If you were the World Dictator, how would you solve the Obesity Problem?

BU Medical Sciences
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touchpause13 said:
I wouldn't do anything. I really don't give a **** if people are fat, it doesn't affect me.
#comeatmebro
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It will when you're performing or observing a pelvic exam on a 400 pound land whale. The smell sticks with you for days.
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ElCapone said:
This is going to be really blunt of me to say this, but most people don't have the discipline to follow through with weight loss. That's why so few people go into Powerlifting/Strong Man/Olympic Lifting/Bodybuilding and stick around than you'd think there would.

Here's an example of our fellow peers/the common man/Joe-schmo/the average American:

http://1-media-cdn.foolz.us/ffuuka/board/sp/image/1352/04/1352049224110.jpg


EDIT: I apologize for the language used in that picture. I didn't make it, and just put it up to illustrate a point.
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I'm 5'11" and I've gone from 280 lbs to 185 lbs over the past year and a half through better eating habits and a mix of cardio and barbell training. When heavy people ask me how to lose weight, the conversation, always goes like this: http://www.youtube.com/watch?v=VKs0oEIVOck
 
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If I were a dictator, I will declare a civil war between the fat-rich people and fat-poor people.
 
I would throw out the Lipid Hypothesis and set food guidelines that resemble a paleolithic diet. I would also ban "vegetable oils" (which are really just seed oils) and would make livestock eat nothing but grass.

That would solve almost every health problem we have today.

And no, saturated fat isn't bad for you.
 
Dictators should order their people to increase veggies and lower food fried in non-natural saturated fat. Butter is still better than artificial stuff like margarine.

Dictators order HFCs banned for all members of the ruling party and mandate them as staples of all opposing parties and people of low socioeconomic status to curb any uprising (btw, I've implemented a Caste system, so you're stuck where you are when you're born.)

If you can't have normal physical exams and imaging due to you not taking care of yourself, you forgo them entirely.
Accelerated Natural Selection.

Extra HFC-filled sodas for the non-believers with every snack and meal.
Diet-mediated Natural Selection.

Sterilization of anyone smoking cigarettes beyond a carton per year or having a BMI above 30 for more than a few years.
Implement a "rump radius index" to decide whom gets healthcare and whom doesn't.
Mandated Natural Selection.

By the way, the word dictator looks a lot like doctor; I'm going to embrace and run with it. In the end, I'll dictate that we should help along Natural Selection in the most expeditious way possible for those that don't care about their health to navigating themselves away from it.

PS: I've gotta admit, I'm a firm 'mirin' advocate.
 
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The simple answer is make "healthy" food less expensive and "unhealthy" food more expensive. However as a dictator you can't tell people to do this without also making it easier to do.

Remove some farm subsidies which only further reinforce the cost barrier to healthy eating. Has anyone ever heard of a broccoli subsidy? No its corn and soybeans which in turn feed mega corporations that raise beef, pork, chickens.

Change the culture of the country away from immediate satisfication. Think drive-thru's, TV dinners, immediate fixes at the doctors office etc. (This is the hardest-personal responsibility)

Outlaw marketing, any marketing towards food all food. As much as we would like to deny it, marketing brainwashes us.

Also, a calorie is not calorie. It takes your body much more energy and calories to digest celery than it does that box of oreos. Researchers are looking at this at the molecular level in your body now. Fat goes straight to fat much easier than glucose goes to fat.
 
FakeEmpire said:
Also, a calorie is not calorie. It takes your body much more energy and calories to digest celery than it does that box of oreos. Researchers are looking at this at the molecular level in your body now. Fat goes straight to fat much easier than glucose goes to fat.
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It takes your body much more energy and calories to digest an equivalent caloric amount of celery as it does oreos?
 
MedPR said:
It does if you've ever paid for healthcare ;)
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yeah. I went on "subsidized" unemployment healthcare for like 2 months before obamacare kicked in (as I was 25 at the time). Holy ~$500/month batman! :eek:
 
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MedPR said:
Yes, I understand that. However, if I eat 10,000 calories worth of lettuce, is it any different than 10,000 calories worth of oreos? I'd have to consume a much larger volume of lettuce to hit 10k calories than oreos, but I would still be eating 10k calories.
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vastly different.....

2400 calories/day at Five Guys? you'd be on the fast track to the cath lab

2400 Balanced calories/day? not so much
 
WhizoMD said:
vastly different.....

