Talk:Obesity/Archive 9

Genetics

"The percentage of obesity that can be attributed to genetics varies, depending on the population examined, from 6% to 85%.[104]"

This line is just wrong, constitutes original research, and needs to be removed. The source actually says 16-85%, and the sources that this source cites say 16%, and 80%, respectively. In the Finnish 80% study, the percentage of participants that were overweight was 5.3%, and even if they weight a metric ton each, they would not have contributed significantly to the total population variation. This means that most of the variation attributed to genetics in this study is between people that are within a BMI range of 20-25. So, in essence, it says absolutely nothing about obesity or how heritable it is, because it was looking almost exclusively at people in a normal weight range. There is a huge, tremendous, extraordinary difference between heritability and inheritability, and heritability has a very specific meaning, which is completely inapplicable to this discussion.

Signed, a credentialed biologist.

Hello credentialed biologist. Could you recommend how the current content should be changed, and do you have sources that might be useful for that? JFW | T@lk 22:51, 12 August 2014 (UTC)

It should be straight up removed from this article. These studies don't really have anything to do with obesity and genetics. There aren't enough obese people in the population to make any meaningful conclusions from it. They do however have something to say about BMI and genetics, but they are covering a population that is mostly normal weight people, rather than overweight. It's sort of hard to explain, but let's make up some data for the sake of understanding. I'm obviously simplifying, and using an extreme example of a population to give a sort of realistic picture of what is going on in this study. All these numbers are made up, and I didn't actually do any math here, just giving a possible example. The mathematics behind it is complicated statistics, and I don't really have the time to generate random population distributions and do all the statistics for the sake of argument.

Let's say I have two populations of people. The first population, 95 people, live in completely identical environments, get identical exercise, and eat the same amount of food every day. Some of them, due to genetic factors, have lower metabolism, or caloric absorption issues, which leads to a distribution centered around 23 BMI, with all of the 95 people falling in the range of 20-25 BMI. For these 95 people, 100% of the variation in BMI is caused by genetic factors, and the heritability is therefore 100%.

Now, we have another population of 5 people that are genetically identical to the 95 in population 1, but they are obese because they eat twice as much food as the people in population 1. They all have BMIs between 38 and 42. Within this population 2, all 5 members eat the same amount of food, and live in the same environment so the 4 points of variation (38-42) are caused by genetic factors, just like with population 1. So, for this population, 100% of the variation in BMI is caused by genetics.

Ok, now finally, let's combine both populations. Now, we have 95 people that are about 22 BMI, and 5 that are about 40 BMI in one population. What happens is that we end up with a population of mostly 22 BMI, with five 40 BMI outliers. These outliers introduce a lot of variation into the population, and most of that variation (~20 BMI difference) is due to them eating twice as much, rather than genetics. This therefore lowers the heritability of BMI from 100% down to something like 80%.

So, this is just one example of how the obese individuals in the population could be obese without any genetic contributions, but still end up with a figure that makes it seem there is one. The reverse is also true. This makes heritability studies kind of useless, except in specific scenarios, when used in specific ways. In our case, it says nothing at all about obesity and genetics, unfortunately.

Signed, a credentialed biologist. — Preceding unsigned comment added by 75.167.214.249 (talk) 23:35, 12 August 2014 (UTC)

Let's try again: Yang/Kelley/He (PMID 17566051) is the source for the current text, and our text is almost verbatim from the abstract. Are you suggesting the source is wrong, or that we are misrepresenting its findings? Are there other (more recent) sources that contradict the current source? I have no problem believing your credentials, but it would be good to clarify this.

Jmh649 (talk · contribs) might want to weigh in. JFW | T@lk 08:58, 13 August 2014 (UTC)

When you look in the main article, "Heritability estimates ranged from 16 percent to 85 percent for body mass index (30–34)" Interestingly, the source #34 says 80%, so I'm not sure where 85 came from. Now the problem isn't whether this source is right or wrong. The problem is that heritability doesn't mean what you think it means. It doesn't mean obesity is 80% genetic. It means that when you look at a population of thousands of Finnish (And it's different for every population you look at) people, on average, 80% of their difference in weight is explained by genetics. Since the population is 95% normal BMI people, it means that if I take two normal BMI people and compare them, over 80% of the difference in their weight (literally 5 or so pounds) is caused by genetics. If the population was 95% overweight people, then I'd be able to compare two overweight people, and say the difference in weight (5 pounds or so) is 80% genetic. What this doesn't give me the ability to do, though, is compare an overweight person to a skinny person and say 80% of that difference is genetic. It just doesn't work like that, and it can never really work like that. What you'd be able to say (if you had the data in front of you) is that up to 2-3 BMI of the difference between the fat and skinny populations is attributable to genetics. — Preceding unsigned comment added by 75.167.214.249 (talk) 14:31, 13 August 2014 (UTC)

Removed by my alter ego diff. How about the rest of the article, and Genetics of obesity? Wiki CRUK John (talk) 14:03, 23 August 2014 (UTC)

Ref says "Heritabilities for obesity-related phenotypes varied from 6% to 85% among various populations." [1]

Heritability is the proportion of the differences in a trait in a population that is due to differences in genetics.

It can thus reasonable be summarized as "The percentage of obesity that can be attributed to genetics varies, depending on the population examined, from 6% to 85%"

It is often based on twin studies. Some people consider heritability to be junk and that trying to separate genetic from environmental components of a disease is useless. Others consider it to be reasonable. Yes it is a bit of a controversial measurement. Still not justification to remove it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:28, 23 August 2014 (UTC)

Somewhat apart from this point, and those made above, I don't believe that "Heritabilities for obesity-related phenotypes" = "The percentage of obesity that can be attributed to genetics", whichever view of heritability in general you take. That might work for some inheritable factor that had no environmental component, but that is clearly not the case here. Wiki CRUK John (talk) 17:22, 23 August 2014 (UTC)

How would you suggest summarizing it? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:19, 23 August 2014 (UTC)

I wouldn't try myself - I'll ask for a suitable phrasing next week (Monday is a holiday). Or "86" might be able to help. The abstracts of these later (2010) papers don't suggest there is a neat statement to be made - [2] and [3]. Johnbod (talk) 21:43, 23 August 2014 (UTC)

Yup thus the incredibly wide range of %s. We want this text because some days the popular press will state "NEWLY 90% of OBESITY DUE TO GENETICS" and then a couple week later a title will run "SCIENTIST SAY LESS THAN 10% of OBESITY GENETIC" as a new peice of primary research comes out. Than the promoters of primary research will come add it here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:08, 23 August 2014 (UTC)

The problem is, this isn't what heritability means, at all. It isn't concerning obesity. It is not a measure of a difference between two groups (normal and obese in this case). You are incorrectly applying a Population statistic to individuals in that population and you can't do that, it's bad math and it doesn't work like that. For the last time, I'm going to try to explain this. There is a certain amount of variation in the population, distributed differently among different individuals of a population (if mean = 22 bmi, then 40 bmi has more of that variance than 30 bmi. ok?). A certain proportion of that total population variation is genetic, but its distribution among individuals is not flat. It could just as easily be that 80% of the people in the population have their variance completely explained by genetics as it could be that 100% of the people have their variance 80% explained by genetics, etc... What you are doing, by saying x% of obesity is genetic, is making a statement about the distribution of the genetic component of the variance, and you can't do that, because that's not in any of the sources, and never will be, because that is not what heritability measures are for. An easy example is with money. Let's say we have a population of 100 that has a total net wealth of 500 dollars, distributed randomly among the population; not everyone has $5 here. 20% of that 500 is cash, the other 80% is assets. Can you pull someone with $9 out of the population and tell me, based on the statistic just stated, how much of their net worth is in cash and how much is in assets? no, you can't. All their money could be cash, all could be assets, or anywhere in between, because someone else in the population offsets them to get the 20%/80% split. That's how heritability works when you're trying to pull people from a certain group out and say that the average values are also true for them. In order to say what you're trying to say, you need to find a study which compares obese people, and only obese people, to the population mean for the whole population, and calculates the heritability that way. I doubt you will find any such study.

Also, Doc James, "Heritabilities for obesity-related phenotypes varied from 6% to 85% among various populations." means exactly that, and you're reading into it a lot. It means to say that the heritability of things that are related to obesity, like BMI, ranges from 6-85%. This is very, very different from saying obesity is 6-85% heritable. 75.167.216.226 (talk) 13:43, 25 August 2014 (UTC)

From the wikipedia page on heritability

"Heritability estimates are often misinterpreted if it is not understood that they refer to the proportion of variation between individuals in a population that is influenced by genetic factors. Heritability describes the population, not individuals within that population. For example, It is incorrect to say that since the heritability of a personality trait is about .6, that means that 60% of your personality is inherited from your parents and 40% comes from the environment."

