On obesity

[FatalMuse]

Today on a completely non-philosophical forum I read, someone copy/pasted an article about a new pill being developed which claims to have the same effect as having excercised, which sparked a discussion about the Western (particularly US) trend towards people becoming heavier - and the continuing attempts to treat it.

Does the medical industry have an obligation to help obese people?
Should it be treated as an illness?
Is it fair to devote research to finding drugs to treat obesity when the same research could be devoted to diseases that can't be fixed through something as simple as excercise and diet?
What are society's obligations in regards to the health of the obese?
Should instituitions be able to section & ration people who are endagering their life through obesity in the same way many institutions handle chronic alcholism and drug addiction?

[Aedes]

Originally Posted by FatalMuse

Does the medical industry have an obligation to help obese people?

Obesity is a form of malnutrition that has both genetic and acquired components. Most people who are obese are already overweight at under 1 year of age. Now, I'm not sure what you mean by "medical industry". If you mean doctors, then the answer is absolutely. MANY diseases we treat can be easily linked to something preventable, and just because someone does something preventable doesn't mean that we physicians have the right to punish them for it. And of the preventable things out there, obesity is actually an EXTREMELY difficult one for people to surmount.

Should it be treated as an illness?

It is an illness.

Is it fair to devote research to finding drugs to treat obesity when the same research could be devoted to diseases that can't be fixed through something as simple as excercise and diet?

If it were as easy as exercise and diet, then far fewer people would be obese. One major problem that I've encountered time and again is that obese people are not capable of much exercise -- they develop restrictive lung disease, sleep apnea, arthritis, chronic back pain, things that greatly impede their exercise capacity no matter how motivated they are.

Besides, obesity is one of the leading causes of preventable death in the country, it exerts a HUGE public health burden and enormous health expenditures, and it's unquestionably in society's interest to address this epidemic.

What are society's obligations in regards to the health of the obese?

The health care community should not punish people. This is a pretty easy one -- you treat them for the problems they have and you work on getting them into weight loss programs. Far harder are the IV drug users, for instance, who give themselves endocarditis (infected heart valves), which sometimes requires valve replacement. I've seen people who have actually infected their replaced valve, requiring another replacement. When they get to this point, it's usually technically impossible to operate on them again anyway, and most surgeons will decline. But again our job is to treat the patient in front of us, not judge them.

Should instituitions be able to section & ration people who are endagering their life through obesity in the same way many institutions handle chronic alcholism and drug addiction?

Not unless their obesity impedes their job. Alcoholism and drug addiction will greatly affect job performance. For many jobs obesity will not.

[FatalMuse]

Thanks for your reply Aedes and I mostly agree with you.

I'm not sure on the exact medical terms and it's possible obese wasn't the correct one. I'm meaning in regards to people who are over-weight to the point of endagering their health. I understand for some people this is a genetic problem, but for many it is a genetic problem combined with a lifestyle problem - and for some simply a lifestyle problem.

Originally Posted by Aedes

Now, I'm not sure what you mean by "medical industry". If you mean doctors, then the answer is absolutely.

I probably should've clarified more, by industry I was referring more towards the pharmaceutical & medical research industry - but also including doctors and surgeons.

I can understand there is a need for drugs and surgery (ie stomach stapling) for people who have gotten to the point where exercise is dangerous or impossible. But for people who still can excercise, should doctors be trying harder to get patients to go down this route before recommending drugs and/or surgery?

I guess the real question I'm trying to get to is: If someone can cure their condition through lifestyle changes and is able to do so but refuses, does the doctor still have an obligation to try and treat them through other means?

I'm starting to think medical ethics is a very interesting subject.

[Aedes]

Originally Posted by FatalMuse

I'm not sure on the exact medical terms and it's possible obese wasn't the correct one. I'm meaning in regards to people who are over-weight to the point of endagering their health.

That's a correct use of the term.

I probably should've clarified more, by industry I was referring more towards the pharmaceutical & medical research industry - but also including doctors and surgeons.