2400 calories/day at Five Guys? you'd be on the fast track to the cath lab

2400 Balanced calories/day? not so much
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Like I said. Portion control is the bigger problem.

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Teach people how to read nutrition labels. A lot of food manufacturers make nutrient claims that many people fall for. They think food is healthy because it's been fortified with vitamins (like Poptarts). I mean at least they might be getting some vitamins, but these people fail to take into account all the fat, sugar, sodium, etc. that's making the food unhealthy and increasing their risk for obesity and health problems.
 
Healthy food also needs to taste good to the average American. People try healthier options, realizes it tastes bad, and go back to "unhealthy" food which tastes good. After all, if it doesn't taste good, there is no incentive to eat it. Same with if it takes more than 10 minutes to make. I have no idea how to fix that however :(

Banning "bad" foods would lead to black markets of fried chicken and chicken McNuggets. It's bad enough that if a dietitian tells someone to cut down on major foods, they scream at their face and sue them. If there was a ban, prepare for riots, marching protests, vandalism of Whole Foods + Subway....

Definitely not an easy fight to face!
 
Force activity and success to obtain food. Attach a burger to one of those rabbit things at the dog races that they chase.
 
HopefulSlav said:
I would throw out the Lipid Hypothesis and set food guidelines that resemble a paleolithic diet. I would also ban "vegetable oils" (which are really just seed oils) and would make livestock eat nothing but grass.

That would solve almost every health problem we have today.

And no, saturated fat isn't bad for you.
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I thought I would have to be the first person to say it.

My first order of business would be to ban wheat and wheat products.
 
Tax credits for gym memberships, ID cards for buying fast food - illegal to buy unless you are 18 or 21... You do it for alcohol...

I like the whole no more cars idea lol
 
impose a fat tax. too poor to pay? better lose some weight, porky!
 
Require all workplaces to fully insure their employees. Offer drastically reduced costs for healthy people. Let the market do the rest.

If I had unlimited money: implement a comprehensive public transportation system (read: Japanese-quality trains and subways, not Amtrak and NYC's "system") in and between all major metropolitan areas, jack up gas prices, and convert a fair amount of pavement into green space. This would force many to walk, either to the train, or from the train at their destination.

MedPR said:
It takes your body much more energy and calories to digest an equivalent caloric amount of celery as it does oreos?
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A calorie of the various kinds of protein, (saturated) fat, and carbohydrates are all processed differently in the body. The calorie as a measure of heat is an easy way to provide an "energy amount" within food, but your body doesn't produce energy by combusting all that material in your stomach.

A more accurate way of tracking your food intake (and output) would be to physically weight everything. You can't gain 2 kg if you're only putting 1 kg inside your body.
 
Cut out high carbohydrate foods that are loaded with refined sugar. They are worse than just eating high fat foods alone. High carbohydrate foods that are high in fat are really bad for you and are way worse than either alone.

Get people to use things like the HAPIfork, while eating. Also using things like food scales and logging it in to software such as CalorieKing. Use heart rate monitors while exercising, pedometers to monitor progress, which is beneficial for everyone.

There are other potentially futuristic ideas, that would work for eating. Being diabetic, I know there are all sorts of possibilities with Near Field Communication (NFC) and Radio Frequency Identification (RFID). I can think of some creative technology applications for eating that would not impede on the eating process itself, such as the social aspect.
 
We cannot punish companies for selling products people want in a free market like the US.


Simply the most effective method would be,

1. structured taxing system "higher taxes for public services and food products all based on the overweight appearance of the individual"
 
Truckers pay by the pound for the cargo they transport, have people be weighed and taxed on the road or in the air based on their BMI. BMI is still sloppy, but it's a good start. Yes, if you take up more than one seat, you pay for the one next to you. If you or the luggage you carry on doesn't meet the size requirements, you should be checked to baggage with a parka and an oxygen mask if you're flying the Dictator's airline.

Keep all the good or bad foods out there available, just cut people off from healthcare, INCLUDING ED VISITS, until they follow what's in the 5 page nutrition pamphlet written for a 5th grader that you go through with them once and have a nurse go over again and again when they come in. Have them pay cash for a hearing aid if they don't comply.

Don't be afraid to fire patients, or, in the case of a dictatorship, shackling them to a vegetable cart to do a couple of laps around the Supreme Commander's palace.

I went to a dark place with this post. I apologize for that.
 
