Should medically judged fat people pay higher medical costs? [W:87]

imagep said:

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Do you not understand that different injuries come with different limitations?

Dittohead not! said:

Choosing a high impact aerobic activity like running long distances may not be the best in the long run either. High impact activities take a toll on the knees and back in particular, and can lead to a situation in which the individual can no longer even walk comfortably. A low impact activity such as hiking, biking, the ellipticals at the gym, or swimming would be a better choice.

When you're 20, running may seem like a good idea. Fifty years down the road, it just might not.

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My doctor that just retired at age 83 still runs over 20 miles a week. Its a myth that running is hard on your knees. No study has ever found that to be the case. What is hard on your knees is being overweight. If running, or any other form of exercise, keeps the weight off you you probably will never have knee issues. I know its not for everyone, but its easily the best activity for maintaing a healthy weight because of the high calorie expenditure. However, cycling, hiking, swimming laps, and on are all excellent exercises for general fitness as well.

ChrisL said:

Do you not understand that different injuries come with different limitations?

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My daughter with Cerebral Palsy is a runner and on the swim team. There are people with MS that run marathons. While my daughter has limitations - for example she can't ride a bike, it doesn't prevent her from being strong and fit, she simply found other activities she could do. The question is whether someone has the drive to do it. I am constantly amazed, and this thread is a perfect example of this, how those that argue for personal responsibility will rationalize all sorts of reasons why that doesn't apply to their personal health choices.

SouthernDemocrat said:

My daughter with Cerebral Palsy is a runner and on the swim team. There are people with MS that run marathons. While my daughter has limitations - for example she can't ride a bike, it doesn't prevent her from being strong and fit, she simply found other activities she could do. The question is whether someone has the drive to do it. I am constantly amazed, and this thread is a perfect example of this, how those that argue for personal responsibility will rationalize all sorts of reasons why that doesn't apply to their personal health choices.

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That's wonderful, but some people suffer from severe back injuries and nerve diseases and it is nearly impossible for them to mobilize.

ChrisL said:

That's wonderful, but some people suffer from severe back injuries and nerve diseases and it is nearly impossible for them to mobilize.

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I understand that, but the vast majority of people can, yet choose not to. The vast majority of people that are clinically obese were not victims of a horrific accident.

SouthernDemocrat said:

My doctor that just retired at age 83 still runs over 20 miles a week. Its a myth that running is hard on your knees. No study has ever found that to be the case. What is hard on your knees is being overweight. If running, or any other form of exercise, keeps the weight off you you probably will never have knee issues. I know its not for everyone, but its easily the best activity for maintaing a healthy weight because of the high calorie expenditure. However, cycling, hiking, swimming laps, and on are all excellent exercises for general fitness as well.

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While some individuals get away with long distance running, others don't. As you said, it's not for everyone. What is for everyone is exercise in one form or another. The human body was not designed to be sedentary.

But Chris has a point, too, that a few individuals have physical limitations that make exercise extremely difficult. Often, these limitations are brought on by lack of exercise, a sort of Catch 22.

I pack my lunch every day. Most days my lunch consists of something like the following:

1-Apple
1 - Whole Grain Smoked Salmon Wrap
1 - Spinach and Berry Salad with Vinegrette
1 - Plain Greek Yogurt with Berries
1 - Serving of Nuts and a little cheese
1 - Serving of Grapes.

For a snack I might have a half an avocado on a whole grain english muffin. I cannot tell you how many times I have had people look at my lunch at work and say something like "That lunch looks so good and healthy, I wish I could eat like that" I always think well why don't you? It is not like I had to go out and get some kind of a permit that allows me to eat a healthy lunch.

I am fortunate enough to work at a company with a fitness center. So I regularly strength train or run over my lunch hour and then later eat lunch at my desk. I can't tell you how many times I have seen people in the elevator when I had my running clothes on that said something like "I wish I could get out and exercise over lunch". To which I always think well why don't you then? What prevents you other than a conscious choice not to do it.

If you want to exercise personal responsibility, then there is not a better way to do it than your personal health choices.

SouthernDemocrat said:

I pack my lunch every day. Most days my lunch consists of something like the following:

1-Apple
1 - Whole Grain Smoked Salmon Wrap
1 - Spinach and Berry Salad with Vinegrette
1 - Plain Greek Yogurt with Berries
1 - Serving of Nuts and a little cheese
1 - Serving of Grapes.

For a snack I might have a half an avocado on a whole grain english muffin. I cannot tell you how many times I have had people look at my lunch at work and say something like "That lunch looks so good and healthy, I wish I could eat like that" I always think well why don't you? It is not like I had to go out and get some kind of a permit that allows me to eat a healthy lunch.

