page 3 says "no fatties"

10/19/2009 2:07:51 PM

^2

Quote :

"And since when does a state get to simply opt out of portions of a federal act that it deems inconvenient? I'm no lawyer, but this doesn't pass the smell test to me.""

i thought it was rhetorical and part of a thought. i suspect there are some legal issues with it and if the state is in violation of the law then I suspect that will be instrumental in stopping this from becoming a reality. but if, as an individual, you uphold the belief that states rights are the most important and that increased control over states by federal government is tyrannical then reasonably a state should be able to decided, for themselves, which provisions they wish to adhere to and which ones they do not. it was my understanding that you held the previously mentioned ideals and as a result i was curious why in this situation you did not appear to be in alignment with that ideal. in all honesty, i still am.

10/19/2009 2:18:50 PM

Quote :

"your claims here are unsubstantiated and filled with both misinformation and bias."

Yes, of course. And here comes the part where you demonstrate how it's misinformation and bias...oh.

Quote :

"this is simply not the case. studies have shown that a large part of the problem with obesity in the US is due to liquid calories. meaning fruit drinks, sugary coffees, sodas, etc.. These items do not have hardly any cholesterol in them, and usually are at 0%. Other factors would include unhealthy snacking, as in grabbing a candy bar instead of an apple. you'd be hard pressed to find a candy bar with >4% of cholesterol in it."

You're right that soda/sugary drinks are a big part of the problem. It's not the only problem though. Are you really going to deny that a large number of obese people are eating chips/french fries/fried foods/meat? It's not like you either drink soda, or eat high cholesterol foods. You can do both, and many people obviously do. Do you expect me to believe that the majority of obese people are simply fat because they drink too much soda or consume empty carbohydrates, but have otherwise healthy diets? High cholesterol is a very common problem among obese people. It's pretty absurd to say that it isn't.

Quote :

"as stated earlier when it comes to people there are health conscious and those who are not. calories in vs calories out are more heavily correlated with weight than the nutritional metrics of food consumed. "

Even if you are eating perfectly nutritious food, when you eat too much of it, that's a problem. The obesity itself is unhealthy. It's bad for the human body to be very overweight. It puts a strain on the heart, the organs, your bones, your skin, and probably other stuff too. You can be overweight and perfectly healthy, but once you venture into the realm of obesity...that is unhealthy.

Quote :

"higher sugar consumption is what leads to diabetes II, not increased weight. there are plenty of overweight people who are not type II diabetics and it is ignorant to assume all who are overweight are on the path to develop the disease. regardless given that heart disease is the leading cause of death in the united states and far far far above anything diabetic related I think it is a sound conclusion that cholesterol is more unhealthy as a whole than weight difference. "

And obese people are at higher risk for diabetes. Why? Because they're eating too much, and a lot of that "too much" is coming in the form of carbohydrates. I'm not ignorant, because I haven't assumed that everyone who is overweight is on the path to develop diabetes. They are more likely to develop diabetes, though. Do you seriously think that hasn't been established? And how about all the other problems that I listed that come about due to obesity? Those aren't really a big deal, I guess?

The overall problem is unhealthy diets combined with inactivity. Obesity is a common result of those practices, and is - on its own - a health problem. Yes, you can be unhealthy and skinny...duh. That doesn't make obesity a healthy condition.

Quote :

"this isn't what you said above. it may be what you meant (doubt it based on what you argued immediately above this statement) but it isn't what you said on any occasion."

What isn't what I said above? I said that all other health factors equal, the obese person is more unhealthy than the non-obese person. That's absolutely true. I don't see how what you have quoted conflicts with anything that I've said.

Quote :

"you even point out that a fatter person who is in better cardiovascular shape is simply less healthy than a sedentary person based on fat percentage alone."

That isn't what I said at all. Just because a fat person is in better cardiovascular shape than some skinny person doesn't make them healthy. They can still be unhealthy, overall. They're just in better cardiovascular shape than someone in very poor cardiovascular shape...that isn't the bar for health. I never made that direct comparison, as you just have. I did say that I had never seen an obese person that was in better cardiovascular shape than a person of normal weight...which is true, I never have seen that. I'm sure it exists, somewhere. The obese person is still unhealthy, though.