JGimpel said:
Truckers pay by the pound for the cargo they transport, have people be weighed and taxed on the road or in the air based on their BMI. BMI is still sloppy, but it's a good start. Yes, if you take up more than one seat, you pay for the one next to you. If you or the luggage you carry on doesn't meet the size requirements, you should be checked to baggage with a parka and an oxygen mask if you're flying the Dictator's airline.

Keep all the good or bad foods out there available, just cut people off from healthcare, INCLUDING ED VISITS, until they follow what's in the 5 page nutrition pamphlet written for a 5th grader that you go through with them once and have a nurse go over again and again when they come in. Have them pay cash for a hearing aid if they don't comply.

Don't be afraid to fire patients, or, in the case of a dictatorship, shackling them to a vegetable cart to do a couple of laps around the Supreme Commander's palace.

I went to a dark place with this post. I apologize for that.
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I remember airlines tried to charge for weight and the crap they got for it was pretty remarkable.

I don't agree with your second point, the medical community actually seems pretty ignorant on what a good diet/exercise program is. I'd hate to be forced to follow some doctor's broscience routine.
 
sliceofbread136 said:
I remember airlines tried to charge for weight and the crap they got for it was pretty remarkable.

I don't agree with your second point, the medical community actually seems pretty ignorant on what a good diet/exercise program is. I'd hate to be forced to follow some doctor's broscience routine.
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We're still talking about what would happen under a dictatorship, right?

Don't worry, I'm not going to quote any of that "holistic" crap, but I think I got a great background in nutrition from my medical school and feel confident in advising patients on what to do in making good lifestyle choices.
 
sliceofbread136 said:
I remember airlines tried to charge for weight and the crap they got for it was pretty remarkable.

I don't agree with your second point, the medical community actually seems pretty ignorant on what a good diet/exercise program is. I'd hate to be forced to follow some doctor's broscience routine.
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Heh, medical school nutrition and exercise courses are science based and go on what is in the literature. I'd argue that approaches outside of medicine are much more "bro-science" based that what you'll find in a medical school.
 
sliceofbread136 said:
I remember airlines tried to charge for weight and the crap they got for it was pretty remarkable.

I don't agree with your second point, the medical community actually seems pretty ignorant on what a good diet/exercise program is. I'd hate to be forced to follow some doctor's broscience routine.
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I'm pretty sure that the premise of this thread was how much behavior would change if one had absolute control over the respective penalties for non-healthy lifestyles. It's a light-hearted approach to a common frustration that all physicians must deal with.

You are not even in medical school yet. I would avoid making blanket statements about the quality of people's medical education based on the profile of their patients or any other index that you can't begin to discuss before you begin your medical training.

'Broscience' has a pretty bad connotation on this site; I wasn't even sure what people were referring to at first, but it sounds like what one pro weightlifter advises another one at the gym that doesn't have much EBM behind it. Again, painting with such a broad brush when you haven't even bought the canvas yet is not advisable.

Back to the silly; if I were a dictator, I would ship people over a BMI over 32 UPS Ground or freight. If anyone can't fit in a normal CT or MRI machine, they don't get one and get blind laparotomies for any kind of abdominal pain. I could go on all day, but let's not get too serious about this.
 
Make everyone run on elliptical machines so that I can harness the energy to power all the things!!!
 
JGimpel said:
I'm pretty sure that the premise of this thread was how much behavior would change if one had absolute control over the respective penalties for non-healthy lifestyles. It's a light-hearted approach to a common frustration that all physicians must deal with.

You are not even in medical school yet. I would avoid making blanket statements about the quality of people's medical education based on the profile of their patients or any other index that you can't begin to discuss before you begin your medical training.

'Broscience' has a pretty bad connotation on this site; I wasn't even sure what people were referring to at first, but it sounds like what one pro weightlifter advises another one at the gym that doesn't have much EBM behind it. Again, painting with such a broad brush when you haven't even bought the canvas yet is not advisable.

Back to the silly; if I were a dictator, I would ship people over a BMI over 32 UPS Ground or freight. If anyone can't fit in a normal CT or MRI machine, they don't get one and get blind laparotomies for any kind of abdominal pain. I could go on all day, but let's not get too serious about this.
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In my experience most doctors know jack diddly crap about correct exercise and diet habits. I dont care if I'm in medical school yet or not, I've heard so much bullcrap broscience from doctors it blows my mind. Brb, follow the food pyramid, eat natural food to lose weight, cut fats out of diet. FACEPALM.
 
JGimpel said:
I'm pretty sure that the premise of this thread was how much behavior would change if one had absolute control over the respective penalties for non-healthy lifestyles. It's a light-hearted approach to a common frustration that all physicians must deal with.