I am fortunate enough to work at a company with a fitness center. So I regularly strength train or run over my lunch hour and then later eat lunch at my desk. I can't tell you how many times I have seen people in the elevator when I had my running clothes on that said something like "I wish I could get out and exercise over lunch". To which I always think well why don't you then? What prevents you other than a conscious choice not to do it.

If you want to exercise personal responsibility, then there is not a better way to do it than your personal health choices.

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That's a lot like my typical diet, except that I eat more protein, and have multiple small meals, eating something about every two to three hours, even it if is just a piece of fruit or a protein shake or bar.

And I either use my home gym before going to work, or I go to a local commercial gym after work. During work days, I don't spend very long on a workout at all, 15-20 minutes tops, but on weekends, unless I have a full day event planed, I will spend about an hour or so in the gym on both days.

SouthernDemocrat said:

As any endurance athlete knows, everyone burns 5 calories per liter of oxygen. Genetics, race, sex, age, all have no effect on that. Ultimately your body must adhere to the laws of chemistry and physics. If you burn more calories than you take in, you lose weight. If you consume more calories than you burn, you gain weight.

For example, a 155 pound individual running on a 60 degree day at a pace of 7.5 minutes per mile without wind and on level terrain, will burn a net of 108 calories per mile regardless of their genetics because the physical laws of the universe requires that much energy to move their body at that pace over mile.

Some people rationalize a lot of excuses on why they cannot lose weight or why they are not in better shape, or why various entirely preventable diseases afflict them. I have have a daughter with Cerebral Palsy. She has no use at all of her right arm and little use of her right leg. Despite that she runs cross country and is on the local swim team. Just last weekend she got out and ran 6 miles with me. If she can be strong and fit, then just about anyone outside of a wheelchair can be. Its all a matter of choosing to make those life choices.

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It's fairly obvious that you do not have a useful understanding of type 2 diabetes, or the genetic condition that underlies it; and you do not have any grasp of how difficult this condition makes it for some of those who have it to maintain the balance that you so simplistically think you understand between calories taken in, and calories used through exercise.

Yes, anyone with this condition can, in theory, maintain a healthy weight, but for many, it is not nearly as easy as you think it is. I've been extraordinarily fortunate in this respect, but most others on my father's side of the family have not been.

Health insurance is a shared risk program. Thats why and how it works.

You'll never see a health insurance company lower my costs because I work out.. sooo...

imagep said:

Exactly. Two years ago I was diagnosed as being diabetic, and a bunch of other stuff. I started eating better and started exercising and lost weight, and I am now off of most of the medications that I was on. I guess that technically I am still diabetic, but I control it with diet, instead of pills.

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Good for you. That's great. I have a friend who did the same, and I was very impressed.

Ryan5 said:

Wow the fat influential posters weren't able to corrupt the poll! There's hope for the world!

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Ugly goes all the way to the bone. Good luck to you, Ryan. I mean that.

Bob Blaylock said:

It's fairly obvious that you do not have a useful understanding of type 2 diabetes, or the genetic condition that underlies it; and you do not have any grasp of how difficult this condition makes it for some of those who have it to maintain the balance that you so simplistically think you understand between calories taken in, and calories used through exercise.

Yes, anyone with this condition can, in theory, maintain a healthy weight, but for many, it is not nearly as easy as you think it is. I've been extraordinarily fortunate in this respect, but most others on my father's side of the family have not been.

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The person you are responding to is like many I have encountered throughout my life time. Doesn't matter what the issue is... if it works for them it will work for everybody else... if they don't suffer from it, it doesn't exist... and so on.

Diabetes is a common example. I have met many people who had narrow-minded and dismissive attitudes regarding diabetes... then they got diabetes. Some were able to maintain it relatively easily, some were not. For those who maintained easily, some were able to do so for a long time, most were not (only a few years, at best). For those who struggled from the beginning, it was interesting to watch their minds open regarding things that they thought they knew.

Skinny people can be out-of-shape as well. I know one woman in particular who is extremely thin, yet she is also extremely sedentary and couldn't jog across the street without getting winded. She has zero interest in doing anything strenuous. She is probably the least fit person I have ever known in my life, and I know many other people who are in good shape, in the sense that they exercise regularly and routinely do good activities for work and/or recreation, yet who would otherwise be categorized by many as overweight. All could exercise circles around my skinny friend.

Bottom line: People and human bodies are not little robots manufactured in the exact same way as the next one. It's not just about appearance or weight numbers. Even Dr Dean Edell says fitness and health is not tied to appearance and weight as so many want to think.

radcen said:

The person you are responding to is like many I have encountered throughout my life time. Doesn't matter what the issue is... if it works for them it will work for everybody else... if they don't suffer from it, it doesn't exist... and so on.

