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Re:Many people living in the 'Diabetes Belt' are plagued wit... by StrangeATractor on Tuesday May 09, 2023 @12:47PM (#35877073)
The diabetes belt has more problems than diabetes. The entire culture is degenerate, people live unhealthy lifestyles in an economic dead end. It's no wonder they're sick and broke.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by areoform on Tuesday May 09, 2023 @01:28PM (#35877608)
I don't think it helps to call them "degenerate." They're human beings. Some of them, more clever than you. Who are trapped in lives of quiet desperation.

We think we are civilized, but we are just as barbarous as the world of Hugo's Les Misérables. We live in a world filled with Inspector Javert's spending their lives chasing their Valjeans.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by rayiner on Tuesday May 09, 2023 @01:58PM (#35878077)
Changing labels doesn’t change the underlying reality. Spend some time talking to some old stock Yankees. Their attitude towards food is different. A phrase you’ll often hear is “eat to live.” It’s not a wonder that Alabama has an obesity rate that’s over 60% higher than Massachusetts.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by burkaman on Tuesday May 09, 2023 @02:37PM (#35878613)
This is a very extreme claim that requires a lot of evidence. If we're just throwing out ideas, I'll make a claim that "attitude" is a lot less of a factor than having only dollar stores and no grocery stores within an hour's drive.

Also, I've lived in Massachusetts my entire life and I've never heard anyone say "eat to live".

Re:Many people living in the 'Diabetes Belt' are plagued wit... by xyzzyz on Tuesday May 09, 2023 @02:53PM (#35878799)
I seriously doubt that in Alabama there are many people who don’t have a grocery store within an hour drive. Almost certainly less than 10% of population. Even if you said 20 minutes instead of an hour, it wouldn’t be a lot of people either. The thing with areas this remote is that few people live there.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by burkaman on Tuesday May 09, 2023 @04:00PM (#35879642)
I did exaggerate a little, I apologize. It's not just rural areas though, there are plenty of small towns without any grocery stores, and urban areas where the nearest grocery store is very far away, especially if you don't have regular access to a car. Here's one source that says 1.8 million Alabama residents don't have a grocery store within 45 minutes: http://humsci.auburn.edu/news/hunger_solutions_institute_awa...
Re:Many people living in the 'Diabetes Belt' are plagued wit... by xyzzyz on Tuesday May 09, 2023 @04:53PM (#35880229)
Are these people more or less obese than the ones who have easy access to grocery store? You are suggesting that this is a major driver of obesity, so you must be basing this on some data, no?

Also, that link doesn’t say whether this is 45 minutes drive, and since it does not reference any source, it’s hard to look that up.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by burkaman on Tuesday May 09, 2023 @05:45PM (#35880793)
Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there. If it's an urban area where a significant portion of people don't have easy access to a car, then you wouldn't look at driving times.

These are called food deserts, and there is a ton of research on them. From what I've read there is not a direct line between food deserts and higher obesity rates, but it is a relevant factor, especially when abundant dollar stores and fast food places are offering cheaper and more accessible food than the nearest grocery stores (if there are any). I've also seen this described as a "food swamp".

I've never seen any research or data showing disparities in American obesity rates are influenced by cultural attitudes toward food.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by xyzzyz on Tuesday May 09, 2023 @06:49PM (#35881364)
> Well the driving part doesn't matter, the thing we care about is how hard it is for someone to get to a place with affordable healthy food, however they get there.

Can’t be much harder than it was 100 years ago, when everyone was extremely poor by today standards, and visiting a grocery store was often a whole day trip, no? Obesity didn’t seem to have been a problem at that time. Seems like it really is not about lack of access to affordable healthy food, which today, by any historical standard, is very easy even in most deprived places in US.

> If it's an urban area where a significant portion of people don't have easy access to a car, then you wouldn't look at driving times.

Most poor people in urban areas do have easy access to a car. Cars are extremely cheap in US, poor Americans enjoy high consumption levels by global standards, which typically entails access to cars.

In any case, for this to support your argument, which that lack of access to affordable healthy food drives obesity, we’d need to have that in urban areas, carless people are significantly more obese than people with cars. To reiterate, your argument is that drivers are less obese than people who are too poor to drive. Is it actually the case? I seriously doubt it, but you’re welcome to show data supporting your theory.