Well, pharmaceutical companies are trying to make something marketable. Obesity is such a prevalent problem, AND people don't like being obese, so an effective anti-obesity drug is going to become one of the best selling drugs in history. As for medical research, you study things you think are important. Obesity is probably under-studied. Sure, hookworm and sleeping sickness and other tropical diseases are far more understudied, but obesity is legit.

I can understand there is a need for drugs and surgery (ie stomach stapling) for people who have gotten to the point where exercise is dangerous or impossible. But for people who still can excercise, should doctors be trying harder to get patients to go down this route before recommending drugs and/or surgery?

Well, there are no drugs for this yet (other than, maybe, metformin which might help prevent the onset of type 2 diabetes). But we DO try hard to get patients to exercise, we have them do calorie counts, send them to nutritionists, etc. But I can tell you that if I weighed 500 pounds, I'd give myself 1 year to take a big chunk out of that weight and if not I'd be getting myself on a list for bariatric surgery.

I guess the real question I'm trying to get to is: If someone can cure their condition through lifestyle changes and is able to do so but refuses, does the doctor still have an obligation to try and treat them through other means?

Yup. Look at hypertension (high blood pressure). If hypertensive people completely cut salt intake out of their lives and lost some weight, they'd no longer be hypertensive. But it just doesn't happen, and we have a million drugs for blood pressure. We HOPE people make lifestyle changes, but honestly it's really hard to do. The best I've ever done was gotten a guy to quit smoking crack and later on he quit smoking cigarettes. But that's one in a million.

I'm starting to think medical ethics is a very interesting subject.

Yup. So many scenarios too.

[Justin]

Great post fellas, and very educational as well! I have my opinion on this subject as well but please understand that I'm not scientist nor am I educated in the health portion of it. I'm just a self-proclaimed philosopher that has pondered and taken a keen interest in obesity.

First off, I'd make a perfect obese person. I eat good, eat a lot and eat rather quickly but enjoy food more than many things. Actually, from a philosophical standpoint I feel that I've actually been obese.

Anyway, I have a dear friend who is severely overweight which has been something that he and I have been discussing for many years. I've watched him from skinny in high school to SEVERELY overweight today. This with my own mind is all I know of obesity and that of which I've observed through years of being an observer from a birds-eye-view.

What is Obesity?

As I see it, obesity is a state of mind not body. It is merely a physical reflection of that which the mind accepts and likewise produces in the physical form. I'm not sure of all the medical aspects of it but lets consider for a moment how one becomes obese and I'll use an example.

With my friend, his mother was slightly obese. Observation and interaction along with deep inner pondering on this and understanding of various things lead me to believe it's more of a state of mind than anything else.

If you are obese or become obese, I feel it has less to do with genetics and more to do with level of conscious thought and the perception of reality and as we know, signals of perception can alter the proteins within the body and likewise produce physiological change,... , .. thus producing an effect which we call obesity.

While some may be obese prior to birth or after birth, I believe this state of mind can be altered easily based solely on the level of consciousness our mind vibrates at... (It does sound a little off the wall.) With this in mind, our consciousness and conscious thought creates merely a reflection in the physical form. This physical form becoming to many of us, who we are when in all actuality, it's merely a reflection of separation from who we really are... does this make sense?

So, basically obesity could be considered a state of mind. Let's think about that for a moment...

Obesity and Fear

I can only speak for what I see amongst Americans and have stumbled upon on the net but from what I understand, America is an obese country. We've enjoyed wealth and food and a lifestyle like no other. There are obese people everywhere and many of them don't get that way until they are 30-50. I've talked to many a men that say, "this six pack is paid for".

America, as a whole has been living in fear just as I have lived in fear. Fear of debt, fear of death, fear of love, fear of flying, fear of terrorist, fear of retirement, fear of God, fear of the government, fear of bills, fear of living, fear of cancer, fear of mosquitoes, fear of heights, fear of nearly everything around us including fear of OBESITY... The perception of fear and the signal of fear would send signals throughout the entire body. It's the acceptance and living in fear, and the perception of fear that creates physiological change which is merely a reflection of conscious thought transmuted into what we call physical matter. Fear of obesity will create obesity. ... hang on, there's more.

