Obesity lectures

[Gifted Hands]

[QUOTE="Gifted Hands, post: 15176605, member: 301565]. I have one med school friend who is at least 50 lb over weight and another who might be more. Both are brilliant, both are not slobs and don't really eat differently than me...

That's fine, but in reality, perhaps they should be eating differently. Or exercising more. Or both.

At the risk of offending the overly-PC crowd, most people who are overweight have little to blame but themselves. I am absolutely not calling them bad people, but there is an alarming lack of accountability when it comes to obesity. And, most people who say they are "eating healthy" are, in fact, not.[/QUOTE]

I don't necessarily disagree, although I would add that it's not as simple as diet and exercise for most people because life isn't that simple, and if it were there wouldn't be nearly as many obese people in this country. It's easy to tell someone to eat 1200 cals and work out everyday but people have jobs and busy lives and bad food is highly addictive...

But let's just say yea it's completely within their control. So? I just think it's silly to think that there is a certain body profile that you must have and maintain to be a physician. Your skill as a physician comes from social skills and your brain, not how you look or your BMI.

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[deleted564496]

But in any case, when you get to medical school, just remember that you're going to school with alcoholics, drunken meatheads, and club girls. Except they have brains and a work ethic.

Only like 30% at my school, if that.. The rest are sheltered people who say that the weekends are for "resting". Yes, even the weekends after tests….. It's sad….. I'm not gonna bash em', I just don't agree with em'.


EDIT---Or married with kids, in which case, I understand… kinda

 

[username456789]

That's fine, but in reality, perhaps they should be eating differently. Or exercising more. Or both.

At the risk of offending the overly-PC crowd, most people who are overweight have little to blame but themselves. I am absolutely not calling them bad people, but there is an alarming lack of accountability when it comes to obesity. And, most people who say they are "eating healthy" are, in fact, not.

I don't necessarily disagree, although I would add that it's not as simple as diet and exercise for most people because life isn't that simple, and if it were there wouldn't be nearly as many obese people in this country. It's easy to tell someone to eat 1200 cals and work out everyday but people have jobs and busy lives and bad food is highly addictive...

But let's just say yea it's completely within their control. So? I just think it's silly to think that there is a certain body profile that you must have and maintain to be a physician. Your skill as a physician comes from social skills and your brain, not how you look or your BMI.[/QUOTE]

I'm not even necessarily talking about body profiles to be a physician; rather, to fall somewhere close to an acceptable or "healthy" profile (however you choose to define that). It's not secret that obesity is tied to some of the most common/prevalent morbidities, costing patients and society boatloads. You're taking an extreme example (1200 cals) and trying to make it sound as if that would be the norm. Have you seen what most people eat? I know people that get close to 1200 calories just from their "healthy salad" they have for lunch (globs of dressing, croutons, side of soda). You don't even need to make drastic cuts to your diet; even cutting out 500 cals per day would potentially save you a pound per week. Not to mention altering activity level, which is whole extra dimension.

It seems way too common for people to think like you: "Oh, I'd have to go on some crash diet and be miserable in order to get out of this spiral of obesity . . . guess it's out of my hands, I'm not gonna live on twigs and berries alone." There are very real, very simple modifications that can be made if people are interested in changing. There's also a ton of misinformation out there that's hard for the average bear to sift through. Ever read the nutritional label for "fat free" or "reduced fat" products? The calories are generally the same, they just replace something rather innocuous (fat) with something almost guaranteed to interfere with weight loss (sugar). Yet people still buy these products thinking they're helping themselves.

 

[Pons Asinorum]

You're really crushing it with these new threads lately. This is a beut.

 

[PL198]

Yeah definitely agree that things are being taken to the extremes in order to invalidate a point. It's not that difficult to maintain a decent BF %(lets arbitrarily say sub 20, but I feel that's decent). Nearly any functioning adult is going to have a BMR over 1200. If you exercise hard and smart, you can eat quite a bit of calories and still maintain a decent body. With medical students taking biochemistry, it shouldn't be too difficult to see what to eat and how to exercise to relatively easily obtain a lower BF percentage. High protein, highish fats(my school vilifies them in lecture, whatever) and then enough carbs to meet your calorie goal from what is remaining. Couple this with high intensity exercise and it's not that difficult. Everyone understands the hormonal responses to different forms of activity, so I'm not sure why I see medical students running for hours and then wondering why they are skinny-fat. If you want to run, then run, but if you are trying to do it to become lean, not the best idea(which everyone should already understand from an academic standpoint).

