Re: Pay the obese to lose weight

[Guest guest]

You and the rest of us are paying for it either way by the burden on the health

care systems among many other things.

I find it slightly more than somewhat appalling how negative and unwilling to

take advantage of such available technology people are all for the sake of

making moral arguments. No one is suggesting that people should be paid rewards

for the rest of their lives to remain normal weight. But you have to understand

the nature of how such conditions might come to be at least is some cases and

take advantage of available contingencies to create initial behavior change in

some fashion - similar contingency management approaches are used in some drug

treatment modalities - and most often get the same short-sighted responses I

have seen here.

I am sure that moral indignation feels good to those who either are fit or have

made a change and feel self-righteous for it - it does science and those who

continue to need help little good however.

Jack Darkes, Ph.D.

Tampa FL USA

________________________________

From: Supertraining on behalf of Ward, Mark - CKHS

Sent: Fri 12/12/2008 2:11 PM

To: Supertraining

Subject: RE: Pay the obese to lose weight

Just one more example of being " bailed out. " Make bad loans -

government should help. Poor business model and poor car design -

government should help. Get fat - someone else should help me. Too

tired and hung over - I should get paid for my troubles.

Mark Ward

Silverdale, WA

________________________________

From: Supertraining <mailto:Supertraining%40yahoogroups.com>

[mailto:Supertraining <mailto:Supertraining%40yahoogroups.com> ]

On Behalf Of Carson Wood

Sent: Friday, December 12, 2008 7:22 AM

To: Supertraining <mailto:Supertraining%40yahoogroups.com>

Subject: Re: Pay the obese to lose weight

What happened to the idea of helping those who help themselves. This is

sad.

Carson Wood.

Westbrook, ME USA.

Pay the obese to lose weight

The below may be of interest:

Pay the obese to lose weight, says study

21:00 09 December 2008 by Jim Giles

The focus of the next diet fad might be cash rather than

carbohydrates. Volpp of the University of Pennsylvania in

Philadelphia found that obese people offered a financial reward for

every kilogram shed lost more weight during a 16-week trial than

those given standard diet advice.

The drawback? Like other weight-loss methods, many of the

participants put the pounds back on once the programme ended. To

achieve longer-lasting results the monthly payments, some totalling

several hundred dollars, might have to be made for longer periods.

Volpp's results mean that obesity may join the list of social

maladies that can be addressed using financial incentives. Previous

experiments have shown that smokers and cocaine addicts can be weaned

off their habits by paying them to stay drug-free. Incentives have

also successfully been used to ensure that parents in developing

countries send their children to school.

One of the biggest incentives schemes ever run in a rich nation got

underway last year in New York. Over 5000 families are being studied

to see if cash incentives can improve the rate at which children

receive regular health check ups and adults attend work training

courses.

Journal reference: Journal of the American Medical Association, vol

300, p 2631

===================

[Guest guest]

If you read the study ( JAMA 300: 2631, 2008 ) carefully, the subjects lost

most weight during the first four months. By seven months the weight loss was

modest— less than one-year studies using exercise, low calorie diets, or

weight loss drugs. Financial incentives might work in the short run but are

probably not effective beyond 6-months.

The National Weight Control Registry described characteristics of people who

successfully lost weight and kept it off (Source: www.nwcr.ws):

NWCR Facts

You may find it interesting to know about the people who have enrolled in the

registry thus far.

80% of persons in the registry are women and 20% are men.

The " average " woman is 45 years of age and currently weights 145 lbs, while the

" average " man is 49 years of age and currently weights 190 lbs.

Registry members have lost an average of 66 lbs and kept it off for 5.5 years.

These averages, however, hide a lot of diversity:

Weight losses have ranged from 30 to 300 lbs.

Duration of successful weight loss has ranged from 1 year to 66 years!

Some have lost the weight rapidly, while others have lost weight very

slowly--over as many as 14 years.

