Gosh Libby - With the possible exception of an occassion [and probably bad] joke I didn't know I was so outspoken about obesity - staying mostly about things I actually know something about ... Iraq and EEEEVVVVIIILLL Corporations.

Please steer me to the link where I pushed this button.

My longtime stand on Weight Control is while there are certainly genetics involved - making one bigger that others - I think everyone knows, as
you point out, it's income vs. outgo.

One can argue readily and successfully argue the factors you mention stress the equation - I'll stick my neck out and prioritize them, althought many are inter-related and family influenced:

Genetics
Socioeconomics
Discipine
Exercise
Stress
Smoking cessation

and way down on the list, "medical conditions".

My biggest insensitivity come from the hearing often the fat man claiming "medical conditions" as he gobbles up a biggie fry.

One more thought about the 500 calorie meal:

My wife was about 160#'s when we met - on her frame she was not obese but was thick. At some point she decided to do better, and joined weight watchers, which is more about learning and changing than any get-thin-quick plan.

I was surprised at how much she had to eat - but it was fruits a veggies. At our wedding, she had made 135#'s, a weight she still holds today, and while the boby porportions have shifted, she still loks great - mostly from learned and maintained healthy eating habits.

James,

You are correct in your assessment that most obese folks are that way because they have a discipline or will-power issue. I am overweight, not because I have diabetes or permnant injuries which make strenuous exercise impossible, but because I am too lazy to do what I can to lose these extra 35 lbs. Sure it's harder to lose weight at my age (almost 61) and with my limitations, but I know it's truly because I'm not willing to forefit my love affair with food.

Most overweight or obese folks will not be so honest with themselves, much less admit it in public. Most I know whine about "I just can't do it" while blaming it on everything (and everyone) else. But unless people can accept some personal responsibility for how large they are and how they got that way, things will never change.

It reminds me of a woman who came into my unit recently. She was about to be intubated because of respiratory distress. The amount of drugs we give is based on weight. Since we could not weight her at that time, we asked her what she weighed. She replied "Not a pound over 172". I looked at the doc and said, "If she's not at least 250 pounds, I'll pay for lying." All the while she kept repeating 172.

When we were able to weigh her (immediately after intubation), she tipped in at 249 pounds. Had we dosed her for a 172 lb. person, she would have been undersedated for intubation.

The point of this story is to illustrate how people lie to themselves and others. Little progress or change can occur until people stop blaming it on food labels, food companies, the fast-food industry and life's hard knocks. As adults, we are responsible for what food we put into our mouths, what food choices we make.

I guess Libby will lump me into the next letter because I think her premise is a cop-out in most cases of obesity. It is just another way for the grossly obese to say "See, it's not my fault". While I certainly empathize with people who are so heavy, I'm not giving them a free pass.

I used to be very lean and slender, able to run many miles.

I ate that man sometime in the mid 90's.

I am now overweight.

I am not overweight because I am too ignorant to correctly read a food label and ascertain that if a coke has 100 calories per serving, and a 20 oz. bottle has 2.5 servings, then the entire bottle has 250 calories.

I am also not overweight because I eat too many carbs. When I eat a Thickburger from Hardees, it isn't the bread that is the problem, it is the 1200 or so calories oozing out of the patty, cheese and mayo.

I am overweight because I eat too much and exercize too little.

But, I have started a new diet. I have put myself on a 1600 calorie a day diet. It is possible, but you have to do things like read the labels, apply basic math in computing serving sizes, and exercize a little self control.

But you want to hear about low calorie meals? First of all, skip the 100 calorie drink. Needless. Drink water. It's free and has no calories. That right there is the first step. At a party and don't want to offend? Then eat! One single meal isn't going to doom your diet unless you allow it to. No matter how strict your diet, if you go out to a party and eat a lot, then make it a one time only event. The next day, stay on your diet. A single slip up will not matter at all. What will matter, though, is when someone has the single slip up and is then unable to return to their diet.

Can't skip the drink or control yourself to remain on a 500 calorie per meal diet? I have a hard time myself. And I am overweight because of it. But it has nothing to do with my inability to comprehend food labels.