It goes beyond just the fear many of us have and into the influences of how we were raised and what we accepted as truth as we grew physically from birth further and further away from our, (real) conscious self into what we see as a reflection of our conscious thought... an illusion... an effect. I know, I often tend to ramble but my thoughts come quicker than can be typed...

Obese People Think Obese

My friend, the one that I care so much about, lives an obese lifestyle. We've had many philosophical discussions however he's so separated from himself that he cannot see himself other than a fat, (obese) man.

I'm speaking of a fella that's 340+ pounds. He's accepted this lifestyle and accepted his fate and has accepted the fears of dying young because of his obesity. He tries real hard to lose weight and has taken all kinds of pills and all kinds of classes and can even lose weight for a period of time but then gains it all back again.

I observe this over and over and it's killing me to see this and trying to find a way to help my pal... However, I've discovered I cannot help him at all. His thoughts are obese, his actions are obese and he's accepted obesity and therefore has created his obesity. Maybe it was how he was raised, maybe the lack of a loving father or mother,.. maybe a friend that tried to change him... maybe a fear of staying obese. Who really knows?

Whatever it may be... He does not visualize himself thin therefore can loose the weight for a month, maybe even a year just to return to where he started off or even worse... I this the cause? Or could merely be an effect? When he's lost the weight and looks into the mirror, he sees himself not a thin man but an obese man.

Obesity as an Effect

Too often as we live in this world of effect we tend to think that we can change the effect by treating the effect. Obesity is only an effect of something much greater and much deeper. We live in a world of effect and that's exactly what mankind studies and treats. Obesity is no more a disease than chocolate pudding... It's an effect of a much larger and prevalent cause. If we treat obesity, we are only treating the effect. The effect can be altered with drugs and it can be changed with practice but what of the cause?

This leads into cause... oh gosh, I'd have to write a book to explain it properly, please forgive me for rambling.

Needless to say, we can change obesity when we start dealing with the cause rather than obesity. What is the cause? ... well, ponder on that a few months... This is intended to only inspire thought.

Obesity as a Disease

Is it a disease? Is it a disease of the mind or is it a disease of the flesh? Is Obesity a cause, or is it an effect? Those are some questions that come to mind when referring to Obesity as a disease. Obesity is exactly what we've excepted it and feared it to be... we've created it. The frame of mind, the vibration of thought consciousness, the signals of perception we've accepted into our bodies... the alterations of our own perception reflected in physical form through conscious thought..., (difficult to explain).

If obesity be a a disease, is it a disease of cause or effect? (a disease of mind or matter?) This is something to think about.

Can We Overcome Obesity?

You bet your 'sweet bippie' we can. I have to believe that man has been given the power to change the physical world to that of his ability to think from within in accordance with his knowing of himself. Obesity can be overcome easily if we stop treating the effect... Meaning, we stop treating Obesity and start treating the cause of Obesity. Sure we can scientifically alter the effect but in treating the effect, (Obesity) we experience more of it as seen throughout the ages.

To overcome obesity we must overcome the acceptance of it. We have to take a good look at what Obesity is caused by and work on the cause.

• Obesity is an effect
• Cancer is an effect
• Obscurity is an effect
• Tooth Aches are an effect
• Emotions are an effect
• Disease is an effect
• ... Merely everything we think of as real, or reality is only an effect.
• .. .. All of the above as a cause, would produce yet another effect.

We as a mankind live within a world of effect. Obesity is an effect of a much greater cause.

I could go on and on because this is a topic of great interest. I feel that I've rambled on enough and to describe effect, (Obesity) it would take a very long book or essay to understand it a way that could be understood. So, taking issue with the cause of obesity would be on the only way of overcoming it. We can treat obesity with drugs and science but is that actually overcoming it?

To finish, the only way that I can help my dear friend is to help myself in this obesity ordeal. When I see him, I see myself and it's something that I've lived and experienced and something that I have not let loose of.

