Talk:Obesity/Archive 8

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Archive 8

Archive 9

Alcoholism and obesity

Alcoholism and obesity can be linked: ever heard the phrase beer belly?

Due to the high calories in beer and other alcoholic drinks, I believe alcohol at least warrants a mention in this article, even if it is currently considered a 'good article'. At present there is no mention of the link between alcoholism and obesity.--86.170.83.101 (talk) 19:33, 22 January 2011 (UTC)

Stands to reason, but you need to provide a reliable source from the medical literature to support this claim. JFW | T@lk 03:09, 23 January 2011 (UTC)

Obesity and Women

A new review [1] Doc James (talk · contribs · email) 22:11, 25 January 2011 (UTC)

Poor caption

"Overweight people, such as U.S. President William Howard Taft, have been ridiculed at various times." The combination of the passive voice with the equivocal "various" makes it sound like the caption is trying very hard to be completely uninteresting. How about something with a bit more gusto, like "U.S. President William Howard Taft was often ridiculed for being overweight". Kaldari (talk) 03:55, 22 March 2011 (UTC)

Agree and done. Doc James (talk · contribs · email) 03:57, 22 March 2011 (UTC)

Undue weight to Size Acceptance

The Size Acceptance section is way too long considering the amount of weight it deserves, especially compared to Epidemiology. This is inappropriate considering many people will come to the article wanting to know the prevalence of obesity and find little and not understand Epidemiology but very few will come looking for something which is sourced in fat acceptance movement as "remains a marginal movement." Munci (talk) 10:26, 18 January 2011 (UTC)

Hahaha. WEIGHT... geddit? JFW | T@lk 13:37, 18 January 2011 (UTC)

Didn't think of that one. But still it doesn't warrant having as much in this article as it is currently given. To be honest, a sentence or two would fit its importance. Munci (talk) 14:29, 18 January 2011 (UTC)

"Not important" - interesting view considering that the vast majority of obese individuals deal with discrimination on an almost daily basis. I wonder why you feel 300 words out of almost 7,000 for this article is too much discussion of an important, personal, and potentially devastating problem for one-third of the population of the United States. 204.44.5.4 (talk) 22:03, 22 March 2011 (UTC)

"Not important" is your words, not mine. The article is not called 'prejudice against obese people' but 'fat acceptance movement'. And we're not supposed to include things based on what you think is 'important, personal, and potentially devastating problem'. Things are revealed to be important based on how much they are discussed in reliable sources are whether reliable sources say they are important. Munci (talk) 23:04, 22 March 2011 (UTC)

The main picture

What's with the main picture? Is only the male human? There should be a picture of both a male and a female silhouette for the main picture. —Preceding unsigned comment added by 89.165.18.227 (talk) 19:00, 2 February 2011 (UTC)

All this would not fit well. We had to go with one of the other. Doc James (talk · contribs · email) 21:49, 3 March 2011 (UTC)

I have other concerns about the diagram. Where did it come from? How is it useful? Obesity is diagnosed according to BMI, not waist circumference. I'm not really clear on what the point of this image is. Ketsuekigata (talk) 23:28, 3 March 2011 (UTC)

You can find that info here [2] Doc James (talk · contribs · email) 12:58, 6 April 2011 (UTC)

A few minor points I would like to be added - I don't seem to be able to

The conditions and outcomes obesity is related to should be updated. For example, a recent narrative review in which systematic reviews were synthesised concluded that the relative risk ratios when comparing obese versus non-obese persons are approximately ≥5 for type 2 diabetes, dyslipidemia, and non-alcoholic steatohepatitis; 2–5 for all-cause mortality, hypertension, myocardial infarction, stroke, and polycystic ovary syndrome; and 1–2 for cancer mortality, obstetric complications, and asthma. Dixon JB. The effect of obesity on health outcomes. Molecular and Cellular Endocrinology 2010; 316(2):104-108.

Body mass index (BMI), a measurement which compares weight and height,

Would "Body mass index (BMI), a measure of height-adjusted weight" be more accurate? — Preceding unsigned comment added by Dbann (talk • contribs) 21:08, 10 April 2011 (UTC)

Emerging Risk Factors collaboration

doi:10.1016/S0140-6736(11)60105-0 is a meta-analysis (essentially) of over 200,000 people. It appears to show that obesity alone without hypertension, diabetes etc. does not significantly raise the risk of cardiovascular endpoints. JFW | T@lk 13:41, 8 April 2011 (UTC)

But obesity is one of the primary causes of diabetes... Interesting paper though. I guess we could state something like "obesity increases mortality primarily through its effects on the risk of diabetes, hypertension, and hypercholesterolemia" Doc James (talk · contribs · email) 22:02, 11 April 2011 (UTC)

Brazilian case

Brazil has got silly over anti-obeasity policies[[3]].--Wipsenade (talk) 17:13, 25 April 2011 (UTC)

Caloric

I've replaced some instances of "caloric" (as in "caloric intake") with the more clear term "food energy". Wiktionary calls it "rare". It might also be confusing for people in countries which have moved to SI. JIMp _talk·cont 01:03, 28 April 2011 (UTC)

Edit request from 203.214.66.249, 18 June 2011

The total annual direct cost of overweight and obesity in Australia in 2005 was AUD $21 billion. Overweight and obese Australians also received AUD $35.6 billion in government subsidies. 203.214.66.249 (talk) 13:04, 18 June 2011 (UTC)

 Done ^Avic_ennasis @ 17:41, 16 Sivan 5771 / 18 June 2011 (UTC)

Obesity appears to act entirely through DM, hypertension, and hyperlipidemia

Not a review but wondering if we should comment Emerging Risk Factors, Collaboration (2011 Mar 26). "Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies". Lancet. 377 (9771): 1085–95. PMID 21397319. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)? Doc James (talk · contribs · email) 11:37, 30 June 2011 (UTC)

See #Emerging Risk Factors collaboration above - it's the same paper. JFW | T@lk 12:30, 30 June 2011 (UTC)

Thanks :-) While what do you think? Doc James (talk · contribs · email) 12:32, 30 June 2011 (UTC)

Another interesting paper

Could have more info added from it Mozaffarian, D (2011 Jun 23). "Changes in diet and lifestyle and long-term weight gain in women and men". The New England journal of medicine. 364 (25): 2392–404. PMID 21696306. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Doc James (talk · contribs · email) 01:38, 11 July 2011 (UTC)

And Another Interesting Paper...

Although this reports on work in dogs, there is apparently anecdotal evidence that supports the same idea in humans:

International Journal of Obesity (2011) 35, 1011–1018; doi:10.1038/ijo.2010.253; published online 23 November 2010; Association between obesity and reduced body temperature in dogs AncientBrit (talk) 23:25, 14 August 2011 (UTC)

Too early, but interesting

"New research links common RNA modification to obesity" -- http://www.sciencedaily.com/releases/2011/10/111017155622.htm -- Jo3sampl (talk) 21:55, 19 October 2011 (UTC)

Another Interesting Paper: Hormons against weight loss ;-)

Long-Term Persistence of Hormonal Adaptations to Weight Loss http://www.nejm.org/doi/full/10.1056/NEJMoa1105816 --Fisch4Fun (talk) 13:38, 5 November 2011 (UTC)

When it's reached a secondary source, yes. JFW | T@lk 23:36, 7 November 2011 (UTC)

Evolutionary psychology

See [4]. While there is something similar in the genetics section, it is not exactly the same. The genetics sections talks about specific ethnic groups. The EP argument is more general and not limited to a specific group. Miradre (Talk E-mail) 15:20, 17 October 2011 (UTC)

Maybe the genetics section could be expanded to also include the more general argument? Miradre (Talk E-mail) 15:22, 17 October 2011 (UTC)

This article is an overview. Feel free to add it to the Genetics of obesity subpage. Doc James (talk · contribs · email) 15:26, 17 October 2011 (UTC)

There is nothing wrong with a few lines on the suspected evolutionary mechanisms of obesity, but evolutionary psychology is a highly unscientific approach to phenomena. To understand why certain behaviours pose an evolutionary advantage, you need a level of knowledge about the selective environment that is simply not available to us. JFW | T@lk 19:32, 17 October 2011 (UTC)

Actually, you do not. For example, you can make predictions about novel phenomena based on your evolutionary theory and if these are confirmed your theory is strengthened. Just like for other sciences. Thus, there were predictions based on some variants of the thrifty gene hypothesis that were not confirmed. I will be expanding that article shortly and maybe then update this article also. Miradre (Talk E-mail) 19:42, 17 October 2011 (UTC)

Sounds good, just make sure you stick with review articles. Cheers Doc James (talk · contribs · email) 21:06, 17 October 2011 (UTC)

Just to make clear, the source was a textbook/handbook and thus a secondary or tertiary source. Miradre (Talk E-mail) 08:16, 12 November 2011 (UTC)

Done. Corrected the description of the theory which was incorrect. Miradre (Talk E-mail) 15:49, 21 October 2011 (UTC)

This is not about diabetes?Doc James (talk · contribs · email) 23:57, 21 October 2011 (UTC)

As noted the theory is now more general. The version you restored is also grossly factually incorrect. The theory is not primarily about ethnic groups. Miradre (Talk E-mail) 00:19, 22 October 2011 (UTC)

Why is DIABETES mentioned. This page is about obesity? Doc James (talk · contribs · email) 00:34, 22 October 2011 (UTC)

Well, in the interest in of historical accuracy. But we can fuzz over that and only describe the current version if you prefer. Miradre (Talk E-mail) 00:35, 22 October 2011 (UTC)

This article is not about the history of the thrifty gene hypothesis but how it relates to obesity. Also please use review articles in the last 5 years.Doc James (talk · contribs · email) 00:37, 22 October 2011 (UTC)

That was the last review article by creator and long-term researcher of the theory. But if we are not interested in the history we likely do not need it. The other article is also a review. Note the previous version was factually incorrect. Miradre (Talk E-mail) 00:41, 22 October 2011 (UTC)

Yes agree. And have changed the wording. Is it better now? Doc James (talk · contribs · email) 00:41, 22 October 2011 (UTC)

Much of the previous material regarding this theory in Wikipedia seems to have been written/heavily edited by some advocate of low-carbohydrate diets and was largely factually incorrect propaganda pieces. The Pima indian material is a minor detail and does not belong in an overview. It should also be mentioned that there are now several alternative theories formed in response to criticism of the theory. Miradre (Talk E-mail) 00:54, 22 October 2011 (UTC)

So what do you propose we do to improve it? Doc James (talk · contribs · email) 04:47, 22 October 2011 (UTC)

Sorry for the long delay in responding. Made some improvements to the text. Miradre (Talk E-mail) 08:16, 12 November 2011 (UTC)

Death in the EU

In the "mortality" section, this article states that "while 1 million (7.7%) of deaths in the European Union are attributed to excess weight."