We have also started to learn about how the weight loss was accomplished: 45% of

registry participants lost the weight on their own and the other 55% lost weight

with the help of some type of program.

98% of Registry participants report that they modified their food in

take in some way to lose weight.

94% increased their physical activity, with the most frequently reported form of

activity being walking.

There is variety in how NWCR members keep the weight off. Most report continuing

to maintain a low calorie, low fat diet and doing high levels of activity.

78% eat breakfast every day.

75% weigh them self at least once a week.

62% watch less than 10 hours of TV per week.

90% exercise, on average, about 1 hour per day.

Tom Fahey

Cal State Univ, Chico

===========================================

Re: Pay the obese to lose weight

I'm just a layman, but it sounds to me like they are replacing the nebulous

rewards of " better health " and " better appearance " with something more

immediate and tangible. Personally, I don¹t think great strides will be made

toward helping the obese until medicine can regulate the physiological

forces that control appetite.

I can say from experience that restricting calories can be extremely

physically uncomfortable. I don't buy the idea that obese people simply have

no willpower to help themselves. And, environment may be part of it for some

people, but around here you can drive for miles and never see a restaurant,

and there are still plenty of heavy people.

Lynn Worth

Sparta NC USA

> What happened to t

he idea of helping those who help themselves. This is sad.

>

> Carson Wood.

> Westbrook, ME USA.

>

> Pay the obese to lose weight

>

>

> The below may be of interest:

>

> Pay the obese to lose weight, says study

> 21:00 09 December 2008 by Jim Giles

>

> The focus of the next diet fad might be cash rather than

> carbohydrates. Volpp of the University of Pennsylvania in

> Philadelphia found that obese people offered a financial reward for

> every kilogram shed lost more weight during a 16-week trial than

> those given standard diet advice.

>

> The drawback? Like other weight-loss methods, many of the

> participants put the pounds back on once the programme ended. To

> achieve longer-lasting results the monthly payments, some totalling

> several hundred dollars, might have to be made for longer periods.

>

> Volpp's results mean that obesity may join the list of social

> maladies that can be addressed using financial incentives. Previous

> experiments have shown that smokers and cocaine addicts can be weaned

> off their habits by paying them to stay drug-free. Incentives have

> also successfully been used to ensure that parents in developing

> countries send their children to school.

>

> One of the biggest incentives schemes ever run in a rich nation got

> underway last year in New York.

Over 5000 families are being studied

> to see if cash incentives can improve the rate at which children

> receive regular health check ups and adults attend work training

> courses.

>

> Journal reference: Journal of the American Medical Association, vol

> 300, p 2631

>

> ===================

[Guest guest]

Jack Darkes wrote:

> I find it slightly more than somewhat appalling how negative and unwilling to

take

advantage of such available technology people are all for the sake of making

moral

arguments.

replies:

I'm also surprised at the responses, because the study doesn't make any

reference to who

pays the reward. If an overweight person paid a fee to enter such a program and

all

rewards and administrative costs were paid by that fee, then there'd be no moral

hazard.

How many people would complain about a program like that...and what would they

complain about?

If the fees were paid by third parties then there's a moral hazard, i.e., people

are being

rewarded for not taking responsibility for their own well being. But if the

fees are paid

voluntarily, e.g., as a charitable contribution, then who would complain, and on

what

grounds?

On the other hand, if the fees were paid by the government's compulsory power of

taxation, then it's legitimate for people to demand that the potential costs of

the program

(including the moral hazard) be weighed not only against the benefits, but

against the

distribution of the benefits.

If such a program were funded by taxation but administered

so as to reach a " Pareto optimal " result, (i.e., all parties end up better off),

then we might

find that very few people would complain about being taxed to support such a

program.

Otherwise--if the cost of the program outweighed the benefits to

non-participants--then

any government would have a duty to the taxpayers to make sure that the

resulting

redistribution of wealth is morally justified.

