Thursday, August 14, 2014

Visionary Quotes from 1929 Obesity Textbook - On Society

Given society's never ending unhealthy and toxic focus on weight, the "reducing craze" isn't all that difficult to understand today but that doesn't make ideal weights or BMI based goals any less crazy.

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8 comments:

  1. When you say, "that doesn't make ideal weights or BMI based goals any less crazy", would you say that dietitians that work with overwt/obese clients to assist them in achieving wt loss to a target of an IBW/healthy BMI have an unrealistic/unreasonable approach? Would you say it is a waste of time? Or would you simply say that the focus is wrong?

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    1. Wrong focus. Goals have to be behavioural given that people simply don't have full control over the dozens/hundreds of variables that impact weight.

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    2. I totally agree in that wt loss is NOT a goal in and of itself, but that it is one of the possible end targets that we would hope to influence when setting a behavioural goal.
      But would you not agree that wt/BMI is often the springboard from which we would initiate a behavioural goal in the hope of influencing a parameter (weight) that is associated with poor outcomes and in making this goal we hope to bring the wt closer to 'target'? In that sense, wt loss is one of our endpoints/goals and we are indirectly attempting to influence weight via a behavioural goal...?
      Do you disagree with the whole notion of working towards IBW or BMI targets? Or simply disagree with the idea of having these be the goals in and of themselves?

      Thanks for your thoughts!

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    3. Not a springboard in my experience. Definitely not helpful and often has ability to harm if patient feels (often very rightly so) that it's wholly unrealistic. "Some more thoughts from me on this here."

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    4. Especially not a springboard if someone feels that attaining the goal is so impossible that it's worthless to try. I have the best success when I focus on the healthy habits I want to have in my life and let the weight loss fall where it may.

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  2. So in your practice, Yoni, are you finding that weight/BMI measurement is somewhat of an outdated measurement in general?
    I know that in my own practice, I have been weighing people less because I don't want weight to be the focus of our visits - rather, I'd have them focus on lifestyle and (as Toledo mentioned above) then let weight fall where it may.

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    1. We measure both, but don't discuss BMI at all (other than to say it's not a useful measure (though OHIP requires its measurement by me)) and we de-emphasize weight throughout.

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  3. You could also say the same thing regarding men and being bulked up. Look at pictures of the original Superman--he's a fairly regular looking guy. A strong one that's worked out a bit, but still well within range of "normal person," which is not the case today.

    Sure, the various implications for the genders are different, but I think that steroid use for men is in the same vein as the anorexic look for women.

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