Reply #14: Oh fun! A thread where people get to make themselves feel smugly superior since they aren't fat!

[moriah]

Sorry, OP, I kind of doubt that was your intent, but that's what it looks like this is going to turn into. So I'll get my opinion out there now.

1) Obesity runs in families. I think it's both a nature and nurture issue, not just one or the other. We learn the behaviors and coping mechanisms we see our parents use in our childhood, and tendencies toward insulin resistance and the sequelae of insulin resistance that doctors call "Metabolic Syndrome", as well as thyroid dysfunctions, can be inherited.

2) Usually by the time a person has become clinically obese, they have been on multiple diets/yoyo dieting. Their metabolism is deregulated and they do not metabolize calories the same way that a person who has never dieted would. The "calories in/calories out" equations all vary from person to person, but it's a known fact that a person who was 20lbs overweight and then lost back down will have a slower metabolism than a person of the same weight who never gained and lost that 20 lbs. It is quite scientifically possible for a person who is morbidly obese and who has been on numerous yo-yo diets to gain weight on 1200-1500 calories a day. By dieting they trained their bodies to process energy from food more efficiently. Add in any history of eating disorders, and their metabolism will be even worse.

3) Physical activity becomes more and more difficult as a person gains weight. Stress on the knees and other joints make it painful to work out, and when a person is seeing people on the elliptical for hours on end, the fact they can only do 10 minutes on the recumbent bike is very discouraging. It hurts, they feel like they will never be able to exercise enough to make a difference, and give up on the programs fairly quickly without significant support to get them past the hurdle and at a point where they will actually start seeing positive reinforcement in the fit of their clothes and on the scale.

4) While I'm sure that some people who overeat are not doing it for psychological reasons, there's a reason they call it "compulsive overeating". The coping mechanism they have learned is to stuff their feelings by stuffing their stomachs with food. It's not as simple as refusing to buy cigarettes when you've been stuffing your feelings by smoking, or not going out to bars if you stuff your feelings by drinking. Eating is required to live, they can't drop food cold turkey. This is the reason why most doctors require a psychological evaluation and therapy if needed to address eating disorders (and yes, compulsive overeating is an eating disorder) before considering a patient a candidate for gastric bypass. It's not just laziness and gluttony. People attributing it all to laziness and gluttony just make the person feel even worse about themselves, and make them want that chocolate cake more than ever because it's the coping mechanism they know.

I've been fat. I'm still clinically obese, but I've been a lot fatter than I am right now -- I'm 65 lbs down from my high weight. I am going to the gym 4 times a week and have built up to 45 minutes on the seated elliptical. It is possible to lose weight -- we all know this. But it's not as easy as most people who have never been fat think it is. The judgmental attitudes do nothing to actually help the obesity epidemic.