is a choice after all right? Obviously, to some degree, there is a factor of freedom, but in a realistic sense, this isn't the case.

No, correlation does not equal causation, but we must extrapolate what that correlation means. Why are SAT scores correlated with how many pots you have in your kitchen cabinet? We can extrapolate that correlation to mean that it's likely to be wealth that leads to increases in SAT scores. The same is done for here. Ignoring the fact that there is a correlation would be foolish, since correlations don't happen just because.

How many times have I mentioned that obesity is a highly nuanced, multifactorial issue?

No one is ignoring any facts. The truth is that somethings are within a person's control and some things are not. The level of health that a person is able maintain with the resources that person has is highly variable, but the amount of importance that a person places on their own health is certainly within their control.

And to bring us back to the point: do you believe that the majority of overweight Americans are trying their best to be healthy?

The thing that I take issue with is the lack of importance that people place on their own health.

 

[tmn]

Most obesity is related to lifestyle. Why is it such a big deal to say what we already know?

THIS. I would have never guessed that so many medical or future medical people are having trouble understanding this.

 

[Aerus]

How many times have I mentioned that obesity is a highly nuanced, multifactorial issue?

No one is ignoring any facts. The truth is that somethings are within a person's control and some things are not. The amount of importance that a person places on their own health is certainly within their control. The level of health that a person is able maintain with the resources that person has is highly variable.

And to bring us back to the point: do you believe that the majority of overweight Americans are trying their best to be healthy?

The thing that I take issue with is the lack of importance that people place on their own health.

Stop trying to change your argument to fit the person replying to you. I was always referring to your comment here:

While it certainly is anybody's choice to be overweight or smoke or use heroine, it shows bad judgment.

I'm sorry that prioritizing your family's financial stability is poor judgement. I'm sure the family should just uproot themselves to a city hundreds of miles away where healthier food options exist. Also, working to pay rent? Nah, I should just exercise.

THIS. I would have never guessed that so many medical or future medical people are having trouble understanding this.

I would have never guessed that a "future medical person" would be having so much trouble defending their initial position.

 

[tmn]

Stop trying to change your argument to fit the person replying to you. I was always referring to your comment here:



I'm sorry that prioritizing your family's financial stability is poor judgement. I'm sure the family should just uproot themselves to a city hundreds of miles away where healthier food options exist. Also, working to pay rent? Nah, I should just exercise.



I would have never guessed that a "future medical person" would be having so much trouble defending their initial position.

Answer one question please.

Do you believe that the majority of obese people are trying their best to be healthy?

If your answer is no, then can you see that the majority of the obesity problem is related lifestyle choices?

If someone chooses to not place importance on their own health, I consider that bad judgement.

 

[jakeislove]

THIS. I would have never guessed that so many medical or future medical people are having trouble understanding this.

Intellectual and emotional understanding aren't always in sync.

 

[Aerus]

Answer one question please.

Do you believe that the majority of obese people are trying their best to be healthy?

There you go again, changing your initial argument. Majority? No. A significant portion? Yes, because it is out of their control. You can't just apply something to a "generalized people" by simply addressing the majority.

If your answer is no, then can you see that the majority of the obesity problem is related lifestyle choices?

As I said, this is a gross overgeneralization. Yes, there are people who are obese who simply make poor lifestyle choices. There are also many people who don't have a choice in their lifestyle. Their lifestyle is poor, but not due to a choice.

If someone chooses to not place importance on their own health, I consider that bad judgement.

I consider someone who prioritizes their own health over the survival of their family to be of poor judgement.

 

[tmn]

There you go again, changing your initial argument. Majority? No. A significant portion? Yes, because it is out of their control. You can't just apply something to a "generalized people" by simply addressing the majority.



As I said, this is a gross overgeneralization. Yes, there are people who are obese who simply make poor lifestyle choices. There are also many people who don't have a choice in their lifestyle. Their lifestyle is poor, but not due to a choice.



I consider someone who prioritizes their own health over the survival of their family to be of poor judgement.

I have been transparent that I have been generalizing, estimating, and speculating. My position is based on an estimation, but as far as I can tell, no one has suggested an alternate estimation, let alone contrary data. Try to follow me here, because I haven't changed my argument. I will try to outline my position for you.