Quote :

"i agree that if you take the same person with the exact same eating habits that they will likely be healthier if they drop from being obese, but the health benefits seen will diminish significantly once the 10 - 15lb over weight mark further indicating that lifestyle, and not weight, is what determines if one is healthy or unhealthy."

That's because if you're only 10-15 lbs overweight, you're pretty much normal. We're talking about obesity, not having a little extra. Weight is an common indicator of lifestyle, which is the underlying problem.

Quote :

"its evident that you have some biased mentality and inherent discrimination towards people who have fat"

It's only evident to you. I'm not biased, and there is no "inherent descrimination" against people who have fat...which is every single human being alive. I don't even have a problem with obese people. I was a fat person for a very long time. I'm simply pointing out that obesity has causes, and is a health risk.

Quote :

"however, fat in and of itself is not unhealthy."

No, but an excess of fat is unhealthy - every single time. That's why I use the word excess.

Quote :

"Then you've had your head buried in the sand. For example, there are any number of conditions that can cause people of "normal weight" to have lower "physical endurance." And if you can't admit that there are normal and underweight people who are not physically healthy enough for exercise or much of anything, then you're simply fooling yourself."

Normal weight was the incorrect wording to use. Perhaps I should have said "normal physical condition." Really, what I should have said is that I've never seen an obese person that was in good physical condition, which is true. How many obese people can run a 5k without walking? Hell, how many obese people can walk up a set of stairs without breaking a sweat or huffing and puffing? It's like walking around with a 50-300 lb backpack on, all day, every day. I'll reiterate the real point, though: just because you're in better cardiovascular health than some person within a normal weight range doesn't mean you're in good health.

[Edited on October 19, 2009 at 3:29 PM. Reason : ]

10/19/2009 3:23:36 PM

^^ You'll pardon me if I doubt your supposed curiosity. Are you saying that the state be allowed to exempt itself from portions of, say, the Americans with Disabilities Act, the Family Medical Leave Act, and the latest version of the Civil Rights Act? Maybe the state will eventually trample on an act that means something to you.

It would appear to me that a state is either in or out of federal acts--based on the correct application of the Tenth Amendment--not in piecemeal compliance. This is simply unfair to the people as citizens and as employees. It would seem to me that the state is attempting to create a new special class--but this time it's not for protection, it's for discrimination.

^

1. Define "obese."

2. It appears that an affected employee will not have to be "obese," but merely overweight, according to BMI.

3. Who decides what is the "correct" BMI?

[Edited on October 19, 2009 at 3:37 PM. Reason : .]

10/19/2009 3:35:21 PM

Obese is having excessive body fat. I can pretty much tell by looking someone if they're obese. There's the grey area, which is overweight. So, the real question is, how much body fat is too much? I would say that anything over 30% body fat counts as excessive body fat, but I'm sure there are varying opinions on it.

Quote :

"It appears that an affected employee will not have to be "obese," but merely overweight, according to BMI."

That could be a problem, then. People that are simply "overweight" can be healthy.

Quote :

"Who decides what is the "correct" BMI? "

Some bureaucrat, probably. I don't think BMI is the correct measure to use. Obviously, the guy that is totally jacked might show a high BMI, but he's not unhealthy. Really, they should be measuring body fat %.

10/19/2009 3:49:09 PM

^ I'm really not trying to give you shit, but your post is pretty much nonsense. You base everything on what you "think" rather than what is actually happening.

A few examples:

Quote :

"Obese is having excessive body fat."

Wrong. Define "excessive."

Quote :

"I can pretty much tell by looking someone if they're obese."

Wrong.

Quote :

"There's the grey [sic] area, which is overweight."

Right--you've pinpointed the problem.

Quote :

"I would say that anything over 30% body fat counts as excessive body fat, but I'm sure there are varying opinions on it."

"I would say. . ." is where you first went wrong with that sentence. And "I'm sure there are varying opinions on it. . ." is a gross understatement.

Quote :

"People that are simply 'overweight' can be healthy."

Yes, now you have it.

Quote :

"Some bureaucrat, probably [will decide who is 'overweight']. I don't think BMI is the correct measure to use."

Do you think? Please check the facts about what is actually happening and then return to the discussion. Thank you.