 

[KnuxNole]

To be fair, there are a number of specialties where being fat wouldn't have an effect on them, since they won't be telling patients to lose weight

 

[Arkangeloid]

Only like 30% at my school, if that.. The rest are sheltered people who say that the weekends are for "resting". Yes, even the weekends after tests….. It's sad….. I'm not gonna bash em', I just don't agree with em'.


EDIT---Or married with kids, in which case, I understand… kinda

Eh, I understand where they're coming from. After some exams I used to cry myself to sleep.



I still do sometimes.

 

[ChEMD]

To be fair, there are a number of specialties where being fat wouldn't have an effect on them, since they won't be telling patients to lose weight

I can't think of an area of medicine that isn't affected by obesity and subsequent co-morbidities.

 

[KnuxNole]

True, but I was thinking more like peeps like gas, ophtho, derm, psych, etc. who for the most part, dont counsel on obesity as much. It IS true that there are obesity counseling depending on what disease you have(Ex: a derm condition that is linked to obesity). Then again, there are doctors who say "ITS NOT MY JOB MOFO, That's for the PCP!" such as EM docs, surgeons, other sub-specialists, etc. I know an EM doc that thanks obese people for giving him job security, lol

And, there are students/residents/attendings who KNOW how to eat healthy, but don't give a **** about their own health.

And even though it sounds easy, remember, to the average American person, change is EXTREMELY hard. Whatever tastes good, and is easy is what wins. If exercise is too much hard work, it's not gonna be favorable. And if food tastes bad, forget about it :O

 

[PL198]

True, but I was thinking more like peeps like gas, ophtho, derm, psych, etc. who for the most part, dont counsel on obesity as much. It IS true that there are obesity counseling depending on what disease you have(Ex: a derm condition that is linked to obesity). Then again, there are doctors who say "ITS NOT MY JOB MOFO, That's for the PCP!" such as EM docs, surgeons, other sub-specialists, etc. I know an EM doc that thanks obese people for giving him job security, lol

And, there are students/residents/attendings who KNOW how to eat healthy, but don't give a **** about their own health.

And even though it sounds easy, remember, to the average American person, change is EXTREMELY hard. Whatever tastes good, and is easy is what wins. If exercise is too much hard work, it's not gonna be favorable. And if food tastes bad, forget about it :O

I wouldn't call a licensed physician average, at least with respect to health knowledge and a social responsibility to be healthy. It just befuddles me how schools stress empathy and relating with the patient, yet there is almost 0 actual consideration given to students actual health. Sure there are little groups at every school, but I feel this should be a pretty significant aspect. Honestly with the whole push for managed care and preventative medicine, I can't think of anything better to target than obesity. However to do so, would require stepping on some people's toes and acknowledging that they have failed. No one wants to be the bad guy. No one wants to take ownership.

 

[synecdoche]

I can't think of an area of medicine that isn't affected by obesity and subsequent co-morbidities.

I recently heard a story about a c-section on a patient with bmi>70

 

[Snoopy2006]

There is no ideal body profile "required" to be a good physician. Your ability as a diagnostician and clinician is independent of your own healthy choices (whether eating poorly, smoking, drinking excessively, etc.)

However, obesity is visible to your patient in ways that these other problems are not. And it simply carries less weight when a 350 lb physician is warning his patients about the ill effects of metabolic syndrome. As a patient, my first reaction would be "Practice what you preach." I agree that this is more important for PCPs and other physicians who invest more time in weight counseling.

 

[JoshSt]

A while back we did a surgery on a BMI >100

 

[alpinism]

I recently heard a story about a c-section on a patient with bmi>70

Lol you gotta dig around in there to find the baby...

 

[touchpause13]

Lol you gotta dig around in there to find the baby...

Excuse my premedness but how does that not crush the fetus?? BMI of 70 is one big woman...

 

[Psai]

Excuse my premedness but how does that not crush the fetus?? BMI of 70 is one big woman...

Fluid is hard to compress and fat is not that dense.

 

[CherryRedDracul]

That's fine, but in reality, perhaps they should be eating differently. Or exercising more. Or both.

