Talk:Obesity/GA2

GA Review

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The review can take a while (it's a long article), so I'll dump issues here in the meantime.

• removed page number ref 18 (Clinical obesity in adults and children ): the pages parameter should be the page you took the info from, not the total number of pages in the book.
• removed classical "In Classical Latin, this verb is seen only in past participial form". Surely classical latin is not relevant, rather, New Latin is?
• fixed "and behavioral techniques as medications are not approved for use in this age group" needs some rewording to avoid misunderstanding
• think I fixed it "which often includes diabetes mellitus type 2, high blood pressure, high blood cholesterol, and triglyceride levels" a missing "and" and a comma too much?
• changed to excess body fat "Excess weight is behind 64% of cases of diabetes in men and 77% of cases in women" excess weight is only a proxy for body fat, not a cause for diabetes
• Adults usually have a set number of fats cell. But under extreme excesses of calories they divide and thus the number increases " or by the increased number of fat cells" this could be misinterpreted as eating more->getting more fat cells, which isn't the case. Adults have a constant number of fat cells.
• Complicated issue. There are a number of ways to approximate food consumption. You can ask people but the greater their BMI the less accurate their food consumption estimates. Or you can look at the amount of calories that are available for consumption. This over estimates as some is thrown out. Therefore it is dietary energy availability not consumption. "dietary energy availability ", "daily availability" you mean consumption, not availability
• Okay reworded the sentence. Didn't write that bit. What the ref says is "These days, a wealth of nutrition information is at your finger tips. From diet books to newspaper articles". Even though it seems to imply that the info is good it doesn't say so. Will try to find better wording. "Despite the widespread availability of nutritional information in schools, doctors' offices, on the internet, and on product packaging" not quite what the source says, it says many people have opinions on nutrition, not that they give good advice

Narayanese (talk) 20:00, 8 February 2009 (UTC)--Doc James (talk · contribs · email) 15:07, 9 February 2009 (UTC)

Few comments

• "Obesity is a condition in which excess body fat has accumulated to such an extent that health may be negatively affected." can this be rephrased or shortened and made more precise?
• The line "It has, however been" can be improved.

corrected wording

• The photo "Children with various degrees of body fat", I see only one "children" properly and the rest are not visible correctly, is this picture required in the first place? I dont see much value add.

Removed and agree.

• excessive linking can be avoided, such as "smoking" , "sleep"

One link to smoking is pertinent as it is another major public health condition as is lack of sleep. Will remove others if there is more than one.

Will let know if I have any more. --Bluptr (talk) 10:00, 12 February 2009 (UTC) --Doc James (talk · contribs · email) 02:03, 17 February 2009 (UTC)

Replies

• You should explain what dietary availability means in the text. I understand your explanation here, though a shorter one would be better in the article.

Clarified the definition.

• Regarding the number of adipocytes above, I was thinking of PMID 18454136.

Yes but than you have PMID 9038586 This ref says that the number is not altered in "early onset obesity" implying that it is in later onset obesity.

• "Worldwide there has been a large shift towards less physically demanding work.[79] This has been accompanied by increasing use of mechanized transportation, a greater prevalence of labor saving technology in the home, and less active recreational pursuits." While a found where in the source it came from after you pointed it out, I'm still not too happy about the reference, it doesn't cite its sources (it's "less active recreational pursuits" I question)

This is from the WHO. Have come across this in other sources as well. The research is difficult. Each cause really deserves a page to itself to do it justice.

New things

• "As societies become increasingly reliant on energy-dense, large portion, fast-food meals, the association between fast food consumption and obesity becomes more concerning.[74] In the United States consumption of fast food meal has tripling and calorie intake from fast food has quadrupled between 1977 and 1995.[75]" You draw a much strong connection between obesiy and fast food than your sources do.

The complete article of 74 makes a stronger statement than the abstract if you wish to see it.