> These are called food deserts, and there is a ton of research on them. From what I've read there is not a direct line between food deserts and higher obesity rates, but it is a relevant factor, especially when abundant dollar stores and fast food places are offering cheaper and more accessible food than the nearest grocery stores (if there are any).

Yes, I’ve heard about this stuff, and most of this stuff is highly motivated logic with extremely meager support in facts. Even you admit that the whole food desert thing has little actual observed causal impact on obesity rates. Instead, the poor just go to convenience stores and buy crap, and they do this even if they have healthy options easily available (this is true, because otherwise you’d see clear correlation that people close to grocery stores with cheap and healthy food are not obese, which you don’t).

Here, let me propose an alternative theory, which matches facts on the ground much better: many poor people in US are low in conscientiousness and long term thinking, and so instead of engaging in relatively complex activity of buying bulk staples and cooking simple and healthy meals, prefer to spend extra for convenience of unhealthy foods from dollar stores and fast food. This is possible, because their “poverty” is not an absolute level, but rather relative measure. By this I mean the fact that by global standard, American poor enjoy quite high consumption levels, so they can easily afford these unhealthy habits. Making healthy food easier to obtain for them will, as you admit, not change much, because people will just not take advantage of it, instead preferring easy and unhealthy food instead. Instead, what you’d need to do is to immiserate them even more by either taking away convenient and unhealthy options nearby, or reduce their purchasing power to make them unaffordable. This is, of course, seen as immoral, so it will not happen.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by burkaman on Tuesday May 09, 2023 @07:08PM (#35881545)
> visiting a grocery store was often a whole day trip, no?

I mean, no. 100 years ago was the 1920s. Not really sure what you're referring to and this is not a useful comparison anyway, obviously many many aspects of the US food system and economy have changed in 100 years. I don't really know how to respond to this.

> To reiterate, your argument is that drivers are less obese than people who are too poor to drive. Is it actually the case?

Yes, because obesity is very strongly linked to poverty. Rich people tend to have more cars and eat healthier food because it's more accessible. Here's a study: https://www.sciencedirect.com/science/article/pii/S222658561...

Obviously I disagree with your opinions in the last two paragraphs, but if you have some evidence for them I'd be happy to look at it.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by xyzzyz on Tuesday May 09, 2023 @09:50PM (#35882669)
> Not really sure what you're referring to and this is not a useful comparison anyway, obviously many many aspects of the US food system and economy have changed in 100 years. I don't really know how to respond to this.

It is extremely useful comparison, and this is why you don’t really know how to respond to it. Your theory hinges on the fact that worse access to fresh food makes people more obese, but 100 years ago (and 150 years ago, even more so) most people had even worse access to fresh, healthy foods, but nevertheless obesity was not a problem at all. This is a problem to your argument, which is why you are lost for words.

> Rich people tend to have more cars and eat healthier food because it's more accessible. Here's a study:

The graph you linked shows that men with a car have higher BMI than men with no cars. Thanks for supporting my argument with evidence, I guess? In any case, this is just purely correlational study, which does not even attempt to answer whether access to car causes lower obesity. You might as well show me a graph of square footage per person against BMI and argue that small houses make people fat. On the other hand, it is perfectly consistent with the theory I elucidated above, which is that conscientiousness causes people to both be wealthier, and less fat.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by maxerickson on Tuesday May 09, 2023 @06:49PM (#35881358)
What makes things so bleak? My small county is somewhat below the national median income (so doing fine but not wildly wealthy) and like half of the people that live here live within 10 miles of 3 large grocers and multiple other grocers. The most concentrated population is within a couple miles, and the people that live further away are doing so because they want to live outside of town, they mostly aren't stuck there or whatever.

Small stores out in the county mostly don't have much fresh stuff, but probably a few things.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by xyzzyz on Tuesday May 09, 2023 @11:31PM (#35883312)
They are not bleak, it’s just you are responding to a narrative, not facts.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by rayiner on Tuesday May 09, 2023 @03:23PM (#35879176)
You think that “different cultures have different attitudes towards food” is an extreme claim?
Re:Many people living in the 'Diabetes Belt' are plagued wit... by burkaman on Tuesday May 09, 2023 @03:52PM (#35879543)
No, I think "different American subcultures having different attitudes towards food is the primary factor causing a 60% difference in obesity rate" is an extreme claim.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by jefftk on Tuesday May 09, 2023 @02:10PM (#35878234)
I live in MA, and "old stock Yankees" is not most of the population.

