I'm obese, more than just a little bit so (although far less than some people, I don't think it's even possible for me to get as heavy as some people I see do).
I would try not to conflate obesity and overweight when worrying about health outcomes. I don't have a link, but if I remember, our idea of what is the ideal weight for people is actually wrong, and being mildly overweight has a protective effect in terms of health outcome. Once you near (and of course, cross) the line of obesity instead of just being overweight, the benefit goes away. But if everyone in the country was mildly overweight, things would be better off, apparently.
Additionally, there was a recent study that found that while the yearly costs are higher the lifetime costs of obese patients are lower than skinnier patients (do to earlier deaths). Now, I am not sure that doesn't mean obesity would cost the health system... that would more depend on the ratio of lifetime taxes paid for healthcare to the lifetime cost, which I don't know personally. But just because something like 15% of healthcare costs are related to obesity does not actually mean obesity costs more, you need different figures to argue that.
Obesity is a major health concern. Aside from my political leanings, one of the reasons I hate universal healthcare is because it gives the government and even random taxpayers a vested interest in my weight, which I am deeply uncomfortable with. If I want to be fat, that should be my business, noone elses. I'm going to be a doctor, but even if I was not, I could afford to pay for private health insurance to cover any increased costs to the system, and it would only be between me and my insurance company, not every random person walking down the street.
Part of the problem, from a socialized healthcare POV, is that not all obesity is the same. Some people truly could exercise more, cut back on food, and lose alot of weight (if not make it all the way down to normal). You'd want to incentivize that somehow. On the other hand, there are people whose other medical problems (or, for example, drugs used to treat other medical problems) cause them to gain weight or make it very hard to lose it. Thyroid problems, etc. That's even without getting into genetic predisposition to weight gain (my wife and I eat and exercise similarly, but shes' around 120, and I'm around 250; for clarity, I think it's mostly her good genetics, not my bad ones. I could probably lose weight if I tried alot harder), which are not under people's control. Part of the benefit of socialized healthcare is not charging people more for conditions outside of their control, and there is a subset that we would definitely want to include that are obese, and another subset that we might want to include in that (genetic predisposition), along with those who really could lose the weight easily if they wanted to. It's complex.
Brother I here you. I have struggled with weight my entire life, in fact I was 335 lbs at age 18, (my heaviest) pre-diabetic, monstrously hypertensive and my cholesterol was through the roof. I would have been dead within 5 years had I not changed my life.
And it is true that being overweight does not mean you are unhealthy.
For example, according to the BMI I, who am 6 foot 3.5 inches should be 202 lbs in order to be at weight. Anything over is overweight.
Yet, today I am 251 lbs, (training hard everyday so I can get into the army med dep) and losing weight fast.
I had my blood pressure taken yesterday and it was: 120/64 with pulse of 63. In other words, though I am considered Obese by technical standards my cardio-puminoary health is great.
Now I still have a lot to lose, at least 50 lbs, but you are right that we shouldn't strive to become "fit" by some random definition.
In fact studies have shown that excercising alone can have a big impact on health, despite being morbidly obese.
For example, on the last season of biggest loser, all of the contestants recieved massive health benefits just from a good diet and excercise.
One contestant who started over 400 lbs and was diabetic, lost 40 lbs in a month and was off their diabetes meds despite still being morbidly obese. Similar things occured for all contestants and for myself as well.
As to the point of genetics playing a role in weight loss, or health conditions such as hypothyroidism, here is the simpy truth.
Weight is a function of net caloric burn, ie calories in - calories out.
Why it may be true that everyone has different metabolism which can be influenced by many factors, one thing is certain, bad genes or a hypothyroidism cannot keep you from losing weight if you eat the proper amount of food.
For example, if you eat 1600 cals/day it dosn't matter what genes you have, you will eventually come down in weight, even if it takes you a long time.
Now it does take a lifestyle change and commitment but it can be done and it dosn't have to suck.
Despite eating only 1600 calories/day I eat like a king (4 times/day), because I have discovered how to replace high calorie foods with low calorie subsititues.
For example, instead of white bread which is 100 calories/slice I eat light, whole wheat bread which is 40 cal/slice.
Instead of a beef hot dog, a turkey frank has 45 cal/link.
Instead of regular ketchup, 20 cal/tsp, reduced sugar ketchup has 5 cal/teaspoon.
I still eat all my favorite foods, hot dogs, burgers, mashed potatoes, heck even twinkies and cupcakes, but I do it smart.