[Edited on October 19, 2009 at 4:18 PM. Reason : .]

10/19/2009 4:14:42 PM

Quote :

" Yes, of course. And here comes the part where you demonstrate how it's misinformation and bias...oh. "

I guess you missed the parts where I pointed out lifestyle and not weight is the most highly correlated factor for health risks and that heart disease is far above diabetes and fat percentage. Heart disease being a frequent killer of normal weight people since those viewed skinny often devour too much of poor food because they see no incentive to watching what they eat as they appear healthy since they are skinny.

Quote :

" You're right that soda/sugary drinks are a big part of the problem. It's not the only problem though. Are you really going to deny that a large number of obese people are eating chips/french fries/fried foods/meat? It's not like you either drink soda, or eat high cholesterol foods. You can do both, and many people obviously do. Do you expect me to believe that the majority of obese people are simply fat because they drink too much soda or consume empty carbohydrates, but have otherwise healthy diets? High cholesterol is a very common problem among obese people. It's pretty absurd to say that it isn't. "

I never implied they were the only problem and I’m not denying that larger people do eat poorly. However, your previous claims* indicated that overweight people were more unhealthy than skinnier people no matter what. My statement was that this is not the case and why. Overweight people with active lifestyles do exist and despite weight are healthier, by most metrics, than sedentary skinny people. This means better blood pressure, lower triglycerides, better cholesterol, etc… So once again, fat percentage is not as important an indicator of health as lifestyle.

Quote :

"And obese people are at higher risk for diabetes. Why? Because they're eating too much, and a lot of that "too much" is coming in the form of carbohydrates."

Hey do you recall when you said this ?

Quote :

" Do you expect me to believe that the majority of obese people are simply fat because they drink too much soda or consume empty carbohydrates,"

Quote :

"They are more likely to develop diabetes, though. Do you seriously think that hasn't been established? And how about all the other problems that I listed that come about due to obesity? Those aren't really a big deal, I guess?"

They are more likely but the obesity itself is not the cause. I’ll continue to mention this because you seem to miss it. lifestyle is the biggest factor. Inactive skinny people with poor diets are almost as likely to develop diabetes than the overweight and the obese. If you’re body has too much sugar in it (poor diet) and this sugar doesn’t get used (sedentary lifestyle) your body has to produce insulin to resolve this and this overwork can cause it to fail.
The other things you listed aren’t really a big deal, no. As mentioned numerous times by this point cardiovascular disease is the number one killer. These issues about which you’re mentioning are very minor both in cause of death and cost to our health care system. Furthermore no one described obesity as a healthy condition. That is an entirely distorted slant of what I said.

Quote :

"What isn't what I said above? I said that all other health factors equal, the obese person is more unhealthy than the non-obese person. That's absolutely true. I don't see how what you have quoted conflicts with anything that I've said."

For one it is misleading. All other factors equal means they have the same measurements on blood work and other tests. That is on par with me saying all other athletic abilities being equal the runner without legs will be the worst one.
Secondly, the point I have made from the beginning is that someone overweight can have a healthier lifestyle and this would make them healthier than the lesser weight skinny person. Within that point is a major distinction between the two parties and in a situation where all other factors are equal the point being made cannot be addressed.

Quote :

"That's because if you're only 10-15 lbs overweight, you're pretty much normal. We're talking about obesity, not having a little extra. Weight is an common indicator of lifestyle, which is the underlying problem."

Weight can be, but is not more often than you would think. This is an example of the bias I was describing to you earlier.

Quote :

". I'm not biased, and there is no "inherent descrimination" against people who have fat...which is every single human being alive. I don't even have a problem with obese people. I was a fat person for a very long time. I'm simply pointing out that obesity has causes, and is a health risk."

Your comments suggest otherwise

Quote :

" The reality is that usually, they forget the trips to Golden Corral where they consumed 2500 calories in one sitting, or the entire box of Oreos they ate."

Quote :

" why should I pay the same premiums as the guy that hasn't exercised in 15 years and has a diet consisting primarily of doritos and butterfingers?"