Isn't this just that MA is richer than AL, and richer people are less likely to be obese?

Re:Many people living in the 'Diabetes Belt' are plagued wit... by rayiner on Tuesday May 09, 2023 @03:31PM (#35879281)
The nearly universal trend among nations is that they get fatter as they get richer. So it would be quite bizarre to see affluence, in and of itself, suddenly causing the opposite effect.

Maryland has comparable median income to Massachusetts, but much higher obesity rates. Vermont and Kansas have similar incomes, but Vermont has much lower obesity rates. (Same is true for Virginia versus Colorado, Montana versus South Carolina, etc.)

Re:Many people living in the 'Diabetes Belt' are plagued wit... by fortran77 on Tuesday May 09, 2023 @01:21PM (#35877499)
The majority of people with T2D who are also overweight would be asymptomatic if they lost weight. So there’s a free treatment available to a large subset of these people.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by EatingWithForks on Tuesday May 09, 2023 @01:25PM (#35877563)
Most health insurance doesn't cover weight loss treatment without a condition like T2D, heart issues, etc. If you're fat enough that it's damaging your health you're extremely unlikely to be able to lose it without significant support through medicine, nutritionists, etc.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by johngladtj on Tuesday May 09, 2023 @01:27PM (#35877596)
Losing weight doesn't cost money.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by anonymouskimmer on Tuesday May 09, 2023 @01:38PM (#35877788)
No, it just requires constantly feeling hunger pains. Along with bouts of lightheadedness, distraction, and things of that nature.

There are a variety of reasons people get fat, and a variety of reasons people stay fat. Treating the specific reasons for the specific people is a lot safer, and easier, than just having people eat less.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by George83728 on Tuesday May 09, 2023 @03:58PM (#35879620)
> No, it just requires constantly feeling hunger pains.

No it doesn't, just eat more filling foods with lots of fiber. Veggies are cheaper than dirt, far cheaper than junk food, and far more sating. Junk food is engineered to leave you feeling hungry, to encourage you to buy more. Stop buying junk food completely; no more chips, colas or frozen pizzas. Buy vegetables, particularly the leafy ones, and eat as much as it takes to make yourself feel full. You'll lose weight and save money at the same time.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by anonymouskimmer on Tuesday May 09, 2023 @11:39PM (#35883361)
I eat "double fiber" bread and take 4 tablespoons of whole psyllium husk per day.

The chips are a good idea, but my diet is already so limited to PB&J, hummus and cheese and mixed green sandwiches, and the occasional whole grain rotini + prego chunky garden (and mixed greens), oatmeal, apples, frozen blueberries, bananas, and the occasional frozen quinoa dish that chips and occasional ice cream or Italian ice are a nice change of pace.

I haven't had a soda or the like since, I think pre-COVID.

I just eat too much, and don't exercise enough. I could probably use more water, too, but I don't like using the restroom at work. I do find that when I'm working I can often not eat without feeling and hunger pains, but I usually make up for that by eating a lot at night when I get home.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by George83728 on Wednesday May 10, 2023 @09:07AM (#35886787)
> I eat "double fiber" bread and take 4 tablespoons of whole psyllium husk per day.

You should really try vegetables. I know bread is a processed plant product, but we generally don't count bread as a vegetable.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by EatingWithForks on Wednesday May 10, 2023 @01:33PM (#35890596)
I'mma tell you as an avid veggie eater: veggies are not cheap. The amount of leafy greens that will make someone full (and properly nourishing leafy veg: spinach, kale, dandelion and beet greens, etc.) isn't cheaper.

Poor people aren't living high on spinach and kale. They're eating butter sandwiches for lunch because they're too poor for nut spreads and jam. They're eating 5 boxes for 2$ mac dinners. They're checking which of the soup cans they bought on a 10 dollar for 10 cans sale years ago are still good (aka not puffy) even though they're long expired. The cheap vegetables are starchy roots, but even the 50c/lb carrots don't hold up to processed food prices.

