Obesity and the railways

[whole diary]

[TaplowGreen]

trout - can I sit next to you on the train please? 

[bobm]

TaplowGreen - you might get a seat next to him, but just look through the forum at all the scrapes he gets into on his travels!   

[LiskeardRich]

Generally speaking I think it's a lifestyle issue, starting with youngsters eating rubbish and plonking themselves in front of computers rather than playing sport, through to adults being similarly inactive and troughing on pies, junk food etc - I think the huge amount of resource the NHS has to devote to paediatric and adult bariatric surgery is beginning to bear this out.

I resisted the urge to comment in this thread, but now that's been thrown out there I can no longer hold back

Everything you have described there is me all over. Poor diet, sat in front of computers all day and no playing of sport. (Do alot of walking though!)

I'm the opposite to you, I eat a great diet, very particular about what I eat, yet I am 18 stone. I've played rugby since age 6. I'd personally say I am very fit, I am of a muscular build, yet the NHS deem I am grossly obese, my life insurance premiums are 15% higher than they would be if I was 15 stone, as they work it on a height vs. weight ratio, irrespective of the make up of the weight

however BMI is a blunt instrument and does not distinguish between tubs of lard and muscular related weight/build.

Regardless how blunt BMI is as a measure, this is the only factor the UK^▸ (United Kingdom) use to define whether somebody is obese or not, and as the title of the thread was about "obesity" it doesn't distinguish between a "fatty" and a person of muscular build, who is medically determined to be obese in the UK.

[TaplowGreen]

Richwarwicker I know exactly what you mean, I played for 25 years (too old now!) and was somewhat surprised in my late 20s at 14 stone to be described as "obese" by my Doctor, who then made me feel better by telling me what a dodgy & crude measurement BMI is!

Nevertheless I think availability and excessive consumption of saturated fat, sugar, booze rather than fruit and veg combined with lack of exercise plays more of a part in obesity, particularly over the last 20 years?

Anyway, somewhat ironically I am now off to the rugby club for a Xmas party at which I will consume unhealthy amounts of ale, so I wish you all the best for a happy Christmas and if you are travelling by train, a spacious journey unsullied by a bit of rain causing utter chaos!!!   

[bobm]

Rugby club and alcohol - I find that hard to believe!   

[stuving]

Regardless how blunt BMI is as a measure, this is the only factor the UK^▸ (United Kingdom) use to define whether somebody is obese or not, and as the title of the thread was about "obesity" it doesn't distinguish between a "fatty" and a person of muscular build, who is medically determined to be obese in the UK.

Not quite. The NICE guideline on obesity is, I think, the definitive source for medical definitions in this. It shies away from actually defining obesity, but treats it as a synonym for adiposity or fatness. My dictionary gives obese as abnormally fat, too. On how to measure this, the full guideline says:

There are many methods of directly measuring the amount of fat in the human body. These usually involve complicated procedures that can only be carried out in specialist laboratories.

Indirect methods, based on the relation between height and weight, can be used in everyday clinical practice to estimate adiposity. The most common and accepted, at least in adults, measures are those of body mass index (BMI) and waist circumference.

So BMI is used because it is very much easier than any better method, but for most people still give a good estimate of the parameter that counts - body fat as a fraction of body mass. So much so that they do, perhaps unwisely, label BMI ranges as obesity I to III:

The degree of overweight or obesity in adults should be defined as
follows.
Classification              BMI (kg/m2)
Healthy weight 1         8.5^24.9
Overweight                25^29.9
Obesity I                   30^34.9
Obesity II                 35^39.9
Obesity III               40 or more

However, they do add a bit as well:

BMI may be a less accurate measure of adiposity in adults who are highly muscular, so BMI should be interpreted with caution in this group.

Generally this "muscle weight effect" is left to clinical judgement, though there are also tables for using waist circumference to shift people one step along the obesity scale. But that's upwards - waist >94 cm pushes overweight men into the same category as obesity I with waist <94 cm. There are also some more details specific to the risk of diabetes.

I can see a problem for GPs in this. They are supposed to use a bit of judgement as well as BMI, but the table tells them you get the label "overweight" or "obese" based solely on BMI. So they may tailor the advice they give, but can't really change the label.

I think the upshot is that BMI is only seriously misleading for the few people with very muscular bodies achieved by really hard training regimes. However, the vagueness of this category, combined with the simplicity of BMI, leaves us all confused by it. Which makes it easy to kid yourself ...

[eightf48544]

There is an interesting article in Jan's Modern Railways about teh possible shape of the railway in 2043 (Hopefully I  won't be around). 3 railway gurus  have given their views which are very intersting in themselves but too complex to summarise here.

However what is interesting is the table of Demographic change which gives a rise in the population of   10.9 million from 62.3 to 73.2

But it also gives a predicted rise in the number of people with a BMI over 30 from 15% to 26% but the latter is reached in 2030!

So quite a chalenge for the railway and the country in general more and bigger people to carry.