Consider this analogy: assume that the United States of America produces more

carbon

emissions *per capita* than all other nations. Should the others pay the

USA to reduce its carbon emissions per capita? If such a proposal seems morally

objectionable, then why is it counterproductive to express moral indignation at

the idea of

taxpayers paying the overweight to lose fat?

Regards,

s

Ardmore, PA

[Guest guest]

Most insurance companies in the USA go by height/weight charts that the U.S.

Food and Drug Administration publishes yearly. And forget BMI for athletes

with a lot of muscle - won't ever fit into that.

I was at the hospital lab for routine blood tests about a month ago. One

lady sitting next to me started telling me about how much weight she lost -

then I told her how much my minister lost - then she went on to comment, " You

need to lose some weight too. " Sure I probably need to lose some weight; but

I'm not a fat guy. I lift a lot of heavy weights - plus I do cardio as well.

I give my best to my training.

It's not very nice the way folks can judge others by just one look and not

knowing anything else about a person.

Edwin Freeman, Jr.

San Francisco, USA

=========================

In a message dated 12/15/2008 11:38:25 A.M. Pacific Standard Time,

deadliftdiva@... writes:

Sigh. I just went 10 rounds with my health insurance carrier again. Being

fit and athletic but being 5'9 " 220 lbs = a 25% upcharge. I can weigh 185,

they'll " permit " me to do that, but not be the fit, lean and powerful drug

free athlete I am. Nothing is persuasive to them by the way.

========================

[Guest guest]

Sigh. I just went 10 rounds with my health insurance carrier again. Being fit

and athletic but being 5'9 " 220 lbs = a 25% upcharge. I can weigh 185, they'll

" permit " me to do that, but not be the fit, lean and powerful drug free athlete

I am. Nothing is persuasive to them by the way.

I was told I could submit a protest at my own expense, copy records and argue -

but that it was not likely they would rule in my favor!

So those who choose to be cheeto snarfing sofa slugs are costing me PERSONALLY!

<growl>. If they have to pay more for their own, that's one thing...but they

are directly costing me more! Choosing to be in less than good fitness at 48 is

their choice, not mine!

Doesn't seem to matter which company fyi - obviously with rates rising when you

don't use your insurance either for more than an occasional exam to maintain

your health, a person ends up shopping around and trying to reduce the overhead!

Is it too late to defect to possibly Sweden? <in half jest, sigh...>

The Phantom

aka Schaefer, CMT, competing powerlifter

Denver, Colorado, USA

--------- Pay the obese to lose weight

The below may be of interest:

Pay the obese to lose weight, says study

21:00 09 December 2008 by Jim Giles

The focus of the next diet fad might be cash rather than

carbohydrates. Volpp of the University of Pennsylvania in

Philadelphia found that obese people offered a financial reward for

every kilogram shed lost more weight during a 16-week trial than

those given standard diet advice.

The drawback? Like other weight-loss methods, many of the

participants put the pounds back on once the programme ended. To

achieve longer-lasting results the monthly payments, some totalling

several hundred dollars, might have to be made for longer periods.

Volpp's results mean that obesity may join the list of social

maladies that can be addressed using financial incentives. Previous

experiments have shown that smokers and cocaine addicts can be weaned

off their habits by paying them to stay drug-free. Incentives have

also successfully been used to ensure that parents in developing

countries send their children to school.

One of the biggest incentives schemes ever run in a rich nation got

underway last year in New York. Over 5000 families are being studied

to see if cash incentives can improve the rate at which children

receive regular health check ups and adults attend work training

courses.

Journal reference: Journal of the American Medical Association, vol

300, p 2631

===================

[Guest guest]

> Sigh. I just went 10 rounds with my health insurance carrier again.

> Being fit and athletic but being 5'9 " 220 lbs = a 25% upcharge. I

> can weigh 185, they'll " permit " me to do that, but not be the fit,

> lean and powerful drug free athlete I am. Nothing is persuasive to

> them by the way.