How is this possible? According to Wolfram Alpha, there are 5 million deaths in the EU. So either the number is less than 1 million or the proportion is more than 7,7%.

http://www.wolframalpha.com/input/?i=annual+death+in+the+EU

87.96.234.6 (talk) 18:41, 7 December 2011 (UTC)

Good catch. It should be Europe not European union. Have changed to reflect the ref in question.--Doc James (talk · contribs · email) 19:16, 7 December 2011 (UTC)

New 2011 review article on management

[5] Doc James (talk · contribs · email) 00:26, 22 October 2011 (UTC) [6] And another on measuring adiposity.Doc James (talk · contribs · email) 17:34, 13 December 2011 (UTC)

Edit request on 22 December 2011

harmacotherapy for obesity is still being practiced despite the anecdotal evidence. Obesity has proven to be a difficult target for successful pharmacological intervention as it gulps crucial expenditures with little beneficial results so far. Due to variety of side effects associated with such medications, many drugs had been yanked from the market. Orlistat and sibutramine are obesity experts’ favorite drugs as far as the pharmageddon arena of anti-obesity drugs are concerned. Aakifa.javed (talk) 14:43, 22 December 2011 (UTC)

Read the article. There are reasonable quality studies, including meta-analyses, on the pharmacological management of obesity. We know that it isn't very effective, but "anecdotal" does not do the research justice. Aromatherapy has no evidence base, and while I like your coinage of "pharmageddon", you should not be making any changes to the article at the moment. JFW | T@lk 00:44, 23 December 2011 (UTC)

Edit request on 30 January 2012

Th

[www.geckoli.com looking at contemporary weight loss methods]

Ossesepia (talk) 11:17, 30 January 2012 (UTC)

 Not done, per WP:EL--Jac16888 ^Talk 12:17, 30 January 2012 (UTC)

Chart of BMI Classification Is Incorrect

The BMI classification chart does not account for those between 24.9-25.0 BMI, 29.9-30.0, 34.9-35.0, 39.9-40.0. I recommend that greater than or equal to and less than or equal to symbols are used to account for all BMI ranges. — Preceding unsigned comment added by Azamora723 (talk • contribs) 01:50, 16 November 2011 (UTC)

What's more confusing is that there two different 22.5-24.9 bars on both mortality graphs. 84.215.29.250 (talk) 09:27, 4 February 2012 (UTC)

Exogenous vs. Endogenous

Since exogenous obesity redirects to obesity and since exogenous (as well as endogenous, for that matter) is a fairly uncommon word in laypeople's parlance, would it not be useful to include at least some reference to the term in this article? --Jhfrontz (talk) 20:04, 10 December 2011 (UTC)

What do you propose? --Doc James (talk · contribs · email) 04:50, 13 December 2011 (UTC)

Perhaps something under Obesity#Classification? I'm not competent to write something definitive, but I could stick a blurb in there to stimulate an edit by someone who is more informed. --Jhfrontz (talk) 18:56, 13 February 2012 (UTC)

Obesity rates of different countries

According to this website:

http://www.nationmaster.com/graph/hea_obe-health-obesity

The twelve countries with the highest rates of obesity are:

1. The United States of America; 2. Mexico; 3. The United Kingdom of Great Britain and Northern Ireland; 4. Slovakia; 5. Greece; 6. Australia; 7. New Zealand; 8. Hungary; 9. Luxembourg; 10. Czech Republic; 11. Canada; 12. Spain.

Perhaps this information could be added to the article. ACEOREVIVED (talk) 22:10, 16 February 2012 (UTC)

WHO references

All the WHO references are very poorly done. "WHO 2000 p. 9" is not an actual thing. I'm trying to find the reference and am not at all being successful. — Preceding unsigned comment added by 137.43.188.232 (talk) 17:10, 16 April 2012 (UTC)

The actual reference is further down, under "References":

World Health Organization (WHO) (2000). Technical report series 894: Obesity: Preventing and managing the global epidemic (PDF). Geneva: World Health Organization. ISBN 92-4-120894-5. . --bonadea contributions talk 17:17, 16 April 2012 (UTC)

New report 2012

From the IOM [7] Doc James (talk · contribs · email) 22:12, 10 May 2012 (UTC)

Reflections on Body Image

http://issuu.com/bodyimage/docs/reflections_on_body_image -Fisch4Fun (talk) 08:47, 7 June 2012 (UTC)

Why should we discuss this? JFW | T@lk 21:48, 7 June 2012 (UTC)

USDA Supplemental Food Program and obesity

Amber Waves Magazine is a secondary source. The primary source is a published research study conducted at a university, and is cited in the article. The magazine is published by the US government, so, of course, the article tries to spin the result as much as possible, but they cannot deny the fact that women in their supplemental nutrition program are more likely to be obese than women who are comparable in every other characteristic.

Daniel Kellis (talk) 00:30, 9 June 2012 (UTC)

I think what is needed is something that is 1) peer reviewed 2) published in a respected medical journal. --Doc James (talk · contribs · email) 00:44, 9 June 2012 (UTC)

OK. I thought it was removed because facts from reliable primary sources are not allowed in Wikipedia articles. Because the correlation between food program participation and overweight is obvious and undeniable, I will have no problem choosing a study from any number of peer reviewed journals. — Preceding unsigned comment added by Daniel Kellis (talk • contribs) 02:21, 9 June 2012 (UTC)

Edit request on 23 June 2012

Broken link in External links should be

• {{Dmoz|Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders}}

The Health level is missing

184.78.81.245 (talk) 00:41, 23 June 2012 (UTC)

Thanks --Doc James (talk · contribs · email)(please leave replies on my talk page) 01:41, 23 June 2012 (UTC)

Edit request: 'Management' section photo caption

Currently: "Orlistat (Xenical) the most commonly used medication to treat obesity and sibutramine (Meridia) a recently withdrawn medication due to cardiovascular side effects"

Suggested change: "Orlistat (Xenical), the most commonly used medication to treat obesity, and sibutramine (Meridia), a recently withdrawn medication due to cardiovascular side effects" — Preceding unsigned comment added by Smooha (talk • contribs) 03:03, 14 July 2012 (UTC)

 Done. In the future, you may use the {{Edit semi-protected}} tag for faster responses. BigNate37_(T) 15:40, 31 July 2012 (UTC)

No relation between Economic Impact and Size Acceptance - why group them?

Both 'economic impact' and 'size acceptance' are currently subsections of a vague "Society and Culture" section. I don't see any reason to group these two under a such a vague, extensive heading and believe they would be much better divided. I think the Economic impact is big enough a topic to stand on its own as a section in this article, and the Fat Acceptance subsection could easily be moved to the History section of the page, where it would make more sense than where it is now, right beneath the economic implications.

The economic aspects of obesity are not at all cultural and not even especially social - only part of the costs of obesity are paid for by governments or by society at large, the rest falling on individuals and often their employers. An issue like worker's compensation, for instance, or the increased cost of gasoline for airlines (both of which are featured in this section) aren't really social at all so much as business concerns - which is to say, economic. It makes little sense to brand an economic issue as a social one and couple it with a cultural consideration such as the fat acceptance movement.

I made an edit earlier (which made two individual sections out of both topics) which was promptly reversed. If anyone has any serious objections, go ahead and post them here, because I still would like to divide the subsections, let the econ section stand on its own, and fold size acceptance into history, probably right before the arts subsection. Mxheil (talk) 20:09, 26 July 2012 (UTC)

I bet there is enough literature on the Economics of obesity so that an article should exist, so sure, I think a section by itself is fine under the title of "Economics". The social acceptance efforts are a cultural thing though. So I don't think they should go under history unless sources treat them as historical. The text I saw doesn't treat this as history. And WP:MEDMOS is a guideline that exists, though that is written more from clinical medicine point of view, in my opinion. Biosthmors (talk) 20:58, 26 July 2012 (UTC)

The reason I suggested appending Size Acceptance to the History section is that that section already is 95% social/cultural. It would take minimal editing to change the History section to a "Social and cultural perceptions of obesity" section or some variation thereof - we could even preserve the "historical trends" section as a subsection under either that name or just plain "history". Mxheil (talk) 12:58, 27 July 2012 (UTC)

Per WP:MEDMOS we have sections on society and culture. Economics and social movements fit under this heading. All/most of our medical articles are organized like this. Economics is a social science. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:22, 27 July 2012 (UTC)

Those seem to be suggestions rather than laws, and I think this particular situation is an exception from the typical treatment of most diseases, and we should at least discuss the matter before defaulting to the MEDMOS suggested organization. I understand the value of these suggestions - having edited pages here and there around Wikipedia, it makes the page much more navigable while minimizing any repetition that might otherwise happen. But these are only suggestions, as one size usually doesn't fit all. I think the key thing in this instance that distinguishes obesity from a typical 'disease' or 'medical condition' is the sheer extent of the role society and culture play in obesity itself - obesity is (in a way no other disease I can think of is) as much a social issue as a medical one. It's practically inextricable, which is why at least four other sections (at first glance I notice material in causes, public health, epidemiology, history) discuss social aspects of obesity, sometimes at length (Causes has an entire section on social factors - not even counting sections on diet and sedentary lifestyle - and the history section is almost exclusively social and cultural). Becaus it is such a social disease, there's hardly anything to speak of in the 'Society and culture' section *besides* economics, as everything else has already been covered. And the economics, for their part, fit imperfectly under this headline and, as has been stated, could easily merit an article of their own related to this subject. I stand by my point that, based on the particular nature of obesity itself, the suggested heading don't make sense on the subject of 'Society and culture' vs a distinct economics section. Obesity is an extensively social disease, as the prevalence of social and cultural information throughout the existing article shows. It's not something you can cleanly isolate into a 'Society and culture' section, though you can conceivably do so for the economics, which is already three quarters of the so-called 'Society and culture' section. Mxheil (talk) 19:57, 30 July 2012 (UTC)

Sure it is editorial judgement. I do agree that we could have a whole article on the Economics of obesity. Feel free to create it if you wish. I however typically place economics of conditions in the society and culture section. Many conditions are closely related to environmental factors such as hepatitis C or lung cancer. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 20:27, 30 July 2012 (UTC)

Mxheil, I think you make worthwhile points. But I don't think this type of reorganization really is going to improve the article. I don't see why readers would be confused when "Economic impact" fits under a society rubric while fat acceptance is a cultural thing. We have a manual of style to guide us and we tend to default to it unless there's an apparent better solution. Best. Biosthmors (talk) 20:34, 30 July 2012 (UTC)

(edit conflict × 2) Well I can't fault someone for upholding the MOS recommendation. However now that we've had some discussion on the issue, you are right—there are circumstances where the MOS should not be followed to the letter. It's within our discretion to decide whether diverging from MOS recommendations is in the best interest of the article. To that end, I'm no topical expert here but Mxheil's argument is convincing and I agree with it. Right now, the article seems to be a bit of a patchwork piece, without any obvious logical flow. While it may give a sense of uniformity to those familiar with other medical condition articles, we should be writing for readers, not editors. What about rearranging the sections so that the article transitions gradually from purely medical matters through mostly-social matters towards the economic section? BigNate37_(T) 20:37, 30 July 2012 (UTC)

If you are discussing making changes to how we organize disease related articles generally this should be done at WP:MEDMOS. I am of the opinion that having a style and ordering for content makes it not only easier to edit but easier to use especially if you use it extensively. I do not see sufficient justification to deviate from our standard outline.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 21:20, 30 July 2012 (UTC)

No, I am not discussing the general case, but this specific one. I understand your opinion, and I simply disagree with you. Most importantly I feel that ease of reading supersedes ease of editing. To that end it becomes a matter of whether consistency with other articles is a priority over consistency internally, because I contend that this article taken in isolation is an organizational mess. I suppose that devolves into whether your priority is to the casual reader or the frequent reader. The former is probably more likely to have difficulty finding what they want. Take my opinion as you will, though; I saw this discussion and chose to contribute my opinion to give a broader set of input, as it's hard to establish consensus when only two editors are talking. I've no intention of screaming until I get my way. BigNate37_(T) 22:11, 30 July 2012 (UTC)

Sure so we are equally split then :-) Both have there positive and negatives. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 22:42, 30 July 2012 (UTC)

Obesity is only partly - and not, I would say, principally - a medical condition. Typical definitions, including our own, do not emphasize the medical aspect of the condition. I do not object to using the MEDMOS suggestions to guide the medical parts of the page, but I do not think WikiProject Medicine can claim ownership of an article that describes a human state that is not foremost a medical condition despite its medical consequences. By all means, treat obesity as a medical condition to the extent that it is one, and to that extent follow the guidelines. But I don't think we need to force this page completely in line with the MEDMOS suggestions. As it is the guidelines deemphasize the social aspects of obesity, in part because they were designed to treat diseases and not social conditions.