At the risk of offending the overly-PC crowd, most people who are overweight have little to blame but themselves. I am absolutely not calling them bad people, but there is an alarming lack of accountability when it comes to obesity. And, most people who say they are "eating healthy" are, in fact, not.

So true. Count up them calories them calories and you realize you haven't been quite as little (or even as much) as you've been thinking. This especially applies to people who graze on snacks which is what almost every obese patient I've had in clinic does. They cut down on portions for their standard meals, but they continue to graze on snacks without realizing how much they're actually eating.

 

[NontradCA]

So true. Count up them calories them calories and you realize you haven't been quite as little (or even as much) as you've been thinking. This especially applies to people who graze on snacks which is what almost every obese patient I've had in clinic does. They cut down on portions for their standard meals, but they continue to graze on snacks without realizing how much they're actually eating.

I couldn't help but laugh at the usage of the word graze. 10/10

 

[Mad Jack]

I dunno about that

Ours were given by someone who, herself, quite obese. Which was awkward. I can't imagine giving six hours of lecture on all the terrible things obesity does and simultaneously being 100 lbs overweight.

Nothing speaks to a subject quite so strongly as first hand experience.

Are you aware that there are people in this world that have a severe medical condition which causes them to be that way? My mother for instance is one of those people. She is a truck driver that has bad knees and a bad back from driving the truck but you probably do not care about that case either. Oh well I am not one of those people I am 6'4" 245lbs and I exercise every day. I would love to see you say something like to my mother in front of me. Probably never happen though you are probably just an internet tough guy. I doubt very seriously you would say that to someones face. Just my thought.What do you think. Oh I am sorry you probably do not have a brain. I on the other hand will be happy to buy you a plane ticket to come here and see if you have the nerve to say that to someone I know.

Seriously though, totally agree with you. I work with a girl who was an athlete all through high school and college, but then had her thyroid removed and gained roughly 100 lbs despite no changes in lifestyle. There are a lot of people out there who can't help being obese. Even those that are otherwise healthy but overweight or obese have some serious challenges to overcome, often both physically and mentally. People need to be supportive and ease back on the judgement. Kicking people while they're down certainly won't help them in any way.

 

[DermViser]

I love these lectures because afterwards the fat girls feel super insecure and depressed and smashing them is so much easier.

Bye, bye GangaMaster. Nice knowing you.

 

[Mad Jack]

RIP my favorite troll. Ganga was usually fun because he generally wasn't too much of a jerk like rifle or any of the other trolls, but it seems he went too far this time.

 

[PL198]

Nothing speaks to a subject quite so strongly as first hand experience.

Seriously though, totally agree with you. I work with a girl who was an athlete all through high school and college, but then had her thyroid removed and gained roughly 100 lbs despite no changes in lifestyle. There are a lot of people out there who can't help being obese. Even those that are otherwise healthy but overweight or obese have some serious challenges to overcome, often both physically and mentally. People need to be supportive and ease back on the judgement. Kicking people while they're down certainly won't help them in any way.

I couldn't disagree more. Medical related issues cause extremely small amounts of obesity. Everyone wants to make an excuse and justify someone else's failure. Yes there are people who have bodies that make it nearly impossible. But that is the exception, not the norm. When we dictate policy based on the exception, then the average person gets tremendously screwed. Fear is the best motivator, I'd think a tom of medical school students would understand this. Holding someone's hand and telling them it's ok to fail isn't really a good motivator. I'd rather have someone pissed at me initially , shape up their health and live 15 years longer and ultimately be happy than be scared to offend them.

 

[atomi]

I'm sorry but the ole eat less exercise more is not some golden rule that works on everyone. It's more complicated than that.

Not really. It's a math problem. Your body requires a certain amount of energy everyday. If you intake less than this amount you will lose weight. If you intake more, you will gain weight (the degree to which is where the variability comes into play).

 

[DermViser]

RIP my favorite troll. Ganga was usually fun because he generally wasn't too much of a jerk like rifle or any of the other trolls, but it seems he went too far this time.

Yes, I still don't understand how he and Browny Lover gets banned, but people like rifle who purposefully troll don't. I'm curious if they get warnings or not. I never saw a Probation thingy on his avatar.