Can we all agree on this now? This is getting kind of ridiculous.75.167.216.226 (talk) 15:37, 25 August 2014 (UTC)

Okay so we cannot copy and paste it into the article as that is not allowed. I have tried to paraphrase the content in question. Would you be interested in trying to paraphrase the content in question and we can discuss? Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:06, 26 August 2014 (UTC)

I hesitate to chime in again, since I agree with "75" that the statement should have been removed, but remember it was "The percentage of obesity that can be attributed to genetics varies, depending on the population examined, from 6% to 85%.[104]", which only really makes sense as a proposition applied to populations, not individuals. Johnbod (talk) 17:39, 25 August 2014 (UTC)

Yes this is clearly about populations not people. Heritability is always about populations. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:06, 26 August 2014 (UTC)

Ok. It sounds like you want me to try and paraphrase it and still include the studies cited. Well, then it's going to have to say something like "Studies have shown that the heritability of BMI ranges from 6% among old-order Amish, to 85% in Finnish teenagers. Heritability is measure of the proportion of variation, between individuals in a given population, due to genetic factors. Because heritability is a measure on populations, and because it is unlikely that each member of the population has the same genetic proportion of BMI, this evidence cannot be used to infer any relationships between individuals or groups in the population, and it cannot be said that, for example, any particular obese person's weight is 85% due to genetics. In another sense, it is the average genetic component, which could be quite high for some, and low for others. Just as we do not assume that everyone in a population with average height has that height, we cannot say the everyone in these populations has the same genetic component to BMI" 75.167.216.226 (talk) 01:01, 26 August 2014 (UTC)

This is not the place to discuss all the limitations of heritability. So we could summarize / simplify this as "The differences in BMI between individuals in a given population that is related to genetic factors ranges from 6% to 85%." yes?Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:11, 26 August 2014 (UTC)

That's still wrong. Monozygotic twins have a difference in BMI that is 0% heritable. These studies looked at the heritability of obesity related factors (weight, bmi, body fat, etc...), and quantified the amount of total variation in the population that is due to genetics. This "genetics cause obesity" myth needs to stop being perpetuated. Wikipedia has a responsibility to INFORM people, and by simply stating the heritability of obesity, you're being very misleading.

Are you saying that this is a misinterpretation of the source or are you saying the source in wrong? Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:12, 27 August 2014 (UTC)

Well, I don't know about you, but I'm pretty sure that Prader–Willi syndrome is a genetic disorder, and I'm pretty sure that it causes obesity by any reasonable definition of the word cause. 'Genetics cause obesity' is not entirely a myth. WhatamIdoing (talk) 15:45, 27 August 2014 (UTC)

Of course, but "The incidence of PWS is between 1 in 25,000 and 1 in 10,000 live births", and in the US some 3,500/10,000 are obese these days. At bottom, it is difficult to explain the huge leaps in obesity rates over recent decades in the West as being "caused" by inherited genetics, as we all know perfectly well. Johnbod (talk) 16:09, 27 August 2014 (UTC)

Per [4], The role of genetics in obesity is twofold. Studying rare mutations in humans and model organisms provides fundamental insight into a complex physiological process, and complements population-based studies that seek to reveal primary causes. Gene-environment interactions may be extremely relevant [5], especially perhaps within and among populations that have been exposed to rapid changes in lifestyle, such as the introduction of fast food and other modern, Western dietary habits, etc. [6] 86.134.200.29 (talk) 18:19, 27 August 2014 (UTC)

Dear all, I have seen your discussion, and I could not catch up where is the problem, it seems there is a misleading concept. I did not read all the discussion, once it is long. But, according to a source of mine, using studies in twins, "as we have previously mentioned, researchers also appreciate the enormous contribution of genetics in this equation: up to 70% heritability has been found for body mass index (BMI) values" https://books.google.it/books/about/The_Gravity_of_Weight.html?id=qQMNtiyFl3kC&hl=en. They cite O’Rahilly S, Farooqi IS: Genetics of obesity. Philos Trans R Soc Lond B Biol Sci 361:1095– 1105, 2006. I hope it helps to settle down the discussions. Best, Jorge Pires 08:01, 25 May 2015 (UTC) — Preceding unsigned comment added by Jorge Guerra Pires (talk • contribs)

Arbitrary break

A few rapid considerations in response to an informal request for comment by Wiki CRUK John:

While certainly agreeing with Doc James about the need to satisfy readers' wish to know, I do have major concerns, broadly per 75.167 [7], about the current wording/presentation.

• The phrase "The percentage of obesity that can be attributed to genetics" is presumably intended as a non-technical gloss for a highly technical concept. I think that, at the very least, we need to link to heritability -- a term that is currently missing. I also question whether the use of "attributed" is suitable here, given that (in my limited understanding) heritability is quite separate from attributable fractions etc rather different from a theoretically preventable population attributable fraction. And as 75.167 notes, such misconceptions can propogate myth.
• The currently cited source [8] states "Heritabilities for obesity-related phenotypes varied from 6% to 85% among various populations." That seems to me to be a different kettle of fish.
• Taking a couple of steps back for a moment, I can't help thinking that if we're finding it hard to get our heads around this sort of stuff what's it going to be like for our lay general readers who simply want to know... We need to find editorial ways of explaining these things better. That's a problem for us, both because a) communication of technical concepts to the general public is by no means a straightforward editorial task; and b) we actually rely on a rather limited number of medical editors, few of whom, I guess, happen to be genetic epidemiologists (or, more relevantly perhaps, have a background in explaining the subject to lay readers). In this light, I think the contributions already made here by 75.167 are most welcome!
  86.134.200.29 (talk) 10:49, 27 August 2014 (UTC)

The issue appears to be around the meaning of the word heritable. Some use it to means "the extent to which genetic individual differences contribute to individual differences".[9] Thus it means how much does the differences in genetics in a population cause the differences in a characteristic. Which is more or less the way we are using it.

How do others wish to explain heritability? Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:40, 27 August 2014 (UTC)

Ummm... Making Sense of Heritability perhaps...? Fwiw, the publisher's blurb bills Neven Sesardić's 2005 book as "a fresh and compelling intervention in a very contentious debate." The reality is that traditional (ie 'environmental') epidemiology and genetic epidemiology are two largely separate scientific disciplines that are by no means immune from interpretive divergence and even conflict. 86.134.200.29 (talk) 17:10, 27 August 2014 (UTC)

Have adjusted further. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:44, 27 August 2014 (UTC)

Just re that change [10]: if we choose to talk in terms of variability in BMI, 40% to 70% seem to be recently quoted figures [11] (based on PMID 8782724 from 1996). The same range is also quoted elsewhere for "obesity" [12] (based on PMID 9519560 from 1997, which in turn stated "genetic factors explain 50 to 90% of the variance in BMI"). According to Commuzzie et al (2010) [13], "Heritability estimates suggest that 40-70% of the variation in obesity-related phenotypes is attributable to underlying genetic variation." (Note: While genetic epidemiology isn't my scene, I don't think that can be simply taken to mean the percentage of obesity attributable to genetics.) 86.134.200.29 (talk) 14:13, 27 August 2014 (UTC)

• Also, per Willyard (2014) [14], "Classic twin studies in the 1980s and 1990s, which relied on pairs of identical and fraternal twins, suggest that 40–70% of variation in body size is due to genetic factors." 86.134.200.29 (talk) 18:34, 27 August 2014 (UTC)

Maybe we can paraphrase that statement? (And perhaps also explain a bit more about the potential relevance of these findings, per some recent medrs?) 86.134.200.29 (talk) 20:12, 27 August 2014 (UTC)

Fellow editors, there is a problem, still with where this is going. Saying that 40-70% of the variation in body size is due to genetic factors is sort of irrelevant when we're looking at populations where the majority of variation is within, not between groups (normal vs overweight), and when one group is much larger than the other. In the twin studies I have seen, the concordance between twins was inversely related to the higher BMI of the two. The implications of that negative correlation are pretty telling with regards to the "genetic component of obesity", i.e. there is none. 75.167.216.226 (talk) 20:54, 27 August 2014 (UTC)

Can you perhaps provide some suitable secondary sourcing for that observation? (note to new contributor: for various reasons related to the running of Wikipedia we actually have to follow rather stringent guidelines here for reliable scientific sources, and reliable medical sources in particular, that go beyond the basic sourcing guidelines that are designed to help guide inclusion of encyclopedic content and avoid personal, essay-like content). 86.134.200.29 (talk) 22:16, 27 August 2014 (UTC)

Adding: Fwiw, the source I suggested above (ie [15]) does at least acknowledge that those frequently cited estimates "relied" on studies of twins. 86.134.200.29 (talk) 22:45, 27 August 2014 (UTC)

86 the numbers you mention of course are within the wider range we currently have so support our current text yes? Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:30, 28 August 2014 (UTC)

Hum, a bit as in "subtract the number you first thought of"? Or perhaps also add in that the population attributable risk for obesity linked to the most statistically significant loci, like FTO and MC4R, remains discouragingly low, explaining only small fractions of the overall variance of body weight, per Russo et al (2010)? Not sure I'm the right person for this... Rather than support or otherwise, I've preferred to send out a hopeful mayday call WP:Genetics. Imo, it would be good to improve the section as a whole. 86.134.200.29 (talk) 18:41, 28 August 2014 (UTC)

It's good to note that genetics and environment interact to from health outcomes, but it should also be noted that some individuals and populations have genetic predispositions to obesity that only come to the surface when exposed to new or adverse environments. This way, we can see that genetics play a role in different ways throughout a lifecycle.