I did not intend to start a lengthy discussion here, but I do not object to one. My original edit made the page cleaner and better organized in my opinion, and I was mostly curious as to the reasons it was reverted - as a relatively new user, I'm enjoying this conversation and learning from it. Mxheil (talk) 13:33, 31 July 2012 (UTC)

You know, wikt:tumor doesn't say it's a medical condition either. However if you follow the link from wikt:obesity to wikt:obese you will see that it has been quantitatively defined, which implies it is more than a "social status" (for want of a better term). You'll need to do a bit more legwork if you want to make a good case that WP:UNDUE weight has been given to the medical implications of obesity in this article. Britannica, for example, treats obesity solely as a medical condition[8] though it's fair to say it's a medical condition with a particularly complex place in society. BigNate37_(T) 15:22, 31 July 2012 (UTC)

Yes there is a huge social and culture aspect to this condition. There are however many medical disorder with significant social aspect. I do not see obesity as being that unique.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 18:32, 31 July 2012 (UTC)

I think any article on obesity might necessarily involve 'undue weight'. ;) That said, my point wasn't that we should treat obesity as primarily social condition, only that we shouldn't treat it as an entirely medical one. While I think the MEDMOS guidelines serve well to organize the medical parts of the page, I feel they do not function very well to address the social aspects of obesity. I'm not talking about radically changing the page - the medical sections, which comprise most of the page, would stay the same. Even if obesity is not uniquely social, it absolutely is particularly social compared to typical medical conditions. As it is, several sections ('Causes' and 'History' in particular) of the article are heavily social in content, and the actual 'Social & Cultural' section ends up being a sort of miscellaneous section that throws two completely unrelated topics together under a very broad heading. Given that the MEDMOS guidelines are only suggestions, I don't think it makes sense to contort the social aspects of the article to comply with them - in fact it is impossible to do so in a decent way because of how thoroughly embedded social concerns are in the topic itself. A seperate economic section also makes sense because of the sheer amount of social and cultural implications of obesity - as it is, almost all of the strictly social and cultural information on the topic is already in the History section, some of it in the causes section, leaving little besides economic information to put under a misleadingly vague heading in the 'Social and Cultural' section. Mxheil (talk) 19:32, 2 August 2012 (UTC) I also worry that the both of you are nitpicking rather than recognizing the core of the argument - that the article makes more sense one way than it is now. Yes, I'm aware of the definition of 'obese', which itself I linked in my last post. No, obesity is not 'uniquely' social, but it is absolutely more social in nature than the typical condition those guidelines were designed for. Again, they are suggestions, and I respect their value but do not think they need apply restrictively to the entire page. The MEDMOS page itself admits they don't. There is no need to treat a suggestion as a rule.

Medicine does deal with social and cultural issues. Our guidelines do deal with all these aspects. I recognize your argument but simply disagree.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 21:35, 2 August 2012 (UTC)

Environmental obesogens?

Not for me (too busy!) but this is interesting stuff, and there's likely to be quite a bit more out there on this. Also on endocrine disruptors to which the mother was exposed during pregnancy here and in other places. It seems that the article as it currently stands may be giving too much weight (lol!) to the diet / exercise aspect and possibly not enough weight to the role of environmental obesogens. Have fun!

"The ability of organotins to act as bifunctional ligands that regulate both RXR and PPARγ signaling is troubling. RXR plays a central role as the common heterodimeric partner to many other nuclear receptor partners in multiple hormonal signaling pathways. In permissive heterodimers, RXR-specific ligands (rexinoids) can contribute to regulation of gene expression. Therefore, inappropriate activation of RXR can be expected to lead to wide-ranging disturbances in the body’s homeostatic hormonal controls. In particular, RXR-PPARγ has been shown to play a key role in adipocyte differentiation and energy storage and is therefore key to the control of whole-body metabolism." ^ref

Pesky (talk) 11:57, 16 August 2012 (UTC)

See also this diagram showing "known and potential pathways through which TBT might act to modulate adipocyte differentiation and obesity." Pesky (talk) 12:54, 16 August 2012 (UTC)

Adding: this study concludes by saying:

"The existence of chemical obesogens in and of themselves suggests that the prevailing paradigm, which holds that diet and decreased physical activity alone are the causative triggers for the burgeoning epidemic of obesity, should be reassessed."

Pesky (talk) 13:01, 16 August 2012 (UTC)

Thanks will take a look. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:25, 16 August 2012 (UTC)

You're welcome! I wish that I personally felt more competent to cover this issue, but my feeling is that the article could almost certainly do with an entire subsection on obesogens, and it may well be worth (you!) contacting some of the editors who have been the best contributors to the Obesogens article itself in order to produce a good section in this.

Page 7 of this(Barouki; et al. (2012). "Developmental origins of non-communicable disease: Implications for research and public health" (PDF). Environmental Health 11:42. Retrieved 12-08-17. {{cite web}}: Check date values in: |accessdate= (help); Explicit use of et al. in: |author= (help); Italic or bold markup not allowed in: |publisher= (help)) has some good(ish) coverage, and the sources cited in the obesogens article will no doubt be very interesting. There's also some interesting stuff on that page on epigenic effects from both maternal and paternal sides.

Adding: from a personal point of view, the attitude which has prevailed for so long ("obesity is a self-inflicted problem") has some echoes in the god-awful "autism is caused by bad parenting" attitude which was widely prevalent not so long ago. As it seems that there's at least some strong scientific background on obesogens, multiple studies, etc., I think it's time that Wikipedia maybe should reflect this a bit more strongly than we currently do! Just out of fairness to those who suffer from obesity and for whom it's not (wholly or even partly) a self-inflicted problem. Which, it seems, may be quite a large proportion of them. It's not impossible, for example, that in utero exposure to Diethylstilbestrol alone could account for up to 6 million obese people ... and when we think what outrage would have been caused if, for example, the Thalidomide children had been blamed, themselves ... "if you had more will power you could grow limbs" ... Pesky (talk) 10:08, 17 August 2012 (UTC)

Thought for the day: every era of medicine / health / social (combined) practices and attitudes has had some things which later generations have come to view as ranging from irresponsible to barbaric. It may be that the obesity / diabetes / cardiovascular-problems epidemic which we currently have will be "this generation's barbarism" in the way that it's viewed, blame allotted, and treated. Rather a horrifying thought when we consider how many millions of people it affects. Pesky (talk) 04:24, 18 August 2012 (UTC)

Obesity#Management

Orlistat (Xenical), the most commonly used medication to treat obesity, and sibutramine (Meridia), a recently withdrawn medication due to cardiovascular side effects

For management, is a picture of medications really necessary, especially since one is withdrawn? Perhaps we could do an illustration of exercise and proper portion size.Smallman12q (talk) 23:42, 20 August 2012 (UTC)

Seems like it was used because it was the only image at the main article, Management of obesity, which itself uses the image in a Medication section (whose main article, Anti-obesity medication, uses the image in the lead). More images in Management of obesity would be an improvement, and would make selecting a more appropriate image for this article's section an easy task. BigNate37_(T) 23:46, 20 August 2012 (UTC)

Globalize

It strikes me that much of the article has been written from the viewpoint of US car culture. References included: some of the determinants of the recent "obesity epidemic" in the Western countries explicitly mention personal car transportation. That is done evenwhile the epidemic is rife in countries where personal transportation is much fewer and far between than in the US. Most of the studies have been conducted in the US as well.

To wit, for instance, in my native Finland people drive insane distances to work and remain at normal weight, and at the same time also drive very little in the metropolitan areas while gaining significant heft. The same goes e.g. for the Tokyo and Osaka metropolises in Japan, where I believe wide variability in medically relevant obesity is observed regardless of the use of personal transportation.

Even if nutritional and exercise factors clearly play a role, and car culture can affect those, I believe it is a uniquely stateside thing that it factors in as grossly as it does. International studies certainly don't support such a central role for personal transportation in the genesis of the epidemic.

Be as it may, I'd hope personal car transportation as a determinant of obesity would be relegated to the status of a US specific phenomenon and/or a derivative cause of lack of exercise, pure insulin balance, poor nutrition and whatnot. There the correlation surely holds, but both the studies and the viewpoint which concentrate on cars are very much US specific.

(Full disclosure: no ties. I don't even own a car. Nor would I mind driving one for a change.) Decoy (talk) 00:31, 5 December 2012 (UTC)

Having spend a fair bit of time in Tokyo I am well aware that car culture is much less there. This however is just one of many factors which are discussed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:45, 5 December 2012 (UTC)

2013 article on BMI and mortality

Will need to update [9] Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:33, 14 January 2013 (UTC)

It's pretty controversial already. JFW | T@lk 22:35, 14 January 2013 (UTC)

Fat v. muscle

The article defines obesity as "a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health" then goes on immediately to say that "People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilograms by the square of the person's height in metres, exceeds 30 kg/m2.". This strikes me as a contradiction considering that muscle, like fat, also has weight, and significantly greater weight per volume, in fact--muscle is denser. The article later says that "BMI is closely related to both percentage body fat and total body fat," but obviously body fat can not be determined simply by weight (or weight per height or weight per square of height). Is obesity excess fat in particular or simply generally great weight? The two are not at all equivalent, and it's critical that the article address this question. TheScotch (talk) 18:14, 23 January 2013 (UTC)

Myths, presumptions and facts

NEJM doi:10.1056/NEJMsa1208051. This strikes me as a very good secondary source. JFW | T@lk 20:10, 31 January 2013 (UTC)

Disease vs. condition caused by risk factors

Does the AMA's upgrade from condition to disease apply outside of the US? Why isn't any condition caused by other risk factor(s) considered a disease? I.e., why wasn't it a disease to begin with and is it considered a disease elsewhere? EllenCT (talk) 19:20, 12 July 2013 (UTC)

I'm not sure about the finer details and implications of the distinctions between "condition" and "disease," but the American Medical Association's pronouncements don't "apply" outside the U.S. -- and AMA classifications aren't even legally binding inside the U.S. for that matter! TIme will tell, what the implications of this classification will be. RCraig09 (talk) 22:28, 12 July 2013 (UTC)

Once considered a high-income country problem, overweight and obesity are now on the rise in low- and middle-income

countries, particularly in urban settings. Close to 35 million overweight children are living in developing countries and 8 million in

developed countries.- Overweight and Obesity World Health Organization (2008)

— Preceding unsigned comment added by Soranoch (talk • contribs) 01:21, 13 July 2013 (UTC)

Edit request on 13 July 2013

In the infobox, the MedlinePlus code for obesity [10] should read 007297 (rather than 003101, which is for overweight [11]).