You might as well be talking about welfare queens in cadillacs that you don’t want to pay for because you work hard.
You suggest that all obese people are sitting around living unhealthy lifestyles and not paying attention to their diet, while that may not be the case at all. It may be what led them to get to that point but just because they are and will remain obese doesn’t mean that they are not participating in a more conscious lifestyle than those who weigh less and are around them.

[Edited on October 19, 2009 at 4:51 PM. Reason : quotes]

10/19/2009 4:47:53 PM

Quote :

"Wrong. Define "excessive." "

No, not wrong. That's the actual definition of obese. Excessive body fat means more body fat that would normally be acceptable. How much body fat is acceptable varies from person to person, but I think somewhere in the range for 25-30% body fat for men is generally agreed upon.

Quote :

"Wrong."

There might be someone that I would say, upon observation, that they're not obese, when medically, they actually are. It would never go the other way. Overweight is the gray area where you might not be able to tell, but once I can see gigantic fat rolls in the abdominal region...that's obese. When you start getting past the obesity cutoff, it starts to become increasingly obvious that you are obese.

Quote :

""I would say. . ." is where you first went wrong with that sentence."

I didn't go wrong, I just made it clear that it was my evaluation of obesity, not the undisputed truth. I'm not trying to suggest that there's an across the board, accepted cutoff for obesity. I'm telling you what I think the approximate cutoff is.

Quote :

"Yes, now you have it."

Yes, but obese people are not healthy. I make a distinction between overweight and obese.

Quote :

"Do you think? Please check the facts about what is actually happening and then return to the discussion. Thank you."

I mean, I skimmed through the article. I didn't see where it said exactly who determined the obesity cutoff, but it's not that important. And yes, I'm providing an opinion - I don't think BMI is the best measure of obesity. I've said that body fat percentage is a better measure. BMI doesn't account for muscle mass. Body fat percentage does. We're not talking facts, here, though, we're talking about what I think. I don't care that you don't care what I think, because I'm telling you anyway.

Quote :

"I guess you missed the parts where I pointed out lifestyle and not weight is the most highly correlated factor for health risks and that heart disease is far above diabetes and fat percentage. Heart disease being a frequent killer of normal weight people since those viewed skinny often devour too much of poor food because they see no incentive to watching what they eat as they appear healthy since they are skinny."

Obesity is a result of lifestyle, and both the lifestyle and obesity contribute to declining health. If a skinny person and a fat person both are sedentary and both eat junk all the time, the fat person is more at risk because they're obese. Obesity itself is a health risk. It's not just a result of poor lifestyle. Obesity puts a strain on the body that isn't there with a skinny person that doesn't exercise and has a poor diet. Or are you denying that? Do you want to make the argument that obesity, itself, is not a health problem?

Quote :

"However, your previous claims* indicated that overweight people were more unhealthy than skinnier people no matter what."

I like how you put in the astericks, but don't actually include a foot note. Probably because I never actually said that overweight people were more unhealthy than skinnier people no matter what. I said all things equal, the obese person is more unhealthy than the skinnier person. All things are not always equal, so that's not a "no matter what."

Quote :

"So once again, fat percentage is not as important an indicator of health as lifestyle. "

That may be the case, but your original claim was that cholesterol is a more important indicator of poor health than obesity. I disagreed, and still disagree. I'm not going to deny that lifestyle (that is, nutrition, calorie intake, and activity level, all in one) is a better indicator of overall health than just obesity. Obesity is a direct indicator of lifestyle, though, except for very rare cases. And, as I've mentioned so many times before, obesity itself is a health problem.

Quote :

"Inactive skinny people with poor diets are almost as likely to develop diabetes than the overweight and the obese."

Almost as likely? Is that anything like "as likely"?

Quote :

"If you’re body has too much sugar in it (poor diet) and this sugar doesn’t get used (sedentary lifestyle) your body has to produce insulin to resolve this and this overwork can cause it to fail."

If the person is skinny, the sugar is getting used. That isn't really the point, though. You're absolutely right that skinny people with poor diet can be at risk for diabetes. There's still a strong association between obesity and diabetes. I'm sure you know the difference between causation, and association. The insurance company only cares about risk, though. You probably won't dispute that obese people are at risk because of their obesity. In other words, obese people are more likely to develop health problems associated with obesity. On the other hand, you can't say that skinny people are more likely to develop health problems associated with being skinny. You could say they're more likely to develop health problems associated with poor lifestyle, if they do indeed exhibit poor lifestyle choices...but that's about it.