For example, “Ethnic groups in many industrialized countries appear to be especially susceptible to the development of obesity and its complications. Evidence suggests that this may be due to a genetic predisposition to obesity that only becomes apparent when such groups are exposed to a more affluent lifestyle... … It appears... that a number of ethnic groups are more prone to the risks of obesity when exposed to the lifestyle common in industrial societies. For the majority, this problem seems to result from a combination of genetic predisposition and a change from the traditional [lifestyle].”[12] Orthopedicfootwear (talk) 03:31, 8 December 2014 (UTC)

Good comment imo from Orthopedicfootwear. I think the quotation is from:
Obesity: Preventing and Managing the Global Epidemic. World Health Organization. 1 January 2000. p. 138. ISBN 978-92-4-120894-9.
86.164.164.29 (talk) 15:58, 14 December 2014 (UTC) (ex-86.134.200.29)

Obesity Chart Error

The heading in the chart under "Classification" shows BMI = K squared / m squared. It should be K squared divided by h squared. — Preceding unsigned comment added by 2601:1C0:C101:E7B6:6532:78B5:5B97:E611 (talk) 14:17, 14 August 2015 (UTC)

You confuse several things. BMI is defined as mass (m) divided by height squared (h²). The unit in which it is expressed in the table is kilogram (kg) divided by meter squared (m²). −Woodstone (talk) 15:39, 14 August 2015 (UTC)

asking about a reference?

Hello, would there be a place in this article for the following reference? ? --Cityside189 (talk) 23:49, 24 August 2015 (UTC)

Semi-protected edit request on 8 September 2015

In the section 'classification', the BMI is defined as follows:

"BMI is defined as the subject's weight divided by the square of their height and is calculated as follows. \mathrm{BMI}= \frac{m}{h^2}, where m and h are the subject's weight and height respectively.

BMI is usually expressed in kilograms per square metre, resulting when weight is measured in kilograms and height in metres."

This is not correct. It should read:

"BMI is defined as the subject's mass divided by the square of their height and is calculated as follows. \mathrm{BMI}= \frac{m}{h^2}, where m and h are the subject's mass and height respectively. BMI is usually expressed in kilograms per square metre, resulting when mass is measured in kilograms and height in metres."

i.e. substituting the word 'weight' for 'mass'. Although it is common to refer to your weight in kilograms, it is not correct.

Stevejm22 (talk) 15:48, 8 September 2015 (UTC)

Not done: please provide reliable sources that support the change you want to be made. The lead states it as weight by height. The WHO links also refer to weight by height. Inomyabcs (talk) 16:20, 8 September 2015 (UTC)

Correctly speaking it is in fact mass. See Human body weight, Mass versus weight. I´ve added references and slightly adapted the wording to account for this. (diff-link) --Chris Howard (talk) 15:14, 9 September 2015 (UTC)

Semi-protected edit request on 27 October 2015

Please add the statements below with a new section "Urban Sprawl" as one of the Causes because urban sprawl is one of the important potential factors to impact on the risk of obesity. Although exact association is still being studied, numerous reliable studies have shown significant association, thus this will be helpful information for visitors to the page.

Urban sprawl is the result of people moving into urban areas and subsequently consuming more geographical area as well as creating greater distances between workplaces, schools, stores and homes. Similar to the rise in obesity rates seen in the past few decades, rates of urban sprawl have been increasing over time.(1) Urban sprawl is a contributing factor in lowering physical activity levels and although it might not be directly associated with obesity prevalence, it subsequently increases the risk of obesity.(2)  For instance, one study examined metropolitan cities and found that for every one point rise on the urban sprawl index, there was a 0.2% greater risk of being overweight and a 0.5% greater risk of being obese.(3) An additional study found that BMI is strongly and negatively correlated to urban sprawl index scores- meaning a decrease in index score (more sprawl) was associated with an increase in BMI.(4)  

Some of the proposed mechanisms by which urban sprawl contributes to the obesity epidemic include decreased street accessibility and connectivity, increased commute times, lack of variety of land uses, and increased distance to parks and recreational facilities. These factors contribute to both physical inactivity and increased sedentary behavior by reducing an individual's propensity to walk and causing a reliance on automobiles as a primary form of transportation. For example, land use, one of the indicators of urban sprawl, is closely related to travel patterns. If distinct land uses are separated and the distances between them are great, people are more likely to rely on automobiles for their transportation rather than walking or bicycling. In the US where there are numerous low density areas, the population who walk or bike to a workplace is significantly lower (less than 7.5% in 49 states) compared to other compact and densely populated countries.(5) Additionally, research has indicated that time spent commuting longer distances between work and the home may be linked to increases in both obesity and inactivity.(6) In one study, individuals who commuted an hour longer than the average commute time showed a 6 percent decrease in time spent engaged in health-related activities, 16.1% of which was a reduction in physical activity.(7) Furthermore, individuals who commuted for two hours longer than the average commute time were associated with a 12 percent reduction in time spent engaged in health-related activities, of which 20.3% was attributed to a reduction in physical activity.(7)  

The research has demonstrated a clear relationship between urban sprawl and both physical inactivity and sedentary behavior. These factors undoubtedly play a role in the current obesity epidemic. Data from the Centers for Disease Control (CDC) show that in areas of the United States where rates of obesity are higher than 30%, the prevalence of adults who report no leisure-time physical activity is also higher than 30%.(8) Although obesity is a complex disease influenced by diet, genetics, environment, and numerous other factors, the role urban sprawl plays in this relationship cannot be ignored. Estimates indicate that if the average metropolitan area had not experienced the decline in the proportion of population living in dense areas over the last 30 years, the rate of obesity would have been reduced by approximately 13%.(9) Many cities and counties have taken preventive measures and developed policies to reduce urban sprawl, and health benefits from said policies are already being observed.

References 1. Fulton, William B., and Rolf Pendall. Who sprawls most?: How growth patterns differ across the US. Washington, DC: Brookings Institution, Center on Urban and Metropolitan Policy, 2001. 2. Ewing, R., Schmid, T., Killingsworth, R., and Raudenbush, S. “Relationship Between Urban Sprawl and Physical Activity, Obesity, and Morbidity.” American Journal of  Health Promotion Vol 18; Sep-Oct (2003):47-57. 3. Lopez, R. (2004, September). Urban Sprawl and Risk for Being Overweight or Obese. American Journal of Public Health, 94(9), 1574-1579. 4. Ewing, Reid H., and Shima Hamidi. Measuring sprawl 2014. 2014. 5. Howard F. (2002, May-June). The Center for Disease Control and Prevention. Public Health Report. Urban Sprawl and Public Health, 117. 6. Christian, T. J. (2012, October). Trade-offs between commuting time and health related  activities. Journal of Urban Health, 89(5), 746-757. 7. Lopez-Zetina, J., Lee, H., & Friis, R. (2006, December). The link between obesity and the built environment. Evidence from an ecological analysis of obesity and vehicle miles of travel in California. Health & Place, 12(4), 656-664. 8. Barnes, Ann Smith. “Obesity and Sedentary Lifestyles: Risk for Cardiovascular Disease in Women.” Ed. Stephanie A. Coulter. Texas Heart Institute Journal 39.2 (2012): 224–227. Print. 9. Zhao, Zhenxiang, and Robert Kaestner. "Effects of urban sprawl on obesity."Journal of Health Economics 29.6 (2010): 779-787. Kenta215ok (talk) 05:17, 27 October 2015 (UTC)

Thanks for this, but it is far too long and diffuse, and this is Obesity not American obesity, which I see we do have (and is not protected). You might try there, though I'd suggest not at such length. And/or urban sprawl. No doubt urban sprawl is a factor in the rise of a sedentary lifestyle, but I think our section on that, though rather short, covers the broad, global picture ok. Johnbod (talk) 15:50, 27 October 2015 (UTC)

Changing answered parameter to yes as request has been answered. --Stabila711 (talk) 03:07, 28 October 2015 (UTC)

Animal Obesity

This article is really about human obesity, despite the passing reference to the lab mice.

It would be interesting to include data on:

1. The BMI of domestic pets owned by obese humans.

2. The BMI of wild animals which live in close proximity to humans.

3. The BMI of domestic pets owned by anorexic humans. — Preceding unsigned comment added by Jofresh01 (talk • contribs) 22:54, 21 May 2016 (UTC)

I have no supporting data, but I think there's a strong correlation between animal-human interaction and animal obesity. Animals in the wild, removed from human contact, are never obese. Obesity seems to be a human trait which has the ability to affect other species. 24.51.217.118 (talk) 17:57, 18 January 2016 (UTC)

Text addition

This text was added "A low-fat, low glycemic index (GI), and high protein diet was more beneficial to long-term weight-loss retention than low fat, high GI, low protein diets."

Yet the source says "In the long term, there are no differences in the effect on weight loss between advice on strict and moderate low carbohydrate diets, low fat diets, high protein diets, Mediterranean diets, diets aimed at achieving a low glycaemic load or diets containing a high percentage of monounsaturated fats."[16]

This appears to agree with the prior review article from 2014.