>

> I was told I could submit a protest at my own expense, copy records

> and argue - but that it was not likely they would rule in my favor

Greetings DD (deadlifting diva)

Are there not other criteria from which you could appeal? blood

pressure, blood profiles?

I agree with their approach but someone needs to be aware that only

68% of us fit into the first standard deviation. This has been a

problem forever with standardized systems. If your blood profiles and

pressures are off we can fix that in about 3 months leaving you as big

strong and beautiful as ever. If % bodyfat is a problem (it shouldnt

be) that takes more doing --the irony meaning use of anabolics!!

Are there any studies correlating % bodyfat, blood pressure- profiles

and CV-anaerobic efficency?

Jerry Telle

Lakewood CO USA

[Guest guest]

> See figure 2 in the the study. While paying people to lose weight

> was effective at 4 months, the average person gained back 50 percent

> of the lost weight at 7 months. This technique doesn't appear to

> work very long. Also, it does nothing to change behavior. Short-term

> greed is not the solution to the obesity problem in America.

>

> Tom Fahey

> California State University, Chico

>

> I find it slightly more than somewhat appalling how negative and

> unwilling to take advantage of such available technology people are

> all for the sake of making moral arguments. No one is suggesting

> that people should be paid rewards for the rest of their lives to

> remain normal weight. But you have to understand the nature of how

> such conditions might come to be at least is some cases and take

> advantage of available contingencies to create initial behavior

> change in some fashion - similar contingency management approaches

> are used in some drug treatment modalities - and most often get the

> same short-sighted responses I have seen here

Hi Jack, Tom and all

I always look forward to your posts. At the point of redundancy – short-term

fixes are only as useful as long-term paradigm outcomes. I dont think the

bleeding hearts realize this.

In this case, just so no one thinks I am really up for paying people

to stay healthy let me add that I promote (which will eventually

become) a responsibility based health care system. That is you smoke

--commensurate insurance rates, govt pays (monitors ins companies)

for healthy standards. Everything else becomes the same -- lard ass

='s increased rates, standardized base coverage. If you cant make the

payments, TS, find some one who cares. " Let them die and decrease the surplus

population. " works for me.

Hospitals will be required to release patients at end of standardized stays.

There is always some bleeding heart that believes that food, not prophylactics,

is the only answer to starvation. Or in this case someone who believes a hand

out will

promote responsibility -- or the difference between an enabler and a

true helper. I have volunteered as an adult literacy teacher,

suicide lifeline counselor and hospice companion -- I know from whence I speak

-- death has a way of crystallizing life.

Reinforcement works both ways positive and negative. This --

responsibility pays – will be a really tough transition -- that is

maybe 3 -4 presidential cycles – to create enough momentum to bring the

ignorant masses on line. As it is now paying these BLITHERING

SINK HOLES OF CONSUMPTION to be responsible needs to be associated with

experientially realizing the benefits of responsibility.

Subsidizing irresponsibility (long term) is as insane as it gets.

My pay for responsibility comments was meant to emphasize the importance of

immediate overwhelming outcomes. Not that those outcomes need be positive.

Jerry Telle

Lakewood CO USA

[Guest guest]

Jack Darkes wrote:

> I find it slightly more than somewhat appalling how negative and

unwilling to take

advantage of such available technology people are all for the sake of

making moral

arguments.

replied:

I'm also surprised at the responses, because the study doesn't make

any reference to who

pays the reward. If an overweight person paid a fee to enter such a

program and all

rewards and administrative costs were paid by that fee, then there'd

be no moral hazard.

***

TELLE – brilliant idea -- my partner and I thought it was when we

tried this with potential personal training clients. That is if they

chose this option they had to pay double the hourly rate and could

earn back 55% of their initial payment if they met their goals. As I

remember only a few takers – one or two who almost made their money

back. The ones who failed, lost so much they didn’t train with us

again!!!! I even tried betting to negative avail. The negative

potential of either scheme seemed to increase the probability of

failure – (many assumptions here and more than likely biased

perceptions and memories!!)