Disclaimer and Credentials

Zero! Zilch and None. These are simply my thoughts written above and I have absolutely no sound proof other than my experience of it. Academically I have ZERO credentials so take from it what you may and do with it what you will. Is it complete... Absolutely not! Obesity is something that interests me very much and I don't have the answers to it, just a lot of thoughts that hope to inspire more thought and dialog. This is obesity as seen through the eyes of a self-proclaimed philosopher.
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To overcome obesity we must see ourselves as NOT obese when we look into that mirror. Is the mirrored reflection a cause or is it an effect?

The reflection will only be that which the mind reflects. We can call it a disease, but is it a disease of the mind or a disease of the flesh? Could it be possible that we believe the effect into existence?

OK, I'm done for now!

One more... ... .... Can we change the effect by changing the cause of that effect?... Is the effect merely a reflection of self?

[Aedes]

Very interesting post, Justin.

I'd just say, and this is critically important in understanding obesity, is that virtually everyone who is obese as an adult was already overweight at 2 years of age, and many were overweight between 9 and 12 months of age.

This is long before there can be 'states of mind', I mean a baby is in (in Piaget's terms) a sensorimotor stage of cognitive development. Now one could argue that the baby's weight has to do with the parents' state of mind, because often times overweight babies are not being fed appropriately (i.e. getting high calorie / low nutrition food like juice), but just with respect to the baby and its weight it's a purely physical thing.

I'd also add that obesity is far more common among poor people. This is because going to McDonalds is a lot cheaper than going to the farmer's market. High calorie, low nutrition food abounds, and people on limited incomes make food decisions financially.

Finally, the one thing that really IS a matter of 'state of mind', is our expectations for portion size. The sort of semi-formal chain restaurants like Olive Garden, Applebees, Chilis, etc, give enormous portions. People come to expect that. They look for bargains, free breadsticks, supersizing for 25 cents more, second helpings, etc.

[Justin]

Originally Posted by Aedes

I'd just say, and this is critically important in understanding obesity, is that virtually everyone who is obese as an adult was already overweight at 2 years of age, and many were overweight between 9 and 12 months of age.

This is long before there can be 'states of mind', I mean a baby is in (in Piaget's terms) a sensorimotor stage of cognitive development. Now one could argue that the baby's weight has to do with the parents' state of mind, because often times overweight babies are not being fed appropriately (i.e. getting high calorie / low nutrition food like juice), but just with respect to the baby and its weight it's a purely physical thing.

Sure, I'd agree to the point that we are looking at Obesity as an effect. The state of mind or level of consciousness of a child at birth is there. The influences of the parents state of mind and the collective state of mind of the family, the city, the country and so on effects that child. I'd disagree that's it purely physical because the physical can only be produced as we see it through conscious thought.

This is going back to the 'Chicken or the Egg'. First, there's thought and then there's motion or creation. Nothing can be created without the thought of it first. I would think this applies to obesity as well.

Just because the child is a child and hasn't really gained full control of their conscious thought as pertaining to their physical world, doesn't really make obesity purely physical. There is nothing purely physical. The purely physical that we see is only a mere effect. So treating the effect or dealing with only the effect, in this case, Obesity... It's easy for us to assume that it's purely physical because collectively man resides in the physical world of effect, never knowing of the cause. Likewise we treat one effect after another producing yet more effect.

The difficulty in Science is it's limitation to the effect. We measure and analyze obesity as an effect and study the effects and then treat the effects. Science says, it's purely physical... But can it possibly be? How can we have pure physical in a thought wave universe of motion?

Originally Posted by Aedes

I'd also add that obesity is far more common among poor people. This is because going to McDonalds is a lot cheaper than going to the farmer's market. High calorie, low nutrition food abounds, and people on limited incomes make food decisions financially.

As I see it through my own eyes, this poverty consciousness or the fear of not having creates the obesity and not the food itself. It's the fear of poverty that alters the cells within the body through signals and likewise changes physiology. It's not the food, it's the mindset of the man eating the food. The level of the vibrational thought of the man or child eating the food. The food is merely an effect that is treating the effect of hunger or starvation and in turn we have the effect of obesity... yet all of these are only effects. What's to be said about the collective consciousness of the here and now this child is within?