Doc James (talk · contribs · email) 19:49, 18 June 2016 (UTC)

Assume it was just a mix up between long and short term effects. Doc James (talk · contribs · email) 19:56, 18 June 2016 (UTC)

"the Japanese" is not a nation

"some nations have redefined obesity; the Japanese have [...] while China [...]" — Preceding unsigned comment added by 50.111.209.141 (talk) 05:29, 21 July 2016 (UTC)

Thanks and fixed. Doc James (talk · contribs · email) 12:44, 5 September 2016 (UTC)

water-losing and deobesification

I heard that some obeses were like this because of too much water-keeping (so they were obese but not really "fat"). Is there deobesefying methods that use water-losing? — Preceding unsigned comment added by 86.69.154.12 (talk) 12:03 pm, 30 May 2016, Monday (5 months, 24 days ago) (UTC−7)

Wishful, dangerous thinking. See sauna suit --Elvey^(t•c) 06:33, 27 September 2016 (UTC)

Idea:Survey

Someone should do a survey - ask lots of folks what they think, in a word, is the most important thing to pay attention to when managing one's weight, and their weight/BMI - and correlate the answers to their weight. I bet we'd find some really interesting data! I.e. how does weight correlate with answers like fat, sugar, carbs, soda, candy, TV, exercise, ... perhaps the answers that correlate most with the healthiest weight would be the ones experts would name, but perhaps not! --Elvey^(t•c) 07:53, 7 October 2016 (UTC)

Elvey What does this comment have to do with the article? Please have a look at WP:TALK. JFW | T@lk 08:39, 7 October 2016 (UTC)

More diet than exercise?

A new review states: "Excessive intake of food, especially palatable and energy-dense carbohydrates and fats, is largely responsible for the growing incidence of obesity worldwide." and has lots more good stuff, IMO, expecially about why people (and other animals) who become obese stay obese. --Elvey^(t•c) 23:09, 30 September 2016 (UTC)

We list diet first under causes. Doc James (talk · contribs · email) 23:22, 30 September 2016 (UTC)

Why so dismissive? To Lose Weight, Eating Less Is Far More Important Than Exercising More. (Preemptive Ack: Can't use this for medical claims, even though the NY Times is of course a WP:reliable source.) I provide a review to back this up, plus lots more good stuff, and it's free content, and that's all you have to say? ([meta analysis] confirms it too.)

I don't think we need to go into all the details of the industry-funded efforts to hide the connection, but we owe it to our readers not to perpetuate ignorance. Speaking of free content, our DOI link (which brings me here) does a really shitty job of indicating that the full article is available for free. Even if, after going there, I click on "Rights and Permissions" and fill out a form, the fact that the content is free is hidden from me. ([https://www.ncbi.nlm.nih.gov/pubmed/26549651 here, FREE, in red, alerts me to the status, and at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825944/ is the whole article and the license. (It's only CC BY-NC 4.0, so we can't quote from it too much.) Are other editors aware of this, seeing it as a problem and trying to rectify it? IIRC, you're a fan of open publishing.--Elvey^(t•c) 01:44, 2 October 2016 (UTC)

I am not sure how me stating that we give diet the greatest weight by mentioning it first is dismissing?

We cannot use large quotes from stuff that is NC as it is not a compatible license.

The WHO as of 2016 states "The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been: an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization."[17]

Doc James (talk · contribs · email) 02:22, 2 October 2016 (UTC)

I'd say deleting two paragraphs I'd written :

Extended content

Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution. Fad diets are popular even though they, by definition, haven't been shown to work; industry-funded misinformation campaigns both obscure accurate information about what does contribute to obesity, and spread false claims about so-called health-foods that are actually obesogenic. A 2016 review reports, "Excessive intake of food, especially palatable and energy-dense carbohydrates and fats, is largely responsible for the growing incidence of obesity worldwide." The main cause of epidemic obesity is excessive food energy intake.[meta analysis] A meta analysis of studies found objectively measured physical activity and fat mass aren't associated. References

with the one-word edit summary "adjusted" is inappropriate dismissive spraying of liquid. Would you be willing to give a shot at being more collaborative, Doc ? --Elvey^(t•c) 07:11, 7 October 2016 (UTC)

The request was to use high quality reviews not popular press. So yes I paraphrased and move the review [18] and removed the popular press. Doc James (talk · contribs · email) 12:52, 7 October 2016 (UTC)

That's not true. You made no such request... But I will request that you stop removing content that complies with WP:MEDINDY/BIOMEDICAL, which, I remind you, states :"What is not biomedical information?": "Statements about patients' beliefs regarding a disease or treatment" "why people choose or reject a particular treatment" "information about disease awareness campaigns", and is very reliably sourced to, e.g. the PBS NewsHour. True; I missed that; kudos. DOI? --Elvey^(t•c) 16:36, 10 October 2016 (UTC)

The cause of obesity needs to be supported by high quality references. A single review in a mid quality journal does not override a statement by WHO. Your text was giving undue weight to a single position. Thus I adjusted. Doc James (talk · contribs · email) 22:18, 10 October 2016 (UTC)

Zeroth: Did you miss the 'True; I missed that; kudos.' part of my message above, Doc? I'm fine with the move and paraphrase/shortening you did. You belittle the review for no reason; your comment feels hostile. )

First: Any chance you can comment on the DOI issue? I've asked 3x about it. Is my concern about it indecipherable to you? You seem to be skimming my replies.--Elvey^(t•c) 08:08, 11 October 2016 (UTC)

Second: "Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution" is not about obesity. It's about patients' beliefs regarding obesity, and information about obesity treatment ad campaigns. Try to think like a layman for a minute. --Elvey^(t•c) 08:23, 11 October 2016 (UTC)

Not sure what you are hoping for with respect to DOI? We do have "PMC=" in the cite templates.

We have a single review from 2011 only about children. A single review does not trump all other sources. That is not hostility.

Most people know that obesity is related to energy expenditure and diet. Doc James (talk · contribs · email) 13:51, 11 October 2016 (UTC)

Most people know the main cause of obesity? Evidence? I don't think they - or you - or I - know with confidence what the main cause is! Most people don't think it's mainly diet and exercise, though I think we both do.--Elvey^(t•c) 21:56, 12 October 2016 (UTC)

[Silence is interpreted as a lack of evidence.]

Not only was this "Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution" supported by poor refs, it is not encyclopedic in tone and I am not even clear what the last bit after the last comma means. Doc James (talk · contribs · email) 13:52, 11 October 2016 (UTC)

(Note:I've corrected the indentation of your edit and added the obvious but missing "an" to my quoted addition to the article that you removed.)

You say the refs are poor. Have you read them? Bloomberg? PBS? What are you on? AGAIN: I request that you stop removing content that complies with WP:MEDINDY/BIOMEDICAL, which, I remind you, states :"What is not biomedical information?": "Statements about patients' beliefs regarding a disease or treatment" "why people choose or reject a particular treatment" "information about disease awareness campaigns", and is very reliably sourced to, e.g. the PBS NewsHour. Please try harder to engage with what I've said rather than talk past me and ignore my questions and arguments. --Elvey^(t•c) 21:56, 12 October 2016 (UTC)

< silence from User:Doc_James>. Hello? Your position is so inconsistent. You praise Jytdog's edit which uses a blog as a citation, and yet remove content and Bloomberg and PBS sources when I use them. And praise Jytdog's edit when he uses my sources that you said were shit. Pisses me off. What's your problem with me? Explain here please.--Elvey^(t•c) 19:22, 26 October 2016 (UTC)

<still silence from User:Doc_James>, though he asks me a question, below.--Elvey^(t•c) 20:37, 27 October 2016 (UTC)

Big money is spent to obscure the causes of obesity. Is mentioning that fact encyclopedic or not, Doc? Why/why not?--Elvey^(t•c) 21:56, 12 October 2016 (UTC)

< silence from DocJames>

• I added this in the Society and Culture section, picking up on the discussion above. The Sept 2016 JAMA paper is really about coronary heart disease not obesity; discussion belongs there and in articles on the sugar industry - it is already discussed for example at Sugar Association. We already had an article on Global Energy Balance Network.

