Talk:Obesity/GA1

GA Review

Kind of a lot of points here, so this is just a partial review. Don't worry, most of them are minor. Over all a very well-done article! Let me know when you've gotten through these and I'll finish the review.

• Done I think "waist hip ratio" and "waist-hip ratio" should be "waist–hip ratio" (with an n dash). At any rate, they should be consistent.
• Done The absolute waist circumference (>102 cm in men and >88 cm in women) or waist-hip ratio (>0.9 for men and >0.85 for women) are both used as measures of central obesity. define central obesity.

• Done Awkward sentence: BMI is an accurate reflection of body fat percentage in the majority of the adult population, but is less accurate in situations that affect body composition such as in body builders and pregnancy. - The "situations such as in body builders" in particular.

• Done Splitting the sentences didn't address the problem; I was more concerned about the "situations that affect body composition such as in body builders and pregnancy". "Situations...in body builders" doesn't make sense. Maybe 'people such as body builders and pregnant women in whom body composition is affected' or something.

• Done with the results being accurate to +/- 4 %. - this is confusing. 'With' is an awkward linker, and the use of +/- is unclear. Maybe write it out in words.
• Choose British or American English and use consistently throughout ('recognizes', 'metre').The rest of the world uses bits and pieces of both American and British English

Health effects section

• Done Be careful of sweeping statements like "Obesity is one of the leading preventable causes of death." This would not be true worldwide, I doubt it's a significant cause in the third world. In fact, the source is US-specific. It would be good to find a source with worldwide applicability and give an analysis of that. Failing that, at least make sure the statements in the article don't overstep what the sources actually say.
  • Can you quote the sentence in that article that backs up this statement? I can't find it. Once again, it is of utmost importance that the article is faithful to the references, and that we never say a reference says something it doesn't say. If this is an instance of a source being misrepresented, other sourced statements will have to be checked. delldot ∇. 18:17, 29 September 2008 (UTC)
    • Here is a second source that the first source quotes. The first sources says diet and inactivity in it heading. Under this section it refers to overweight. Then when you look up the article they use to get their reference to overweight this article refers to obesity. Therefore we can quote both.--Doc James (talk) 18:33, 30 September 2008 (UTC)
      • I still see only one source cited in the article, the one in which I see no mention of the cited fact (and which is US-specific). What's the second source?sorry, I was looking at an older version of the page I think you should use only the one that endorses the exact fact you're citing. How about instead saying "a leading cause of death worldwide" and cite the last article you posted to my talk page? delldot ∇. 19:38, 30 September 2008 (UTC)
        • DoneI don't see that fact in the second source either (I could be missing it, I just skimmed it). I do see "Obesity is a major cause of mortality in the United States", but that's not the same thing as what our article says. I see nothing about the 'Western world' in either article; they're both US-specific. Doc James, do you understand my concern about focusing too heavily on the US? Do you understand my concern about accurately representing what sources say? delldot ∇. 19:52, 30 September 2008 (UTC)
• Done This reference needs to be fleshed out with author, date, title, etc.: Emedicine
  • 'Done I'm talking about current ref 22, used as a reference for ...20 years for men and 5 years for women. This has not been done. delldot ∇. 18:17, 29 September 2008 (UTC)
• Done Awkward sentence: "Increases in body fat alter the body's response to insulin leading to insulin resistance, it creates a proinflammatory state, and it increases the risk of thrombosis." Surely these are big enough topics to deserve a sentence each at least? Be careful about switching singular to plural from the subject, I've caught a few of these but it might be worth a read-through to catch more.
• Done hyperuricemia / gout slashes discouraged by MOS. See WP:SLASH.
• Done In the table, cancer is not a system. Psychological is also kind of pushing it, but I'm not sure what to do about these two. Maybe they should be taken out of the table and discussed in prose.

• DoneDoes the table have any organization? Why is the order of the systems the way it is? For example, I would expect to see reproductive and genitourinary close together, but they're second and last respectively. Why not a top-down organization (head, chest, abdomen...) or a most important to least important (brain, heart, lungs... skin, musculoskeletal) approach?

