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should overweight people be held accountable?

someone asked this question on a thread about doctors, and it is a good question. I tend to think so!

Thu. Nov 8, 1:24pm

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well, i guess that depends. if you eat crap and have a terrible life style and overweight, then they are accountable, but for what?

if you have auto-immune diseases that cause you to be overweight, then no.

Thursday, November 08, 2007, 1:58 PM

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Would the same go for daredevils? I have a friend who has broken all kinds of bones over the years, some of them several times. His son is 14 and is a chip off the old block. Should they be held accountable for their medical bills?

I also have athletic friends who have gentler injuries (shoulder, wrist, ankle, knee problems etc.) that require some medical attention. Should they be held accountable? What about injuries sustained while woodworking or renovating without proper experience/protective gear?

And what about parents who knowingly have children even though they have inheritable disorders?

You'd think all the negatives involved with obesity would be motivation enough for someone to change. I doubt that more negativity would help.



Thursday, November 08, 2007, 2:24 PM

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I think so too OP, but they probably never will be.

Last poster you make great points. But I think the obesity epidemic is contributing to the high price in health care more than a few daredevil friends or athletes.
What percentage of America is overweight today...? I would guess it's higher than the injured athletes/daredevils...

Thursday, November 08, 2007, 3:51 PM

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Honest question: accountable for what? health care cost?

Thursday, November 08, 2007, 4:37 PM

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I thought I heard that in California they were talking about having an extra tax on soda because it contributes to obesity, which contributes to higher health care costs. Hilarious, but maybe....?

I don't know what it's like it the states, but here in Canada the government is making a big push in advertising to let people know the risks of being overweight, and really pushing healthy eating and active living. And our schools in Manitoba are now having to follow 'healthy eating' guidelines, offering healthier choices in schools. The result of this is that kids are selling black market pop out of their lockers and melted butter for their perogies!

Rambling...but the point is, lots of efforts are being made to encourage people to be healthier, but it's hard to force it on people.

Thursday, November 08, 2007, 4:50 PM

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Exactly, people know that what they are doing to their bodies by overeating, not exercising and eating foods with no nutrients... But they do it anyway. Isn't it obvious that being 50 pounds or more overweight is a health problem?!?! Do we really need to be spending more money "educating" people on what is already so obvious? And don't say it's not obvious, unless someone lives under a rock they know they shouldn't eat that 4th serving of fried chicken, they just CHOOSE to do it anyway.

Thursday, November 08, 2007, 5:12 PM

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devil's advocate, 5:12- I commute to work year round on my bike, and ride mountain bikes on the weekend. I also do some whitewater kayaking.

All of these things involve risk. It wouldn't be a stretch to say that I've got a pretty good chance of becoming injured or hospitalized doing what I do. My chances of getting injured or killed are probably equal to or greater than someone who's sedentary and overweight, certainly in the short term.

Should I have to pay more as well? I mean, I am definitely CHOOSING to participate in activities that make me more likely to get hurt...

Just a thought.

Now I gotta go ride my bike home in the dark.

Thursday, November 08, 2007, 6:36 PM

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intelligent dialoge. How refreshing!

Thursday, November 08, 2007, 8:59 PM

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I try so hard not to take offense to the thought that just because I ended up overeating to numb my pain that I should be held any more accountable that anyone else for their health situation.
I think it is the word Choose that bothers me most.
Yes I will admit that I know I am putting food into my body that is not healthy and there are times that I don't care. Or didn't. But it is so easy to look past what is happening to you healthwise and especially in light of how I am feeling emotionally.
So rather than DO drugs, or alcohol or premarital sex which all harm your body I DO food.
It is a huge and complex issue that has so much involved in it you just can't make some light decision about it.
But I am trying to make a difference in my life and see that I am worthy of life and a happy life at that. I am worthy of being treated like any other person. And I am working on my issues that have led me to the over eating in the first place. That is why I am here. Because I want more out of life and I am the only one who can change me.
But there are others who have not come to that point yet and for them, kindness is the best way to handle it. The more you point the finger the more guilt a person feels and the more guilt the more you need to numb the pain.
Time to start being loving and caring about the people we are connected to.
I will say too that I appreciate the understanding that extreme sports and such are just as great a risk.
Just my two cents

Thursday, November 08, 2007, 9:36 PM

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By the same argument, aren't smokers in even deeper shit?

Thursday, November 08, 2007, 10:01 PM

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no because smokers usually die much earlier so they're not a "burden" on health care for as long.

and on a random side note for 9:36's comments....this has nothing to do with whether or not i appreciate what you have to say. but having or not having a premarital sex is more of a moral issue. it doesn't actually physically harm you body you know....at least not like drugs or food do

Thursday, November 08, 2007, 10:20 PM

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^^^ multiple partners increases your risk of stds- which pretty nuch always require medical assistance. Pre-marital sex or sex outside a legal union, is more likely to result in single parethood which is often a drain on the rest of society. I'd be more inclined to hold people accountable for stupid sexual behavior than overeating.

