Creepy Crawley: Obesity in adolescents with chronic fatigue syndrome

[Hip]

What do I look like? An expert in special ed?

Half an hour ago you offered to explain, now you've suddenly lost your enthusiasm?

 

[Glycon]

Half an hour ago you offered to explain, now you've suddenly lost your enthusiasm?

"Offered to explain"? Really? I don't recall saying anything like that...

 

[Hip]

"Offered to explain"? Really? I don't recall saying anything like that...

You have already forgot that you said: "And I know enough to point out many ways in which what you said is disputable and/or imprecise. However, that would be off-topic. But if you want to go there, we certainly can." ?

 

[Hip]

The problem I have here is obesity can be seen as a psycho-social problem, which can possibly solved with changes of behaviors. I think researchers at the NIH have demonstrated that obesity is a bigger problem than psycho-social. That metabolisms are very difficult to change and if someone loses weight intentionally, the body fights a mighty fight to return to the original body weight. It's quite fascinating unless you're in that situation.

I agree. I had an athletic and lean physique, never put on any weight, and whether I did a lot of exercise or no exercise, my weight would remain totally unchanged.

But soon after catching the suspected enterovirus that appeared to trigger my ME/CFS, my belly budged out to the point that if I were female, I'd look 5 months pregnant. And some others who caught the same virus as me also developed this central obesity (though they did not develop ME/CFS).

I went on a diet to burn off the belly fat. This is hard, because I believe belly fat is one of the most difficult areas of fat to lose, and I found I only made progress by going down to 800 kilocalories a day (instead of the normal daily 2100 kilocalories for males). I successfully burnt off the belly fat on that diet, but within 6 or 9 months, the belly came back again, in spite of the fact that my food intake is only moderate, and I never have sugar (always use sweeteners), and usually avoid sweet food such as desserts.

I repeated the same diet the following year, and got the same results: the belly fat is burnt off, but comes back again within 6 or 9 months.

And as I don't suffer much from physical exercise induced PEM, I engage in a reasonable amount of exercise (typically I will do a brisk 40 minute walk 4 times a week, and occasionally do short jogs).

So it was quite clear to me that the viral infection permanently alters metabolism in such a way that your become predisposed to accumulating fat.

In the case of central obesity (abdominal obesity), low human growth hormone, and high leptin (which can result from leptin resistance) are implicated; regular obesity is a different story though.

So when Mrs Crawly is attacking the problem, she will likely only take a look at psycho-social interventions and issues like: 'your kid is obese because he's playing video games all day.' And 'your kid should exercise more' . i am sorry but I know her antics.

You might be right, but perhaps we should give the benefit of the doubt, ie, assume innocent until proven guilty.

 

[Glycon]

You have already forgot that you said: "And I know enough to point out many ways in which what you said is disputable and/or imprecise. However, that would be off-topic. But if you want to go there, we certainly can." ?

I'm sorry, but that wasn't an offer to compose an accessible intro to probability. Besides, I did provide a link to a very informative introductory article...

 

[Kati]

@Hip

This: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0

I gained 100 lbs with onset of disease. Lost 48 over 1.5 years, on 1200 cal/day. Regained 30. Need to go back down again, but hard to get my brain back into it.

I wouldn't emphacize central vs generalized obesity. Women carry their weight differently.

 

[Hip]

I wouldn't emphacize central vs generalized obesity. Women carry their weight differently.

True, but my understanding is that abdominal obesity (central obesity) is a distinct form of obesity. I have no weight gain on my legs, arms, chest, neck; it's all on my belly (and some also on my lower back / buttocks).

Abdominal obesity is also a symptom of metabolic syndrome (the latter being more common in ME/CFS).

 

[HowToEscape?]

@Hip post #34

"An the idea that lack of exercise might cause obesity makes little sense, because the amount of kilocalories burnt through exercise is minimal. The average human consumes around 2,000 kilocalories per day in food and drink.

If you were to go for a jog for 15 minutes every day, the amount of kilocalories that would burn is only 200. So that is going to make little difference to your net total kilocalorie intake. By comparison, the amount of kilocalories in a jam donut is 250. Thus food intake is far, far more influential than exercise on your net kilocalories."​

Well, if one's idea of exercise is a 15 minutes pitter-pattering and one's definition food includes jam donuts, then exercise won't work. It's like defining wheels as square and engines as steam boilers, and then declaring automobiles to be impossible.

 

[Hip]

Well, if one's idea of exercise is a 15 minutes pitter-pattering and one's definition food includes jam donuts, then exercise won't work. It's like defining wheels as square and engines as steam boilers, and then declaring automobiles to be impossible.

What are you on about!?!

 

[HowToEscape?]

@ Hip

"I went on a diet to burn off the belly fat. This is hard, because I believe belly fat is one of the most difficult areas of fat to lose, and I found I only made progress by going down to 800 kilocalories a day (instead of the normal daily 2100 kilocalories for males)."
​

Somewhat like my experience. I seem to now have a bizzarly low base caloric need; to break even on calories in need only drive by food. Except I'm too tired to drive, and with no job I can't afford a car. Wunnathesedays I'm going to get my BMR measured, I'd like to have a number and not just a guess as to what's going on.

 

[HowToEscape?]

What are you on about?

For us, 15 minutes may be all we can do. For someone who is into exercise it's barely a warmup.

e.g., I have a friend who recently did a fundraiser bike for lung cancer. It's meant to be accessible, not a race and not an elite event. It's also 170 miles over 2 days. He's weaker than he was previously, as he has lung cancer himself, which is currently being controlled by a new type of drug. That's an old guy. You wanna talk exercise, follow people on a varsity sports team. That'll be 6-10 hours per week, if not more. Or hang out with some dancers. They're rehearsing 2 hrs a day, practicing stuff by themselves beyond that, hitting the weights and then doing Pilates.
Aint' no 15 minutes!

