Welp - I guess my O+ doesn't make me Superman.

Standard of Care for those hospitalized is still Remdisivir? How's the availability? If they progress on that, then what?

Goodbull_19 said:

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Infection_Ag11 said:

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Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

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BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

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The average American (male and female) has put on 30 lbs since 1960.

I am 6'1" and have weighed between 205-215 for most of my adult life. I considered myself "bigger built" but few would have described me as fat.

I have in the last 3 months lost 30 lbs. Now 6'1" and finally truly healthy.

All that to say, I totally agree, our perceptions of "slightly overweight" or "normal" are so skewed

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I'm 5'10, 165 and have been thought of by most as very skinny my entire adult life. My grandfather was 5'11", 170 when joined the Navy in 1942 and was one of the bigger guys he went through training with and said he was never called skinny at any point in his adult life.

It's pretty crazy how different perceptions are

tbh i'm glad i grew up in post WWII plenty

sugar everywhere is no bueno, but it beats starving

Same. Just shy of 6 ft and worked myself down to ~180. Still considered overweight by BMI standards but haven't gotten comments just like that. "you look unhealthy", "skin and bones", etc.

I've been super skinny my whole life. I'm 5'8 and have been around 130-140 since high school and all I ever heard was that I need to put some meat on my bones. It didn't matter what I ate I stayed the same size. Started taking some anxiety medication at the end of last year and it made me put on 20 pounds and all of a sudden I'm borderline "obese" according to BMI.

I'm 60 and have lost 23 lbs this year with a diet change and regular exercise. According to some health standards I've seen I need to lose another 5 to be just right/healthy. I'm calorie counting and trying to balance macros. I look and feel better and Ms Champ is doing it wth me so we are trying to make it a lifestyle change. I highly recommend it.

shertown04 said:

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I've been super skinny my whole life. I'm 5'8 and have been around 130-140 since high school and all I ever heard was that I need to put some meat on my bones. It didn't matter what I ate I stayed the same size. Started taking some anxiety medication at the end of last year and it made me put on 20 pounds and all of a sudden I'm borderline "obese" according to BMI.

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Same...super thin until 2000-ish when anxiety meds and life put 20-30 extra lbs on me. Cannot seem to lose more than 5 to 8 pounds before stalling for a long time.

Life changing experience for me was living in the UK, especially London. You walk everywhere or cycle and people seemed so skinny at first. Now when I go back to the states everyone looks overweight to me. It has been life changing.

On cue, I lose weight when in the UK and gain when in US. 5'-11" white male late 30s. Years of data in both countries back and forth. Consistently 170-180 range in US depending on season. Consistently 160-165 in UK and no seasonal dependence. I can lose 15# coming here without even trying, and I drink way more alcohol here that has way more calories (heavy beers vs light beers). America has a health problem, and I'm not talking about Covid.

ETA it's also not culturally unacceptable here to call people out for being overweight. I once gained a few pounds here (maybe 10 or so over a few months) and got over 170 and several coworkers called me out in a joking but serious way. These were people who were good friends and honestly just cared about me and my health. It was more of an accountability call out and not exactly shaming, but I got the message. It really opened my eyes to how culturally acceptable it has become in America to be unhealthy.

Any of you losers (weight losers) want to share what worked?

From March 12th through May I was walking 4 to 5 miles a day. I lost a few ponds but not much more.

Aggie95 said:

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Any of you losers (weight losers) want to share what worked?

From March 12th through May I was walking 4 to 5 miles a day. I lost a few ponds but not much more.

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You may try exercising before you eat in the AM, and if possible, go with a 16:8 fast program. It's really not that hard (that fasting approach), and really cut down on the calories.

I'll list differences I've noticed in day to day and week to week life between US and UK and it should make sense. Tbh I have never counted calories, dieted or even worried about what I eat or drink. Like anything else there is not a single silver bullet. It's a balance and it is obvious and simple. America just has bred a culture that makes it way harder:

-Be active and move consistently throughout the day. I almost always get at least 10k steps per day on my Fitbit. I average about 13k without even trying much.