• Done reduces daily energy expenditure by about 300–400 kcal/d -- if d stands for day, it's redundant; the 'daily' covers that.

Fat acceptance and the obesity controversy

• Done This should probably be two separate sections, or at least two separate paragraphs in this section; there's a big difference between the arguments that fat people should be accepted and treated fairly and challenging the accepted relationship between diet & exercise, obesity, and health risks.

Genetics

• Done This sentence is unclear: The 16% of adults in the study who were homozygous for this allele weighed about 3 kilograms more than those who had not inhereted this trait and subsequently had a 1.6 fold greater rate of obesity. Which group subsequently had a 1.6 fold greater rate of obesity? If it's the former, how about The 16% of adults in the study... weighed about 3 kilograms more than those who had not inhereted this trait, and the former group subsequently had a 1.6 fold greater rate of obesity.
• Done What does above-average physical exercise mean? More than usual? More intense than usual? above average amounts would cover it if the former.

Management

• Done Very low calorie diets: might be good to say how many calories a person on these diets eats.

References

• Done Some refs need more info. e.g. University of Szeged. "CGFA".

I'm seeing a lot of typos and some poor organization (e.g. a lot of apostrophe abuse and neglect, and some spelling errors). If you don't mind, it would save me some time if you or someone who owes you a favor could go through and give it a copy edit before I pick back up for the next part of the review. Otherwise I'll correct it myself or bring it here. The referencing looks good, and the content is great, good job with a no doubt very difficult article! delldot ∇. 22:52, 28 September 2008 (UTC)

Very quick response! Permit me to jump in even though you're not done. Good job on some of these, on others my points have not been addressed; I've marked these. delldot ∇. 18:17, 29 September 2008 (UTC)

More

Whoops, I lied; a couple more comments for now:

• Done WHO is another ref that needs to be fleshed out with title, author, date, etc.

• the study was done over two years so the data collected is from both Under Canada in Epidemiology, "1978/1979" should be clarified. 1978 and 1979? 1978 or 1979? Same with 1967/1968 under History.
• Done Avoid statements that date quickly, like "over the last 75 years." and "recently". These are examples only, the whole article should be checked.

• Done Here is another sentence that I'm not sure is accurately reflecting what the source says: "One sixth of the rise in obesity in North Americans can be attributed to falling rates of smoking," where the source says about a sixth (1.3 of 8.0 percentage points) of the increase in the prevalence of overweight could be attributed to smoking cessation within the past 10 years. (emphasis mine). There's a difference between obesity and overweight, and the time period is important; this is a specific time frame, so the article is overstating what the ref says. This is a serious problem with accuracy. I've removed this sentence for now until a ref can be found that actually backs it up. delldot ∇. 20:48, 29 September 2008 (UTC)

On the other hand there are many aspects of the article that make it very high-quality. It's got a lot of good citations and a lot of info from scientific studies. Good work on the improvements that have been done, I look forward to more. I'm sorry to fail it because obviously a lot of work has gone into it, but it looks like too much needs to be done to pass it at this stage. Let me know if I can offer any help or clarification. After these are addressed, best of luck next time this is up at GAN. delldot ∇. 21:27, 1 October 2008 (UTC)

• Done Liposuction is discussed in the "Bariatric surgery" section. According to the Bariatric surgery article "The term does not include procedures for surgical removal of body fat such as liposuction or abdominoplasty."
• There is confusion between overweight and obese throughout the article. Sources referring to overweight are used to back up claims about obesity, so this is another accuracy concern.

The scientific literature often uses these two terms interchangeably. For example see "In children, the term overweight has been preferred because of the potential for stigmatization associated with the term obesity." The WHO for example says obesity is a subtype of overweight.

• Extensive citations need to be added; they've been marked in the article.
• I think the article goes into excessive detail in some places about overweight rather than obesity per se (it should be summarizing that info per WP:SUMMARY) and fails to cover other areas in enough detail (for example, as I mentioned, I think the age issue should at least be summarized). Another example of insufficient detail: some of the drugs mentioned under "Clinical protocols" are not discussed in the pharmacology section. With excessive detail, examples include: the "Weight loss drugs" section under "History and culture" is interesting but it's not clear that it pertains specifically to obesity; that info might be better moved to another article with a summary left here. Info like "The average height of Miss America pageant winners increased by 2% from 1922 to 1999, while their average weight decreased by 12%." probably pertains better to body weight or overweight or something; at no time were obese women participating in Miss America pageants, so this info is probably not very relevant to obesity.