1) My estimation: The majority of the obesity problem in America is related to choices. a) Obviously there are pathological reasons for being overweight. b) There are also may be factors outside of a person's control that make it impossible (or even unreasonably difficult) for that person to improve their health. We'll call this group the people who have maximized their health with the resources they have. Despite maximum effort, they have reached a "ceiling" of health based on their unchangeable situation. c) There are also people who are overweight who have made the decision to place importance on their health and are making real progress towards a healthy life or are at least making a genuine, whole-hearted effort to be healthy. This group is trying their honest best to improve their health.

- I would venture to guess that the overwhelming majority of overweight Americans do not fit into a), b), or c). Therefor, the majority of the obesity problem is a result of choices. If my estimation is correct, the majority of overweight Americans have within their control the ability to improve their health. (Unless I am overlooking something, in which case I would genuinely appreciate hearing about it.)

2) If you disagree with my estimation that the majority of the obesity problem in America is related choices, then we are at an impasse. (Any data would be appreciated.)

3) If you agree with my estimation that the majority of the obesity problem in America is related to choices, then here is where we bring it home: overweight people who choose to not prioritize their health and choose to not improve their health (via lack of exercise and poor diet), despite knowing the risks, are of poor judgement. I am of the belief that very few things (especially not things like comfort/convenience) should take priority over one's personal health. If you don't believe that personal health should be a priority, then I guess this is another impasse.

Caveat: It is possible that there are obese people who choose to be sedentary and choose an unhealthy diet, but are unaware of the health implications of obesity and would make healthy choices if they knew better. (Again, I would venture to guess that this is a small minority). In this case, education is an obvious (maybe not easy) solution.

Addendum: If groups a), b), and c) are unable to improve their health based on their conditions, then it is not worth mentioning them when discussing the cause/solution to the modifiable obesity problem in America. It is conceivable that obesity has been around for some time. The existence of the above groups does not appear explain the dramatic rise in obesity in America over the last 100 years or 20 years.

I really want to hear where people may disagree, if people have any alternate estimations, or if anyone has any data supporting or refuting anything I've estimated.

 

[SkipJunior]

Caveat Emptor! Weight loss is not as easy as tmn portrays it to be. Changing one's lifestyle is not as easy as is portrayed in this thread. Notice how tmn has refused to respond to my challenge of losing 10 pounds. He won't do it but if he did, he will realize that losing weight is not as simple and easy as changing one's judgement and making different choices.

 

[tmn]

Caveat Emptor! Weight loss is not as easy as tmn portrays it to be. Changing one's lifestyle is not as easy as is portrayed in this thread. Notice how tmn has refused to respond to my challenge of losing 10 pounds. He won't do it but if he did, he will realize that losing weight is not as simple and easy as changing one's judgement and making different choices.

http://forums.studentdoctor.net/threads/weight-gain-and-interviews.1098453/page-2#post-15686916

 

[Zelda840]

Do you believe that the majority of obese people are trying their best to be healthy?

The majority of obese people in general or the number of obese medical school applicants? I think those data sets will probably differ somewhat. I think the med school applicant who is obese would be more likely to have a health issue of their own or be actively working on losing the weight. Just a guess though, no data to support it.

 

[SkipJunior]

http://forums.studentdoctor.net/threads/weight-gain-and-interviews.1098453/page-2#post-15686916

You never said it but you implied it throughout this thread. That's why you feel shaming and humiliating fat patients and refusing admission to fat med school applicants (again implied but not stated) will cause them to change their "bad judgement" and "re-align their priorities". You make it sound so easy! Why don't you show us how easy it is then, lose 10 pounds and get back to us. I know you won't do it because you know it's too hard for you, you don't want to take your own advice.

 

[tmn]

Caveat Emptor! Weight loss is not as easy as tmn portrays it to be. Changing one's lifestyle is not as easy as is portrayed in this thread. Notice how tmn has refused to respond to my challenge of losing 10 pounds. He won't do it but if he did, he will realize that losing weight is not as simple and easy as changing one's judgement and making different choices.

Assuming you're addressing overweight people who genuinely attempt to lose weight via exercise and diet but are unsuccessful, then I would direct you to 1)c) here: http://forums.studentdoctor.net/threads/weight-gain-and-interviews.1098453/page-2#post-15687103

Me losing 10 pounds has nothing to do with my argument. A more congruent challenge would be to challenge me to exercise regularly and eat healthy.

 

[jakeislove]

I'd be willing to gain 10 pounds.