Could someone kindly fix this? Thank you.

86.161.251.139 (talk) 17:36, 13 July 2013 (UTC)

Done. EllenCT (talk) 19:17, 13 July 2013 (UTC)

Legislating Obesity

Legislation can be used to encourage people to become less obese. One way this can be done is through regulating speech. In the article “Innovative Legal Approaches to Address Obesity” Commercial speech is defined as any form of communication encouraging someone to complete a transaction whether it is through advertisements, flyers, or labels. Regulating commercial speech would prevent companies from falsely advertising about their products and requiring them to put accurate information on their products and any commercial speech deemed false or misleading could result in fines or even lawsuits. Another possibility is content regulation which is much less invasive than speech regulation. While speech regulation requires companies to alter their packaging, content regulation dictates where certain items can be displayed. Normally in any super market, in the front area near the registers, rows of candy, gum, and other sorts of unhealthy foods can be found. Content regulation would require less healthy processed foods to be moved to the back of the store and have healthier put foods up front. While people can still just walk to the back of the store, it subtly encourages people to buy healthier foods. (Pomeranz, Teret, Sugarman, Rutkow, Brownwell 187-194) Another idea that made it to the state of New York’s senate floor, introduced by Senator Parker, was article 24-A Office of Nutrition and Fitness. This bill would create an office in the executive department designed to assist the government of New York in creating and regulating state efforts to promote nutrition and wellness. This office would have the power to adopt or repeal laws and regulations that pertain to keeping New York a healthy state. (Parker 1-2) Another bill introduced in California by Assembly Member Holly Mitchell required that items sold in vending machines or any establishment on state property must meet a certain nutritional requirement. (Mitchell 2)

Europe’s governments, in an attempt to keep their countries healthy, have considered many pieces of legislation. The governments in Bucharest and Taiwan have been considering a tax on fast food. Bucharest passed the legislation and announced that the extra funds from the tax would be spent supporting programs that encourage good health and system infrastructure programs. This tax is one of the first of its kind. Denmark, on the other hand, looks to implement legislation that affects chocolate, soda, and other sweets. This tax stacks on top of an already implemented tax on soda and the government projects that this tax will generate 200 million pounds or about 300 million dollars. Austria and Spain recently introduced legislation severely limiting the use of unsaturated fats. (Büchner)

Sources

Büchner, Wolfgang, “Outlawing Obesity: European Governments Seek to Mandate Healthier Diets” Spiegel Online International. 11 January, 2010. Web. <http://www.spiegel.de/international/europe/outlawing-obesity-european-governments-seek-to-mandate-healthier-diets-a-671334.html>

Mitchell, Holly, “Bill AB 459 Public Contracts: Healthy and Sustainable Food” Yale Rudd Center. 19 February, 2013. Print.

Parker, Kevin S, “Article 24-A Office of Nutrition and Fitness” Yale Rudd Center. 31 January, 2013. Print

Pomeranz, Jennifer L, Stephen P. Teret, Stephen D. Sugarman, Lainie Rutkow, and Kelly D. Brownell, “Innovative Legal Approaches to Address Obesity” Milbank Quarterly. 1 March, 2009. CCCO Database.

Dietvorstcj (talk) 15:34, 1 August 2013 (UTC)

What changes to the article are you proposing. JFW | T@lk 22:10, 3 August 2013 (UTC)

Error: Don"t be judgmental

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.[1][2] People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilograms by the square of the person's height in metres, exceeds 30 kg/m2.[3]

NO. This should be changed. The definition is not adverse effect. Wikipedia should not be trying to change society.

Instead, an objective definition should be given as a first sentence.

Proposal:

Obesity is defined as a condition where the body mass index (BMI) exceeds 30.

DeathToObesity (talk) 19:40, 4 August 2013 (UTC)

Well, it does say "may have an adverse effect on health," and it is cited. It's not a judgement on anyone, just stating what can happen as a result of Obesity. Howicus (talk) 19:45, 4 August 2013 (UTC)

Furthermore the proposed definition has it backwards. BMI is just a rough estimator to determine if someone is obese. −Woodstone (talk) 10:04, 5 August 2013 (UTC)

Changes need to be supported by evidence. What refs support this suggestion? Or goal is simply to reflect the best available sources rather than to write the "truth" Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:00, 5 August 2013 (UTC)

Claim about where obesity is common

@Jmh649: I deleted this claim:

The only remaining region of the world where obesity is not common is sub-Saharan Africa.

User:Jmh649 reverted this edit with the message "please read ref in question, not contradicted by map."

The reason I say the map seems contradictory is that File:World map of Male Obesity, 2008.svg shows rates of <5% in China, India, Indonesia, and neighboring countries, which is the same as most of the sub-Saharan African countries, except for South Africa which actually has higher rates of obesity. File:World map of Female Obesity, 2008.svg seems to show generally higher rates of obesity in sub-Saharan Africa than southern and eastern Asia. This seems to directly contract the claim. The claim does not define "common", which is why I say it's "telling" rather than "showing" as the numbers documented by the map do.

I cannot read the referenced article, since it is published in for-pay journals, though I would be curious to know what it says on this issue since that might help clear this up. -- Beland (talk) 00:48, 10 August 2013 (UTC)

One need to look at the finer degradations than the map properly displays. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:51, 10 August 2013 (UTC)

@Jmh649: But the article is discussing entire countries and entire regions of the globe. I'm not sure how it's justified to imply that China has more obesity than South Africa, when the map clearly shows that on average it's the opposite. -- Beland (talk) 07:16, 26 August 2013 (UTC)

Rates of underweight are most common in countries such as Somalia, Chad and the Democratic Republic of the Congo. Currently there are millions starving and refeeding programs being run. Obesity is not common in these countries. South Africa is an exception being much more developed than the rest of the area. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:37, 26 August 2013 (UTC)

@Jmh649: It's possible for both hunger and obesity to be common in the same country, as they are in the United States. You are making a claim about specific countries, which is not what the article is doing. If we want to change the article to refer to specific countries, that might be more accurate. The maps do not show any data for Somalia or Chad, but the female rate of obesity in the Democratic Republic of the Congo is shown as higher than India and China, and the male rate is the same; this seems to contradict your claim. I would argue it would also be a good idea to not make any generalizations and let the maps speak for themselves. -- Beland (talk) 21:55, 1 September 2013 (UTC)

We are just going by the ref in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:04, 1 September 2013 (UTC)

AHA

AHA Scientific Statement, Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches JFW | T@lk 14:19, 8 October 2013 (UTC)

Public Health

Some scholars deny that obesity is a public health problem, even if they accept that it can impair individual health. The reasons are, first, that obesity does not spread like a disease, in an involuntary and unpredictable way, and second, the extent to which obesity imposes costs on others is almost entirely a function of public policies which determine how benefits are allocated by governments or insurance companies.

The sentences proceeding footnotes 77 and 78 directly contradict the sources cited. While the statement proceeding footnotes 80 and 81 are correct, the studies (77 and 78) actually contradict whoever wrote the proceeding statements. People aren't checking the actual references, again, but instead just using them willy nilly, even when they contradict what was posted in the article. This should be changed. — Preceding unsigned comment added by 24.0.131.236 (talk) 04:05, 9 November 2013 (UTC)

Dec 2013

Meta analysis Are Metabolically Healthy Overweight and Obesity Benign Conditions?: A Systematic Review and Meta-analysis Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:44, 3 December 2013 (UTC)

Semi-protected edit request on 2 January 2014

Please add the following reference to =Further reading= section

• Sharabiani, M.T.; Vermeulen, R.; Scoccianti, C. (2011). "Immunologic profile of excessive body weight". Biomarkers. 16 (3): 243–51. doi:10.3109/1354750X.2010.547948. PMID 21506696. {{cite journal}}: Invalid |display-authors=3 (help); Unknown parameter |author-separator= ignored (help)

Mymata (talk) 12:28, 2 January 2014 (UTC)

Not done. The further reading section is not a collection of primary source papers. Please read WP:MEDRS regarding reference requirements for medical content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:41, 2 January 2014 (UTC)

BMI as a number

Part of the reversion mentioned above was to put the "in kilograms" and "in metres", which I'd removed, back into the definition. It seems that these did in fact belong there after all. On 2 February the article had a number of mentions of BMI, some of which were plain numbers others were in kilograms per square metre. I thought I'd make things consistent by putting the unit in throughout. According to the references you've provided, it looks as if I should have done the opposite: removing the unit throughout. Jimp 08:31, 13 February 2014 (UTC)

How is mass/(length squared) just a number? It evidently has a dimension. It is universally expressed in kg/m², even in the U.S.A, where a conversion factor of 703 is applied when inputs in pounds and inches are used. See for example the world health organisation. −Woodstone (talk) 10:35, 13 February 2014 (UTC)

Well, that's what I thought but the refs above seem to give only numbers so it looked like not mass on length squared but mass divided by 1 kg on length divided by 1 m squared. If it is just a number, it wouldn't be the first time a definition didn't make sense. If it's not a number, then the conversion factor is 1 not 703 (there's a riddle). Jimp 11:31, 13 February 2014 (UTC)

WHO uses kg/m^2. Thus so should we. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:27, 15 February 2014 (UTC)

International convention is kg/m^2. Agree with above Ian Furst (talk) 11:30, 15 February 2014 (UTC)

BMI is a dimensionful quantity, expressed in units of kg/m². Those units are standard enough, used by organizations like the WHO and the CDC, that folks tend to drop the units when talking about them. In those cases, the units are implied. The WHO and CDC are good enough sources for us to follow the same convention in units. And we should probably note in the article that BMI expressed as an unadorned number has the implied units of kg/m². --Mark viking (talk) 21:43, 15 February 2014 (UTC)

Thanks, it's good to know. Jimp 09:56, 18 February 2014 (UTC)

BMI ranges

We follow the reliable sources. Thus reverted again [12]. For example see [13] or [14] Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:02, 12 February 2014 (UTC)

The examples above give limits leaving gaps of 0.1 kg/m². Other sources inconsistently leave gaps of 0.01 kg/m², for example:

• world health organisation
• U.S.A. national institue of health
• medscape

But there are also sources that give a clean classification without gaps, for example:

• weight watchers
• health discovery
• web md
• obesity action

In case of contradicting sources it is the task of WP editors to choose the most correct one. There is no doubt as to how the classes are meant. Clearly a classification with gaps is not really a full classification. It is rather a dumbed down way to represent the classes. If a measurement comes to precisely the boundary, the classification is arbitrary. Just exhale a few times and the loss of moisture and CO2 will bring you down in the lower category. Theoretically of course the classes are half open intervals, like [25-30), but that is an unnecessarily opaque notation. The fact that the list starts with < 18.5 and ens with ≥ 40 is sufficiently suggestive of the intended choice for exact equality to a boundary value.