Quote :

"All other factors equal means they have the same measurements on blood work and other tests."

That's not what I meant to suggest. When I said "health factors," I meant things that factor into your overall health. Nutrition, caloric intake, fitness, that type of thing...if all those things were held equal between a skinny person and a fat person, the fat person would be less health solely due to their fatness. But really, we can just bring all the other measurements that you mentioned into the mix as well. If all those things were also equal, the obese person is still more at risk to develop disease than the skinny person, statistically speaking.

Quote :

"Secondly, the point I have made from the beginning is that someone overweight can have a healthier lifestyle and this would make them healthier than the lesser weight skinny person."

I haven't disputed that point, but "healthier" or "more healthy" is not the equivalent of "healthy."

Quote :

"Weight can be, but is not more often than you would think. This is an example of the bias I was describing to you earlier."

I have no idea how that demonstrates bias, but alright.

Quote :

"You suggest that all obese people are sitting around living unhealthy lifestyles and not paying attention to their diet, while that may not be the case at all. It may be what led them to get to that point but just because they are and will remain obese doesn’t mean that they are not participating in a more conscious lifestyle than those who weigh less and are around them."

They may be paying attention to it, but they're still eating too much or not exercising enough. It really is that simple. They could make a conscious decision to reduce calorie intake and start exercising. I did it. A lot of people have done it. Some obese people have made that decision, and are in the process of burning excess fat. If you're staying the same weight, you're just not doing enough.

As far as the golden corral/oreo/doritos/butterfinger comments, I don't see the problem. Think of any high calorie food that people consume too much of. Like I said, people aren't getting fat off healthy foods...they're consuming some kind of junk on the side, or they're sedentary. It's time to toss the stigma attached to fat people, and the whole idea that pointing out their activities is demeaning or an insult. I view being fat as a health problem. We shouldn't treat it like something that should only be spoken of when no fat people are around. We should talk about it like we talk about anything else.

10/19/2009 7:07:35 PM

Quote :

"We're not talking facts, here, though, we're talking about what I think."

Um. . .yes, we are "talking facts." The thread title is N.C. to impose "fat tax" on state employees--so, in other words, the rational folks are talking about what the state is doing or is proposing doing to state employees. Whatever you've made up in your head--while fascinating to you, I'm sure--appears to have no direct relationship to what is actually happening in the actual world.

Quote :

"I didn't see where it said exactly who determined the obesity cutoff, but it's not that important. And yes, I'm providing an opinion - I don't think BMI is the best measure of obesity."

Yes, it is extremely important who determines the "obesity cutoff"--if for no other reason than your position that opinions vary on the subject. And it's great that you don't think the state should be using BMI as the "best measure of obesity"--but apparently, that's the very measure they will be using.

And if obesity is defined merely as "excessive" weight, what is "overweight"? Isn't it also "excessive" weight--that could in fact still be a healthy weight?

[Edited on October 19, 2009 at 9:11 PM. Reason : Right?]

10/19/2009 9:10:33 PM

Quote :

"Um. . .yes, we are "talking facts." The thread title is N.C. to impose "fat tax" on state employees--so, in other words, the rational folks are talking about what the state is doing or is proposing doing to state employees."

Oh, right. So you didn't come here to espouse your particular view on the subject, or to voice your opinion - you came here to state facts.

Quote :

"Yes, it is extremely important who determines the "obesity cutoff"--if for no other reason than your position that opinions vary on the subject. And it's great that you don't think the state should be using BMI as the "best measure of obesity"--but apparently, that's the very measure they will be using. "

I definitely agree that it's generally important who determines the cutoff, but I've made an assumption that health care professionals had some input on this decision. Now, that may not be the case, but I certainly hope it is. If they did, there's a well established cutoff range for BMI and body fat percentage. Maybe I'm out of line for assuming that the people involved were even slightly competent.