My error. Narayanese (talk) 20:53, 11 February 2009 (UTC)

• "Agricultural policy and techniques in the United States and Europe have led to lower food prices. In the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the main sources of processed food cheap compared to fruits and vegetables.[77]" The first sentence is US-centric, the second should use the primary source, or anything but a newspaper. A problem though is that Drewnowski's articles present little in the way of evidence for his reasoning and are rarely cited, so I wonder if it should be included at all. But you should read the intro to his The economics of obesity: dietary energy density and energy cost for yourself, it's amusing :).
• "Another study found that 80% of the offspring of two obese parents were obese, in contrast to less than 10% of the offspring of two parents who were of normal weight" I'd rather you used the primary citation, "Anouther study" kind of begs the question of which one

Other editors prefer that I use a review. It is on pg 232 of http://books.google.ca/books?id=u7RvldSr5M0C&printsec=frontcover&source=gbs_summary_r&cad=0#PPA232,M1 which refs PMID 1264536

• "The percentage of obesity that can be attributed to genetics varies from 6% to 85% depending on the population examined" The 6% comes from obesity est. with waist/hip ratio and 85% for BMI, so also the method used is an influence, not sure if that can be said in a good way though or should be left out

This is almost a direct quote from the abstract. It basically says that if you hold the environment constant ( ie everyone has the same access to the same food and forms of exercise ) than obesity is due more to your genes but if there is a wide veriability in the environment than the environment is more important ( ie different rates of wealth lead to food for the rich and none for the poor )

• "Driving one's children to school has become increasingly popular." Is this for the US or worldwide? And I'd move it and the following sentence to the last paragraph of the section where there are similar items

This is a ref from the UK. I am sure that I could find refs from all areas of the first world. And even some of the third world. But obesity is rare in Africa and parents do not drive there children. One again exercise will require its own page before FA status is attempted.

• Socioeconomic section - fewer, longer paragraphs would be better I think (not important)

Narayanese (talk) 05:38, 10 February 2009 (UTC) --Doc James (talk · contribs · email) 18:15, 10 February 2009 (UTC)

Cause

Under the discussion of diet and exercise as a cause of the global obesity epidemic what we are really discussing is: are we eating more ( and I think from what is presented we can say yes ) and are we exercising less ( this is still a little narrow in focus ). Have created a subpage Exercise trends to expand the discussion as one cannot present this type of info in map form such as we have done with Dietary energy supply. --Doc James (talk · contribs · email) 18:15, 10 February 2009 (UTC)

main review

• Well written
  • It's actually an easy read. "average calories available per person" is still unexplained, whichneeds fixing, otherwise it's fine.

Repeating the term doesn't help - it is still hopelessly technical. I get the impression from [1] that it is food bought per person, did I get it right?

• Verifiable and reliable
  • It's a good this there are sources for the whole article, this is a controversial topic. A few fall short though:
  • "Extra pounds mean insurance fees for Ala. workers". Associated Press Writer. August 22 2008. http://news.yahoo.com/s/ap/20080822/ap_on_bi_ge/obesity_penalty_8. Retrieved on 2008-09-09. Dead link. Since it seems to be an AP article a more persistent version should be around

fixed

• • "The Oxford English Dictionary (website)" This reference could use more info, like a direct link

The problem is the OED requires subscription. Have added other refs.

• • ""Calories per capita per day" (gif). UN Food and Agriculture Organization. http://www.fao.org/statistics/chartroom/chart.asp?image=img/charts/fbs/chart08.gif. Retrieved on January 10,2009." Link the full report instead, the picture doesn't have the sources and could be out of context.

Refernced

• • ""WHO: Obesity and overweight". World Health Organization. http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/. Retrieved on January 10, 2009." This source isn't good, the reader must be able to track the research.

Were are you referring to?

Same as before I'm afraid. I haven't been able find a source myself to supplement it (a primary source gainsaid the leisure activity thing, didn't come across any review).

can you please tell me were in the article you are refering to the WHO is used a number of times

"Worldwide there has been a large shift towards less physically demanding work.[79] This has been accompanied by increasing use of mechanized transportation, a greater prevalence of labor saving technology in the home, and less active recreational pursuits.[79]"

• • File:Indicatorslongrun579.gif uses a raw url ref, I'd like a full ref.