You can spread out 1 cup of rice with 9 cups of water as a soup. I was stirfrying cabbage with almost no seasoning. And it would still be cheaper and more filling to indulge in mac dinners and hamburger helper.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by EatingWithForks on Tuesday May 09, 2023 @01:28PM (#35877612)
If you're that fat you're statistically unlikely to lose weight without medical intervention of some sort, even something as basic as talking to a fucking nutritionist about portion sizes.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by yibg on Tuesday May 09, 2023 @01:40PM (#35877821)
I sympathize with how hard it is to lose weight, but at some point personal responsibility kicks in right?
Re:Many people living in the 'Diabetes Belt' are plagued wit... by EatingWithForks on Tuesday May 09, 2023 @01:44PM (#35877873)
When you're that obese you're well beyond personal responsibility. Personal responsibility is enjoying a big thanksgiving dinner and then eating light for the next week or so, or eating some salads for a bit to have a hot girl summer. Obesity is increasingly looking more like a hormone disorder (the latest "miracle" weight loss drugs are all hormone-regulating) or an eating disorder of some sort and should be addressed as such.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by nradov on Tuesday May 09, 2023 @02:45PM (#35878705)
Personal responsibility is great, but we're all paying for patients with type-2 diabetes (and other lifestyle related chronic conditions). We pay in terms of higher taxes for Medicare/Medicaid, higher premiums for private commercial insurance, and higher charges from providers trying to cover losses from indigent patients who default on medical debt. People are unlikely to suddenly become more responsible so what is your solution?
Re:Many people living in the 'Diabetes Belt' are plagued wit... by antifa on Tuesday May 09, 2023 @11:04PM (#35883182)
The optimal amount of helping hands and second chances are greater than zero.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by Gordonjcp on Tuesday May 09, 2023 @01:35PM (#35877718)
There's this thing called "the Internet" now. You can find out all sorts of cool stuff on it.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by EatingWithForks on Tuesday May 09, 2023 @01:39PM (#35877811)
Statistically, if a person is so obese for so long they get T2D, they are not going to go into remission just from googling weight loss or following whatever they find on the internet (doubly so if they fall into some crank Liver King style nonsense). That's just the facts. It's been studied over and over again for many years at this point.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by tstrimple on Tuesday May 09, 2023 @01:46PM (#35877906)
I honestly don't understand responses like this. We're presented with systemic issues, and your "solution" is just "personal responsibility"? Something which has demonstrably failed and lead us to the situation we're in today? Do you often think that doing more of the same thing will lead to different results?

Since we're in a technology forum. Let's say you're a product owner and your app is suffering from severe performance issues. Would a "solution" of telling the developers of the app "just write code more efficiently! Use Google if you have to!" be acceptable to you? Do you think it would produce the results you want?

Re:Many people living in the 'Diabetes Belt' are plagued wit... by rixthefox on Tuesday May 09, 2023 @03:13PM (#35879061)
I think a better analogy to use would be a very slow loading app.

Say your app takes 5 minutes to load the first page and 1 minute to switch between pages after that. Instead of blaming the developers, blame the users for expecting too much of the app. Personal responsibility and all that.

It's the users fault they are using the app during peak times. If they really needed access to X part of the app they should have done it before it got busy.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by tstrimple on Tuesday May 09, 2023 @03:55PM (#35879580)
I used the app dev side because I think it's more illustrative. There are various teams with various competing priorities who have collectively developed a product which is horribly slow. No individual developer is at fault. Some are efficient with their code, and some are less so. But there is no architecture team or mature SDLC to handle cross cutting concerns or a foundational platform for everyone to build from. Everyone is free to do their own thing and write code the way they want use whatever standards they can find on Google. In that world, just telling the devs to write more efficient code is insufficient to correct the course. The systemic problems that have developed require systemic solutions. A blanket "just do better" has never been useful to anyone.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by Gordonjcp on Tuesday May 09, 2023 @03:30PM (#35879271)
It is entirely down to personal responsibility.

If you're morbidly obese, it is because you chose to eat too much and you chose to exercise too little.

It was your choice to stuff all that food in your face, no-one else's. You did it.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by tstrimple on Tuesday May 09, 2023 @03:49PM (#35879511)
And your "solution" is completely meaningless because it's been proven to not work across societies. It's like saying the solution to world hunger is easy. Everyone should just feed themselves! Want world peace? Everyone should just be more peaceful! It's completely useless rhetoric with absolutely no value in the conversation. Are you actually incapable of looking at these things as systems with a large number of variables and broad societal impact?
Re:Many people living in the 'Diabetes Belt' are plagued wit... by Gordonjcp on Tuesday May 09, 2023 @04:36PM (#35880057)
Your analogy breaks down.