 

[tmn]

You never said it but you implied it throughout this thread. That's why you feel shaming and humiliating fat patients and refusing admission to fat med school applicants (again implied but not stated) will cause them to change their "bad judgement" and "re-align their priorities". You make it sound so easy! Why don't you show us how easy it is then, lose 10 pounds and get back to us. I know you won't do it because you know it's too hard for you, you don't want to take your own advice.

Reductio ad absurdum. And straw man. I never said it was easy. Me losing 10 pounds has nothing to do with the priority that people place on their health.

If you have something to address in regards to my thought-out summary of my stance, I will gladly engage you. Otherwise I think we're done. You seem uninterested in discussing the real topic.

 

[SkipJunior]

Assuming you're addressing overweight people who genuinely attempt to lose weight via exercise and diet but are unsuccessful, then I would direct you to 1)c) here: http://forums.studentdoctor.net/threads/weight-gain-and-interviews.1098453/page-2#post-15687103

Me losing 10 pounds has nothing to do with my argument. A more congruent challenge would be to challenge me to exercise regularly and eat healthy.

Yes it does because plenty of people (a lot more than you think) try to lose weight and they can't. They eat healthy, exercise regularly and still can't lose weight due to physical and psychological ailments. You come in here like a big boss and say "change your judgement, change your choices, re-align your priorities and weight loss is very doable! Oh and if you don't do what I say, don't mind if I start shaming and humiliating you!"

Sure thing buddy, why don't you show us first? Lose those 10 pounds and show us how do-able it is. I'm pretty sure you won't agree to it and will bring up some other nonsense. We won't take you seriously here unless you put your money where your mouth is, lose those 10 pounds and show us how do-able it is!!

 

[reapplicanthelpme2014]

Hey, can @Winged Scapula close this thread? COMPLETELY off base with the question I initially asked and got answered. I just wanted to know if being a big girl would affect my med school acceptance chances. Done.

 

[Aerus]

I have been transparent that I have been generalizing, estimating, and speculating. My position is based on an estimation, but as far as I can tell, no one has suggested an alternate estimation, let alone contrary data. Try to follow me here, because I haven't changed my argument. I will try to outline my position for you.

1) My estimation: The majority of the obesity problem in America is related to choices. a) Obviously there are pathological reasons for being overweight. b) There are also may be factors outside of a person's control that make it impossible (or even unreasonably difficult) for that person to improve their health. We'll call this group the people who have maximized their health with the resources they have. Despite maximum effort, they have reached a "ceiling" of health based on their unchangeable situation. c) There are also people who are overweight who have made the decision to place importance on their health and are making real progress towards a healthy life or are at least making a genuine, whole-hearted effort to be healthy. This group is trying their honest best to improve their health.

- I would venture to guess that the overwhelming majority of overweight Americans do not fit into a), b), or c). Therefor, the majority of the obesity problem is a result of choices. If my estimation is correct, the majority of overweight Americans have within their control the ability to improve their health. (Unless I am overlooking something, in which case I would genuinely appreciate hearing about it.)

2) If you disagree with my estimation that the majority of the obesity problem in America is related choices, then we are at an impasse. (Any data would be appreciated.)

3) If you agree with my estimation that the majority of the obesity problem in America is related to choices, then here is where we bring it home: overweight people who choose to not prioritize their health and choose to not improve their health (via lack of exercise and poor diet), despite knowing the risks, are of poor judgement. I am of the belief that very few things (especially not things like comfort/convenience) should take priority over one's personal health. If you don't believe that personal health should be a priority, then I guess this is another impasse.

Caveat: It is possible that there are obese people who choose to be sedentary and choose an unhealthy diet, but are unaware of the health implications of obesity and would make healthy choices if they knew better. (Again, I would venture to guess that this is a small minority). In this case, education is an obvious (maybe not easy) solution.

Addendum: If groups a), b), and c) are unable to improve their health based on their conditions, then it is not worth mentioning them when discussing the cause/solution to the modifiable obesity problem in America. It is conceivable that obesity has been around for some time. The existence of the above groups does not appear explain the dramatic rise in obesity in America over the last 100 years or 20 years.

I really want to hear where people may disagree, if people have any alternate estimations, or if anyone has any data supporting or refuting anything I've estimated.

I don't disagree with what you said in this post. My only reason for posting in this thread in the first place was to address your over-generalization that obesity was a choice and that people who are obese have poor judgement. You never stated anything about a category of obese people of choice vs. non-choice. If your original post stated your position like you just did, then I would not have posted in this thread. If you want to over-generalize, then prepare to be called out on it. That's all I've been trying to say for the past three posts.