−Woodstone (talk) 16:12, 14 February 2014 (UTC)

When you are using numbers to one decimal point you get 24.9 and than you get 25.0. No gap. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:31, 14 February 2014 (UTC)

You ignore my pointing out sources that disagree with you (less or more decimals). The definition of the classes is inherently by half open intervals. We need to agree on a way to represent them in WP. There may be a shortcut by clipping all numbers first to 1 (or 2) decimals and then looking at shortened intervals, but that is at best a practical matter for practitioners, not suitable for a definition. And let's hope no health service programme would ever use that method, because clipping to decimal paces is not reliable in a binary computer and might lead to failure to find any class. −Woodstone (talk) 17:28, 14 February 2014 (UTC)

There is something called clinical significance. We in medicine round because after a couple of digits it doesn't really matter. Maybe User:Jfdwolff will give us his opinion. We are not having 25 in two classifications. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:41, 14 February 2014 (UTC)

Anyway it was perfectly fine before and in line with much of the literature. Please remember that Wikipedia is about verifiability not about an editors version of "truth". If you do not like the definition of BMI and how the term weight rather than mass is used first get the World Health Organizations to change. Anyway have adjusted to match WHO and added the WHO ref Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:11, 15 February 2014 (UTC)

I've read this thread for 45min and I'm still trying to wrap my head around it. Regarding the use of mass v weight, the convention in all sources is to use weight. Given that Wikipedia is intended for the layperson, changing to mass will confuse the average reader and make the health issues unintelligible. Also, the relationship between excessive mass and health effects are proven on Earth only so my vote is to stay with weight. Maybe if we colonize the Moon or Mars the issue will need to be revisited. Regarding the definition of BMI classes and overlap, there is enough conflict between sources that it's up to the WP editors to pick the "best" source. Imo, that is the WHO (where there is no overlap) although I could be talked into using only 3 significant digits as height and weight are rarely reported to any greater accuracy. Ian Furst (talk) 11:27, 15 February 2014 (UTC)

You mean use this source [15]? This is what we are doing now. Yes I am happy with either 3 or 4. May as well use 4 as that is what WHO uses and they are the ones that have created the classification in the first place. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:08, 15 February 2014 (UTC)

Yup - that's the source I think is best. Not sure why they use 4 significant digits in the table and 3 in the example. Ian Furst (talk) 13:00, 15 February 2014 (UTC)

Clearly the sources are describing the same thing but some are clearer with their notation. I totally agree that "weight" is fine rather than "mass", because the vast majority of readers will not care about the distinction and would misunderstand "mass". Similarly we need to find a consensus solution for the notation. Is a BMI of 25 safe, or is that "overweight"? It seems the sources define BMI >= 25 as overweight, and BMI>=30 as "obese", so that's what we need to say in some way or another. JFW | T@lk 07:35, 16 February 2014 (UTC)

Yes it however is not our job to "correct" WHO's classification. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:21, 17 February 2014 (UTC)

There is no reason we can only use one source. We can and should combine knowledge from various sources to come the most accurate description of the intended classification.−Woodstone (talk) 09:58, 18 February 2014 (UTC)

The WHO is the definer of BMI. If you do not like their definition write to them and ask they change it. We at Wikipedia are not the definer of BMI. We only reproduce the conclusions of the best available sources which in this case is the WHO. If the WHO changes there definitions then so will we. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:15, 18 February 2014 (UTC)

Woodstone's right, the definitions given here have gaps in them and are thus poor definitions. However, Doc James makes a fair point that these figures are supposed to be the rounded measurement. The thing is, though, given that this is so, it would have to be explained otherwise it looks like a definition with gaps to whoever isn't clued in to the medical lingo. In other words, sure, stick with the WHO's definition but tell us what they actually mean by it. Jimp 11:48, 19 February 2014 (UTC)

Do any sources see this as a problem and comment on it? Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:16, 19 February 2014 (UTC)

I don't know, do they? Do they need to? Do we need a source to prove to ourselves that we've found a problem when it's staring us in the face? If 18.50–24.99 kg/m² is normal weight and 25.00–29.99 kg/m² is overweight, 24.995 is neither, it's in between, at least if we take the definitions here literally. You might get it but we're writing for a general audience. These definitions don't makes sense, they have gaps in them. You're saying that there are no gaps but taken literally there are. You're suggesting that they've got to be interpreted in a certain way, that you've got to read between the lines (or perhaps rows in this case) so to speak. Then if you know what is meant by this, why would you not want to let the reader in on it? Jimp 09:57, 24 February 2014 (UTC)

This is the problem with any expression of ranges, but in this case it is a matter of definitions. Somewhere in the world there might be someone who is delighted that with a BMI of 24.999999999999999999999999999 he is not, in fact, considered "overweight".

Can we possibly draw this discussion to a close? JFW | T@lk 21:06, 24 February 2014 (UTC)

It is not a problem with ranges. Classification ranges are technically half-open intervals. The class "overweight" is when 25 ≤ BMI < 30, or BMI ≥ 25, and BMI < 30. Boundaries are 25 an 30, 25 is inclusive and 30 is exclusive. I made that clear in the article a while ago by having a column for each boundary with subheaders ≥ and <, but it was reverted. −Woodstone (talk) 09:24, 25 February 2014 (UTC)

Grammatical error in locked article

I believe there is an error in this article. I propose that the sentence "Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient food energy present" in the section headed Genetics should read "when sufficient food energy is present". Could an editor with appropriate access rights, please take a look and amend the article, if necessaryCaesarsPalaceDude (talk) 01:32, 1 March 2014 (UTC)

 Done--LukeSurl ^{t c} 02:22, 1 March 2014 (UTC)

The relation between fat cell size and obesity-related disorders

In section 2.2 ( Morbidity), It is stated that diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease are health consequences due to increased fat cells number.

In fact, these diseases are related to the size of fat cells rather than the number. because the increase in size causes inflammation in adipose tissue followed by systemic insulin resistance leading to the aforementioned problems.

according to the provided reference():

"Enlarged fat cells produce the clinical problems associated with obesity either because of either the weight or mass of the extra fat or because of the increased secretion of free fatty acids and numerous peptides from enlarged fat cells. The consequence of these two mechanisms is other diseases, such as diabetes mellitus, gallbladder disease, osteoarthritis, heart disease, and some forms of cancer."

and you can check out the "Pathogenesis of health problems associated with Obesity" provided with the article. ( Link: ) 133.50.98.90 (talk) 05:56, 22 March 2014 (UTC)

I do not read this that "size" of the cells is the only issue. It could be the amount as well. Would be good to use newer sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:02, 22 March 2014 (UTC)

Image size

The image at 420 pixels width

The image at 300 pixels width

The image at 220 pixels width

Doc,

You mention that "we generally leave image size at default so that people can set it themselves under preferences". I'm afraid that I'd have to say that this reminds me a bit of the old argument for date linking. There are a few problems with this as far as I can see.

1. Not all users have set a preference for thumbnail size.
2. Not all users even know this is possible.
3. Not all users log in all the time.
4. Not all visitors to WP are users.

These are general objections to the argument. Let's look at the image in question. Should this really be treated as a thumbnail image? I'm suggesting a width of 420 pixels (it aligns nicely with the maps above); it's still a little small but at least you can read it. If we go into preferences, the maximum we can set it to is 300 pixels. The graph in question is barely legible at this resolution. Of course, as I've mentioned, not everyone is going to have their prefs set to 300 px. For most of us we'll be looking at the graph at the default width of 220 px. It's impossible to read the graph at this resolution; you'll strain your eyes trying. So perhaps in the general case, yes, the default width is quite all right but here I'd say we have a good example of an exception to the rule. Jimp 09:32, 7 February 2014 (UTC)

One can see the general information well at the current size. It takes longer for it to load from what I understand when we set the image size larger.Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:35, 7 February 2014 (UTC)

You may be able to see the general information well at the current size. What I'm saying is that I cannot. I've just tested the two images in my sandbox and, you're right, it does take longer to load the larger image. The page with the 420-pixel image took 0.196 seconds whereas with the default size it took 0.162 seconds. This is an entire 34 milliseconds. It seems to me, though, more time will be wasted with readers trying to read the illegible text. Jimp 04:21, 10 February 2014 (UTC)

Feel free to change the size of the images you see under preferences. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:21, 10 February 2014 (UTC)

I don't see that this addresses the issue. I'm not going to change my prefs for the sake of this one image. I wouldn't expect other users to do so. Those who are not logged in cannot do so (much of WP's readership don't even have a login). Furthermore, even if I did change my prefs, the maximum size for thumbnail images is 300 pixels which is still to low a resolution to make the graph legible. Jimp 08:24, 11 February 2014 (UTC)

I agree with Jimp, currently the picture is far too small to see, its just a line going up on a graph. I certainly don't know how to change any preferences, and I think that the article should be tailored for easy reading. A wiki article is meant to be like encyclopaedic content, which should generally mean that(within reason)the article is accessible and legible to all, including any pictures, and I can't see how unless you knew the title of the graph and knew the ranges on either axis, then you'd have no clue what the graph was about. And surely the point of the graph having that information is to convey it. So, yes, I would say the increasing the graph size would be best. It would look neater too, as the size of the map and the size of the graph would align their edges for a better look. At least consider it. Dellkitty (talk) 07:49, 28 April 2014 (UTC)

Desobesification

What are the methods desobesifying people efficiently? Sports desobesify well only with regular training some obeses cannot achieve. — Preceding unsigned comment added by 77.192.55.209 (talk) 18:59, 27 April 2014 (UTC)

Firstly, "deobesifying" is not a word, and obese people are not collectively referred to as "obeses". Plus, its been well proven that obesity can be countered with regular, light training and a change in diet, so I don't think that's a particularly valid point that should be added into the article. Dellkitty (talk) 07:54, 28 April 2014 (UTC)

What changes are you proposing to the article? Please see WP:TALK. This is not the place to introduce neologisms. JFW | T@lk 09:26, 28 April 2014 (UTC)

Obesification can be prevented or at least limited by doing sports, and any regular physical activity can be a desobesifier, although some bodies are more desobesifiable than others. 193.54.167.180 (talk) 12:06, 28 April 2014 (UTC)

There really is no relevance to the article so far in this topic, other than discussion of losing weight. And can we please use real English words?

1. Deobesification being replaced with real words, ie "losing weight" or "lowering body fat"
2. Deobesify in the context used seems to be more like "help people lose weight/ lower body fat"
3. Obeses= obese people
4. Obesification= gaining weight/ increasing body fat
5. Deobesifier= an action that helps people lose weight/lower body fat
6. Deobesifiable (in this context)= helpful when losing weight.

If your only contribution to this discussion is the idea of including your new nonsense words, then please leave well enough alone.