This was back in the day when we thought people actually wanted to

improve their lot – not. We only trained those who we believed really

wanted progress – believing that progress would mean referrals.We even

let those go who didn’t make progress -- if you can believe that. What

we apparently learned is that most clients want to think they are

changing – would rather not change because that in almost certainly

would mean having to face their unrealistic hopes/ dreams/goals.

Training, paradoxically, without gains keeps unrealistic fantasies

alive and well -- and out of reach!!

I eventually put together what I thought was a brilliant questionnaire

to implicitly/explicitily elicit real intent, realistic goals and

strategies, and implicitly plant a positive expectation set of

progress. Problem was it took about 2-4 hours at the very least to go

through and became time cost dissonant -- in others opinions that is.

Now the questionnaires seem more and more appropriate, i.e., how much

more important the psych strategies are than any exercise or

nutritional plan. I have the best of these exercise and food plans and

if I don’t I know who does. Mental set is everything. Unscrupulous and/

or ignorant self help writers seem to ignore this fact.

Bill was going broke until he found a way into a Workmans comp

paradigm. When a majority of his clients made enough progress to get

back to work he made money. This illustrates many scenarios. The

ignorance of most physical rehab protocols? The benefits when others

pay for progress and the motivations to succeed -- after all there are

many “malingerers” looking for a free ride.

STEVENS How many people would complain about a program like that...and

what would they complain about?

***

TELLE – How many people would pay for a program that would make them

responsible? Only the responsible ones I suggest. I do think it could

be a great format to illicit awareness and many good strategies to

increase the probabilities of change

STEVENS” “-----------clip----------- then it's legitimate for people

to demand that the potential costs of the program

(Including the moral hazard) be weighed not only against the benefits,

but against the distribution of the benefits-------clip------resulting

redistribution of wealth is morally justified-----------------

clip-----------------then why is it counterproductive to express moral

indignation at the idea of

taxpayers paying the overweight to lose fat?

***

TELLE – Again I think it boils down to 1. does paying the freeloading

gold brickers to be healthy result in eventual savings, e.g., reduced

CV problems and 2. how can we eventually turn the event into an

outcome worth pursuing without pay. That is, how do we give progress a

positive valence –- a positive experience that can be explicit enough

to recall at cue and maybe strong enough to eventually be implicit

enough to influence behavior without conscious awareness, thought and

decision. In short a habit.

In utilitarian terms the former may be the most important. The no

brainer is the 2nd reason is not in opposition/competition/contrast

with the first and may in fact potentiate or at least significantly

promote the cause!!??

As an assize, mucking through the morality issue bogs all down in the

ages old morass of subjective self-righteousness, ignorance and

bipolar (diametric opposites) concept lock. The proof as always, along

with the fly, is in the pudding. Delineating the two still seems to be

a problem.

Jerry “madscientist” Telle

Lakewood CO USA=

[Guest guest]

What about taxing the obese?

Sam Brethauer , LAT, CSCS

Lees Summit, MO, USA

article link and content posted below

***************************************************************

http://www.nydailynews.com/ny_local/2008/12/14/2008-12-

14_governor_paterson_proposes_obesity_tax_a-1.html

Governor Paterson proposes 'Obesity Tax,' a tax on non-diet sodas

BY GLENN BLAIN AND KENNETH LOVETT

DAILY NEWS ALBANY BUREAU

Sunday, December 14th 2008, 11:37 PM

ALBANY - A can of Coke could soon cost New Yorkers more than just calories.

Gov. Paterson, as part of a $121 billion budget to be unveiled Tuesday, will

propose an

" obesity tax " of about 15% on nondiet drinks.

