zlacker

These drugs are expensive and, at least in France, they're discussing offering them. I think this is the main reason explaining the difference in prevalence between the US and the EU.

Despite access to "superior food quality", weight issues are absolutely a problem in the EU, too. Maybe it's not at the same point as in the US, but 51% of the population of the EU (outside Ireland and Germany for some reason) are "overweight or obese" [0].

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[0] https://drees.solidarites-sante.gouv.fr/publications-communi... In French, from the ministry of health, but there's a chart which should be clear enough for everybody.

>>vladva+(OP)
There are valid counterarguments to the overweight values, a lot of women who might be overweight are healthy because different % of fat are acceptable depending on the structure of the body. I agree, that has to do with "malbouffe" and other lifestyle choices. As for offering them that is a nice thing, but I am curious about the mechanics (mutuelles) and such of the medicine.

>>u_sama+07
> a lot of women who might be overweight are healthy because different % of fat are acceptable depending on the structure of the body

This is a tired argument. Most people who have BMI in the obese range do not have one of oft-cited exceptions that make BMI an imperfect measure.

Everyone knows BMI is imperfect at this point, but the number of people who have BMI in the obesity range yet have healthy body composition is very small.

>>Aurorn+A8
Let it be noted that I have said overweight and not obese, if you are in the obese category you are 100% unhealthy (even the bodybuilders who inject stereoirs in this category are unhealthy).

>>u_sama+Wb
It doesn’t change the argument. Most people who have BMI in the overweight range do not have healthy weights.

I say this as someone who did enough weightlifting to be in the overweight BMI range with a low percent of body fat (no steroids involved). Trust me when I say it’s a lot of work to get there. It’s not a category that includes a lot of people or invalidates the measure.

>>u_sama+07
> There are valid counterarguments to the overweight values, a lot of women who might be overweight are healthy because different % of fat are acceptable depending on the structure of the body

But the BMI takes into account the mass, not the size. Usually women have less lean muscle mass than men, which would mean that for a given size and weight, they'd have more fat, without influencing the BMI. I also think there's quite some leeway. My BMI is "normal" at 24, and I have a fair bit of belly fat.

Very athletic people also don't fit in the BMI tables, a dude like Schwarzenegger is probably well in the overweight category if not above because of all that lean muscle, but is also probably healthier than average. These people are extreme outliers, though. I don't think they're anywhere near 1% of the population, so you can't really argue they skew the numbers.

> As for offering them that is a nice thing, but I am curious about the mechanics (mutuelles) and such of the medicine.

It's apparently paid by the social security, but doctors are only to prescribe this when other means of controlling the weight have failed, such as adjusting nutrition.

>>Aurorn+pd
Fair points

>>vladva+(OP)
I can't get a solid statistic on this, but didn't the obesity rate basically plateau last decade in countries like Italy, France and Germany?

https://data.worldobesity.org/country/france-71/#data_trends

My country (Poland) is an unfortunate leader in childhood obesity (and close to the top in terms of obesity in general), but it's very easy to see why: people live very different lives than they did just 20 years ago.

>>Aurorn+A8
> Everyone knows BMI is imperfect at this point, ...

Indeed.

BMI is the best thing that people can readily calculate with easily available equipment (a tape measure and scales either at home, gym, pharmacy, etc) plus some relatively basic maths or sticking the numbers into a website.

Measuring body fat using calipers is better but hugely error prone. Similar for waist/height ratios. Body fat scales can be wildly inaccurate.

BVI is far superior but very few people have access to the equipment needed to measure that.

So we're kind of stuck with BMI as the best "simple" measure.

>>Tade0+dr
According to [0] the overweight rate looks stable, but obesity went up.

[0] https://www.obesitefrance.fr/lobesite-cest-quoi/les-chiffres...

>>Aurorn+A8
It's important to note that overweight and obesity are not the same thing. Most people are overweight, and from what I've seen of modern studies, the health risk of being overweight is almost negligible.

But being obese is a higher BMI than overweight, and the bar is actually quite low. Lower than most people think. A lot of people think they're overweight, but they're not, they're obese.

>>Aurorn+pd
Thank you, this is what I constantly say. For population statistics, BMI is nigh perfect, since it's much easier to gather than more accurate data points, and the number of exceptions are super small.

I know very fit people that still fall well in the BMI 20-25 range. Most around 23. You have to be very focused on natural bodybuilding for years if you want to become an outlier on BMI.

Or some combination with being super short or super tall. But this again affects a tiny minority.

>>vladva+oe
"a dude like Schwarzenegger is probably well in the overweight category"

For illustration, Arnold was 107 kg at 1m88 at his prime, giving him a BMI of 30.3, which is clinically obese. But yeah, LOL at all these people with 130 cm waists going 'BMI is useless'.

>>array_+d61
> Most people are overweight, and from what I've seen of modern studies, the health risk of being overweight is almost negligible.

Health risks of being overweight are very well researched and are significant (cancer risk, type 2 diabetes, cardiovascular health). If you meant the mortality, then it is also worse for overweight people when confounding for smoking and reverse causality.

>>roel_v+eT2
BMI still isn't great for fat people. An active fat person is going to have a significant amount of muscle compared to a sedentary fat person at the same body weight - just doing things carrying around that weight will build muscle. Some health markers, this won't matter for - your heart doesn't like pumping blood to a 300lb body, whether that's at 50% BF or 8% - but for a lot it does. Lipids, insulin resistance, etc. are going to be quite different in someone at 40% BF vs. 20% BF at similar weights with similar genetics.

Unfortunately it's not so easy to get a good BF%. BIA scales are probably what most people have access to, either at home or at their local gym, or calipers, but both are very inaccurate at getting totals and at best can help you understand trend directions. There are places to get cheap DEXAs in a lot of cities these days, but not everywhere, and $30 each time you go is still expensive for some people.

BF% and FFMI are both a lot more useful for everyone than BMI.