Friday, November 09, 2007, 3:47 AM

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i agree, above poster, about the stupid behavior

but did you see the television story yestrday about the world's "heaviest 8 year old"? she weighed in at 420 lbs when she was 8.

some time later, she's lost 300 lbs but needs surgery for all the extra skin.

her mother was heavy and let her eat what she wants. nothing changed unti the girl went to child protective services because she ended up int he hospital. i think that counts as stupid actions of the mother,

Friday, November 09, 2007, 7:52 AM

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To the 9:36 poster.

I read your comment with great interest. I am a pediatric nurse and see the ravages of obesity, drug abuse and premarital sex/early parenthood every day. I admit to being very angry at times with parents that create environments which cause our paths to cross. In the back of my mind I am aware that parents are often a victim as well; victims of poor parenting, disadvantaged backgrounds, limited opportunities, mental illness, etc. Your comments gave me reason to push those thoughts a little more to the front of my mind. Thank you.

Friday, November 09, 2007, 8:20 AM

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uhh....have you people not heard of condoms??

i could use the same silly logic and say that insisting upon pre-marital sex increases that chances that two adults will get married at a young age before they're fully mature enough to understand what they want and result in a high incidence of divorce which is often a drain on the emotional well being of both the parents and the children involved. but that's silly right

stupid sexual behavior before marriage would mean a) not using a condom/birth control, b) not getting yourself tested prior for stds, and c) not finding out if the person you sleep with has stds or not. again, pre-marital sex is a moral decision, not a health decision unless your incapable of doing the above three things. i highly doubt most people who are against pre-marital sex feel that way solely because of "health issues"

Friday, November 09, 2007, 8:21 AM

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Very interesting thread . . .and wonderful dialog!

To 8:21's comment--I agree with your comments about using condoms, getting checked for std's, and inquiring about your partner's health. However, do the majority of individuals really take the time and preparation to do this? I doubt it. You mentioned their "capability" but being capable and responsible are two different things. We're back to the issue of choice. So the result could be std's, pregnancy (with the potential for welfare support, thus cost and health issues for not just one but two individuals now), or abortion (cost issues again and possible health risks). To correlate that to food issues--do the majority of individuals really take the time and preparation to read labels, plan healthy meals and snacks, take the time to buy those items, and adjust their calories/activity level/lifestyle accordingly? Many people do but certainly not enough. Most people are capable with a little bit of instruction but are they/we responsible? Just something to ponder . . .

Friday, November 09, 2007, 9:12 AM

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This is an interesting thread. While it sounds reasonable to hold people accountable for the consequences of bad habits - where would it end and who ultimately suffers? In the examples about premarital sex if you're punishing single moms, the child ultimately suffers the most. And how many divorced moms are living the same life as the never married mom? And, did you know that married sex poses the greatest HIV threat to women? Why - b/c when you're married you don't expect to need protection from your cheating husband, who you didn't know was cheating on you. While everyone loves a good oversimplified, polarized argument, there are way too many sides of the story to cast blame and consequences.

Friday, November 09, 2007, 9:27 AM

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To turn it around on the insurance industry, is it fair to only insure those who don't need insurance?

To look at it another way, would it seem right to you to only put police in neighborhoods where they aren't needed? It would make more fiscal sense, as you'd need less cops and there would be much less chance of overtime or hazard pay. And, after all, people do have a choice- they don't have to live in bad neighborhoods, they can move whenever they want, right?



Friday, November 09, 2007, 9:48 AM

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First, the insurance industry doesn't only insure those who don't need insurance. It insures those who can afford insurance. Just because someone is able to afford insurance doesn't mean they could afford to pay out of the pocket without out (the whole point of needing insurance...).

Second, many people seem to be living under the delusion that life is meant to be fair. Well, it isn't. The private insurance industry isn't designed to be fair. No private market ever is. The private insurance industry is designed to sustain itself a.k.a. not go out of business. However, most people seem to think that there are poor people who still need health care. That's we have Medicaid to help the poor and Medicare to help the elderly, both public health insurance programs provided by the government. Do you know part of the motivation for providing health care to the poor? No, it's not simply "to be fair." It's because having health care or not creates an externality. If someone is sick and chooses not to get medical care because they can't afford health insurance, this doesn't solely affect the individual. There's a risk that this person might cause other people to be sick and that is a big motivation for the government to provide some form of public health insurance to the poor.

Of course, the insurance industry CAN provide health insurance for the poor at lower premiums than they do for others. That would require other people who aren't poor to pay even higher premiums than they are currently doing to cover costs. Money does not appear out of thin air and you can't possibly expect the insurance industry to purposely go out of business simply "to be fair." And don't even get me started about how universal health coverage is NOT a better solution.