For example, a regular hot dog, with bun and regular ketchup is 250-300 calories, depending on how many topings go on it.
My hot dog is a slice of light whole wheat bread, with a turkey frank and 3 teaspoons of reduced sugar ketchup, 100 calories.
Instead of butter, I use Can't believe its not butter spread, 0 calories but tastes just as good.
Instead of a regular burger, I eat a turkey pattey between 2 slices of light whole wheat bread with 2 tsp of reduced sugar ketcup and a bit of zero cal mustard. Tastes great and only 260 cals/burger.
Want a twinkie? Eat the 100 calorie snack packs instead of the regular twinkies which had 150 cal/individual treat.
And do you know what food is my best friend? Egg white omlettes!
Specifically the egg subsitute you can buy in any store, (I like the southwest variety).
210 calories/box, (30 cal/serving and 7 servings/box) for $3.65 and 35 g protein, 0 cholesterol and its microwavable. The omlette covers an entire plate, is very filling, (protein entering the duodenum releases Cholecystikinen, which acts on the hypothalamus as a satiation factor and keeps you feeling fuller longer). Want to make it taste really good?
Try adding a pinch of pepper and a bit of zero cal mustard. It tastes devine is really healthy and still only 210 calories!
Oh and as for soda, the answer is obvious, diet soda. Now I know what you might be thinking, (that **** tastes terrible) but the chemistry of diet drinks has advanced considerably. Coke zero tastes like coke and now coke makes zero versions of everything. Pibb Zero, Fanta Zero, (orange soda) Rootbeer versions and my favorite, Cherry Coke Zero, (which tastes exactly like cherry coke).
Other great foods that allow you to eat well but still healthy?
Chicken breasts, (140 cal/fillet but 30 g protein, so really filling and can be microwaved and bought in different flavors of marinade, lemon, garlic or cajun).
Mashed potatoes, 600 cal/tub, in regular or garlic variet.
Fiesta Corn, (175 cal/can) or Green Beens, (20 cal/serving)
Here is an example of a typical day for me.
Breakfast: whole box of egg whites, (southwestern with pepper and mustard) 210 cals.
Lunch: half tub of garlic mashed potatoes, (300 cals) 1 garlic chicken fillet, (140 cals) 1 can of fiesta corn, (175 cals and tastes devine) 1 can of green beens, (65 cals) and 3 slices of light whole wheat bread slathered in 0 cal butter substitute.
Washed down with 32 ounces of Cherry Coke zero, total calories 800.
Dinner: Another Egg white omlette, preped the same way, 210 cals
Evening snack, (sometimes I flip the order of the last 2 meals) 1 garlic chicken fillet, 1 sugar free jello cup, (60 cal) 1 small vanilla yogurt(with cookie) 100 cal and a twinkie snack pack (100 cal). Total 400 cal.
Total calories for the day, 210+210+400+800=1620 calories spread out over 4 meals and incuding the treats you love.
Of and for those on the go, a 6 inch subway turkey and ham sub is 320 cal, washed down with 16 ounce bottle of skim milk makes the meal 500 calories. And for variety, healthy choice has microwave meals, (steamers) which taste fantastic and are between 250-400 cal/meal, (they have about a dozen varieties).
And don't forget fish which is low cal, high protein and high in HDL cholesterol, (the good kind) And fruit, (nature's candy) A whole green apple, (my favorite) 36 calories The point is that there is a whole world of delicious foods out there that is not very calories dense so you can eat a lot of it and feel very full without eating too much in total calories. You just have to take an interest in what you eat, (check the labels).
Heck you don't even need to excerise to lose weight, (in case you don't have time, it will just take longer). But of course excercise is good for cardio-pulmionary health and it dosn't take that long. For example, running 5K on a tread mill, (or anywhere) can be done in 30 minutes or less and burns a lot, (200 cal/mile for a big guy like me). Don't like running? (I have suffered my share of shin splints) try a cross trainer which can burn up to 1300 cal/65 min session, (about the same as running).
Weight training is great for building lean muscle which increases metabolism, (1 lb of muscle burns 50 cal/day) and dosn't take that long either. Losing weight and getting healthy is not as hard as people make it out to be. It a lot of dedication in the beginning, (to change bad habits) but gets a lot easier as your habits change to good ones. And a healthy lifestyle will work for anyone, no matter how little T3 and T4 their thyroid is putting out or how bad their genes, (as long as caloric intake is controled and excericse is done to speed up metabolism).