You are not even in medical school yet. I would avoid making blanket statements about the quality of people's medical education based on the profile of their patients or any other index that you can't begin to discuss before you begin your medical training.

'Broscience' has a pretty bad connotation on this site; I wasn't even sure what people were referring to at first, but it sounds like what one pro weightlifter advises another one at the gym that doesn't have much EBM behind it. Again, painting with such a broad brush when you haven't even bought the canvas yet is not advisable.

Back to the silly; if I were a dictator, I would ship people over a BMI over 32 UPS Ground or freight. If anyone can't fit in a normal CT or MRI machine, they don't get one and get blind laparotomies for any kind of abdominal pain. I could go on all day, but let's not get too serious about this.
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Also, medical education doesn't teach you how to get fit. I don't know why anyone would think it would...

Some of the worst broscience comes from "literature"
 
I'd make everyone who needs a seat belt extender pay for two seats on their flight.

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I'd make everyone who needs a seat belt extender pay for two seats on their flight.

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If im the dictator, why is it my issue if other people are fat. As a matter of fact, even if im not the worlds dictator why is it anybody else's issue besides for the fat people??
 
I wouldn't...if someone is more comfortable being overweight and at risk for serious health problems than they are with eating regularly and exercising, then that's their choice.

I know why we technically call it an obesity epidemic, but I feel that the term doesn't fit very well. It brings to mind outbreaks of infectious disease, which is an entirely different sort of phenomenon, and a lot less based on personal choices.

What I would do is expect a reasonable charge if and only if the obesity required extra accomodations. Need a plus-sized MRI machine? Those are pricey, and that cost should be reflected in the bill. Take up 2 seats on the bus? You should pay for the extra seat. And so forth...
It's not even that I would implement this to "punish" or "discourage" obesity. It's simply that most services operate by offering a certain range of options, centered around the average consumer. Requiring special treatment costs extra money. Tall people have to pay for extra legroom, wide people ought to pay for extra butt-room.
If obesity becomes average, well, then companies may well adjust their standard options to suit that...but I don't see why we should start with the assumption that these accomodations should only cost the companies providing them.

People should be allowed to make decisions, even stupid ones. :shrug:
 
mehc012 said:
What I would do is expect a reasonable charge if and only if the obesity required extra accomodations. Need a plus-sized MRI machine? Those are pricey, and that cost should be reflected in the bill. Take up 2 seats on the bus? You should pay for the extra seat. And so forth...
It's not even that I would implement this to "punish" or "discourage" obesity. It's simply that most services operate by offering a certain range of options, centered around the average consumer. Requiring special treatment costs extra money. Tall people have to pay for extra legroom, wide people ought to pay for extra butt-room.
If obesity becomes average, well, then companies may well adjust their standard options to suit that...but I don't see why we should start with the assumption that these accomodations should only cost the companies providing them.

People should be allowed to make decisions, even stupid ones. :shrug:
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No, this is not the right approach.

This is a social issue and it has to be addressed systemically, with multiple aspects of prevention and education--and getting rid of certain types of foods. For example, there are certain individuals from certain ethnic groups whose bodies were never meant to eat large amounts of carbohydrates. Just look at Pima Indians and their type 2 diabetes rates.

While there are people who make poor choices and do not mind being obese at all (I know, I have relatives with type 2 diabetes who are out of control when it comes to their eating habits), penalizing them is not the way to go.

For example, obesity was never a mainstream problem when my parents were growing up. Now the problem has exploded, for a variety of reasons. It is a SOCIAL problem, and has much less to do with the problem being the individuals themselves.
 
moco89 said:
No, this is not the right approach.

This is a social issue and it has to be addressed systemically, with multiple aspects of prevention and education.

While there are people who make poor choices and do not mind being obese at all (I know, I have relatives with type 2 diabetes who are out of control when it comes to their eating habits), penalizing them is not the way to go.

For example, obesity was never a mainstream problem when my parents were growing up. Now the problem has exploded, for a variety of reasons. It is a SOCIAL problem, and has much less to do with the problem being the individuals themselves.
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I'm not saying we should penalize them. It's not about punishing them, or trying to reduce obesity. I don't care if they're obese. All I'm saying is that their obesity shouldn't cost other people money. If someone requires a more expensive/difficult service (say, extra wide seats on a plane), it should cost more than the less expensive/difficult service (say, normal seats on a plane). That's all I was trying to get at.
 