Most of the deleted content was about heart disease, not obesity, so I also added a section to coronary artery disease in these diffs. Jytdog (talk) 00:36, 13 October 2016 (UTC)

Sounds good. Doc James (talk · contribs · email) 03:23, 13 October 2016 (UTC)

Good edits, Jytdog. But the issue is clearly bigger than GEBN, as the disputed content shows-it's just the tip of the iceberg. Agreed? The HuffPo often has RS issues, but the article I cited has excellent sourcing; we could use the sources directly. Example: Studies with a financial conflict of interest, including research by PepsiCo and the American Beverage Association, were five times more likely than independent studies to report no correlation between drinking soda and weight gain and obesity, according to the journal Plos Medicine. [19] --Elvey^(t•c) 19:22, 26 October 2016 (UTC)

Jytdog: Please answer: The issue is clearly bigger than GEBN, as the disputed content shows-it's just the tip of the iceberg. Agreed? Wikipedia is built on collaboration, so it's one of our core principles to interact with one another. Instead of answering, which you are obliged to do, per CIVIL, you edited my comments, violating TPO. --Elvey^(t•::::c) 09:25, 22 November 2016 (UTC)

You want to use this source[20] to say what? Doc James (talk · contribs · email) 20:33, 26 October 2016 (UTC)

I think the answer is obvious, but since you ask, I will answer by saying: I want to use the HuffPo piece and its sources to say: as it says, "There’s a lot of junk science — and corporate sponsorship — out there." - or as I put it, "Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution" For each of the following, can you please state whether you think it is is true?:1)"Fad diets are popular even though they, by definition, haven't been shown to work" 2)"industry-funded misinformation campaigns obscure accurate information about what does contribute to obesity", and 3)"industry-funded misinformation campaigns spread false claims about so-called health-foods that are actually obesogenic." --Elvey^(t•c) 20:37, 27 October 2016 (UTC)

What you added does not belong in the section on "causes" and the HuffPo is not a very good source. Doc James (talk · contribs · email) 22:02, 27 October 2016 (UTC)

You are being rude. And you should know better than providing an I DON'T LIKE IT argument (that, is, you say it does not belong in the section on "causes" - yet it's regarding "Misinformation about the causes" - where would it go if not there?) What part of "The HuffPo often has RS issues, but the article I cited has excellent sourcing; we could use the sources directly." do you not understand? Plus, I said using its sources. Which you ignore, along with several questions above ("Have you read them?", etc). As you keep failing to be civil when doing so, don't engage with me, Doc.--Elvey^(t•c) 09:20, 22 November 2016 (UTC)

• elvey what content with what sourcing are you proposing at this time, and where in the article do you intend it to go? thx Jytdog (talk) 09:39, 22 November 2016 (UTC)

Jytdog: For the third time, please answer: The issue is clearly bigger than GEBN, as the disputed content shows-it's just the tip of the iceberg. Agreed? Wikipedia is built on collaboration, so it's one of our core principles to interact with one another. Instead of answering, which you are obliged to do, per CIVIL, you edited my comments, violating TPO.

Be civil. thx. Answer my question. Your question has been answered. What part of "I want to use the HuffPo piece and its sources to say: as it says, "There’s a lot of junk science — and corporate sponsorship — out there." - or as I put it, "Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution" do you not understand? As you too keep failing to be civil when doing so, don't engage with me. --Elvey^(t•c) 10:10, 22 November 2016 (UTC)

Do you want to add "There’s a lot of junk science — and corporate sponsorship — out there." or "Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution" or both. and where in the article do you want to add that. Jytdog (talk) 10:42, 22 November 2016 (UTC)

ok, so here is what you meant -- an addition to the Causes section:

Misinformation about the causes of obesity abounds, leaving people rightly confused, an ongoing problem with no clear solution.

References

yeah, that is not OK per MEDMOS and MEDRS. Maybe something for "Society and culture". Unclear what "rightly" means here but you copied "rightly confused" from the source. The last bit "an ongoing problem with no clear solution" is COPYVIO from the huffpo source. also as already discussed above the bloomberg source doesn't discuss obesity so has no role in this article; it is about heart disease. the PBS source only has passing mention of obesity and is also almost all about heart disease. The huffpo piece is on point for this article. not sure why you re-introduced the bloomberg and PBS refs. Jytdog (talk) 18:55, 22 November 2016 (UTC)

I see you reverted my addition of that. I don't understand your attempted justification. Do you claim that such content would have to be in a section entitled "Society and culture"? That it can't be in a section called 'Causes'? There's no policy or guideline that supports such a claim, but that seems to be what you're saying, and if that is what you believe, why do you delete it instead of move it?

Jytdog : As I've said before, the sources are only backing statements about patients' beliefs, so they can't be violating MEDRS; they don't fall within its scope. As I said:content that complies with WP:MEDINDY/BIOMEDICAL, which, I remind you, states :"What is not biomedical information?": "Statements about patients' beliefs regarding a disease or treatment" "why people choose or reject a particular treatment" "information about disease awareness campaigns", and is very reliably sourced. I'm not sure what makes you think that an article entitled "How Big Sugar Enlisted Harvard Scientists to Influence How We Eat—in 1965" could possibly have nothing to say about obesity. WP:ABF? Based on the title and first sentence alone, your claim is clearly groundless. Hello, Jytdog? --Elvey^(t•c) 01:45, 23 November 2016 (UTC)

Jytdog: For the fourth time, please answer: The issue is clearly bigger than GEBN, as the disputed content shows-it's just the tip of the iceberg. Agreed? Wikipedia is built on collaboration, so it's one of our core principles to interact with one another.--Elvey^(t•c) 01:45, 23 November 2016 (UTC)

Both doc james and i have explained what is wrong with your edit. Jytdog (talk) 02:31, 23 November 2016 (UTC)

A cause: SSB, mainly soft drinks and fruit juices

Review article, quote: <ref name="ObesityReview">{{cite journal|last1=Du|first1=H|last2=Feskens|first2=E|title=Dietary determinants of obesity.|journal=Acta cardiologica|date=August 2010|volume=65|issue=4|pages=377-86|pmid=20821929|url=https://dx.doi.org/10.2143/AC.65.4.2053895|quote=Increased consumption of SSB, mainly soft drinks and fruit juices, is considered as a main driving force for weight gain and obesity, especially among children and adolescents.}}</ref>. Currently there are no medical claims regarding SSB causing obesity in the article. (Just mention of The WHO - and that was recently added) I propose we add some, using this review article. --Elvey^(t•c) 01:45, 23 November 2016 (UTC)

The article says "the primary sources of these extra carbohydrates are sweetened beverages, which now account for almost 25 percent of daily food energy in young adults in America" Jytdog (talk) 02:37, 23 November 2016 (UTC)

Good.

Misleading or biased wording?

Seems to me that there is a little bit of unintentionally misleading (or poorly informed) language at the end of the "management" section. It is well-known that bariatric surgery is the most successful means of management because it has multiple effects - some of which are malabsorptive, some of which are from an alteration in the gut-brain axis, and some of which are simply due to reducing the size of the stomach. It seems that the person who wrote this paragraph is implying that the only reason bariatric surgery works is due to forcing the patient to physiologically eat less (and then goes on to discuss the development of space-occupying devices). While this is part of the equation, the primary reason that bariatric surgery is successful in the longterm is due to the gut-brain axis alterations. The current phrasing seems to imply that only forcing a person to eat less will "cure" them of obesity, when there is a well-established understanding that the surgical procedures themselves change weight set points and hormonal interactions, even immediately post-surgery before any weight has been lost. 160.130.198.57 (talk) 18:16, 5 December 2016 (UTC)

WP is based on what we call "reliable sources", and for health content, the criteria for reliable sources are described in WP:MEDRS. Please provide one or more MEDRS source that supports your claims, and we will certainly consider updating the article based on it/them. Thanks! Jytdog (talk) 21:21, 5 December 2016 (UTC)

Gut Bacteria

You should include this possible cause. see: https://www.scientificamerican.com/article/how-gut-bacteria-help-make-us-fat-and-thin/ Arydberg (talk) 15:27, 8 December 2016 (UTC)

We already have Obesity#Gut_bacteria and that is not a MEDRS source. Jytdog (talk) 15:28, 8 December 2016 (UTC)

Evaluation of Obesity

The sources look good for the most part. The section: "Gut bacteria" could have more detail and information along with more sources because only 1 source is cited. Perhaps the "apple" versus "pair" body shape could be talked about and related to how men and women tend to carry fat. There is a large medical table that does not have a legend underneath or above it Ugok02 (talk) 19:56, 16 January 2017 (UTC) 1/16/2017

NEJM

Review doi:10.1056/NEJMra1514009 JFW | T@lk 17:52, 19 January 2017 (UTC)

Neurological consequences

doi:10.1016/S1474-4422(17)30084-4 Lancet Neurol. JFW | T@lk 11:29, 11 May 2017 (UTC)

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A very interesting reference

Maybe this reference can be used in the article if found useful. Thank you. -- Abhijeet Safai (talk) 11:18, 22 June 2017 (UTC)

An editorial. And it is generally recognized as a disease already. Doc James (talk · contribs · email) 17:24, 22 June 2017 (UTC)

Semi-protected edit request on 7 July 2017

I suggest to introduce this new reference on the Genetics section, first sentence. DOI: 10.1093/bmb/ldx022 185.102.211.19 (talk) 14:05, 7 July 2017 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. jd22292 (Jalen D. Folf) (talk) 14:48, 7 July 2017 (UTC)

Done: Added "The contribution of genetics and environment to obesity" as a reference for the first sentence of the genetics section. --tronvillain (talk) 16:19, 7 July 2017 (UTC)

Social change

Could someone tell me the specific meaning about "social change" in the info box? I need to know it so I can translate it into Chinese, thanks! =) --It's gonna be awesome!✎Talk♬ 05:24, 27 July 2017 (UTC)

The source actually says "societal" not social. I changed that in the article.