I'm only 20 lbs overweight and I know every time I raise a pepsi to my lips that I shouldn't be drinking it, I should choose diet pepsi (fetid!) or water (boring!) I know that instead of the Big and Tasty meal at McD's, I should get a salad. Or better yet, don't even go to McD's at all (I love their fries).

Does my husband feel sorry for me when I complain about not wanting to shop for a bathing suit? Nope! He knows that I know I shouldn't be eating the junk I eat! Of course, he's a smart husband and he may occasionally suggest I have a diet drink instead of a sugared one, but he'd never say that he feels absolutely no sympathy for me when I have to shop for swimwear.

I don't make nasty comments to people who take up two chairs at the Golden Corral and stuff their faces. Just don't ask me to have compassion on them. I'm saving that for people who have real problems, like the disabled and handicapped.

Being over weight is a scourge. There are some people who are very consciencious about diet and exercise etc. and they end up having gastric by-passes. Some even put weight back on, believe it or not and I know that they are being compliant with their program.

For many overweight people, like some of you in this column, be kinder to yourselves. If you are serious about losing weight, is that something that is realistic for you? I'm not suggesting that you drink a pound of liquid fat every day. Even doing the right things, after a while, your metabolism my not cooperate with your efforts and if you slip, the weight just flies back on.
You and I have years of shaping our tastes and taste buds and a life style change can be a beast. I say, do the best you can, forget about the bathing suit. If I really felt that I was in an obesity prison, I could easily see myself saying: "screw it" and then eat a fast food hamburger. Don't feel sorry "for Me" but don't "condemn me either". By the way, I am fairly thin and would love to put some weight on and I can't.

Since I was called out by 'name' in this letter, I've got to respond.

I, like James, can't remember what I said. The fact is that I changed my moniker from yellowdog to nitpicker quite a while ago. The fact that this person remembers all our names this much later makes me happy that I don't use my real name. That's kinda creepy.

I don't drink sugar sodas so that illustration doesn't work well for me. I drink diet or water. Perhaps, that is why I'm at my ideal weight. I watch what I eat--very closely and I exercise regularly.

I don't have a problem reading food labels. I'm sorry if someone can't figure out how many calories are in a 20 ounce soda. IMO, that makes them an idiot.

I agree that it is very difficult to manage and count calories when you eat at social events. That makes the holidays a very tough time, indeed. But I also think that, even though you may not be able to count exactly how many calories you eat, you should be smart enough to know when you are eating more than you should be eating. Also, it helps if you stick with the healthy choices at these functions, if there are any.

If smoking cessation is a factor in weight, then it's been my experience that smoking actually helps me keep weight off. I've read studies that quitting smoking will actually make you gain weight, even in a controlled environment where the calories you eat are exactly the same.
I quit smoking and added a few pounds. I had to adjust my regiment.

Just to clarify, I don't go out at lunch and laugh at fat people. All of my immediate family is obese. I've seen two of them diet for years with very limited results. So, I do agree, that in some cases, it isn't just about diet. Sometimes it is about genetics, biology, etc.

However, I believe that these are the exceptions, not the norm.

Intuitively, it is impossible for me to imagine how someone could eat nothing and gain weight. Just doesn't seem to follow the laws of physics.

So which way do you want it Ms. Libby? People are fat because they are stupid or people are fat because they can't control themselves?

I think it is more a matter of won't and don't. Won't change my lifestyle and eating habbits, because I don't want to.

Fact is fact. I don't think I have ever met a single overweight person who has said that they are fat because the labels on soda made them believe that were only consuming 150 calories.

Being overweight does not make you deaf dumb or blind. It makes you complacent. Either you don;t want to do anything about it, or you didn't want to do anything about it before you got so far gone that you no longer could.

My mother is 300+ pounds. She has had both her knees replaced. She has diabetis and and sleep apnea. One of these or heart disease or heart attack or something weight related is going to kill her. She won't have gastric surgery as her numerous Dr.s have recommended. She has learned that she will not be able to eat the way she always has (she will have to eat small portions and cut out sweets) so she has decided that she will just stay fat or whatever. Now I wouldn't consider my mother stupid, but she certainly isn't being very smart.