I would like to suggest at this juncture that the article is more balanced on its view of weight loss techniques, as currently it seems to come down heavily on the idea that long term weight loss is unlikely, however I think that the health benefits that a modest reduction in weight can bring, or just something to balance it out, as it currently seems to read as "You can lose weight with this method, but who would even bother as only about 2-20% of those who try will succeed" and I think that there needs to be some more emphasis on balancing the argument. Arguments that could help this are that of health or fitness increases, the long term benefits of success, just presenting the other argument fairly. I dunno, thoughts? And please, if I see one more reference to "deobesifying" someone again, I may lose my mind. Dellkitty (talk) 17:38, 28 April 2014 (UTC)

Effects on health

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, obstructive sleep apnea, certain types of cancer, osteoarthritis[2] and asthma.[2][20]Endocrine disorders especially diabetes mellitus type 2, Cushing's syndrome, Hypothyroidism, and PCOS (Polycystic ovary syndrome) are also associated with weight gain. As a result, obesity has been found to reduce life expectancy.[2] Szdianalili (talk) 20:39, 15 November 2013 (UTC)Szdianalili

Done — TheJJJunk ^{(say hello)} 15:01, 16 November 2013 (UTC)

There are two separate issues. Some diseases are caused by obesity and some diseases cause obesity. We should not confuse the two. We also need a ref for this. Best Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:20, 17 November 2013 (UTC)

If any of the informed editors from this page might consider trying to add any scientifically supported information to either the Health or Medical Criticism portions of the Fat Acceptance Movement page I think it would significantly improve that entry's scope and accuracy. Mine and others' edits have been repeatedly deleted by editors of the page to favor their unsupported views on the medical effects of obesity. 97.120.74.235 (talk) 00:16, 26 February 2014 (UTC)

The fact is that a lot of the stuff that the Fat Acceptance Movement usually cites is not good science. Whilst improving scope and accuracy is undeniably a good thing, I don't see how including citations of unproven science is a good thing. I think there needs to be more concrete and concurrent research in that area before it can be added. Dellkitty (talk • contribs) 19:07, 27 April 2014 (UTC)

}}

The old version looked like this. It used the deprecated {{double image}} template (substed here).

1961

2001–03

map of dietary energy availability

(calories per person per day)

  no data

  <1,600

  1,600–1,800

  1,800–2,000

  2,000–2,200

  2,200–2,400

  2,400–2,600

  2,600–2,800

  2,800–3,000

  3,000–3,200

  3,200–3,400

  3,400–3,600

  >3,600

(kilojoules per person per day)

  no data

  <6,700

  6,700–7,500

  7,500–8,400

  8,400–9,200

  9,200–10,000

  10,000–10,900

  10,900–11,700

  11,700–12,600

  12,600–13,400

  13,400–14,200

  14,200–15,100

  >15,100

I had replaced it with this which I'd thought was much better.

• It's clearer which map is for which year(s).
• The caption is not a clutter of words.
• Stuff isn't unnecessarily repeated.
• The units are spelt out in full instead of being a mess of symbols, slashes and words.
• Conversions to SI are given.

1961

2001–03

map of dietary energy availability per person per day

  no data

  <1,600 Cal (6,700 kJ)

  1,600–1,800 Cal (6,700–7,500 kJ)

  1,800–2,000 Cal (7,500–8,400 kJ)

  2,000–2,200 Cal (8,400–9,200 kJ)

  2,200–2,400 Cal (9,200–10,000 kJ)

  2,400–2,600 Cal (10,000–10,900 kJ)

  2,600–2,800 Cal (10,900–11,700 kJ)

  2,800–3,000 Cal (11,700–12,600 kJ)

  3,000–3,200 Cal (12,600–13,400 kJ)

  3,200–3,400 Cal (13,400–14,200 kJ)

  3,400–3,600 Cal (14,200–15,100 kJ)

  >3,600 Cal (15,100 kJ)

I was, however, reverted. It was on the grounds that we don't usually hide this kind of stuff which is fair enough. But can we not keep the conversions? We could use {{convert}} on each of these values but it can get a bit messy with the conversions wrapping as you can see.

1961

2001–03

map of dietary energy availability per person per day

  no data

  <1,600 Cal
          6,700 kJ

  1,600–1,800 Cal
          6,700–7,500 kJ

  1,800–2,000 Cal
          7,500–8,400 kJ

  2,000–2,200 Cal
          8,400–9,200 kJ

  2,200–2,400 Cal
          9,200–10,000 kJ

  2,400–2,600 Cal
          10,000–10,900 kJ

  2,600–2,800 Cal
          10,900–11,700 kJ

  2,800–3,000 Cal
          11,700–12,600 kJ

  3,000–3,200 Cal
          12,600–13,400 kJ

  3,200–3,400 Cal
          13,400–14,200 kJ

  3,400–3,600 Cal
          14,200–15,100 kJ

  >3,600 Cal
          15,100 kJ

Here's another idea: put the conversions underneath. It still looks a bit clumsy, though.

1961

2001–03

map of dietary energy availability per person per day

  no data

  <1,600 Cal (6,700 kJ)

  1,600–1,800 Cal (6,700–7,500 kJ)

  1,800–2,000 Cal (7,500–8,400 kJ)

  2,000–2,200 Cal (8,400–9,200 kJ)

  2,200–2,400 Cal (9,200–10,000 kJ)

  2,400–2,600 Cal (10,000–10,900 kJ)

  2,600–2,800 Cal (10,900–11,700 kJ)

  2,800–3,000 Cal (11,700–12,600 kJ)

  3,000–3,200 Cal (12,600–13,400 kJ)

  3,200–3,400 Cal (13,400–14,200 kJ)

  3,400–3,600 Cal (14,200–15,100 kJ)

  >3,600 Cal (15,100 kJ)

We'd probably be better off ditching the second column so that it could all fit on one line.

1961

2001–03

map of dietary energy availability per person per day

  no data

  <1,600 Cal (6,700 kJ)

  1,600–1,800 Cal (7,500 kJ)

  1,800–2,000 Cal (8,400 kJ)

  2,000–2,200 Cal (9,200 kJ)

  2,200–2,400 Cal (10,000 kJ)

  2,400–2,600 Cal (10,900 kJ)

  2,600–2,800 Cal (11,700 kJ)

  2,800–3,000 Cal (12,600 kJ)

  3,000–3,200 Cal (13,400 kJ)

  3,200–3,400 Cal (14,200 kJ)

  3,400–3,600 Cal (15,100 kJ)

  >3,600 Cal

Or, how about this? Just don't bother converting the calorie value twice. Might this be confusing, though?

1961

2001–03

map of dietary energy availability (calories per person per day) (kilojoules per person per day)

  no data

  <1,600 (<6,700)

  1,600–1,800 (6,700–7,500)

  1,800–2,000 (7,500–8,400)

  2,000–2,200 (8,400–9,200)

  2,200–2,400 (9,200–10,000)

  2,400–2,600 (10,000–10,900)

  2,600–2,800 (10,900–11,700)

  2,800–3,000 (11,700–12,600)

  3,000–3,200 (12,600–13,400)

  3,200–3,400 (13,400–14,200)

  3,400–3,600 (14,200–15,100)

  >3,600 (>15,100)

But, how about this: hide the kilojoules and show the calories (as shown here)? The legend isn't hidden as such ... one version is the other isn't until the reader clicks on the show or the hide. This way we can still have conversions to SI and the reader can choose which he wants to see. This seems the best of the lot. Shall we go with it? Jimp 12:44, 6 February 2014 (UTC)

We do not do hidden values. This is to respect those who are using screen readers. Also we generally leave image size at default so that people can set it themselves under preferences. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:28, 6 February 2014 (UTC)

Fair enough. The version with "1,600 (<6,700)" etc. is a good solution. Jimp 09:32, 7 February 2014 (UTC)

1961

2001–03

Map of dietary energy availability. Calories per person per day (kilojoules per person per day)

  no data

  <1,600 (<6,700)

  1,600–1,800 (6,700–7,500)

  1,800–2,000 (7,500–8,400)

  2,000–2,200 (8,400–9,200)

  2,200–2,400 (9,200–10,000)

  2,400–2,600 (10,000–10,900)

  2,600–2,800 (10,900–11,700)

  2,800–3,000 (11,700–12,600)

  3,000–3,200 (12,600–13,400)

  3,200–3,400 (13,400–14,200)

  3,400–3,600 (14,200–15,100)

  >3,600 (>15,100)

Double image versus multi image

Supposedly Template:double image is deprecated. Unfortunately the new Template:multi image is not supported across all languages of Wikipedia. Until it is I am not supportive of medical articles switching over to multiimage as it will interfere with my work here Wikipedia:WikiProject_Medicine/Translation_task_force Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:41, 6 February 2014 (UTC)

It's a shame we have to be impeded by other language versions of WP's lagging behind. {{Multiple image}} is so much better. What's to be done? The best thing would be to make sure the template is on the other wikis as soon as possible. We could on the other hand, leave a hidden note for translators about the problem and this discussion so that they can deal with it. We could skip the templates altogether and use the raw code (as follows). Jimp 09:32, 7 February 2014 (UTC)

<div class="thumb tright" style="width: 417px; ">
<div class="thumbinner" >
<div style="float: left; margin: 1px; width: 202px">
<div class="thumbimage">[[file:World map of calory consumption 1961 (v2).svg|200px|alt=]]
</div>
<div class="thumbcaption" style="clear:left">1961
</div>
</div><div style="float: left; margin: 1px; width: 202px">
<div class="thumbimage">[[file:World map of Energy consumption 2001-2003.svg|200px|alt=]]
</div><div class="thumbcaption" style="clear:left">2001–03
</div>
</div><div class="thumbcaption" style="clear: left; text-align: left; background: transparent">Map of dietary energy availability.<ref name=Earth09/> Calories per person per day (kilojoules per person per day)
{{Multicol}}
{{legend|#b3b3b3|no data}}
{{legend|#ffff65|<1,600 (<6,700)}}
{{legend|#fff200|1,600–1,800 (6,700–7,500)}}
{{legend|#ffdc00|1,800–2,000 (7,500–8,400)}}
{{legend|#ffc600|2,000–2,200 (8,400–9,200)}}
{{legend|#ffb000|2,200–2,400 (9,200–10,000)}}
{{legend|#ff9a00|2,400–2,600 (10,000–10,900)}}
{{Multicol-break}}
{{legend|#ff8400|2,600–2,800 (10,900–11,700)}}
{{legend|#ff6e00|2,800–3,000 (11,700–12,600)}}
{{legend|#ff5800|3,000–3,200 (12,600–13,400)}}
{{legend|#ff4200|3,200–3,400 (13,400–14,200)}}
{{legend|#ff2c00|3,400–3,600 (14,200–15,100)}}
{{legend|#cb0000|>3,600 (>15,100)}}
{{Multicol-end}}
</div>
</div>
</div>

So they can deal with it, basically means so that I can deal with it. I have enough to deal with and double image is good enough. Multiple image is not so much better. English Wikipedia seems to love making minor inconsequential changes to coding that makes the life of those of us writing content more difficult.