-Walk or cycle to work and stores instead of driving. I walk or cycle somewhere here almost every single day. I rarely drive my car. Like twice a month or so. On the weekends our family activities are focused around long walks or bike rides.

-Try to exercise at least 20 minutes 4-5 days a week. It doesn't matter what you do! Just do something.

-No Tex mex and bbq unless I make it. It doesn't really exist here.

-Fast food. It exists here but way less in your face and cultural. We do order pizza delivery with wings every Friday night. And we go to 5 guys every now and then. But those are treats and not the norm.

-Sugar. Sweets here are so much smaller and have way less sugar. They also taste better! Example: gelato vs traditional ice cream

-portion sizes. Especially at restaurants.

-snacks. Chips and salsa vs carrot sticks and hummus.

Going to the carnivore diet worked for me. Weight has stayed steady at my good college weight with increase in muscle mass. 40 years old and able to handle P90x way better than when 30. Also, I suffered from multiple autoimmune issues and severe chronic sinusitis (5 surgeries) with years of antibiotic use. All of these issues and my allergies are now nonexistent. Anyway, my own path, but some form of low carb seems to be the best path.

Big Al 1992 said:

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Welp - I guess my O+ doesn't make me Superman.

Standard of Care for those hospitalized is still Remdisivir? How's the availability? If they progress on that, then what?

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CVP, remdesivir, toci, dexamethasone, anticoagulation all available yes.

cut sugar and carbs out entirely

ate like 2500 cal at first, increased to 3k

weight melted off and wasn't hard to maintain

COVID killed that run though, put on 8 lbs since March

Aggie95 said:

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Any of you losers (weight losers) want to share what worked?

From March 12th through May I was walking 4 to 5 miles a day. I lost a few ponds but not much more.

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Intermittent fasting. I do 20/4, for the most part. I allow myself to eat between 5 and 9 . So usually dinner, workout, big snack. This makes it really easy to keep calories down and have a good sized, enjoyable dinner. During the day I just drink a lot of water and coffee when I need it. I try to pick healthier foods most of the time, but nothing crazy and will have a "whatever I want" meal once a week.

Exercise daily in the evening / night. Either a run or weights in the garage, or both lately, think i'm catching the workout bug as I see my body change for the better. I have a pretty nice free weight setup.

That's it. The fasting is 90% of the equation, calories in calories out.

Thanks...i've done the fasting some and can see that it could work.

Do you ever find yourself light-headed/week around normal lunchtime if you haven't eaten since 9pm the previous day?

Big Al 1992 said:

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Welp - I guess my O+ doesn't make me Superman.

Standard of Care for those hospitalized is still Remdisivir? How's the availability? If they progress on that, then what?

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Dexamethasone for those still symptomatic or hypoxic after 7 days, remdesivir/plasma/IL-6 inhibitor for hypoxic patients, anticoagulation in those with significantly elevated inflammatory markers or severe disease.

Specifics depend on the patient, their risk of disease progression, their renal function, etc.

I think the biggest risk factor for young people is a sense of invincibility. That and just stupidity

I think there is an element of this.

That coupled with viral load I think certain people can get it just as bad if they aren't careful.

I'm 31 I work out often and am in great shape. I'm also 0+ blood type, but I always wear a mask because I think it helps not spread covid, and I think it lessons the viral load you can receive.

Aggie95 said:

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Thanks...i've done the fasting some and can see that it could work.

Do you ever find yourself light-headed/week around normal lunchtime if you haven't eaten since 9pm the previous day?

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Evvvery once in awhile if I haven't been getting enough sodium, potassium, or magnesium in my diet. A lot of days I'll make myself a sodium/potassium ("NoSalt") water mix before leaving the house and sip on it throughout the day. Now that I'm use to it and have my diet dialed in, I rarely have issues and stay busy enough at work that half the time lunchtime comes and goes before I realize it. Losing 30lbs and running regularly has also made a big difference in my energy, so there's that factor too.

Hardest part of fasting is staying out of the breakroom where drug reps have food catered daily... I've gotten to where I won't even go back between 11:30 and 2.