 

[Microshaft]

Are you aware that I am also aware that there are people in this world that have a severe medical condition which causes them to be that way? My mother for instance is one of those people. She is a truck driver that has bad knees and a bad back from driving the truck but you probably do not care about that case either. Oh well I am not one of those people I am 6'4" 245lbs and I exercise every day. I would love to see you say something like to my mother in front of me. Probably never happen though you are probably just an internet tough guy. I doubt very seriously you would say that to someones face. Just my thought.What do you think. Oh I am sorry you probably do not have a brain. I on the other hand will be happy to buy you a plane ticket to come here and see if you have the nerve to say that to someone I know.

 

[Mad Jack]

I couldn't disagree more. Medical related issues cause extremely small amounts of obesity. Everyone wants to make an excuse and justify someone else's failure. Yes there are people who have bodies that make it nearly impossible. But that is the exception, not the norm. When we dictate policy based on the exception, then the average person gets tremendously screwed. Fear is the best motivator, I'd think a tom of medical school students would understand this. Holding someone's hand and telling them it's ok to fail isn't really a good motivator. I'd rather have someone pissed at me initially , shape up their health and live 15 years longer and ultimately be happy than be scared to offend them.

I'm not saying we should sugar coat their illness. I'm saying we should give them the dignity they deserve as fellow human beings. "Your obesity will very likely lead to negative health care outcomes and possibly your death" isn't a judgemental statement, it is a fact. It's the stereotypes of sloth, gluttony, and a lack of self-control that people often cast on obese patients that is the problem. If you want to help a person lose weight, you'll be far more successful being supportive and inspiring than you will with shaming and judging them.

Many people are quick to say, "why don't you just eat less and work out" without actually thinking about the physical and mental challenges that go along with being obese. Extra weight makes you become exhuasted faster, and often causes back and leg pain, making even the most basic workout plans difficult. Obese patients have more fat cells, which secrete hormones that trigger hunger. It's easy for someone who's never been obese to just say, "just don't eat" without thinking about the fact that these people have stronger urges to do so, and the desire for food is one of the most powerful basic needs we have. Sure, just, you know, fight that powerful urge that's been hard-coded by billions of years of evolution that is in no way adapted for a modern world in which food is readily available at every turn. It also doesn't help that their thyroid hormones are usually out of whack secondary to the stress their increased mass places upon it. Their body, their primal instincts, and their hormones are all working against them in a horrible downward spiral that it is not easy to escape.

I may not help people lose weight, but I'm one of the most effective smoking cessation counselors in my hospital, and I feel a lot of the same techniques apply. The reason I'm so good at it is because I understand where my patients are coming from- I was a heavy smoker for a few years- and I am supportive and not judgemental. When my patients fail, it's alright, we can try again. It took me probably 20 tries to quit- let's just start back at square one, there's no reason to lose hope. You've got to sell them on the benefits of success rather than the price of continuing to live in their current state. We need to combat obesity, but we need to do it the right way, not the good 'ol fashioned approach of shunning the living hell out of them until they either straighten up or withdraw from society.

 

[Brain Bucket]

Are you aware that I am also aware that there are people in this world that have a severe medical condition which causes them to be that way? My mother for instance is one of those people. She is a truck driver that has bad knees and a bad back from driving the truck but you probably do not care about that case either. Oh well I am not one of those people I am 6'4" 245lbs and I exercise every day. I would love to see you say something like to my mother in front of me. Probably never happen though you are probably just an internet tough guy. I doubt very seriously you would say that to someones face. Just my thought.What do you think. Oh I am sorry you probably do not have a brain. I on the other hand will be happy to buy you a plane ticket to come here and see if you have the nerve to say that to someone I know.

If you're gonna retoast, at least make sure someone hasn't done the same thing in the same thread.

GM was banned for this thread? pfft.

 

[VA Hopeful Dr]

There is no ideal body profile "required" to be a good physician. Your ability as a diagnostician and clinician is independent of your own healthy choices (whether eating poorly, smoking, drinking excessively, etc.)

However, obesity is visible to your patient in ways that these other problems are not. And it simply carries less weight when a 350 lb physician is warning his patients about the ill effects of metabolic syndrome. As a patient, my first reaction would be "Practice what you preach." I agree that this is more important for PCPs and other physicians who invest more time in weight counseling.

And my response as a physician were I obese (I'm not) would go something like this...

I'm trying to help you not die of obesity related issues. If you think its more important to belittle my knowledged based on my weight, then I can't help you - get out.