Originally Posted by Aedes

Finally, the one thing that really IS a matter of 'state of mind', is our expectations for portion size. The sort of semi-formal chain restaurants like Olive Garden, Applebees, Chilis, etc, give enormous portions. People come to expect that. They look for bargains, free breadsticks, supersizing for 25 cents more, second helpings, etc.

Yes, this is true to a certain extent... However, on the conscious level though I see it as the collective fear of not having enough.

Take a look at America. Back in the 60's we were much more thin and as America has evolved and as the our consciousness shifts from the love, careless and free being times into a state of fear, we've become more obese. Food is healthier today than it's ever been yet we continue to become more and more obese. In America, the middle class has nearly completely vanished and we have the poor and the rich. There is more poverty in America today than ever before, likewise there is more obesity than ever before. The poverty of state of fear of not having, as I've observed it, has indeed created the effect of obesity.

Again, it would literally take a book to explain and a lifetime of writing because obesity cannot simply be fixed by fixing what it is we eat or how we eat. We can easily alter this and we can scientifically come up with drugs or health plans to change obesity but on another level, we'll never be able to control the effect unless we take a greater look at the cause.

Obesity, as seen as purely physical is something we can treat to a certain extent. The question remains, is there anything that is purely physical? Is the purely physical not a matter first of the thought in which it's created?

Obesity is not the cause of eating poorly but merely a reflection which in essence is an effect of a collective state of mind. When we separate the physical from the spiritual further and further we plunge further and further into the effect world and that's what we study and analyze because we view ourselves as physical beings rather than spiritual beings of energy.

My friend that is obese, eats very little and very healthy. He treats the effect of obesity by spending a lot of money on special foods and participating in all kinds of diets and nearly starves himself into losing weight. However, he's treating an effect. His mind is obese, his thoughts are obese and when he looks in the mirror, no matter how thin he may become he still sees obesity. In order for this man to overcome obesity he must stop treating it and start looking into the cause of the obesity and shift his consciousness from obese to not obese.

Again, I ramble about this because I have a great interest in obesity and would like nothing more than to see people overcome this. We will however, never overcome obesity by treating obesity. It's a far bigger problem than what mankind tends to see... as we see only the reflection or the effect of a much greater cause.

[Aedes]

That's definitely a non-scientific way of looking at cellular function, and while one can speculate about it there's really no way it can be demonstrated. I agree fully about the interplay of states of mind and physiology, particularly insofar as one's behavior is determined by one's state of mind and behavior can have direct biological effects. But it's sort of mystical to say with any kind of factual emphasis that states of mind directly affect cell function, it's not something that scientific rigor can acknowledge.

[Justin]

Thus the limitations of science. Agreed.

[Aedes]

Well, that's one way of looking at it.

But you said: "It's the fear of poverty that alters the cells within the body through signals and likewise changes physiology."

One must ask how we might know that cells are altered by fear of poverty. We know an awful lot about cells. So what particular alteration are you speaking of that we can 1) know about and 2) is not measurable by scientific tools?

We know a lot about physiology. We know a lot about inter- and intra- cellular signals. So what specific alterations and what specific signal do you speak of?

And finally, when you attribute an end-effect to "fear of poverty", how do you know it's "fear of poverty" that is exerting any given change? How do you isolate fear of poverty from the effects of poverty?

I'm not trying to be a pain here, and you know that you and I have different viewpoints on this stuff. But there is something you need to reconcile here:

You highlighted the limitations of science in one sentence, but in the next sentence made a point using purely scientific terminology. So do you believe in science enough to invoke purely scientific outcome measures (like alterations of cellular physiology), but not enough to scrutinize whether we know whether "fear of poverty" per se has any effect?

Why do I harp on this? It's not because I expect my friends here on this forum to use the same scientific rigor as a scientist might use. It's because the original post was ETHICAL, and ethics is philosophy in practice. It has to do with not just what we ponder, but what we DO. At least in science we can apply a specific question to a specific subject and measure a specific outcome.

That's how we know what intervention works and what doesn't: and in the end doing what works is what we ought to do. That is ethics.