Food: After reading some of your other posts, I don't imagine you truly consider a jelly donut to be food, right? That's candy at best, tho I'd call it poison. I don't imagine you actually eat that stuff!

 

[Hip]

@HowToEscape?
I am just looking at an average person, not an exercise fanatic. For an average person, running 15 minutes each day, or 30 minutes every other day, would be considered engaging in reasonable amount of exercise. UK medical recommendations for exercise are 75 minutes of vigorous aerobic activity like running per week.

The jam donut was a randomly chosen food item to illustrate calorific content. You should not read anything into it. I could also have chosen a 330ml can of Coke (139 kilocalories), or a 100 gram portion of French fries (312 kilocalories).

 

[Glycon]

@Hip

This: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0

I gained 100 lbs with onset of disease. Lost 48 over 1.5 years, on 1200 cal/day. Regained 30. Need to go back down again, but hard to get my brain back into it.

I wouldn't emphacize central vs generalized obesity. Women carry their weight differently.

But are you an Apple or a Pear?

 

[J.G]

I think many of us would really appreciate a good introductory explanation of Bayesian versus Frequentist statistics, if it is presented in a accessible way, ie, in a brain fog-proof manner...

Nate Silver's The Signal and the Noise is an excellent exposé of the limitations and misuses of Fisherian statistics, holding up Bayesian methods as an underused alternative in a range of scenarios. It won't teach you any (new) mathematical concepts, but it's a good read.

 

[Kati]

I looked up 'different types of obesity' on google yesterday, and here is what I found out
Source, NHS of course...
http://www.nhs.uk/news/2015/04April/Pages/There-are-six-different-types-of-obesity-study-argues.aspx

"Researchers have identified six 'types' of obese person," The Independent reports. It's argued that each type would benefit from a targeted treatment programme for obesity, rather than a "one-size-fits-all" approach.

This study looked at data from more than 4,000 obese adults taking part in the Yorkshire Health Study. It aimed to see whether it was possible to categorise obese individuals according to common health and lifestyle characteristics.

The study reported six clusters of obese individuals. These were:

• young healthy females – women who were obese, but generally had fewer obesity-related complications, such as type 2 diabetes
• heavy-drinking males – as above, but with higher alcohol intake
• unhappy and anxious middle-aged – predominantly women with poor mental health and wellbeing
• affluent and healthy elderly – generally positive health, but defining characteristics of higher alcohol intake and high blood pressure
• physically sick but happy elderly – older people with more chronic diseases such as osteoarthritis, but good mental health
• poorest health – people who were the most economically deprived and had the greatest number of chronic diseases

This research suggests it may be better to recognise subgroups of obesity, rather than put all obese people into one category, which may help tailor interventions and treatments more effectively. The current study does not prove this hypothesis, though it is worth further investigation

 

[snowathlete]

There's lots of money to be had for doing research on obesity right now isn't there. No doubt that is what this is about; grabbing funding to keep your nice salary going.

 

[Hip]

That's interesting, @Kati.

Not much indiction though as to the underlying cause of obesity in that research.

One fascinating obesity story was the case of the woman with a Clostridium difficile infection of the gut, who received a fecal transplant from her obese daughter to treat that infection, and then herself also became obese, despite all her efforts to remain at a normal weight:

Fecal transplants may up risk of obesity onset - Scientific American

The assumption is that a virus, bacterium or other microbe(s) transferred from her daughter's gut was the cause of the obesity.

 

[Kati]

That's interesting, @Kati.

Not much indiction though as to the underlying cause of obesity in that research.

One fascinating obesity story was the case of the woman with a Clostridium difficile infection of the gut, who received a fecal transplant from her obese daughter to treat that infection, and then herself also became obese, despite all her efforts to remain at a normal weight:

Fecal transplants may up risk of obesity onset - Scientific American

The assumption is that a virus, bacterium or other microbe(s) transferred from her daughter's gut was the cause of the obesity.

Definitely interesting re: gut microbes.

Re: the article I posted, I wanted to make a point that the UK is seriously committed to insert psycho-social twist to biomedical research, without focus on the bio-medical. Mrs Crawly [sic] is one of those researchers.

 

[Hip]

Re: the article I posted, I wanted to make a point that the UK is seriously committed to insert psycho-social twist to biomedical research,

Apparently the research "was carried out by researchers from the University of Sheffield in the UK and the Harvard School of Public Health in the US".

I have not looked at the study itself, just the NHS summary, but it does not seem particularly psychosocial to me, but I don't see it as a study of great value.

 

[taniaaust1]

@HowToEscape?
I am just looking at an average person, not an exercise fanatic. For an average person, running 15 minutes each day, or 30 minutes every other day, would be considered engaging in reasonable amount of exercise. UK medical recommendations for exercise are 75 minutes of vigorous aerobic activity like running per week

I dont know about where you are but where I am a normal person who is seriously exercising to loose weight (not refering to exercise fanatic) wont just exercise for just 15mins a day and expect that to help much, that would be like a warm up.

Most would spend a good half an hour at least or go and do a 45 mins dance class or something usually several times a week or they are serious about loosing weight (that on top of doing right diet thing). (it would be near impossible for a ME person to loose weight by exercise).

The UK medical recommendations though, are those actually to help with weight loss?, arent those recommendations just for keeping fit and just what an average person should have.