 

[Mad Jack]

Yes, I still don't understand how he and Browny Lover gets banned, but people like rifle who purposefully troll don't. I'm curious if they get warnings or not. I never saw a Probation thingy on his avatar.

I think it was the lack of professionalism and the degree of outright disrespect this particular post of Ganga's showed. Probably hit a nerve with a mod. Ganga was weird though- he would start the stupidest threads but they would always lead to really good debates, he was like the autistic savant of original posts.

 

[colbgw02]

I'm not saying we should sugar coat their illness. I'm saying we should give them the dignity they deserve as fellow human beings. "Your obesity will very likely lead to negative health care outcomes and possibly your death" isn't a judgemental statement, it is a fact. It's the stereotypes of sloth, gluttony, and a lack of self-control that people often cast on obese patients that is the problem. If you want to help a person lose weight, you'll be far more successful being supportive and inspiring than you will with shaming and judging them.

Many people are quick to say, "why don't you just eat less and work out" without actually thinking about the physical and mental challenges that go along with being obese. Extra weight makes you become exhuasted faster, and often causes back and leg pain, making even the most basic workout plans difficult. Obese patients have more fat cells, which secrete hormones that trigger hunger. It's easy for someone who's never been obese to just say, "just don't eat" without thinking about the fact that these people have stronger urges to do so, and the desire for food is one of the most powerful basic needs we have. Sure, just, you know, fight that powerful urge that's been hard-coded by billions of years of evolution that is in no way adapted for a modern world in which food is readily available at every turn. It also doesn't help that their thyroid hormones are usually out of whack secondary to the stress their increased mass places upon it. Their body, their primal instincts, and their hormones are all working against them in a horrible downward spiral that it is not easy to escape.

I may not help people lose weight, but I'm one of the most effective smoking cessation counselors in my hospital, and I feel a lot of the same techniques apply. The reason I'm so good at it is because I understand where my patients are coming from- I was a heavy smoker for a few years- and I am supportive and not judgemental. When my patients fail, it's alright, we can try again. It took me probably 20 tries to quit- let's just start back at square one, there's no reason to lose hope. You've got to sell them on the benefits of success rather than the price of continuing to live in their current state. We need to combat obesity, but we need to do it the right way, not the good 'ol fashioned approach of shunning the living hell out of them until they either straighten up or withdraw from society.

I don't think obese people have more fat cells; their fat cells are larger. Not that it matters for your point, but this is medical forum, after all.

 

[PL198]

I'm not saying we should sugar coat their illness. I'm saying we should give them the dignity they deserve as fellow human beings. "Your obesity will very likely lead to negative health care outcomes and possibly your death" isn't a judgemental statement, it is a fact. It's the stereotypes of sloth, gluttony, and a lack of self-control that people often cast on obese patients that is the problem. If you want to help a person lose weight, you'll be far more successful being supportive and inspiring than you will with shaming and judging them.

Many people are quick to say, "why don't you just eat less and work out" without actually thinking about the physical and mental challenges that go along with being obese. Extra weight makes you become exhuasted faster, and often causes back and leg pain, making even the most basic workout plans difficult. Obese patients have more fat cells, which secrete hormones that trigger hunger. It's easy for someone who's never been obese to just say, "just don't eat" without thinking about the fact that these people have stronger urges to do so, and the desire for food is one of the most powerful basic needs we have. Sure, just, you know, fight that powerful urge that's been hard-coded by billions of years of evolution that is in no way adapted for a modern world in which food is readily available at every turn. It also doesn't help that their thyroid hormones are usually out of whack secondary to the stress their increased mass places upon it. Their body, their primal instincts, and their hormones are all working against them in a horrible downward spiral that it is not easy to escape.

I may not help people lose weight, but I'm one of the most effective smoking cessation counselors in my hospital, and I feel a lot of the same techniques apply. The reason I'm so good at it is because I understand where my patients are coming from- I was a heavy smoker for a few years- and I am supportive and not judgemental. When my patients fail, it's alright, we can try again. It took me probably 20 tries to quit- let's just start back at square one, there's no reason to lose hope. You've got to sell them on the benefits of success rather than the price of continuing to live in their current state. We need to combat obesity, but we need to do it the right way, not the good 'ol fashioned approach of shunning the living hell out of them until they either straighten up or withdraw from society.

That's valid but I still would absolutely say that there is a different standard for physicians vs avg joe .