My reading of this article suggests that this wasn't at all a legislated decision or anything like that - it was an administrative decision made within the state health plan department. I don't know a whole lot about the state health plan, but I imagine that it runs somewhat like a private health plan. This isn't really a "tax," because it isn't chosen by legislators (at least not in any way that I could see); it's determined by the health plan officials. The plan just provides a "discount" for not being obese - the cutoff for which is 40...very high. There aren't going to be many people working for the state that are so muscular that their BMI registers as 40. That's a completely acceptable cutoff level, and well above the medically accepted cutoffs. Even if BMI isn't as good of a measure of obesity as body fat percentage, the cutoff is so high that it becomes just as good. There should definitely be a "bodybuilder" clause if there isn't, though.

Quote :

"And if obesity is defined merely as "excessive" weight, what is "overweight"? Isn't it also "excessive" weight--that could in fact still be a healthy weight?"

According to wikipedia:

Quote :

"Overweight is often used interchangeably with pre-obese and is generally defined as having more body fat than is optimally healthy."

Seems like as good a definition as any. As I've said, the state has set the bar way higher than would normally be accepted, which effectively eliminates any of those people that might just be overweight, not obese.

10/19/2009 10:45:59 PM

Quote :

"they'll tone it down as soon as people start bringing lawyers into this"

10/20/2009 8:13:57 AM

Lawyers haven't "toned down" similar measures in private health plans, so I don't know why this would be different. They've been providing discounts like this for a while now, as an incentive to become more healthy.

If the privacy issue comes up, the person can simply waive the obesity/tobacco check, and be defaulted to the normal plan. There's no forced invasion of privacy.

10/20/2009 8:26:20 AM

State Health Plan to employees: We can discriminate

Quote :

"Packets from the State Health Plan are hitting mailboxes this week explaining legislative changes that increase cost sharing for state employees and impose new sanctions for smokers and overweight workers. Included is also an amazing 'Notice to Plan Members' that I'm sure will get everyone excited about working for the state. First the notice explains the federal law known as the Health Insurance Portability and Accountability Act of 1996 (or HIPAA), which prohibits group health plans from engaging in discrimination. But, no worries, the State Health Plan says: 'In order to implement its comprehensive wellness initiative, the State of North Carolina has elected to exempt the State Health Plan from the HIPAA rules prohibiting discrimination against individual participants and beneficiaries based on health status related factors, including health status, medical condition (physical and mental illnesses), claims experience, receipt of health care, insurability, and disability.' There is also a state law, the disclosure explains, that prohibits 'discrimination against individuals based on lawful use of lawful products during nonworking hours.' I'm certain that cigarettes are still legal. So shifting employees into costlier plans because of smoking seems to violate this provision. But the State Health Plan is exempted from that as well. Also, because these draconian measures will likely cause some people to lose their insurance, the State Health Plan will be kind enough to provide you with a certification of creditable coverage. The notice helpfully explains: 'The certificate provides evidence that you were covered under this Plan, because if you can establish your prior coverage, you may be entitled to certain rights to reduce or eliminate a preexisting condition exclusion if you join another employer's health plan, or if you wish to purchase an individual insurance policy.' Translation: you won’t be able to afford our coverage anymore, but we’ll give you a certificate that will make being uninsured a bit easier. I know there are people still out there saying that this entire scheme is a good idea because smokers are hurting the entire health plan. But I think those people are not considering all of the collateral damage — the random mouth swabs for all state employees, the administrative shifting between plans for all state employees, exempting the State Health Plan from HIPAA and state statutes. There is simply no good argument for these policies. And no good excuse for treating state employees like recalcitrant children."

http://pulse.ncpolicywatch.org/2009/09/30/state-health-plan-to-employees-we-can-discriminate/

Be well.

10/20/2009 3:27:51 PM

so how does it define "smoker?" people who regularly smoke cigarettes? occasional cigar smokers? marijuana smokers? smokeless tobacco users? 2nd hand smoke victims? people who smoke a cigarette once a week?

and how will they prove it?

10/20/2009 5:28:49 PM

Usually, with the plans I'm familiar with at least, they'll ask if you have used any tobacco products in the past year. The "default" position is "Non tobacco-free certified." Participants are required to answer truthfully, knowing that if it's somehow found out that they lied, they could risk termination or removal of benefits.

10/20/2009 5:34:14 PM

i see.

10/20/2009 5:36:57 PM