Life's not fair. Get over it.

Friday, November 09, 2007, 10:25 AM

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bump. because i think this is an interesting thread...

Friday, November 09, 2007, 10:54 AM

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10:25 - you're right, life isn't fair. And, looking after Number Uno is the American way.

Friday, November 09, 2007, 11:18 AM

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10:25- by pricing people at greater risk out of care, the insurance industry is effectively providing insurance only to those who don't need it.

Your arguments are all accurate and, if somewhat callous, fair. However, your arguments pretty clearly illustrate just why we need to separate health care from the free market. Eventually, in a free market profit driven system, you reach a point where private insurance becomes too exclusive for all but the healthiest or wealthiest. One could argue that we are getting close to that point now. This wouldn't be a huge problem if there was a safety net, but those nets have been cut back pretty hard over the last 20 years or so, until they only catch those who have lost everything.



Friday, November 09, 2007, 11:24 AM

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There are actually insurance plans that are somewhat affordable and accept people wtih pre-existing conditions. If you do the research you will find them. I know this because my husband has a severe case of colitis and was otherwise "uninsurable". His heart actually stopped during one of his many hospital stays so it was very serious. When he was diagnosed it was summer and he was between classes during college and had no insurance.
3 years later we are married and a company accepted us AND his pre-existing condition from day one. Maybe it's different from state to state but his health is important to us so we are willing to make sacrifices to pay for insurance. We are not rich by the way...

Friday, November 09, 2007, 1:00 PM

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To the 1pm poster..what is your monthly premium?

Friday, November 09, 2007, 3:56 PM

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9:36 Here again.
I appreciate how everyone is discussing this without arguing. That is amazing.
I just wanted to bring to the surface that people who over eat do so for many reasons and because a person seems to have a choice doesn't mean that they do. We are the way we are because of how we have been raised as well as what we have been through.
I am not saying that every person who is overweight has been through abuse. What I mean is life is difficult to live and we all have our ways of numbing the pain.

8:20
Thank you for taking to heart what I said. I appreciate it.

Friday, November 09, 2007, 3:59 PM

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I do believe my doctor nor my "genes" had nothing to do with what, when, and how much I eat... my fat is my fat.

Friday, November 09, 2007, 4:03 PM

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Sorry... incomplete thought about... Since I am fat, and have made myself that way it is MY fault... Maybe if I had to pay for all my "fat related" medical needs, it would encourage me to lose... although I do feel this is a slippery slope.

Friday, November 09, 2007, 4:28 PM

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1PM here again. Our premium is $330 per month, some of which my employer pays. But he has insurance now to cover his colitis, something we thought impossible!

Friday, November 09, 2007, 7:02 PM

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Insurance plans often cover rehab for drugs and alcohol, but not if your addiction of choice is food. And when you qualify as morbidly obese, you didn't get that way because you simply can't control yourself around french fries - there's a whole psychological can of worms hiding amongst the rolls of chub. Since most insurances pay for short-term residential mental health needs and substance abuse rehab, shouldn't obesity clinics also be covered? It really is the same thing, you're just choosing to abuse something legal and unregulated.

Friday, November 09, 2007, 7:52 PM

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several things:
1. being overweight does not nessicerily mean the person is sitting around all day and eating junk food. for example, I exersize an average of an hour a day, walk everywhere I go pritty much, am vegan, and eat under 1400 calories a day, an yet here I am 50lbs overweight. should I responsable for my actions? yes of course, but punishing someone for something they are trying their hardest to fix is not productive in the least.

2. The cheapist foods out there are the worst for you, junk food costs considerably less than produce for example, people who do not have much money cannot afford to eat healthily often, yes maybie they do know that there food choices are making them fat, but most people would choose eating the food they can afford rather than starving, I know I would. also, the people who are obise because they cannot afford good food are generally going to be the same ones who cannot afford health care, should they be held accountable? I think not.


Friday, November 09, 2007, 9:29 PM

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I am not sure that it is more costly to eat healthy.
It has been quite a few months now that my family has been eating a very healthy diet. I agree the grocery bill has doubled. But I no longer have the cost of fast food. I think it just about equals out. And if it is a bit more it is worth it.
And no I do not have a lot of money to spend on food or anything else for that matter. But I am choosing to take care of ME now. Not feed my fear.
Are we responsible for our actions?
Yes we should be. But at the same time What or who else had a part in your eating habbits. Even for reasons you can't even see.
I guess all I can say is I am glad that I have chosen a healthier life.


Friday, November 09, 2007, 11:49 PM

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To 9:29 - just curious

How is it possible for you to be 50 lbs overweight? If I were exercising 1 hr per day, eating less than 1400 calories, and were a vegan, it would be impossible for me to be overweight. Did you gain a bunch of weight before you adopted this (pretty much perfectly) healthy lifestyle?