Added ref

• • "Some U.S. Kaiser Permanente facilities provide oversize chairs for obese patients. Pictured is one at Richmond Medical Center." Uncontroversial I guess, but I think you should remove the details unless you can find some sort of reference.

Not sure what you are getting at? We had concerns in the past that this was a joke which is why all the details.

The bit about concerns about a joke sounds bad... without a source (which I couldn't find myself) it could still be, or a case of overelaborated details. Perhaps it's time to invoke WP:NOR and remove it, even though it adds to the article.

Will try to find the person who added it.

It is refed and I agree wording is now better.--Doc James (talk · contribs · email) 15:12, 22 February 2009 (UTC)

Good, I hope it gets sorted out.

• Broad
  • No worries here

• Stable
  • Yup

• Neutral
  • The large amount of meta-analyses used in the article helps a lot here. Thus my concern is not the scientific parts of the article, but those that mention advocacy groups: the Size acceptance and the obesity controversy section and the external links section. One of the sources is ""WHAT IS NAAFA?". NAAFA. http://www.naafa.org/documents/brochures/naafa-info.html#whatis. Retrieved on 2008-09-29.", and there is no indication that this is a representative organisation (the link is dead btw).

Fixed the link and will try to address the representation of the ref. Will add the ISAA.

Good

• Illustrated
  • It's on the weak side, but good enough. I'm not that fond of the removal of the picture of children.

The picture is still on the childhood obesity page. I do not mind if it is here aswell.

Narayanese (talk) 21:58, 17 February 2009 (UTC)

Exercise and the WHO

The direct line from the WHO is "At the same time, large shifts towards less physically demanding work have been observed worldwide. Moves towards less physical activity are also found in the increasing use of automated transport, technology in the home, and more passive leisure pursuits." I think that they are a good enough source that one does not need the research they base the on. The WHO does lots of research themselves. I also do not think this is a contentious statement.Doc James (talk · contribs · email) 15:36, 22 February 2009 (UTC)

I have emailed the WHO to ask what there statement is based upon. Added another page from the WHO which support the above statement.--Doc James (talk · contribs · email) 16:17, 22 February 2009 (UTC)

Sedentary lifestyle section

This requires cleanup. The mechanized transport text is split in two (by a section on TV watching), and relies too much on primary sources. Narayanese (talk) 14:01, 21 February 2009 (UTC)

Organized text--Doc James (talk · contribs · email) 15:08, 22 February 2009 (UTC)

Yes, I've looked at the review carefully [edit: Ness-Abramof et al]. It provides zero references for what you cite it for (trends). The review isn't even about temporal trends! The author just throws an opinion at the reader wihout giving any evidence. Narayanese (talk) 23:08, 24 February 2009 (UTC)

I still haven't been able to check source 18, since no page numbers are given. Narayanese (talk) 23:10, 24 February 2009 (UTC)

Ref 18 Clinical obesity in adults and children: In Adults and Children can be looked at on google books. You can search the book to find what is being referred too.

Have you looked at these reviews?

• Brownson RC, Boehmer TK, Luke DA (2005). "Declining rates of physical activity in the United States: what are the contributors?". Annu Rev Public Health. 26: 421–43. doi:10.1146/annurev.publhealth.26.021304.144437. PMID 15760296.{{cite journal}}: CS1 maint: multiple names: authors list (link)

• Borodulin K, Laatikainen T, Juolevi A, Jousilahti P (2008). "Thirty-year trends of physical activity in relation to age, calendar time and birth cohort in Finnish adults". Eur J Public Health. 18 (3): 339–44. doi:10.1093/eurpub/ckm092. PMID 17875578. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

I have added these to the page on exercise trends.