KnuxNole said:
Healthy food also needs to taste good to the average American. People try healthier options, realizes it tastes bad, and go back to "unhealthy" food which tastes good. After all, if it doesn't taste good, there is no incentive to eat it. Same with if it takes more than 10 minutes to make. I have no idea how to fix that however :(

Banning "bad" foods would lead to black markets of fried chicken and chicken McNuggets. It's bad enough that if a dietitian tells someone to cut down on major foods, they scream at their face and sue them. If there was a ban, prepare for riots, marching protests, vandalism of Whole Foods + Subway....

Definitely not an easy fight to face!
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Healthy foods only taste bad to people because they've grown up eating unhealthy foods. Your tastes in food are developed pretty young. Start providing healthy meals in schools and people will develop better eating habits. Pizza, steak-ums, tater tots, riblets, etc are whats in school food, so people actually like that crap because its what they're used to.
 
galaxyx said:
Healthy foods only taste bad to people because they've grown up eating unhealthy foods. Your tastes in food are developed pretty young. Start providing healthy meals in schools and people will develop better eating habits. Pizza, steak-ums, tater tots, riblets, etc are whats in school food, so people actually like that crap because its what they're used to.
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Oh god but tots are amazing!

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SpecterGT260 said:
Oh god but tots are amazing!

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I should have left the tots off the list. Even I like tater tots, and I'm not a school food/fast food fan. (When I was a kid, I use to throw tantrums if we went to McDonald's for dinner because I didn't want to eat it.)
 
Make everyone accumulate "Prev-Med Points." If people buy/eat too much junk food, they'll eventually have to take a BP med and a Statin. At least they can swallow 2 pills while swallowing everything else. People want everything solved in a little pill, and there you have it! People with a ton of points also are banned from tight leggings and anything Spandex.

I couldn't wait to see Flight Attendants measuring a BMI and waist circumference on people to see if they need to buy another seat. If nothing else, they get pushed to standby if the flight is full, since they're going to take two seats that can't be accommodated. Throw on a Carbon Footprint/Hoof print tax if they're ginormous, while you're at it.

I'm not touching tots though. Deep fried, loaded with all sorts of fried meats, cheeses, and sour cream is my favorite. I'm not obese, by the way.

In a dictatorship, everyone is getting judged on whatever the dictator chooses to base judgement on; let's at least take advantage of this.
 
galaxyx said:
Healthy foods only taste bad to people because they've grown up eating unhealthy foods. Your tastes in food are developed pretty young. Start providing healthy meals in schools and people will develop better eating habits. Pizza, steak-ums, tater tots, riblets, etc are whats in school food, so people actually like that crap because its what they're used to.
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That's a good point. Reminds of this one show a few years ago(I think Jamie Oliver Food Revolution) where they were trying to change the lunch menu for kids, and people didn't like the taste of fruits and veggies nor knew what veggies even are. Although it makes sense(kids don't beg mommy and daddy to get the chicken salad for lunch!), early exposure is good instead of only giving unhealthy foods. Sometimes parents spoil their kids and submit to tantrums in terms of what they will and will not eat. That's another unfortunate problem.
 
Judging by the course of action the USA takes with intruding in your personal life, I can guarantee the next step is hiring discrimination based on weight.
 
sliceofbread136 said:
People just need to experience how easy it is to lose weight. 3 hours a week in the gym and the IIFYM diet is much easier than what some people resort to lose weight, and it will actually work. It's not like even have to be super consistent to be moderately healthy. I occasionally have 6k calorie cheat meals and I still get great cut results. When I start bulking I'll be having cheat meals everyday. It's not like I'm working so much harder than your avg fatty, I just know what I'm doing (I actually have a great lifting coach :D)
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Even if that works temporarily, the weight won't stay off (for most people). Different people have different setpoints and hormonal regulation of weight varies from person to person. It might work for you but the physiology of weight management is such that some people can pump out a few curls in front of the mirror and look more fit than 95% of the population, while others exercise, diet, etc and see no real change.

Many studies have shown that the only truly effective way to lose weight and keep it off is through gastric bypass, banding, sleeve gastrectomy, and other similar procedures. Behavior therapy and dietary changes often do absolutely nothing in the long run because people's bodies will not let them maintain a weight that is abnormal for them. I can eat whatever I want, never work out, and still have a BMI of 21 with <6% body fat. Since this is the case, why can't the opposite be a possibility?

Read an endocrine physiology textbook instead of Muscle and Fitness before judging people.
 
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