 

[Mad Jack]

I don't think obese people have more fat cells; their fat cells are larger. Not that it matters for your point, but this is medical forum, after all.

They actually have more fat cells. Your fat cells initially grow larger as you put on weight, then divide. When you lose weight, they release their lipids, but their number does not decrease. Basically, once you are fat and subsequently lose weight, having excess lipid-depleted adipocytes messes with your leptin levels, making you hungry all the time.

http://en.wikipedia.org/wiki/Adipocyte
http://www.sciencedaily.com/releases/2008/06/080620195455.htm

 

[colbgw02]

Great. Now I am going to have to question my entire medical education. Where's the hemlock? It cures super-gonorrhea, right?

 

[Mad Jack]

That's valid but I still would absolutely say that there is a different standard for physicians vs avg joe .

Different standard for the physician themselves or how they view obesity?

Yes, physicians should be able to set an example for their patients. But physicians are not saints, they are people, and people are not perfect. Dare I say that every physician has flaws, some physical, some mental. You just happen to be able to see the results of an obese physician's flaw, unlike the ones who might be bipolar, alcoholics, depressed, sociopathic, or drug abusers. They don't deserve extra judgement and scrutiny simply because they lack the ability to hide their imperfection.

 

[DermViser]

You're really crushing it with these new threads lately. This is a beut.

That's what kills me. GangaMaster's posts inadvertently inspire the deepest discussions and debates ever on SDN. But now he's banned.

 

[Doudline]

I couldn't disagree more. Medical related issues cause extremely small amounts of obesity. Everyone wants to make an excuse and justify someone else's failure. Yes there are people who have bodies that make it nearly impossible. But that is the exception, not the norm. When we dictate policy based on the exception, then the average person gets tremendously screwed. Fear is the best motivator, I'd think a tom of medical school students would understand this. Holding someone's hand and telling them it's ok to fail isn't really a good motivator. I'd rather have someone pissed at me initially , shape up their health and live 15 years longer and ultimately be happy than be scared to offend them.

Fine.

You are a failure for working more than 7 hours a day (shown to increase the odds of heart disease and decrease life expectancy).
You are a failure for not seeing your friends regularly (shown to increase the odds of mental illnesses -and possibly cancer- while also decreasing life expectancy).
You are a failure for ever having taken more than 3 alcoholic drinks during a single event (shown to increase the odds of cancer, heart disease, high blood pressure, liver disease, mental illnesses, etc).
You are a failure for not exercising with moderate intensity at least 30 minutes every day (...).
You are a failure for not consumming 7 to 10 portions of fruits and vegetables every day (...).


You see, health is not as simple as being overweight or not.

It's easy to smack people for their weight, because it's a very obvious flaw, yet I'd take a bet and say that it is probably healthier to lead a typical life as an obese person than live a med student/resident life while being of normal weight.

Stop being a judgmental ****.

You know nothing. (Jon Snow)

 

[Gifted Hands]

Different standard for the physician themselves or how they view obesity?

Yes, physicians should be able to set an example for their patients. But physicians are not saints, they are people, and people are not perfect. Dare I say that every physician has flaws, some physical, some mental. You just happen to be able to see the results of an obese physician's flaw, unlike the ones who might be bipolar, alcoholics, depressed, sociopathic, or drug abusers. They don't deserve extra judgement and scrutiny simply because they lack the ability to hide their imperfection.

This is what I was trying to say, but stated much more eloquently. Nice job.

 

[Mad Jack]

But in any case, when you get to medical school, just remember that you're going to school with alcoholics, drunken meatheads, and club girls. Except they have brains and a work ethic.

That sounds like a really good time, actually.

 

[PL198]

Fine.

You are a failure for working more than 7 hours a day (shown to increase the odds of heart disease and decrease life expectancy).
You are a failure for not seeing your friends regularly (shown to increase the odds of mental illnesses -and possibly cancer- while also decreasing life expectancy).
You are a failure for ever having taken more than 3 alcoholic drinks during a single event (shown to increase the odds of cancer, heart disease, high blood pressure, liver disease, mental illnesses, etc).
You are a failure for not exercising with moderate intensity at least 30 minutes every day (...).
You are a failure for not consumming 7 to 10 portions of fruits and vegetables every day (...).


You see, health is not as simple as being overweight or not.

