I noticed my local Jack in the Box has posted calorie counts on its menu...ECB do you know if this was city/state mandate or is it still voluntary?

I'm amazed to say that it changed my decision of what to get the very first time I experienced it.

oh yessss I love fat debates

In Sweden, among other enlightened places, fitness and health-improving activities are integrated right into the workplace and are paid for by the health insurance system (i.e. preventative care is covered). I agree that using a treadmill or equivalent test for people with certain disabilities is way, way better than using BMI (according to which Tom Cruise is morbidly obese, fyi, because BMI doesn't account for muscle mass, among many other things). But even better would be to charge fees of employers over a certain size as well that don't add gyms onsite and that don't establish employee preventative health programs: things like volleyball teams and group weight loss drives, etc., etc., etc. You don't think the Swedes just grow that tall and stay that thin just by eating all that milk, potatoes, and pork do you?

I like how the pictures in the link keep putting quotes around "obese", even on obvious fat people like this, http://farm3.static.flickr.com/2319/1604…

I'm pretty disgustingly fat, but I can still easily hit the 80% heart rate for a man 20 years younger on the stationary bike, and can even touch 160 without too much trouble. Does that mean I'm OK?

Why not just install an exploding GPS device on every American that goes off if you step inside a Mongolian BBQ or Hardee's?

Totally agree with you Erica.

Also, basing these requirements soly on the body mass index doesn't take into account people with a lot of muscle, meaning very healthy and muscular people would also be forced to lose weight.

(I may be mistaken, since it said they check for obesity, but from that snippet it seems to say the BMI is the base guideline.)

America's health care system is a mess.

Fnarf, it depends on how fast your heart rate climbs, and at what resistance you have the bike. You'd have to compare against the results of individuals deemed healthy.

@7 - The definition of "obese adult" is a BMI of 30 or above. There is language in the recommended standard of care for health practitioners to how people who are very muscular may have a BMI of over 30 and fit, but officially, many Olympic athletes are "obese".

Which, btw, is part of why the Illustrated BMI Project uses quotes. It's to clarify that they are following the official labels.

'And fitness is determined almost as easily as BMI is—by having a person perform a treadmill test.'

Naw, this is wrong. For all its flaws, BMI requires only height and weight; it can be reliably measured and tracked over the phone. A treadmill test requires at the very least time and equipment, and more likely trained staff and monitoring and a big fat bill. It's just not a practical alternative unless you think we spend too _little_ on healthcare for interventions with marginal, if existent, benefits.

I have to say, when my physical form asked for BMI last year, my doctor just laughed. She said that she, as a tiny Eastern Asian woman with ample boobs, is considered obese because BMI is made based on a middle-aged white man.While treadmill tests and other fitness tests may be more expensive, I think there's a lot to be said for accuracy when considering impactful medical measures.

I really dislike how the statistics were presented in the piece. You cannot compare them, and they are presented in misleading ways.
To say that someone is "four times more likely to die" could mean the difference between 10 and 40% or 0.001 and 0.004%. These are radically different discrepancies.

Also, why compare the statement: "half of overweight people and one-third of obese people are “metabolically healthy.”
with: "about one out of four slim people — those who fall into the “healthy” weight range — actually have at least two cardiovascular risk factors" unless you want to confuse people? For comparison, these things should be presented in a uniform manner. It should say that "half of overweight people and one-third of obese people are “metabolically healthy.” and that "around 75% of thin people are metabolically healthy". Which is actually a BIG DIFFERENCE.

sheesh.

ECB: Are you in a comparing-tax-strategies-based-on-related-data mood today? What's next, a look at poverty based on race vs. socioeconomic status?

A better criteria than BMI is one that's measures waist size. Still not as accurate as a fitness test, obviously, but far better than BMI.

And FWIW, I'd be shocked if that Arkansas plan actually gets implemented.

Ugh.

So, I read this, and think:

I'm waaaay fat. And I already eat a healthier diet than anybody I know. And I'm active. And my blood pressure, blood sugar, cholesterol. . . all perfect. I'm healthy.

I've lost weight in the past. My body is highly resistant to it. It requires a level of obsession that is NOT worth it to me just for aesthetic purposes. And I don't need to do it for health purposes. Cuz I'm already healthy.

I have exercise-induced asthma. I would fail a standard treadmill test. There are other tests of physical fitness that I'd pass just fine (I can't run for more than a couple of minutes without my lungs spazzing out, but I can easily walk for 6 hours without a break, I'm wicked strong, I'm flexible, etc).

So, while I realize that I'm not typical. . . what about me? Why should I have to pay extra? How do we keep people like me from getting fucked over by such a tax?

I don't see any easy answer.

I can see why they're doing this, but policing people's health makes me very uncomfortable.

To comment about the Fat Tax, I have to say, that I think that the BMI would be a horrible way to determine someone's overall health.

Take me for example. I am a 29 year old male, I am 6’ and weight approx. 220lbs (or so my doctor said at my last appointment). I am not the healthiest eater in the world, but I try my best, avoid soda for the most part, don't drink heavily (maybe once a month I might get 'buzzed'), I don't smoke, and I walk on average about 3 miles every day.

So, what's my problem? Earlier this month I suffered from what they think was a very minor heart attack. They had to put 3 stents in my arteries surrounding my heart. I had blockage and a 'flap' that was preventing my heart to pump enough blood through my body. I was diagnosed with Coronary Artery Disease at 29! If it was not for an after-hours doctor at my doctor’s office to take the step and call 911 for me, I don’t know what might have happened to me. This is not something you would expect at 29.

So, if you look at my overall weight/height, my BMI is 29.8. I’m on the borderline of obesity. I accept that I need to lose some weight, but because I walk a lot, my legs have gained more muscle than the rest of my body. Also, as we all know, muscle weighs more than fat. The problem is, that with what I have, is most likely hereditary. (Thanks Mom and Dad!) My family has a very long history of heart problems. It’s not surprising that I have this disease but what is surprising is that it affected me so early in life.

I agree that when you are overweight, you have a higher chance of having health problems, but the BMI is not a good measure of health. Give them a full physical in order to determine someone’s health.

I once commented to my doctor that based on a chart on his wall, I fell into the 'obese' category, and he laughed and told me to ignore those charts. I ate healthy (with occasional junk food) and I got regular exercise, my blood tests were great, and my blood pressure was excellent. As far as he was concerned, that was much more important.

Mind you, I'm now on a strict low-fat diet, but that's because I was diagnosed with gall bladder disease right before christmas, and I have to be very careful in the next month until it can be removed. Yippee.