The WHO means changing society to make it easier to exercise and eat healthily. "by making the choice of healthier foods and regular physical activity the easiest choice (the choice that is the most accessible, available and affordable), and therefore preventing overweight and obesity." --ChiveFungi (talk) 11:51, 27 July 2017 (UTC)

Thank you--It's gonna be awesome!✎Talk♬ 16:26, 27 July 2017 (UTC)

Severely obese

 I seem to recall that a BMI of over 30 is categorised as being "severely obese". If this is correct, this could be added to the article. Vorbee (talk) 08:25, 18 August 2017 (UTC)

Article already discusses this? Doc James (talk · contribs · email) 06:00, 20 August 2017 (UTC)

 A BMI of 30-34.9 is the range for class I obesity, 35-39.9 is class II obesity, and a BMI of 40 and above is 'severe obesity' (class III obesity).  Hope this helps.  — Preceding unsigned comment added by Neuron Doc (talk • contribs) 20:26, 21 August 2017 (UTC) 

Semi-protected edit request on 4 November 2017

Obesity is when you are too far underweight e.g. Being 40kg at 20 years old 194.143.171.25 (talk) 10:15, 4 November 2017 (UTC)

Not done: please provide reliable sources that support the change you want to be made.  — Ammarpad (talk) 12:43, 4 November 2017 (UTC)

Needs work

The refs need formating. Some of this content is missing refs / is not really supported by the ref in question.

Doc James (talk · contribs · email) 23:18, 19 November 2017 (UTC)

Addictive tendencies

The term food addiction is widely used when acknowledging the increase in the global rates of obesity. Some researchers suggest that certain ingredients can commandeer control of the brain. It has been suggested that people who meet the YFAS criteria for food addiction have personalities which cannot psychologically handle themselves when presented with an opportunity to consume food. Appetizing food triggers the brain’s reward system and this causes the numbers of dopamine receptor DD2R to decrease, this means that to derive the same reward one must consume more as greater incentive is needed (Young,2016)

Dopaminergic circuits and addictive behaviour towards food

The activation of dopaminergic circuits that are associated with reliance on a substance are also associated with overeating behaviors. There was a higher YFAS qualification rate among those with bulimia nervosa than among those with BED. As well as that 30% of those who had suffered from bulimia nervosa in the past also met the YFAS food addiction criteria(Young,2016) Those individuals who met the criteria tended to have a higher intake of macronutrients like fats and protein, yet there seemed to be no pattern among specific foods in this study. In other studies it was suggested that starchy foods, takeaway and cola had addictive properties, however this has not been conclusively proven (Young,2016)It has been suggested that females over 35 years of age may be predisposed to food addiction according to the YFAS. Individuals with disordered eating also had higher rates of food addiction according to the YFAS criteria.

Binge Eating Disorder and obesity

Binge eating disorder is the most common form of eating disorder found in society today. It is associated with superfluous intake of food over a short period of time, it is also associated with obesity. Studies have shown that levels of impulsivity in BED is less than in other addictions. Behavioural inflexibility (an unwillingness to adapt to change) is more seriously debilitated in BED (Voon,2015)(Voon, 2015). Higher scores on the YFAS were achieved by those who ate larger amounts of energy dense, nutrient poor foods as well as those with high dietary fat intake. Those who had a higher intake of wholegrains scored lower on the YFAS. Food addiction is not yet clinically recognized, but it has been suggested to be known as an ‘eating addiction’ as it may be more similar to a behavioral addiction.

BMI of 25 -30

This article says that a BMI of 25-30 is considered overweight, but I thought this was 24-30. Vorbee (talk) 08:22, 18 August 2017 (UTC)

So? --Abhijeet Safai (talk) 13:46, 15 March 2018 (UTC)

Semi-protected edit request on 18 September 2018

"Change

Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease).[2][49] Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Increased fat also creates a proinflammatory state,[50][51] and a prothromboticstate.[49][52]

to include non-alcoholic steatohepatitis in the following

Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease including its more severe form non-alcoholic steatohepatitis).[2][49] Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Increased fat also creates a proinflammatory state,[50][51] and a prothromboticstate.[49][52]" PascalineClerc (talk) 18:08, 18 September 2018 (UTC)

 Not done Why? and the references weren't coped over to the request properly. – BrandonXLF ^(t@lk) 22:58, 2 October 2018 (UTC)

Semi-protected edit request on 18 September 2018

"Please change Effects on health Excessive body weight is associated with various diseases and conditions, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, osteoarthritis,[2] and asthma.[2][30] As a result, obesity has been found to reduce life expectancy.[2]

to

Effects on health Excessive body weight is associated with various diseases and conditions, particularly cardiovascular diseases, diabetes mellitus type 2, Non-alcoholic Fatty liver disease (NAFLD) and its more severe form Non-alcoholic steatohepatitis (NASH), obstructive sleep apnea, certain types of cancer, osteoarthritis,[2] and asthma.[2][30] As a result, obesity has been found to reduce life expectancy.[2]" PascalineClerc (talk) 18:04, 18 September 2018 (UTC)

 Not done: @PascalineClerc: So for your change you wanted to change "diabetes mellitus type 2, obstructive sleep apnea," to "diabetes mellitus type 2, Non-alcoholic Fatty liver disease (NAFLD) and its more severe form Non-alcoholic steatohepatitis (NASH), obstructive sleep apnea," while leaving everything else the same? If I'm understanding your request correctly. Also to include "Non-alcoholic Fatty liver disease (NAFLD) and its more severe form Non-alcoholic steatohepatitis (NASH)" as part of the edit request you should provide reliable sources that support the change you want to be made. ♪♫Alucard 16♫♪ 10:38, 6 October 2018 (UTC)

Semi-protected edit request on 18 September 2018

"Please change In 1997 the WHO formally recognized obesity as a global epidemic.[94] As of 2008 the WHO estimates that at least 500 million adults (greater than 10%) are obese, with higher rates among women than men.[186] The percentage of adults affected in the United States as of 2015–2016 is about 39.6% overall (37.9% of males and 41.1% of females).[187]

The rate of obesity also increases with age at least up to 50 or 60 years old[188]and severe obesity in the United States, Australia, and Canada is increasing faster than the overall rate of obesity.[29][189][190]

To include the latest OECD report of 2017

In 1997 the WHO formally recognized obesity as a global epidemic.[94] As of 2008 the WHO estimates that at least 500 million adults (greater than 10%) are obese, with higher rates among women than men.[186] The percentage of adults affected in the United States as of 2015–2016 is about 39.6% overall (37.9% of males and 41.1% of females).[187] The OECD projects an increase in obesity rates until at least 2030, especially in the United States, Mexico and England with rates respectively reaching 47%, 39% and 35%.

The rate of obesity also increases with age at least up to 50 or 60 years old[188]and severe obesity in the United States, Australia, and Canada is increasing faster than the overall rate of obesity.[29][189][190] " PascalineClerc (talk) 18:06, 18 September 2018 (UTC)

 Done @PascalineClerc: I went ahead and made the change and slightly modified the wording here. When you make a request like this I suggest using the following format: Please add the following sentence The OECD has projected an an increase in obesity rates until at least 2030, especially in the United States, Mexico and England with rates reaching 47%, 39% and 35% respectively. after this sentence The rate of obesity also increases with age at least up to 50 or 60 years old and severe obesity in the United States, Australia, and Canada is increasing faster than the overall rate of obesity. This will make future requests a bit clearer to understand. ♪♫Alucard 16♫♪ 11:00, 6 October 2018 (UTC)

References

Semi-protected edit request on 13 November 2018

I would like to update a map at Reference #187. This map is very helpful for readers but the data is a bit old. In addition, many countries' data is missing from the maps. I have been able to create a new map for the year of 2016 with better mapping format.

Image I uploaded to wikipedia is

Wiki upload ready

Zou32 (talk) 17:49, 13 November 2018 (UTC)

 Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. — LeoFrank  ^Talk 12:45, 25 November 2018 (UTC)

edit request: grammar

Photo caption currently reads

>Services must accommodate obese people with specialist equipment such as much wider chairs.

The word "specialist" primarily refers to a person "who concentrates primarily on a particular subject or activity", or is "highly skilled in a specific and restricted field".

https://en.oxforddictionaries.com/definition/specialist

https://dictionary.cambridge.org/dictionary/english/specialist

Better phrasing would be

>Services must accommodate obese people with specialized equipment such as much wider chairs.

https://en.oxforddictionaries.com/definition/specialized

https://dictionary.cambridge.org/pt/dicionario/ingles/specialized

That is, equipment "designed for a particular purpose".