Diabetes is a common example. I have met many people who had narrow-minded and dismissive attitudes regarding diabetes... then they got diabetes. Some were able to maintain it relatively easily, some were not. For those who maintained easily, some were able to do so for a long time, most were not (only a few years, at best). For those who struggled from the beginning, it was interesting to watch their minds open regarding things that they thought they knew.

Skinny people can be out-of-shape as well. I know one woman in particular who is extremely thin, yet she is also extremely sedentary and couldn't jog across the street without getting winded. She has zero interest in doing anything strenuous. She is probably the least fit person I have ever known in my life, and I know many other people who are in good shape, in the sense that they exercise regularly and routinely do good activities for work and/or recreation, yet who would otherwise be categorized by many as overweight. All could exercise circles around my skinny friend.

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I was like that in my younger days. From childhood, up until well into adulthood, I tended to be unusually thin and frail. I could handle light exercise almost indefinitely. It wasn't unusual for me to walk or bicycle for tens of miles in a day. But I couldn't handle anything very strenuous. Under heavy exertion, I had no stamina. I suspect that I have some unidentified, undiagnosed condition that made me so. I also suspect that it is this same condition that now balances the tendency that my type 2 diabetes would otherwise have toward making me tend to be fat and sluggish. It is in the balance between these two opposing conditions that I finally am able to maintain a normal, healthy weight, and a normal, healthy degree of strength and stamina.

Bob Blaylock said:

I was like that in my younger days. From childhood, up until well into adulthood, I tended to be unusually thin and frail. I could handle light exercise almost indefinitely. It wasn't unusual for me to walk or bicycle for tens of miles in a day. But I couldn't handle anything very strenuous. Under heavy exertion, I had no stamina. I suspect that I have some unidentified, undiagnosed condition that made me so. I also suspect that it is this same condition that now balances the tendency that my type 2 diabetes would otherwise have toward making me tend to be fat and sluggish. It is in the balance between these two opposing conditions that I finally am able to maintain a normal, healthy weight, and a normal, healthy degree of strength and stamina.

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This is good. You understand what works for you. You also understand that what works for you does not necessarily automatically work for everybody else. You're aware of the world around you.

Ryan5 said:

Should medically judged fat people pay higher medical costs?

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Only if medically judged thin people pay the same higher costs.




What's good for the goose is good for the gander, eh?

radcen said:

I've seen many people claim that eating healthier is cheaper. I'm sorry, but that's just not in my experience. Both in observations and personal attempts.

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Now, I'm in a financial position where I can afford better quality food, but not everybody is, nor have I always been as fortunate as I am now.

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I totally agree.

My wife has high cholesterol which she tries to control, as much as possible, with a healthy diet.

It's not cheap.

But, of course, a healthy diet has a lot of benefits.

shrubnose said:

I totally agree.

My wife has high cholesterol which she tries to control, as much as possible, with a healthy diet.

It's not cheap.

But, of course, a healthy diet has a lot of benefits.

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Oh, sure. Eating healthy is the ideal, no doubt. Right with ya there.

Ryan5 said:

Should medically judged fat people pay higher medical costs?

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The photo on the left is uncalled for. Really.

Both of them, actually. Ugh!

OnWisconsin said:

Health insurance is a shared risk program. Thats why and how it works.

You'll never see a health insurance company lower my costs because I work out.. sooo...

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and yet auto insurance offers good driver discounts and charges more for people with DUI tickets and the like. Why can't health insurance do the same?

Dittohead not! said:

and yet auto insurance offers good driver discounts and charges more for people with DUI tickets and the like. Why can't health insurance do the same?

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Good/bad driving is easier to assess than good/bad health. Body type and/or weight is a horribly imperfect measure. Might as well flip a coin or have a computer pick people at random for higher rates.

Dittohead not! said:

and yet auto insurance offers good driver discounts and charges more for people with DUI tickets and the like. Why can't health insurance do the same?

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It's all down to the actuaries and what the state insurance commissions allow.

radcen said:

Good/bad driving is easier to assess than good/bad health. Body type and/or weight is a horribly imperfect measure. Might as well flip a coin or have a computer pick people at random for higher rates.

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It's a pretty safe bet that a 5'5" 400 pound smoker is a higher risk than a 5'5"120 pound non smoker. What do you think the former would pay for life insurance?

clownboy said:

It's all down to the actuaries and what the state insurance commissions allow.

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Legally, yes, but I think the purpose of the discussion is deeper than simply what the law does or does not allow.

*Why* does the state legislate/rule they way they do? Is it a fair standard? Should it be changed?

Dittohead not! said:

It's a pretty safe bet that a 5'5" 400 pound smoker is a higher risk than a 5'5"120 pound non smoker. What do you think the former would pay for life insurance?

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It's easy to "prove" one's own point using extremes. Problem is, it doesn't really prove anything as it doesn't address the vast majority in between.