So if you get this new template up and running on the other 286 languages I will support us using it here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:32, 7 February 2014 (UTC)

The "they" I had in mind were anyone doing the translating; if that's you, sure, you. Is copying the template to another language much trouble compared to translating an article? Sticking with good enough when there is better is not such a great way to make progress. Sometimes the changes make life easier for the editor and, more importantly, for the reader. Jimp 09:09, 10 February 2014 (UTC)

You do not have consensus to change it. There is no indication that it is better. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:15, 10 February 2014 (UTC)

If one person advocates x, another advocates y and nobody else makes any comment, no there is no consensus for either. As much as I have no consensus to change it you've got no consensus to revert me if I were to but I'm not about to start an edit war. As for the indication that the {{multiple image}} version is better, firstly, as noted above, {{double image}} is deprecated and secondly, I'm suggesting that it is clearer to have the years under the map in question than to resort to the more cluttered solution of adding "in 1961 (left) and 2001–2003 (right)" to the caption. Jimp 08:17, 11 February 2014 (UTC)

As Template: Double Image is deprecated, I think the best option here would be to update and use {{Multiple image}} or the raw code to avoid deprecation. And to Doc James, if you are willing to undertake the upkeep and improvements of an article, then you should do so knowing that that will entail code updates as they come along, or you use raw code if you want to avoid this. Plus, the matter of what codes wikipedia should use is not up to the content editors, it is up to wikipedia, we simply have to move with it. My personal view is that the multiple image template makes a more uniform method of including more than one image an a box, so I don't think it was inconsequential, and was intended to make your life easier, not harder. Dellkitty (talk) 08:24, 28 April 2014 (UTC)

What is done is determined on the talk page. I do not see sufficient justification for this change. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:34, 28 April 2014 (UTC)

"What is done is determined on the talk page". Great, all current contributors to the discussion have said that the best thing that we can do is update to the new format, so how do you not see justification for it? Even without the content of the talk page, the double image template is deprecated, and deprecation is a sign that the software code may be binned entirely, which would render the current coding a useless jumble. This would surely be enough "justification" to update the current format, including evidence from the talk page, the evidence you claim to support? Dellkitty (talk) 17:23, 28 April 2014 (UTC)

"all current contributors" Ah no. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:12, 29 April 2014 (UTC)

Very true. All current contributors other than one. And seeing as that is your only objection, I think you have no valid reason to hold off from updating. The guy even gave you raw code to use, took all the work out of it for you, something you'd never need to edit again, and avoids the multi-image format you seem to be obstinately fighting. All you'd have to do is copy and paste! And seeing as 2/3 of three of the contributors say yes you should, and a wikipedia article's content is determined by consensus on the talk page (ignoring the work of bored vandals), it seems that your choice here is go with what the talk page says or ignore and go with your own view. And besides, what would happen if the double image format were eventually completely out-dated, it would stop working entirely. So I think the best solution is to update. Dellkitty (talk) 10:12, 29 April 2014 (UTC)

It worked fine before. Have replaced with the basic coding. It is of far greater of importance to keep Wikipedia's content easily translatable than updated to this weeks newest and greatest templates. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:54, 29 April 2014 (UTC)

Refs needed

Have removed this text "Many recent studies have shown that having poor nutrition can increase a person’s chance of becoming obese. A review of 60 meta-analysis has shown that dietary interventions and multi-component interventions targeting overweight and obesity appeared to have the greatest effects.[1] This means that changes in an obese person’s diet and exercise have significant effects on their weight. This is important information, but it’s useless if we cannot educate people of the information. Studies were chosen that test how well computer-mediated interventions affect a person’s understanding of dietary behaviors. These studies showed 60% of students in school and 80% of students out of school showed significantly positive results in their obesity control after these computer-mediated interventions.[2] A study asked participants to fill a questionnaire of their diet and test their BMI. Then they would retest their BMI after being given specific dietary instructions. This study showed significant results towards people willing to change their behavior.[3]" We need the reference details. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:09, 30 April 2014 (UTC)

2014 worldwide study

Is this legitimate enough to include in the article? 30 percent of world is now fat, no country immune (2014-05-29) Mapsax (talk) 15:01, 30 May 2014 (UTC)

Can you provide the study. We do not use popular press. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:04, 30 May 2014 (UTC)

Based on an article "Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013" in the Lancet, online first, May 29th. Is the Lancet reliable? It looks like popular press, in the same way that Nature or Science is popular press. --Mark viking (talk) 16:58, 30 May 2014 (UTC)

That is a great source. And that is the source we should use rather than the popular press. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:27, 30 May 2014 (UTC)

Okay added it here [16] Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:36, 30 May 2014 (UTC)

Have reverted this edit [17]

A few cases are "exclusively" genetic while most are diet, exercise and genetics combined. Thus was better before. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:54, 31 May 2014 (UTC)

Genetics is involved in most cases via many genes. While a few cases are due to a specific gene. The changes to "Obesity is most commonly caused by a combination of excessive food energy intake and lack of physical activity, although a few cases are caused primarily by genetic susceptibility" do not reflect this.Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:38, 31 May 2014 (UTC)

This is utter nonsense. If genetics were a key factor, obesity prevalence could never have risen so quickly. All cases are caused by surplus energy. Perhaps genetics play a role in how much a certain surplus affects individual people, but it is never the only factor. Furthermore, you cannot have the lead say other things than are supported by the body of the article. −Woodstone (talk) 16:52, 31 May 2014 (UTC)

I'd be wary to use the term utter nonsense. Quite evidently individuals with the same level of physical exercise and same intake of food may have remarkably different BMI. Argue that this may be due to lean body mass/total body mass ratio contributing to different basal metabolism levels etc., but we can not be sure, and even then LBM is just one of many factors where genetics play a role, and to dismiss genetics is not viable. I agree with James. CFCF (talk · contribs · email) 17:16, 31 May 2014 (UTC)

Genetics was not dismissed in my edit (and it is not in the body section). It is just not a key factor. Genetics do not change in a few generations, while food intake and use of bodily strength, and as consequence BMI, do. −Woodstone (talk) 17:25, 31 May 2014 (UTC)

"The percentage of obesity that can be attributed to genetics varies, depending on the population examined, from 6% to 85%" Different people exposed to the same environment have different outcomes due to genetics. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:19, 31 May 2014 (UTC)

• It currently/still reads: "Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness." I do wonder if "genetic susceptibility" needs to be included in the "most commonly caused" list. And the article that "genetic susceptibility" is piped to doesn't seem to mention obesity. Would this be more acceptable: "Obesity is most commonly caused by a combination of excessive food energy intake and lack of physical activity, mediated by the underlying genetic susceptibility of the individual. A few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness." - or something similar? (aka Wiki CRUK John (talk) 11:22, 2 June 2014 (UTC))Johnbod (talk) 18:30, 31 May 2014 (UTC)

Typically all three are involved to some degree. You suggestion does include all three. How about simpler like "Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, and underlying genetic susceptibility" Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:44, 31 May 2014 (UTC)

Support For the record, I would support this change. CFCF (talk · contribs · email) 16:48, 1 June 2014 (UTC)

It does, but I was trying to put a bit more distance between calories in and out & the genetic background. With the %s for strictly defined obesity we are now getting in Western populations (plus Tonga etc) a fair degree of "genetic susceptibility" must be pretty normal, and so arguably not a "cause" - perhaps those who aren't susceptible are less typical. Hence "mediated". The current wording rather implies that the genetic susceptibility of the obese is to some extent beyond the normal - I suspect a dubious proposition in Western society today, where the reverse may be true. It's a matter of emphasis. Johnbod (talk) 18:52, 31 May 2014 (UTC)

How much people eat is partly determined by genetics. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:20, 31 May 2014 (UTC)

Agree that the sources don't downplay the genetic aspect so neither should the article. Zad68 03:37, 1 June 2014 (UTC)

The section "Causes" in the article says: "a combination of excessive food energy intake and a lack of physical activity is thought to explain most cases of obesity". The lead is supposed to be a very short summary of the article. It is unacceptable to have different views there than in the detail sections. Taking in more energy than expending it is sufficient cause for getting obese in the long run. Whether genetics play a role in how much people eat is immaterial and can certainly not explain why obesity prevalence is rising so fast. −Woodstone (talk) 15:30, 1 June 2014 (UTC)

In those who have the same environment, some become obese and others do not. This means that their is also a significant genetic component. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:43, 1 June 2014 (UTC)

Yes, and increased intake is likely affected by genetics. The reason someone overeats isn't only psychological, but is influenced by genetics, and I don't think we should downplay this by omitting to mention genetics in the lede. CFCF (talk · contribs · email) 16:45, 1 June 2014 (UTC)

The genetic effect as key factor is not supported by the source ([18]) given in the "causes" section, which contains:

"The cause of obesity is complex and multifactorial. Within the context of environmental, social and genetic factors, at the simplest level obesity results from long-term positive energy balance — the interaction of energy intake and energy expenditure. The rapid increase in the prevalence of obesity over the past 20 years is a result of environmental and cultural influences rather than genetic factors."

Therefore the mention as such in the lead should be considered unsourced and removed. −Woodstone (talk) 17:24, 2 June 2014 (UTC)

Per WP:LEAD the lead just needs to be supported by the body of the text. We also have refs that say "Within a permissive environment, the more common genetic factors involved in obesity regulate the distribution of body fat, the metabolic rate and its response to exercise and diet, and the control of feeding and food preferences.20,21 There are presently more than 41 sites on the genome that have been identified as possible links to the development of obesity in a favorable environment"[19] Additionally the first part of the ref you bring up says "Within the context of environmental, social and genetic factors, at the simplest level obesity results from long-term positive energy balance"

And what about "Obesity is highly heritable and arises from the interactions of multiple genes, environmental factors, and behavior."[20]

You appear to be attempting to leave out that genetics plays a role in many cases. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:46, 2 June 2014 (UTC)

Nobody has ever become obese without energy in food exceeding expenditure (perhaps excepting by rare cases of oedema). The unbalance is the primary cause. At what point the balance lies may depend on genetics. Digestion and absorption of food may be different, efficiency of body functioning may be different. But one cannot become obese without eating too much for the level of exertion. −Woodstone (talk) 09:03, 3 June 2014 (UTC)

Doesn't make it the "primary" cause, but a cause near the end of a causal chain. I think Jmh649's proposed simplified wording above looks good. Alexbrn ^{talk|contribs|COI} 10:03, 3 June 2014 (UTC)

AHA/ACC/TOS guideline

doi:10.1161/01.cir.0000437739.71477.ee JFW | T@lk 12:45, 24 June 2014 (UTC)

Criticism of health effect

According to [21], "While it is well established that obesity is associated with increased risk for many diseases, causation is less well-established. Epidemiological studies rarely acknowledge factors like fitness, activity, nutrient intake, weight cycling or socioeconomic status when considering connections between weight and disease. Yet all play a role in determining health risk. When studies do control for these factors, increased risk of disease disappears or is significantly reduced." Would this be reliable source to add here? How prevalent is this view? PS. This view seems related to the Health at Every Size/Fat acceptance movement topics mentioned under "Size acceptance", but the article seems to omit two important issues: 1) the argument of proponents of those movement that obesity has no negative health effects, and 2) the critique of that view.--_{Piotr Konieczny aka Prokonsul Piotrus| reply here} 07:49, 26 June 2014 (UTC)

Is this discussed on these two other articles yet? The impact factor of "Nutrition Journal" is fairly low.

As we already have "Fat acceptance movement" as a see also, do not think we need "Health at Every Size" as it is dealt with on the previous page. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:56, 26 June 2014 (UTC)

Cancers

The reference for the various associated cancers is from 2001, and the list in the article seems to go beyond what the abstract says. I haven't checked the whole paper, though it is open access; too old anyway. A better open access ref is:

• Parkin, D M; Boyd, L (NaN undefined NaN). "Cancers attributable to overweight and obesity in the UK in 2010". British Journal of Cancer. 105: S34–S37. doi:10.1038/bjc.2011.481. {{cite journal}}: Check date values in: |date= (help) - which is short and lists other more recent studies.
• also World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 2.6. ISBN 9283204298.