JFD wants the info on weight lose drug kept in this article. WRT Miss America this is from a source that was discussing obesity. I feel it relates.

• I have added fact tags to statements that need sources.
• Some of the weight loss history does not seem to pertain to obesity per se--mightn't it be better moved to weight loss? I think this might be an issue for other sections, too; the info pertains to overweight or fatness in general, not obesity specifically. Some of the info could be moved to other articles with summaries and links to those articles left here.
• I don't know if "Historical trends" is the best place for discussion of modern Western culture's stigmatization of obesity, maybe it should have its own section under a separate "Society and culture" section (see WP:MEDMOS). This is certainly an issue worth going into depth on.
• Childhood obesity has it's own page I was surprised that there was no discussion of Obesity in children. This should at least be discussed in epidemiology, if not in its own section. I'd also like to see more coverage of prevalence in different age groups in the epidemiology section. delldot ∇. 20:30, 29 September 2008 (UTC)

• There should be a short summary of one or two paragraphs here. See WP:SUMMARY. delldot ∇. 18:20, 30 September 2008 (UTC)

Etymology

• with ob added to it. What does ob mean or do? Why is it added? delldot ∇. 18:17, 29 September 2008 (UTC)

Causes

• This section focuses too much on the US. It's understandable since it's such a problem here, but the article should also use statistics from elsewhere. I see you've done a good job on that with the epidemiology section, but you understand my concern about overemphasis on statistics from one region, right?

Lots of European info

The link is good, but in addition it'd be good if you could provide a short definition in the same sentence so readers don't have to navigate away from the page to understand what they're reading: blah are both used as measures of central obesity, obesity of the center or whatever the definition is. delldot ∇. 18:17, 29 September 2008 (UTC)

• Also in the table, some things are referenced and some are not. Are those items without a reference not endorsed by one, or do some references endorse more than one item? It might be worthwhile to repeat some referencing so it's clear.
• How are "complications from general anaesthesia" related to obesity?
• There are some problems with organization: sometimes material is presented in a haphazard way with little logical arrangement. I mentioned before the lack of organization in the body systems table.
• I'm seeing a bunch of mistakes with use of 'then'. Then is used for time, as in 'then and now'. 'Than' is used for comparison, as in 'larger than life'. I've changed the ones I caught, but please do a check through the whole article for any I missed.
• I think there is a POV problem with extensive use of US statistics, sometimes presented as though they are worldwide. Sections such as "causes" don't go into enough detail about other countries. I understand that most research is from the US but an attempt should still be made to provide balance. For example, under "diet" and "Sedentary lifestyle", there's no reason the US diet and lifestyle should be the only one discussed. The article is full of statements like this: "In a prospective study, intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality." But looking at the article title, it is not a general population but one of overweight US white women. So it's not accurate to present this like it applies to everyone; surely it doesn't. This is a problem throughout the article. The epidemiology info from other countries is quite sparse, with one-sentence subsections and no info on places like South America or the Middle East. The paragraph beginning Many cultures throughout history have viewed obesity as a flaw only discusses Greek, "during Christian times", and modern Western. (However, other sections of the article handle the global view well, presenting facts from diverse places).

Yet to fix

• I don't know if the paragraph beginning Many countries and groups have published reports pertaining to obesity is that useful. So what if they have? I do like the info from the reports, e.g. the ability to cripple the health system. Why not integrate that info into other sections with dire publich health warnings and use the report as a citation? e.g. the British government published a report in 2004 that said..." Similarly, rather than just saying the US government published a report, you should find some fact from it and use it as a citation.
• Minor thing about inconsistent referencing format: Some journal abbreviations have periods, some don't. Sometimes authors' first names are spelled out, sometimes there's just an initial.