Intermittent fasting works. Watch Dr. Fungs, Bergs, etc videos on YouTube and countless success stories.

I will offer my perspective. I am an ICU doc in Arizona and have probably cared for a few hundred Covid patients since it all began. Admittedly this is likely fewer than other docs on this board.

-Patients are almost exclusively Hispanic or Native American (though we have high percentage of Hispanic population in general, much like Texas).
-Most are obese
-I have yet to see any completely healthy person under the age of 50 sick enough to require the ICU. I'm not involved with the floor patients unless they're decompensating so I can't say how many healthy "young" people are hospitalized on the regular medical floor
-Those less than 50 years old have had BMI's mid 30s and higher. And no, these aren't muscular people with misleading BMI's
-People aren't dying like they were. Part of it is healthier hosts getting infected, but also we are getting much better at treating this disease.
-As far as the covid-specific therapies, steroids do seem to make a difference, though anecdotally I haven't noticed a difference with plasma, HCQ, or remdesivir. There have been a fair number of AKI suspected due to remdesivir resulting in need for dialysis. I haven't seen toci used here so it may just not be available

Bump showing second waves can hit areas that were already hit once

Sq 17 said:

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Bump showing second waves can hit areas that were already hit once

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these areas are nothing like NY and parts of Italy. There is a huge difference. Not saying it can't or won't happen, but let's see if/when NYC starts asking for nurses to show up from all over the country.

Just worked overnight in the ICU as an intensivist because our hospital's intensivists are short staffed, so they asked a couple of the ER docs to help out. Man, I don't envy y'all's job at the moment. Within 3 hours of showing up I coded 4 patients, had to intubate another 2 that failed HFNC+NRB+proning, and had to unfortunately speak with a couple families about their loved ones passing, and the most heartbreaking part is that they couldn't be there to say goodbye. It's so g*dd*mn draining. And then having to round on these patients that have been there for weeks showing no improvement and their CXRs looking like a bomb went off in their lungs. I don't know that I could do this 40-60 hrs/wk. Hats off to y'all for all you do.

Marcus Aurelius said:

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Just saw 29, 33, 33 y/os. Sick. No cormorbids. No one is immune.

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How many females in this age group? If female, how many are not morbidly obese?

raging_agaholic said:

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Marcus Aurelius said:

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Just saw 29, 33, 33 y/os. Sick. No cormorbids. No one is immune.

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How many females in this age group? If female, how many are not morbidly obese?

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He said no comorbidities so none of them would have been obese right?

Infection_Ag11 said:

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Goodbull_19 said:

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Infection_Ag11 said:

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Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

---

BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

---

The average American (male and female) has put on 30 lbs since 1960.

I am 6'1" and have weighed between 205-215 for most of my adult life. I considered myself "bigger built" but few would have described me as fat.

I have in the last 3 months lost 30 lbs. Now 6'1" and finally truly healthy.

All that to say, I totally agree, our perceptions of "slightly overweight" or "normal" are so skewed

---

I'm 5'10, 165 and have been thought of by most as very skinny my entire adult life. My grandfather was 5'11", 170 when joined the Navy in 1942 and was one of the bigger guys he went through training with and said he was never called skinny at any point in his adult life.

It's pretty crazy how different perceptions are

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My father played football for A&M in the 20's. He was 5'11" 190 lbs and very very low body fat. He played lineman as he was so stout.

Username checks out

Big Shoulders said:

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Username checks out

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He was a bit older when he had kids (my mom was 10 years younger) so I'm old but not THAT old. Well, yea I am.

I'm 5'10" and about 167. I could lose about 10 lbs to be healthier.
I do walk 45 minutes a day 5 days a week.

Chocolate, Dark is my nemesis.

insulator_king said:

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I'm 5'10" and about 167. I could lose about 10 lbs to be healthier.
I do walk 45 minutes a day 5 days a week.

Chocolate, Dark is my nemesis.

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just so you know...most of us on the board want to punch you right now.

That's kind of like Jeff Bezos saying..ya, I could stand to make a couple hundred thousand more a year.