It's easy to smack people for their weight, because it's a very obvious flaw, yet I'd take a bet and say that it is probably healthier to lead a typical life as an obese person than live a med student/resident life while being of normal weight.

Stop being a judgmental ****.

You know nothing. (Jon Snow)

Strawman FTW. Never said physicians have to be perfect. I don't smack people for the weight, I smack people for their fat. This is an Important distinction. If your bet was true, it wouldn't change anything. By that logic, doctors shouldn't give medical advice to patients. Ok then....

 

[Instatewaiter]

Are you aware that there are people in this world that have a severe medical condition which causes them to be that way? My mother for instance is one of those people. She is a truck driver that has bad knees and a bad back from driving the truck but you probably do not care about that case either. Oh well I am not one of those people I am 6'4" 245lbs and I exercise every day. I would love to see you say something like to my mother in front of me. Probably never happen though you are probably just an internet tough guy. I doubt very seriously you would say that to someones face. Just my thought.What do you think. Oh I am sorry you probably do not have a brain. I on the other hand will be happy to buy you a plane ticket to come here and see if you have the nerve to say that to someone I know.

Where do you live? I'd love that plane ticket if you live somewhere sunny.

 

[Instatewaiter]

I’ll have you know I graduated top of my class in the Navy Seals, and I’ve been involved in numerous secret raids on Al-Quaeda, and I have over 300 confirmed kills. I am trained in gorilla warfare and I’m the top sniper in the entire US armed forces.

Is this where you fling poop at insurgents?

 

[Mad Jack]

Is this where you fling poop at insurgents?

Gorilla warfare is something the internet warfare branch of the Navy Seals are trained in. It's super secret, and only the toughest applicants may apply. If you hear a guy is trained in it, you don't know what's about to hit you.

 

[deleted480308]

*edit.....I'm an internet noob and missed the joke. Sorry @CherryRedDracul

 

[PL198]

I'm going to go ahead and say that despite OPs trolling, it's ridiculously inappropriate to be threatening violence on a specific member of the boards, especially if you are going unhinged to the point where you are offering a real life fight over a post. You seem largely composed and thoughtful in other threads, you can do better.

He's joking it's a copy and paste off another site.

+1 for your location . Almost done with the fountainhead

 

[deleted480308]

He's joking it's a copy and paste off another site.

+1 for your location . Almost done with the fountainhead

I'm a doofus, apology's above...

 

[ChEMD]

They actually have more fat cells. Your fat cells initially grow larger as you put on weight, then divide. When you lose weight, they release their lipids, but their number does not decrease. Basically, once you are fat and subsequently lose weight, having excess lipid-depleted adipocytes messes with your leptin levels, making you hungry all the time.

http://en.wikipedia.org/wiki/Adipocyte
http://www.sciencedaily.com/releases/2008/06/080620195455.htm

Hmm...if adipocytes could just go about dividing when they get too full, why would you get ectopic fat deposition ultimately leading to type 2 diabetes?

 

[Winged Scapula]

Fluid is hard to compress and fat is not that dense.

Sounds cozy.

 

[Mad Jack]

Hmm...if adipocytes could just go about dividing when they get too full, why would you get ectopic fat deposition ultimately leading to type 2 diabetes?

I don't have a PhD in cellular metabolism or biochemistry, so I couldn't say. I'd imagine that if a person is eating a diet high enough in fat, they could exceed the ability of their existing adipocytes to absorb the digested lipids, leading to their deposition in other cells throughout the body. In any case, I was under the impression that ectopic fat wasn't a cause of diabetes but rather a marker of general metabolic and endocrine dysfunction (3rd link below). Adipose tissue serves important endocrine functions that become disrupted when it exists in excess. This disruption is another very critical factor in diabetes, and, as I understand it, a large part of the reason that weight loss can lead to patients no longer being insulin dependent. First link goes to a good paper on adipocyte proliferation, second goes to one on the role of adipose tissue in various diseases, diabetes included.

http://www.aleixo.com/biblioteca/obesidade/artigos/The biology of white adipocyte proliferation.pdf
http://eurheartj.oxfordjournals.org/content/29/24/2959.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/18625114

 

[NontradCA]

 

[Pons Asinorum]

Not really. It's a math problem. Your body requires a certain amount of energy everyday. If you intake less than this amount you will lose weight. If you intake more, you will gain weight (the degree to which is where the variability comes into play).

You...did not pay attention in endocrine lectures.