- 189.122.238.134 (talk) 00:30, 21 December 2018 (UTC)

Done. Also removed "must" because depends on jurisdiction. −Woodstone (talk) 06:40, 21 December 2018 (UTC)

Mortality

The graphs showing relative mortality by group of BMI's is quite misleading because the vertical axis does not start at zero. The relative risks are much exaggerated. Could the maker rescale them? If not, the section would be better off without them. −Woodstone (talk) 17:10, 7 February 2019 (UTC)

Obesity Statistics

Obesity has affected about 93.3 million of adults in the United States in the years of 2015-2016, and since then the numbers have continued to rise. — Preceding unsigned comment added by 24.151.242.172 (talk) 03:43, 10 March 2019 (UTC)

Definition of obesity

I recently heard (cannot disclose the source) that the definition of obesity is different for Indian population. They were suggesting that the cutoff is 25. I was not aware of this, nor I support it. I would like to know if it is true and if so, can it be changed here. Thanks. -- Abhijeet Safai (talk) 07:30, 27 March 2019 (UTC)

Excess food & inadequate physical activity are always the reason (CICO)

The article states repeatedly that excessive food & inadequate physical activity are the “primary” cause of obesity. It should be made clear that those factors are always the reason, for every person everywhere.

The basis for this is here: https://en.m.wikipedia.org/wiki/First_law_of_thermodynamics

Asserting that obesity can be caused by “genetics” is misleading, since, due to the laws of physics, obesity occurs only when energy consumed exceeds energy expended. P linkola (talk) 03:28, 19 May 2019 (UTC)

@P linkola: Please see WP:OR. Also, humans are not an isolated system. EvergreenFir (talk) 04:48, 19 May 2019 (UTC)

isolated system? surely you're joking. are people in the south fatter because they sit in the sun? no. nobody is taking excess latent heat from their environment as a substitute for calories. what we are learning now however is that your genetics and gut bacteria can influence how much simple carbs are available so glycemic response varies among people with the same amount of food. unfortunately, (for this point, it is a good thing you can control this!) you can correct this and when restricting calories in hospital setting it is almost universal that folks lose weight. so the thermodynamic perspective stands. it is nuanced by the fact that some folks get extra sugar/less nutrients in their blood and leads to fat production. — Preceding unsigned comment added by 24.255.48.61 (talk) 20:39, 8 October 2019 (UTC)

I'm sorry did i say almost? 100% clinical evidence shows calorie restriction in hospital setting leads to weight-loss. i'd like to read the study depicting the hospitalized perpetually fat man. — Preceding unsigned comment added by 24.255.48.61 (talk) 21:24, 8 October 2019 (UTC)

"Cause" has various levels. In some genetic conditions the underlying cause is the generic condition and the excess food is just part of the mechanism that results in obesity. Doc James (talk · contribs · email) 09:53, 13 October 2019 (UTC)

Yes restricting food and expending more energy will work. However, in saying that you haven't taken into consideration dysfunctional hormones such as Leptin, ghrelin and cortisol etc. In the past 10 years endocrinologists have discovered a lot more than they knew regarding the affects the above can have when they are dysfunctional. Satiety doesn't kick in the same way. Which is why they're now studying how to alter messages sent to the brain. Hunger increases with physical activity which in turn can make long term dieting implausible for those with said dysfunctions. There are numerous and diverse underlying reasons causing weight gain even socio-economic factors have been noted as having vital input into the lives of those living with obesity.

I had a conversation with a highly regarded endocrinologist recently where he stressed how they have finally realised in this battle they have to treat the problem first before the symptoms can be worked upon. He also noted, they realise going forward it won't be a one size fits all as they've discovered with chemotherapy/immunotherapy etc.

Also, take into account the stigma faced on a daily basis by those with weight issues. This stigma and bias only adds to the problems at hand including mental health, self worth and the challenge of leaving the safety of a home environment to be faced with a world that does not find them acceptable and shows it in no uncertain terms.

Some with obesity may show a blasé attitude but is that purely a defensive mechanism? Who knows what goes on in anyone's head? I'm sure if it were as "easy and simple" as eating less and moving more we wouldn't have the worldwide issues we presently have.

Who would choose stigma, bias and the accompanying health issues?

Significantly more research is needed, so too listening to the voices of those living with the condition. These voices have long been silenced due to shame and embarrassment and hearing constantly "eat less, move more". Even health care workers discriminate, in various questionnaires the majority admitted to assuming patients with weight issues were less intelligent than their peers. How does one even begin to fight that form of bias? Bernadette04 (talk) 09:12, 16 October 2019 (UTC)

Mortality

Relative risk of death over 10 years for white men (left) and women (right) who have never smoked in the United States by BMI.

The graphs showing relative mortality by group of BMI's is quite misleading because the vertical axis does not start at zero. The relative risks are much exaggerated. Could the maker rescale them? If not, the section would be better off without them. −Woodstone (talk) 17:10, 7 February 2019 (UTC)

My remark above was just archived by a bot. However no one has improved the graph and I removed it. It got promptly restored in its original faulty form. As long as it keeps this misleading form I intend to remove it again.−Woodstone (talk) 15:13, 9 October 2019 (UTC)

See it now. New comments generally go at the bottom.

Why does it need to start at zero? The important number is "1" as this is relative risk. The rest are compared to that. Doc James (talk · contribs · email) 09:47, 13 October 2019 (UTC)

References

That makes it perhaps even more misleading. If 1 is the neutral number, then the bars should start form there and show negative and positive deviations. −Woodstone (talk) 11:44, 13 October 2019 (UTC)

And it does show number greater than and less than 1. Saying it must start at 0 is the same as saying it should go to infinity. Once again this is relative risk. Doc James (talk · contribs · email) 16:50, 23 October 2019 (UTC)

If you want to propose a different version feel free to make it and we can than discuss. Doc James (talk · contribs · email) 17:01, 23 October 2019 (UTC)

Not really seeing the issue. Flyer22 Reborn (talk) 05:28, 24 October 2019 (UTC)

As read from the scale on the first graph, the values for "normal" and "obese" categories are 1.0 and 1.4, so the mortality becomes 40% higher. The corresponding bars only have lengths 0.4 and 0.8 units, so the visual impression given is that the risk is 100% higher. That is considered misleading in representing data in graphs. Therefore the article would be better off without these graphs. −Woodstone (talk)

I agree this is misleading. If we use a visual presentation of data we should avoid basic flaws like this. Research shows that even medical professionals are extremely prone to be mislead by visual tricks like this, let alone the general reader. Johnbod (talk) 15:14, 24 October 2019 (UTC)

Long silence again from User:Doc James]. Do you now see why that graphic is misleading? −Woodstone (talk) 16:45, 28 October 2019 (UTC)

Agree with Woodstone, the current graph is misleading and considered bad statistical practice, but this graph is extremely informative for the reader, so we should not delete it, but replace it. I agree with making a graph centered at 1 with positive/negative bars (or even better, a violin plot ). Is the source data available somewhere? I may give it a try. --Signimu (talk) 18:46, 28 October 2019 (UTC)

Ok I'll give a try later today using Wikichart, it's a good opportunity for me to discover this tool --Signimu (talk) 18:50, 28 October 2019 (UTC)

Sure we can make the graph start at "1" if that solves the concerns. We could also switch from a bar to a line. Would need to look to see if I still have the spreadsheet somewhere. Doc James (talk · contribs · email) 01:00, 29 October 2019 (UTC)

Do not have it anymore... If someone makes it in a google sheet we can than share. Doc James (talk · contribs · email) 02:14, 29 October 2019 (UTC)

Thank you Doc James for taking the time to look for the data Never mind, I will look into the source ref, and at worse it's possible to reverse engineer the graph directly using something like WebPlotDigitizer --Signimu (talk) 02:32, 29 October 2019 (UTC)

I made it last time by reverse engineering from the graph. Doc James (talk · contribs · email) 04:33, 29 October 2019 (UTC)

Haha ok, but I think I found the data in the source ref, I have remade a graph in Vegalite [21]. However, I can't find how to make it work on Wikipedia, it seems only v2 is understood, and then it's useless to use an older Vega for this purpose (as facets and such are not well supported by older versions), so I guess I'll simply remake it in a simple Wikichart... --Signimu (talk) 05:38, 29 October 2019 (UTC)

Ok here is my attempt with a Wikichart: User:Signimu/Template:ObesityBMI. Not too bad I think And a lot simpler and easier to update --Signimu (talk) 06:06, 29 October 2019 (UTC)

Thanks for the effort. It conveys the information more accurately. However, since BMI's are typically reported in blocks, a bar chart is more appropriate. The interpolations in a line are speculative. −Woodstone (talk) 08:27, 29 October 2019 (UTC)

No pb, it can easily be done, I'll do it. However note that the source itself mention a J shape which is apparently a common data pattern in this domain, hence why i chose to interpolate. I would prefer dots, but strangely wikicharts don't offer this possibility as far as i know. --Signimu (talk) 10:30, 29 October 2019 (UTC)

Here's the final version, if it looks good for you guys, feel free to add it in the article --Signimu (talk) 11:03, 29 October 2019 (UTC)

References

Ah! Someone suggested a great workaround to have a dot graph[22], so here it is. I'll leave it up to you guys to decide which one to choose --Signimu (talk) 20:01, 29 October 2019 (UTC)

One drawback of this version with dots is that at first sight the curve seems to continue into the legend. — Preceding unsigned comment added by Woodstone (talk • contribs)

Ah yes good catch, it's unfortunate we can't customize how the legend is displayed :-/ Then I guess the bar plot is better? Also it makes sense since we are working with intervals, maybe a mention of the J-shape in the description can be added so no info is lost? --Signimu (talk) 10:40, 30 October 2019 (UTC)