Wiki CRUK John (talk) 09:54, 27 June 2014 (UTC)

Portal bar

I recommend the following portal bar to be added below the navigation templates: {{Portal bar|Biology|Medicine|Health}}.

Sher man 3312 (talk) 13:52, 23 August 2014 (UTC).

Broad international perspective

I recommend the following book for a broad international perspective useful for this article:

• Jared Diamond, The World until Yesterday: What Can We Learn from Traditional Societies? (especially the eleventh chapter: "Salt, sugar, fat and sloth"), Penguin Books, 2012 (ISBN 978-0-141-02448-6).

Sher man 3312 (talk) 13:52, 23 August 2014 (UTC).

We are not really a collection of further reading. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:32, 23 August 2014 (UTC)

Management of obesity

This section says that diet and exercise is more important. So it should have a photo of exercise instead of orlistat photo. --Abhijeet Safai (talk) 08:56, 21 September 2014 (UTC)

But such a picture would need to be clearly related to obesity and not to exercise in general. An image with a thin person in a pair of oversized jeans (such as was insereted in the article earlier today) is also not relevant. --bonadea contributions talk 09:23, 21 September 2014 (UTC)

True. Thanks. --Abhijeet Safai (talk) 09:39, 21 September 2014 (UTC)

The image showed that the management of Obesity resulted in those figures by whatever means thats why i put that pictureJainvaibhav1307 (talk) 09:43, 21 September 2014 (UTC)

Well, no, it didn't show that - to be honest that was not an interpretation that would have occurred to me. A couple of issues: there was no indication that the person whose flat stomach was in the picture had ever been obese (anybody can put on a pair of oversized jeans, and the stomach had no stretch marks), and obesity management does not necessarily result in a very slim figure. If anything, the image seemed to poke fun at people who struggle with this serious problem. I'm sure that was not the intention, but that is how it could come across. --bonadea contributions talk 10:23, 21 September 2014 (UTC)

Images

The current image under management is not neutral, as by its presence it advocates the value and use of a particular drug for the condition obesity. This article will be improved by not having an image under management at all, or to remove the image until a more neutral image is found or suggested. Can someone please strongly consider removing the current image on orlistat. — Preceding unsigned comment added by Annie1616 (talk • contribs) 10:15, 21 September 2014 (UTC)

Yeah i do believe that this image should be removed as it only advocates medicine which is secondary to primary physical exercise. --Jainvaibhav1307 (talk) 10:18, 21 September 2014 (UTC)

The image does not "only advocate medicine"; it supplements the text which talks about obesity medication, and it very clearly states that one of the medications has been withdrawn - that's pretty objective, I would say. I am not saying that a better image could not possibly be found but there is no reason to remove the one that is directly related to the section. --bonadea contributions talk 10:23, 21 September 2014 (UTC)

I still think the picture of the drug doesn't add anything useful. The picture will be useful on the page that is only about orlistat, but not as part of a management of obesity page. Annie1616 (talk) 11:22, 21 September 2014 (UTC)Annie1616

I have mixed feelings about this one. Yes meds are not first line but the caption clearly stated that one was withdrawn. Images are hard to find / create. Not all images need to be of the first line treatments. A suggestion of a better image would be welcome before removal. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:07, 21 September 2014 (UTC)

New NICE guideline

... has sent tongues wagging {National Institute for Health and Clinical Excellence. Clinical guideline 189: Obesity: identification, assessment and management of overweight and obesity in children, young people and adults. London, 2014.) for its widened recommendation on bariatric surgery. But it now needs to be worked into this article, ideally replacing the previous version of the guideline. JFW | T@lk 21:27, 29 November 2014 (UTC)

Classification

Currently, the entry says that "Asian populations develop negative health consequences at a lower BMI than Caucasians." However, the cited article does not review Asian populations relative to Caucasian populations, it reviews a Japanese population independently, and compared that to data from Japan, Korea, Philippines, Indonesia, Hong Kong, Malaysia and Thailand. However, the WHO expert Consultation, which is used in the Mortality section, reviews Asian populations compared to European populations. It says: "[The] reviewed scientific evidence that suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations." So I propose changing the sentence to reflect that, and adding the WHO citation. Orthopedicfootwear (talk) 19:39, 29 November 2014 (UTC)

Ref recognizes that most commonly used BMI recommendations are from WHO, but does not/should recognize that WHO recommendations are based on Europids. Orthopedicfootwear (talk) 01:32, 8 December 2014 (UTC)

Causes

Current text says that individual obesity is caused by overeating and under exercising, whereas “increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.” This is basically saying the same thing-- the "accessible and palatable diet" is about overeating, and the last two are contributors to a lack of physical activity. The explanation for macro-level causes need to reflect the size and diversity of the populations affected.

Additionally, the current text cites three studies, none of which are reviews. Two of the cited articles are exclusively study the US, and neither of them are primarily oriented towards the causes of obesity. The other citation, while a China-specific study, is an examination of the causes of obesity; however, the causes laid out in this article are not the same ones written on Wikipedia.

WHO’s most comprehensive document on obesity says “In contrast to the widely held perception among the public and parts of the scientific and medical communities, it is clear that obesity is not simply a result of overindulgence in highly palatable foods, or a lack of physical activity,” which contrasts the current text on Wikipedia.

While it is agreed that the main cause of obesity in individuals is a positive imbalance of energy intake and energy expenditure, “the primary cause of this increase must be sought in the environmental and societal changes now affecting a large proportion of the world’s population,” and that “environmental and societal factors that, through their effects on food intake and physical activity patters, have overwhelmed the physiological regulatory processes that operate to keep weight stable in the long term.”

While changes in diet are responsible for increases in the prevalence of obesity, it is shocking to suggest that obesity can be boiled down to easy accessibility and palatability. In some populations, it is not a change in the accessibility, but a change in the content, which can be influenced by westernization, colonization, immigration and income. In some populations, it is the lack of accessibility to healthy foods. In many populations, palatability has relatively little sway in determining food choices. Even so, increases in affluence (which lead to easy accessibility and palatability) affect obesity differently in different societies, and among different sub-sections of societies. In developed countries, affluence (again, creating easier access to food) and obesity are inversely related; in other societies, affluence allows people to afford more processed, packaged, high fat and meat-heavy food which contributes to obesity. And in some societies, diet is intentionally made extreme in order to achieve overweight or obesity. Additionally, the food-insecurity-obesity paradox illustrates a pattern wherein food-insecure mothers are more likely to be overweight or obese, thus easy accessibility might be a contributor to obesity among some populations, but the opposite is true in other populations.

Increased reliance on cars only affects some populations and is a strangely small and specific variable to list as a top three contributor to obesity. Instead, automated transportation, mechanized manufacturing, sedentary pursuits, urban residence, and an increase in labor saving devices at work and in the home combine to affect physical activity, in ways that also must be understood in a larger social and environmental context.

Much evidence points to environmental and behavioral changes as the primary driver behind the current obesity epidemic. "The global obesity problem can be viewed as a consequence of the massive social, economic and cultural problems now facing developing and newly industrialized countries, as well as ethnic minorities and the disadvantaged in developed countries... Escalating rates of obesity... are frequent outcomes of the modernization/acculturation process." Because the epidemic has occurred in such a short period of time, and because genetics is not a sufficient explanation for the rise of obesity rates, the main cause must be sought in social and environmental changes, and while the original text does reference three social/environmental changes, social and environmental changes that influence the rise of obesity are more broad and regionally- and populationally-distinct than the text suggests. An increase in energy and fat dense foods and a decrease in physical activity are individual causes of obesity, but on a societal level we must explore what causes the trend, not the result of the trend.

I would recommend changing the current text to something that is more inclusive of the various factors-- "Increasing rates of obesity at a societal level are felt to be due to environmental and social changes that affect food intake and physical activity." Orthopedicfootwear (talk) 02:14, 8 December 2014 (UTC)

• This is a high quality secondary source [22]
• This is a review [23] as is this [24]
• What are these environmental and social changes? The two terms are very vague and thus not that useful.Doc James (talk · contribs · email) 03:13, 8 December 2014 (UTC)

Effects on Health

The page recognized that obesity increases the risk of many conditions, but it only touches on metabolic syndromes. I propose the following additions about reproductive health, including neonatal outcomes, subsequent disease risk in the offspring, and obesity and male fertility.

• "Pre-pregnancy overweight/obesity has been shown to increase the risk of adverse neonatal outcome (e.g., preterm delivery, low/high BW, congenital anomalies, neonatal asphyxia, neonatal death, hypoglycemia, and hyperbilirubin- emia), increased requirement for neonatal intensive care, and a longer duration of hospital stay [15–18]. Maternal overweight/ obesity carries an increased risk of subsequent disease risk in the offspring. This can include impaired neurodevelopmental out- come (cognitive problems, attention deficit hyperactivity disorder, and psychotic disorders), asthma, schizophrenia, insulin resis- tance, DM, hypertension, coronary heart disease, stroke, and even death."

• "Recent population-based studies suggest an elevated risk for subfertility among couples in which the male partner is obese and an increased likelihood of abnormal semen parameters among heavier men."

One is that we need to paraphrase and simplify the language used.

Two we already discuss some of this one the subpage here [25] Doc James (talk · contribs · email) 03:30, 8 December 2014 (UTC)

Mortality

Ref says "In Asians risk begins to increase between 22-25 kg/m^2.” The cited document actually says that the cut-off point for observed risk varies between 22-25 kg/m^2 in different Asian populations. I think the original text is misleading and inaccurately groups different Asian populations together. Orthopedicfootwear (talk) 01:37, 8 December 2014 (UTC)

Yes so those two are the same thing? Doc James (talk · contribs · email) 03:34, 8 December 2014 (UTC)

The page gives data about death due to obesity in the US and UK, but does not give data global data, which is easily accessible and should not be overlooked. “Around 3.4 million adults die each year as a result of being overweight or obese.” Orthopedicfootwear (talk) 01:37, 8 December 2014 (UTC)

That is for both, how many for just obesity? Doc James (talk · contribs · email) 03:34, 8 December 2014 (UTC)

Political Causes

The article cannot be edited. Allthough under CAUSES there has to be an article POLITICAL CAUSES i.e. correlation between obesity and poverty especially in the U.S.

So instead of pretexting 'diet' as a CAUSE for bad diet among poor people in the US the POLITICAL DIMENSION of a bankrupt democracy, of the helpless consumer/wage-slave status is to be mentioned. In this light bad diet is an EFFECT of worries over maintainig a future income and/or over insolvency: sedative-eating ("junk food"), spiritual emptiness, feeling of helplessnes, political lethargy: mass diversion by biased 'entertainment'-media instead of edjucation and critical self determination. — Preceding unsigned comment added by 79.195.87.204 (talk) 12:33, 17 March 2015 (UTC)

A lot of this is actually already in the article at Obesity#Social_determinants. However much of what you're saying appears to be original research. If you have a specific article content suggestion change based on reliable sourcing we can consider it. Zad68 13:27, 17 March 2015 (UTC)

Drugs

Systematic review of drugs that cause weight change: doi:10.1210/jc.2014-3421 JFW | T@lk 11:44, 1 April 2015 (UTC)

Reflist-talk

References

The Reference for Hippocrates quote seems to be wrong. — Preceding unsigned comment added by 85.13.17.5 (talk) 09:28, 12 May 2015 (UTC)