People are hungry across the world because there is a lack of food. They cannot just decide to feed themselves food that does not exist.

Terminally online cryptobros who get triggered by comments like "It was your choice to stuff all that food in your face, no-one else's" are not suffering from a lack of food, they are suffering from an excess of sugary poor-quality food. You decided to stuff that fourth twinkie in your face hole, you fat fuck. You can also decide to *stop* stuffing them in there.

Not you *you* obviously, the rhetorical you.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by George83728 on Tuesday May 09, 2023 @05:25PM (#35880584)
They use the internet and find people who tell them that it's not their fault. It's the fault of vegetables for being so expensive, even though vegetables are cheaper than junkfood. It's the fault of food deserts, even though they live in walking/driving range of half a dozen full-sized super markets. It's the fault of their genes, even all 8 of their great grandparents were fit. It's anybody/anything's fault, except their own. And so they stay fat, and join the ranks of those who perpetuate these fat-excusing myths (on full display throughout this discussion section.)
Re:Many people living in the 'Diabetes Belt' are plagued wit... by lghh on Tuesday May 09, 2023 @01:44PM (#35877868)
At a minimum, it costs time. Many people don't have time. The less money you're able to spend on it, the more time it will probably cost you.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by simonw on Tuesday May 09, 2023 @01:45PM (#35877881)
> Losing weight doesn't cost money.

I'm pretty sure it does. Unhealthy food is a lot cheaper.

Re:Many people living in the 'Diabetes Belt' are plagued wit... by hello_computer on Tuesday May 09, 2023 @01:51PM (#35877965)
Re:Many people living in the 'Diabetes Belt' are plagued wit... by throw0101b on Tuesday May 09, 2023 @02:00PM (#35878100)
> Losing weight doesn't cost money.

It can if you live in a food desert:

> USDA’s Economic Research Service previously identified more than 6,500 food desert tracts in the United States based on 2000 Census and 2006 data on locations of supermar- kets, supercenters, and large grocery stores. In this report, we examine the socioeconomic and demographic characteristics of these tracts to see how they differ from other census tracts and the extent to which these differences influence food desert status. Relative to all other census tracts, food desert tracts tend to have smaller populations, higher rates of abandoned or vacant homes, and residents who have lower levels of education, lower incomes, and higher unemployment. Census tracts with higher poverty rates are more likely to be food deserts than otherwise similar low-income census tracts in rural and in very dense (highly populated) urban areas. For less dense urban areas, census tracts with higher concentrations of minority populations are more likely to be food deserts, while tracts with substantial decreases in minority populations between 1990 and 2000 were less likely to be identified as food deserts in 2000.

* PDF: https://www.ers.usda.gov/webdocs/publications/45014/30940_er...

* https://en.wikipedia.org/wiki/Food_desert

Re:Many people living in the 'Diabetes Belt' are plagued wit... by nebula8804 on Tuesday May 09, 2023 @02:04PM (#35878152)
But it requires massive willpower to overcome those first few days of cravings, pain and mental anguish and then extended willpower to keep it going for at least 30 days so you can build some tolerance to the new reality of clean eating and exercise...and then even more willpower after losing all the weight not to fall back into a bad habit and refill all those dormant empty fat cells that your body does not destroy for at least 7 years. Combine that with the fact that a lot of people are living paycheck to paycheck/working multiple jobs to survive and may not have access to clean nutritious foods without extended effort and you see how we ended up in this situation.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by specialist on Tuesday May 09, 2023 @01:26PM (#35877578)
This is bad policy begeting a public health crisis, not just a lot of people all making the same poor life choices.
Re:Many people living in the 'Diabetes Belt' are plagued wit... by zhxshen on Tuesday May 09, 2023 @01:01PM (#35877234)
If you look at recent layoff numbers, their coastal brethren will be joining them soon. It's America! One man copes with food, another with money, another with sex. You are all degenerate!
Re:Many people living in the 'Diabetes Belt' are plagued wit... by hello_computer on Tuesday May 09, 2023 @01:10PM (#35877331)
Haha. We are.