Why do you think that there is so much more obesity now than in previous decades?
Why is there so much more smoking in Germany than the UK? Is it because Germans are less educated? (it isn’t)
it would be interesting to know if the insurance industry acting in their own interest has any role in promoting it.
I thought that sort of thing was against your philosophy? At least when we discussed the potential for increasing premiums for smokers or people who weren’t vaccinated.
kwlf wrote:
Why do you think that there is so much more obesity now than in previous decades?
Food is more affordable to the less educated, in many more forms both good and bad. If you look at the diet of my 90+ year old parents who grew up in relatively poverty, it is bland and minimal because that’s what they grew up with. It’s also fairly healthy.
kwlf wrote:
Why is there so much more smoking in Germany than the UK? Is it because Germans are less educated? (it isn’t)
I know nothing about smoking in the UK, but in the US smoking has largely died as a result of social pressure. I have no idea why that hasn’t occurred to the same degree in other places.
My point about insurance companies and obesity was in relation to funding healthcare providers in developing educational tools and ‘programs’, meaning labor cost to do it. There is some of that stuff in play, and I wonder who pays for it. I used the work ‘promote’ intentionally, I did not mean coercion of health insurance customers.
The life insurance industry selling to individuals does BTW make substantial rate adjustments based on smoking, but I don’t buy their product so I don’t know the details.
Malibuflyer wrote:
You get a class 2 independent of your weight if you are not impaired in movement and show satisfactory results on the exercise ECG
Why an exercise ECG? In your quote from part-MED any additional cardiovascular tests are not mentioned for class 2.
Food / health posts moved here from here
An exercise ECG (in the aviation medical context) is a treadmill, with ECG. Look up Bruce Protocol. You have to do BP stage 1 2 and 3, 3 mins each. At the end of stage 3 your heart rate has to be at certain min figure (220 minus age for FAA; not looked up CAA/EASA Part MED but AIUI identical), and you have to progress into stage 4 until the figure is reached. So a fairly fit person always has to do a bit of Stage 4. Stage 3 is, I was once told by a UK AME, enough to induce a heart attack in several % of serving airline pilots (which is why proposals to make it mandatory annually for a Class 1 were squashed) which doesn’t surprise me because it is basically walking up a steep hill at absolutely your maximum exertion rate; enough to make many people feel sick. And stage 4 is considerably harder than that… You can walk stages 1-3 but stage 4 has to be done running. You can practice these in your local gym 
although you won’t have the ECG monitoring (unless you pay somebody) and they probably don’t have a treatmill capable of being set to the 16% slope.
But there is other stuff also and this is one reason why most pilots in Europe who have had some cardiac issue give up flying altogether, rather than doing the right thing for themselves and their family and get themselves sorted out properly.
Malibuflyer wrote:
So the “limit” for Class 1 is 35 and not 30 plus it is not a hard limit but an assessment needs to be done including an explicit cardiovascular risk review.
For class 2 there is no limit defined at all (creating the the “interesting” situation that it is actually lower than for Class 1 because “obese” commonly refers to BMI>30) and your AME can assess you fit.
Unfortunately this is not how it’s handled in Switzerland. Exceed the limits and you get a warning letter. Exceed it two years in a row and you are off to the cardiologist on your account, temporarily unfit until he clears you. Graham wrote:
Those who say they “can’t lose weight no matter what they do” are 99% of the time lying to themselves – they just aren’t sorting out their diet or getting exercise, even if they convince themselves that they are. I used to work with someone like this who said they were “always dieting” and “could never lose weight”. My observation at the time (which I kept to myself) was that the only thing they were “always” doing was eating cake and crisps at their desk!
Sorry but that is the common perception by someone who has never been in this situation. It is simply not true. Also the stigma of being just lazy louts (a.k.a not disciplined enough) does not stand with most docs who work this problem as their field.
Clearly, people who never have been in this situation may try to suggest social stigmatizing will work. Nope. My experience is the opposite. I never could loose one gram under pressure, the more stress and hazing/mobbing is generated, the less it works. I am thick skinned enough not to let it get to me but the pressure by the EASA limits applied here was quite enough.
Can’t find it back but somewhere in this thread or elsewhere in this forum someone wrote very correctly that after a certain age slimming down is VERY hard and often an exercise in futility due to the bodily changes which happen. For women, post climacterium, it is even worse.
Stigmatizing and hazing/mobbing will create massive depression and frustration. The usual consequence is massive weight gain when people simply give up.
When was the last time you saw a photo of fat concentration camp victims? Don’t eat and you will lose weight.
Silvaire wrote:
When was the last time you saw a photo of fat concentration camp victims? Don’t eat and you will lose weight.
That’s so overly simplistic though. Clearly if someone takes in no/next to no calories they will lose weight, but losing weight doesn’t make it healthy.
What would you suggest if someone was only able to lose weight be reducing their calorie intake to a level which medical professionals deemed unhealthy in itself? Lets say for arguments sake this is through a normal diet, so not junk food nor super health foods, and that it is accurately controlled without sneaking cake and ‘forgetting’ about it?
Pirho wrote:
What would you suggest if someone was only able to lose weight be reducing their calorie intake to a level which medical professionals deemed unhealthy in itself?
I would suggest that the situation doesn’t exist. Your body did not need “medical professionals” to add excessive fat, it doesn’t need them to burn it. As with many topics, analysis paralysis does not add much to the end result.
Concentration camp victims are not a good example of individual agency / personal responsibility being an effective pathway towards weight loss. Nobody is disputing that eating fewer calories or burning more of the calories that you eat leads to weight loss. People are debating how you persuade people to do it!
One of the paradoxes of the second world war was that in Britain, people became healthier and better nourished. This was because of rationing: your parents’ generation had a restricted diet, but it was a healthy one. The pre-war poor tended to eat empty calories such as bread and jam; during the war, sugar was restricted but they had access to butter, meat, vegetables in quantities sufficient to ensure a balanced diet.
The two examples you’ve given show that coercion works well, but such extremes are not something that either of us is advocating.
It is usually on a bicycle here. You would have to ask for the treadmill.