--Doc James (talk · contribs · email) 23:14, 24 February 2009 (UTC)

Nope, I've missed out on those. Bedtime for me atm, but after a glance at the Finnish one I like its intro a lot. And the annual review series is always good. I suggest you replace the section on this page with material from these two sources (but keeping the TV watching and fidgety behaviour text), the section is on the long side as it is now. Narayanese (talk) 23:58, 24 February 2009 (UTC)

Yes. The page I have been editing to justify the WHO's statement is exercise trends. I feel it is best to have the main page give the overview offered by the WHO with the subpage giving the justification for the WHO's comments.

Encyclopedia of Obesity By Kathleen Keller quotes a RAND report as saying obesity is 60% lack of exercise and 40% diet. Have not added it as are am sure this would be to controversial.--Doc James (talk · contribs · email) 00:36, 25 February 2009 (UTC)

Exercise trends

There is evidence supporting the WHO's POV. Some of it is presented on the exercise trends page. I am not sure what exactly is the issue you have with this section?

I do not see any controversy around the statement that their has been "large shift towards less physically demanding work." or that "This has been accompanied by increasing use of mechanized transportation, a greater prevalence of labor saving technology in the home"

The only one that might be controversial is "less active recreational pursuits"

Thanks.--Doc James (talk · contribs · email) 22:56, 24 February 2009 (UTC)

In my opinion, focusing on this one clause is an overly strict interpretation of 2(b) of the Wikipedia:Good article criteria. This is not a Feature article. If the clause is contested with the current referencing, it can be removed. Or its source can be specified: "According to the World Health Organization ..." —Mattisse (Talk) 02:59, 25 February 2009 (UTC)

Sorry for butting in, but "According to the World Health Organization ...", while true (see current ref [80]), is our standard way of hinting that a proposition may be a minority view. I don't think "sedentary recreations promote obesity" is a minority view, e.g. the UK government is banging the drum for participation in sports. I'd much rather the statement remained strong, with the addition of one or 2 non-WHO refs. --Philcha (talk) 22:55, 25 February 2009 (UTC)

I agree "sedentary recreations promote obesity" is the standard view. There however is a strong pro obese lobby. I will add more ref because the cdc agrees as does the uk.--Doc James (talk · contribs · email) 00:39, 26 February 2009 (UTC)

That leisure-time phys activity is decreasing is a minority view, and a strongly object to you removing mainstream sources that reject this and instead reinserted the not-so-scientific WHO sources. Narayanese (talk) 06:26, 26 February 2009 (UTC)

Yes Would agree that "leisure-time phys activity trends are controversial" Would not call it a minority view. The rest however is not controversial. Will remove leisure time activities.--Doc James (talk · contribs · email) 14:43, 26 February 2009 (UTC)

The new version gets around neutrality problems by telling both sides and elaborating the sources, So I'm happy with it. Narayanese (talk) 21:04, 26 February 2009 (UTC)

Any other changes or recommendations?--Doc James (talk · contribs · email) 22:04, 26 February 2009 (UTC)

Two recommendations:

Restore a briefer version of the TV watching and fidgety behaviour to the sedentary section, as there doesn't seem to be much conflicting evidence on these two and they're kind of nice for completeness.

Second, I don't think "A combination of excessive caloric intake, lack of physical activity, and genetic susceptibility is thought to explain most cases of obesity, with a limited number of cases due solely to genetics, medical reasons, or psychiatric illness." is a good wording. It misses out on that genetic suspecibility and various illness presumably acts through increased consumption and/or reduced activity, the current wording makes it sound like unfavourable genetics make fat simply appear with no eating invlved.

I have yet to fully review your last burst of edits, but mostly I'm waiting for the [possible] dispute with 75.56.56.186 to blow over before I pass GA. Narayanese (talk) 23:31, 26 February 2009 (UTC)

Agree with the changes. Have also specific that the causes on an individual level are somewhat different than the causes on a society level.--Doc James (talk · contribs · email) 02:14, 27 February 2009 (UTC)