Saturday, November 10, 2007, 10:24 AM

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I am not 9:29 But just had to comment to the last poster. I have family that are vegan and exercise. Try to do all the right things for their health and such. They are more than 50 pounds overweight. Maybe 100 even. Somehow they continue to be overweight. I don't understand it either. But I would suppose that metabolism plays a part. Oh I don't know how many calories they consume.
I just find it curious too.

Saturday, November 10, 2007, 4:33 PM

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I eat healthy, exercise daily, both cardio and weight training in addition to 2 one hour Pilates lessons a week. I am 5'2 and 150 pounds. Some muscle but also fat, right around the middle..the worst place. I have a BMI of 27-28 which does not take into account the muscle. But when I went out and tried to purchase health insurance I was told I was in a high risk catagory because of my weight. They never asked about diet or exercise. My premium was $635./month. My trainer has a body fat of 19% and can bench press 240 pounds. Yet she was uninsurable because her BMI indicated she was obese..again not taking muscle into account.

Saturday, November 10, 2007, 4:42 PM

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This is a very interesting thread, which I assume was inspired by the CBS news story early in the week about penalties and higher premiums to those with increased health risks, including obesity.

I recently finished a master's thesis on market incentives in helath insurance plans, most specifically the consumer-directed plans (a health savings account with a high-deductible plan for a lower premium). The flip side of penalizing people for thier health risks is incentivizing healthy behaviors and offering a discount for doing them. Some companies are offering cash payments or premium discounts to employees who take a health risk surveys and then agree to follow a wellness plan. Others are building gyms or subsidizing membership fees. Health insurance plans are being designed that offer a cash allowance for health and wellness related activities (gym, acupuncture, swimming lessons, whatever).

The idea is that you can make the people you insure healthier so they will cost you less money. And it can obviously have a tremendously positive impact, far beyond just reducing premium and total health care costs. Imagine helping a smoker quit smoking instead of just charging them 20 percent more. Novel.

I really thought this would be the trend over punitive fiscal incentives. I might have been wrong.

Saturday, November 10, 2007, 5:12 PM

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If a vegan is eating a very starch based, or wheat based diet it can be easy to be overwieght. Many "vegetarians" are starchitarians.

Furthermore, wheat intolerance is more common than most people realise. Myself, I cannot lose weight and have a diet with any kind of wheat product in it. I would easily balloon if I was vegan, regardless of caloric intake or exercise. (Never went vegan, but did small vegetarian stint that made me incredibly ill- and not a detox ill, but a real ILL)

For many people out there, calorie in calorie out doesn't work. Other chemical systems will interfere. Vegans can be fat too.

And I agree BMI stinks. Luckily my GP agrees and when I told her I'd wanted to get to a certain weight (which was in my "heatlhy" BMI range) she told me "don't be silly, you don't want to look like a waife. Aim about 10-15lbs higher if you want to be healthy."


Saturday, November 10, 2007, 5:46 PM

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9:29 here
yes I gained a lot of the weight before I was vegan, although I was vegitarian and exersizing more then than now, so it truly has me mistified (and majorly annoied) too. Part of it I'm sure is that I eat a lot of sugar (although I did manage to cut out sugar intirely for a month and it didn't do anything...) but more of it has to do with matabalism I think. the only time in my life I have lost weight (in fact the only time in my life I havn't been gaining weight) was when I was eating unhealthily little (as in basically anorexic like 400 calories a day) thankfully I recovered from that, but it slowed my already sluggish matabolism down to the point where if I eat anything I gain weight. I'm trying extreamly hard to combat that, and I maintain that I should not be punished for this. I whole heartedly agree with the 5:12 poster and if I were to be offered discounts for going to the gym I would love it! to the 5:46 poster I don't think my problem is wheat intolerence (I've tried, unsuccessfully, the no carb thing) and quitting the vegan/vegitarian thing is not an option for me, I have been vegitarian my whole life (born and raised) and even if it wern't for the moral, ethical and health reasons, my body couldn't physically digest meat.

Sunday, November 11, 2007, 12:08 AM

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about wheat intolerance- you can do low carb and still be ingesting wheat.
Common wheat infested foods: soup stocks, soy sauce, bbq sauce, pre-made meatballs, hamburgers, sausages, soups, etc. Low carb doesn't mean wheat free at all. And for me, ANY wheat slows me down.

Sunday, November 11, 2007, 12:22 AM

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Man this is an interesting thread.
I like the idea of giving and incentive to lose the pounds or quit smoking or whatever.... and not punishment. I think the insurance companies would get a lot further.
I don't know it just makes better sense.

Sunday, November 11, 2007, 2:18 AM

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