This means a Diet Coke might sell for a $1 - even as the same size bottle of its

calorie-

rich alter ego would go for $1.15.

Paterson's budget also calls for a 3% cut in education spending, a $620-a-year

tuition

hike at SUNY and a $600 increase at CUNY - and about $3.5 billion in health care

cuts, a

source said.

The Democratic governor will not call for a broad-based income tax boost, but he

will

push to restore the sales tax on clothing and footwear.

The drastic belt-tightening comes as lawmakers struggle to close a $15 billion

deficit this

year and next.

" It's painful to make these decisions, " Paterson said Sunday.

State employees again will be asked to forgo their 3% raises next year and defer

five days'

pay until they leave their jobs, the source said. In all, Paterson will propose

about $9

billion in cuts, $4 billion in new taxes and fees, and $1.5 billion in

nonrecurring revenue,

a second source said.

The so-called obesity tax would generate an estimated $404 million a year. Milk,

juice,

diet soda and bottled water would be exempt from the tax.

" I'll just buy less, " said Victor , 55, of Manhattan, as he drank a Coke at

a midtown

Subway store.

" I don't like to buy Diet Coke, " said Amaury , 16, who works at a flower

shop in Penn

Station. " I'll just not buy any sodas if it goes up. "

Public health advocates welcomed news of the tax, saying it would help the fight

against

childhood obesity.

" Raising the price of this liquid candy will put children and teens on a path to

a healthier

diet, " said Elie Ward of the American Academy of Pediatrics of New York State.

The Paterson administration also announced steps yesterday to expand the state's

social

services net, including a 30% increase in welfare payments over three years

starting

January 2010, increased money for food banks and expanded access to the state's

Family

Health Plus program.

Paterson also hopes to make it easier for people to enroll in Medicaid by

eliminating face-

to-face interviews and fingerprinting requirements.

[Guest guest]

Hello (Deadliftdiva),

The insurance problem is a topic that really irks me also. I am an

endurance person -- run, swim, bike. 5'3, weight between 130-135.

This is somewhere around the very high end of " normal " but not yet

obese. My body fat is dangerously low. The scale says 12%, but I

haven't had a menstrual period in many years and was diagnosed with

osteoporosis several years ago. I am now age 46. Also have lots of

trouble with upper respiratory infections and have had a hip fracture.

I've been told that I need to increase fat / muscle ratio, but that

is not easy to do while maintaining my active lifestyle. All of this

has cost our insurance lots of money and they never bat an eyelash

because I am not yet in the " obese " range. These insurance people

are complete idiots. I would say they are out to make money but in my

case they are losing all that they save on you and they are too stupid

to know the difference.

Gloria Bach

Willseyville NY USA

> >

> > > Sigh. I just went 10 rounds with my health insurance carrier

again.

> > > Being fit and athletic but being 5'9 " 220 lbs = a 25% upcharge. I

> > > can weigh 185, they'll " permit " me to do that, but not be the fit,

> > > lean and powerful drug free athlete I am. Nothing is persuasive to

> > > them by the way.

> > >

> > > I was told I could submit a protest at my own expense, copy

records

> > > and argue - but that it was not likely they would rule in my favor

> >

> > Greetings DD (deadlifting diva)

> >

> > Are there not other criteria from which you could appeal? blood

> > pressure, blood profiles?

> >

> > I agree with their approach but someone needs to be aware that only

> > 68% of us fit into the first standard deviation. This has been a

> > problem forever with standardized systems. If your blood profiles

and

> > pressures are off we can fix that in about 3 months leaving you as

big

> > strong and beautiful as ever. If % bodyfat is a problem (it shouldnt

> > be) that takes more doing --the irony meaning use of anabolics!!

> >

> > Are there any studies correlating % bodyfat, blood pressure-

profiles

> > and CV-anaerobic efficency?

> >

> > Jerry Telle

> > Lakewood CO USA

> >

> >

>

>

>

>

>