I have copied the improved bar graph into the article. Altough perhaps fitting for the subject, the bar colours turn out to be black and purple, which is rather ugly in my eye. In preview they were much nicer. Anyone agrees and knows how to change them?−Woodstone (talk) 10:07, 2 November 2019 (UTC)

User:Signimu the legend should say sex not gender. This is biology... But when I make the change it breaks. Doc James (talk · contribs · email) 10:29, 2 November 2019 (UTC)

Doc James Ok I fixed the legend in the figures above, is it ok like this? --Signimu (talk) 10:35, 2 November 2019 (UTC)

Thanks Doc James (talk · contribs · email) 10:44, 2 November 2019 (UTC)

I skimmed through the cited article, but cannot find how they correct for age. It seems to me that there is a clear correlation to age both for BMI and mortality. May that invalidate the results? More people with high BMI will be older and therefore have higher mortality. −Woodstone (talk) 11:31, 2 November 2019 (UTC)

That's an interesting point, as indeed older people may have a different metabolism for food intake[23]. It seems they have accounted for it here if we read the Supplementary Material Table 3, from which we took the data:

"Hazard ratio calculated with age as the underlying time scale, stratified by study and adjusted for alcohol (g/day), education, marital status and overall physical activity. *No cancer or heart disease at baseline. **Additionally adjusted for smoking status and time since quitting smoking. ASR/100,000- age-standardized rate, standardized using the US general population."

In any case, even if the age was a confound, I don't think we should exclude references because of that, as all studies have confounds anyway, and our role is not to review the methodology. IMO in such a case I would argue for precising potential confounds in the entry, but it could also be perceived as WP:OR, as it would be speculation unless another reliable source (or at least a commentary to the editor) noted the confound. --Signimu (talk) 02:58, 3 November 2019 (UTC)

Map of sugary beverages taxes

This news article has a map of countries implementing sugary beverages taxes[24]. This may be reproduce in Soft drinks and then to link here (since the article clearly mentions this is done to fight obesity)? --Signimu (talk) 21:24, 23 November 2019 (UTC)

Nature review on dietary supplements

Just stumbled on this great 2019 review from a Nature journal[25], it's reviewing a lot of weight-loss dietary supplements, both the clinical research and safety regulations and drugs interactions (eg, caffein, pyruvate, etc there are so many!). Surely this ref may be exploitable here! --Signimu (talk) 21:15, 25 November 2019 (UTC)

I don't understand your werido slider graph

See or edit source data.

Percentage of males either overweight or obese by year.

one line of description? why does china look like most obese if you select entire range? what does it even mean? why does the information change based on how big the range is? i've never seen a graph show either bmi or percetnage based on what you select without corresponding label change. a couple sentences of explanation or you know, a graph that functions like normal graphs would be nice kthxb. — Preceding unsigned comment added by 24.255.48.61 (talk) 20:31, 8 October 2019 (UTC)

When you select two spots it gives you the growth or percentage change. Doc James (talk · contribs · email) 09:51, 13 October 2019 (UTC)

But when you pull the bar left you get a range of yellows and reds, and China is much the reddest. What does this mean? It all needs to be better explained. Johnbod (talk) 15:19, 24 October 2019 (UTC)

@Johnbod: It means China had the greatest increase in obesity over that period.03:24, 25 January 2020 (UTC)

That's an awesome graph! I can try to make a legend --Signimu (talk) 03:02, 29 October 2019 (UTC)

To run "100m-qu" in the water.

Not a weight. However - no fusst .. Do not worry. Be happy. 176.59.214.34 (talk) 06:40, 4 July 2020 (UTC)

Semi-protected edit request on 30 July 2020

Change from: Obesity is more common in women than men.

Change to: Obesity is more common in women than men. In the United States, women are more likely to have obesity than men, 41.1 percent versus 37.9 percent. Fishmanconsult (talk) 19:46, 30 July 2020 (UTC)

References

 Not done Wikipedia tries to maintain a global view and avoid systemic bias. Statistics for one country do not belong in the overview of the subject. BiologicalMe (talk) 13:46, 31 July 2020 (UTC)

Semi-protected edit request on 18 August 2020

My request is about including references about obesity in migratory birds, which become extremly fat before migration with no impact in their health. Frias-Soler (talk) 12:41, 18 August 2020 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. ◢  Ganbaruby!  (Say hi!) 12:56, 18 August 2020 (UTC)

Gut Bacteria

I added information about how scientists used the mouse model to discover the differences in the gut microbiome between obese and lean individuals. I also included information about how the "western diet" impacts the gut microbial community. JewelSciComm (talk) 00:08, 20 October 2020 (UTC)

References

I removed that because it was based on a mouse study, which we generally do not use per WP:MEDRS. - MrOllie (talk) 00:11, 20 October 2020 (UTC)

Adding Semaglutide to Medical Interventions

I am starting a talk section to ask a question to more experienced medicine editors: should the "Medical Interventions" section of the Obesity article have some information about Semaglutide? There is one very high-quality primary source for this, a recent RCT that showed substantial weight loss. There is a secondary source that states that Semaglutide causes weight loss. However, that secondary article is focused on diabetes treatment, not on regular obesity. There are several secondary sources that review the role of GLP-1 agonists in general on obesity, but they are not focused on Semaglutide specifically.

My tentative conclusion is that Semaglutide should not be added to the obesity page until a secondary source emerges that specifically talks about Semaglutide in the context of obesity treatment. Does anybody disagree or have strong opinions about this? Gardenofaleph (talk) 19:06, 1 March 2021 (UTC)

Treatment research

I removed the following:

Due to its cost and risks, researchers are searching for other effective yet less invasive treatments including devices that occupy space in the stomach. For adults who have not responded to behavioral treatments with or without medication, the US guidelines on obesity recommend informing them about bariatric surgery.

An eventual treatment of obesity by the therapeutic targeting of human brown fat is an active research field reviewed by Samuelson and Vidal-Puig in 2020.

Treatments that are not in widespread use or are still undergoing study should not be in a section called "Management". There is currently not a section called "Research directions" (as per WP:MEDMOS) but the above two interventions should only be included in the context of a broader discussion about current major research trends in obesity research. JFW | T@lk 19:32, 14 April 2021 (UTC)

References

Since the page Management of obesity does have a research section, I have moved the paragraph on brown fat targetting to that entry/section. Thank you for your advice. Neuralia Neuralia (talk) 23:22, 14 April 2021 (UTC)

Effects on health

Mortality

The current text states "In the United States, obesity is estimated to cause 111,909 to 365,000 deaths per year," and cites two sources: Haslam and James (2005) and Allison et al. (1999). Neither of these sources contain the 111,909 or 365,000 statistics, though Haslam and James (2005) does cite the erratum originating the 365,000 estimate. I attempted to include Flegal et al. (2005), which originated the 111,909 estimate. This edit was reverted for being an out of date reference (WP:MEDDATE), despite it being contemporary with the current references, and without it the 111,909 estimate remains uncited. If these two estimates are going to be used the citations should include Flegal et al. (2005) and Mokdad et al. (2005), which originated the 365,000 estimate. Reviews are helpful and encouraged, so retaining Haslam and James (2005) is appropriate, but, as this example demonstrates, relying on them for specific claims without also referencing the original source can be problematic. Narthecium (talk) 21:43, 16 November 2021 (UTC)

References

Semi-protected edit request on 20 November 2021

In the section Causes please remove the sentence "The carbohydrate-insulin model of obesity posits that consumption of processed... adipose tissue, exacerbate hunger, and lower energy expenditure". Reason being as stated in the Low-carbohydrate diet article the hypothesis/model was fraudulent and had been falsified by experiment.

Pls read this article for more info https://www.vox.com/2018/2/21/17036004/do-low-carb-diets-work

Hence kindly consider removing that sentence.

Thank you! 2409:4042:4E86:A9D1:547A:30F2:C3DB:EAE (talk) 18:24, 21 November 2021 (UTC)

 Done. Heartmusic678 (talk) 12:14, 9 December 2021 (UTC)

Problematic image

The data visualization currently labeled "Percentage of males either overweight or obese by year" is problematic, for a few reasons. First, I don't actually see this data present in the source. Can someone verify this? Is this actually real data? Second, the colormap does not extend to all the values in the visualization (China increases 372% over the full time period, but the colormap does not extend much beyond 100%). Third, this is *not* showing the percentage of males either overweight or obese by year. You cannot have 372% of males be overweight or obese. This instead appears to be a percentage change. ParticipantObserver (talk) 11:28, 2 February 2022 (UTC)

list criteria for obesity based on world health organization

list criteria for obesity based on world health organization 2409:4043:4D0E:E88B:C266:E983:63C3:4DA2 (talk) 16:32, 24 March 2022 (UTC)

The article currently does that, in the "Classification" section. ParticipantObserver (talk) 18:15, 24 March 2022 (UTC)

Semi-protected edit request on 17 December 2022

I want to update the CHILDHOOD OBESITY section KashiMastisk (talk) 02:22, 17 December 2022 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. RealAspects (talk) 02:36, 17 December 2022 (UTC)