We do need a proper conversation about obesity and metabolic disorder

[BecomeStronger]

I've been doing some reading about immunity, which affects not only our ability to fight a nasty virus but also things like cancer and heart disease. This is not news, but the stats for the increased impact, of so many different conditions, on those who are obese are truly shocking.

Of course, people who are already suffering should be treated by whatever means are available but isn't it time that the causes were addressed properly?

By which I absolutely don't mean telling fat people it's all their own fault, it's far more complex than that, but we need to move on from a place where you're not even allowed to mention weight, especially in the context of health.

It's simply not true that it's possible to be obese and fit/healthy and even if an obese person appears healthy, it's a ticking timebomb. (certainly it's true that being fat and active is better than fat and sedentary, but that's not the same thing).

IMO we need a massive public health campaign, with the necessary support in place, to address obesity in the same way that we addressed smoking. Of course it won't go away, it won't happen overnight and it won't be easy (like smoking) but something has to be done.

At the moment there seems to be outrage if even doctors suggest to their patients that lifestyle changes are necessary and yet this is by far the most effective "treatment" there is for so many of the illnesses linked to metabolic disorder.

rebelfit.co.uk/blog/2020/if-diets-dont-work-how-do-you-lose-weigh

People need to go cold turkey and eat less. But there’s no money in that.

Exactly. Telling people to eat less, which is the single best way to lose weight, doesnt make money! I hate 'make these healthy swaps' thing as well, a lot of the time the 'healthy swaps' are processed shite which will leave you feeling hungry again after 5 minutes.

It’s certainly possible to be obese and fit. There are people running marathons who are obese. They might be in the minority but my online running groups are full of them.

@RosesinGranGransgarden I agree absolutely that the NHS approach to weight and nutrition generally is awful. With everything we currently know, isn't it shocking that during the course of qualifying a GP will have been taught nothing about obesity.

That was the reason for my post the overall, officially mandated approach needs to change.

Ugh *nothing about nutrition...

I've always, always, always (even in my teens when i had a figuee that turned heads and i got constant compliments on) had a high 'obese' BMI. But i was a fucking SHEPHERD. I felt bloody healthy. I didnt have a tv. I cooked from scratch. You can't wrangle 3000 ewes and trek across hill and dale if you're unfit!! So that cant be fit and fat brigade can bite me. I see plenty of grey skinned, sallow looking slender ppl i could beat up a hill!

At the moment however, im fat and NOT fit, and i feel it - its different.

@Arosadra

It’s certainly possible to be obese and fit. There are people running marathons who are obese. They might be in the minority but my online running groups are full of them.

Yes but that's not the same as healthy. They still have higher risk factors for many illnesses.

@Duckwit

People need to go cold turkey and eat less. But there’s no money in that.

Exactly. Telling people to eat less, which is the single best way to lose weight, doesnt make money! I hate 'make these healthy swaps' thing as well, a lot of the time the 'healthy swaps' are processed shite which will leave you feeling hungry again after 5 minutes.

Yes I hate the NHS change for life campaign, most of the advice is just plain wrong. Why would anyone recommend changing sugary drinks for artificial sweetener, for example? But it's funded by the food industry.

This is exactly what I'm talking about. It's not individual actions, although obviously these have to come to, but the overall government sponsored approach.

We need better research and investment in finding out how to stop people feeling such a huge need to eat. No body wants or chooses to be obese. It’s always self righteous thin people that go on about it being just a case of eating healthily.
Why do almost no obese people ever become a healthy weight long term? The pressure to be thin is in every aspect of our society yet people are getting fatter and fatter.
I am obese. I’m a vegetarian and eat healthy almost all the time, however, I live my life always hungry.
I eat too little, I should have more breakfast, I need more protein, I need less protein I’ve heard it all. Nothing stops me craving food all the time and I can eat way over the calories needed to maintain my weight by eating just healthy food. I can and do lose weight if I restrict myself to very low calorie diets but it’s torture and it never works long term.
I gave up smoking and after about 6 months rarely craved them at all and after a few years I stopped craving completely. Food isn’t like that you can’t give it up.
If you ever discuss weight in RL the comments and advice you get from thin people is enough to make you want to punch them.
I was very thin when I was younger and like my mum and rest of her side of the family put on weight in my 20’s. I’ve seen both side of the coin. Being thin was like being a real human people listened to my ideas and wanted to spend time with me but now the disgust people have for me is palpable. The complete lack of attention from men is the only real positive.

There is not one type of fat person.

This is absolutely right, and because of that there isn’t one way to lose weight. A low carb diet would be utterly miserable for me, but it clearly works for others.

People seem to get really evangelical about the one way that worked for them.

Yes, absolutely Whosthatgirl. And research into what's changed. Presumably our basic need to eat hasn't changed over the last 2 generations but our weight has.

[quote BecomeStronger]@RosesinGranGransgarden I agree absolutely that the NHS approach to weight and nutrition generally is awful. With everything we currently know, isn't it shocking that during the course of qualifying a GP will have been taught nothing about obesity.

That was the reason for my post the overall, officially mandated approach needs to change.[/quote]
I agree with this aspect as well. My experience is doctors have a very limited understanding of what drives people to overeat in the first place and mental health services need to be tied more closely to weight loss services. I really think for some people it is a compulsion that requires eating disorder style therapy to overcome, as well as nutrition plans and exercise. There needs to be a more well rounded approach than just telling a patient who has been struggling with their weight for decades to just go away and lose it. Its akin to saying "just stop being fat" and won't magically fix the patient at all. If they haven't managed the willpower for 40 odd years so far then why do GPs think a telling off from them will make any difference? There clearly needs to be more support to help patients see WHY they overeat and combat those compulsions and change their mindset.

I think doctors aren't at all hesitant to point out weight, so I don't think the issue needs to have less stigma from my point of view as an overweight patient. Its mentioned in every appointment. Broken toe? Lose weight. Nosebleeds? Lose weight. Itchy mole? Lose weight. If anything they can't stop going on about it in appointments that have nothing to do with it, and it's very frustrating to be seen as unworthy of care and you have to "earn" your treatment by promising to diet.

If anything I think doctors should be taught more compassion around the issue, they should be taught to bring it up at appropriate times and to offer lots of varied options and support, not just a ticking off.

People need to go cold turkey and eat less. But there’s no money in that.

Completely agree.
I have a real bug bear about 'tuck' at school. They don't need it and should be running around playat break time not sitting around eating 'healthy' (bollocks they are) cereal bars. At primary school I felt completely hammered on this, every other child had tuck, I felt like I had absolutely no choice but to give my children something as well.

@BecomeStronger

Why does it matter if I'm fat?

As it happens I'm not but I've spent the summer researching a serious health issue of my husband's (we nearly lost him) and have been shocked to learn how much of it was (probably) preventable and that actually there are some fairly straight forward things he can do that make a huge difference to his recovery and future prognosis. He's had a nasty shock and will do what's needed but how much better would it have been (for him and for the NHS) if he'd done it first?

It matters if you're fat because you're on here judging the fuck out of people when you have no personal experience. But I'm really out of this as honestly you're welcome to yiur mouth frothing cesspit of hate for fatties. As I say I'd rather be fat than a person who thinks of other like this. (off to eat all the biscuits)

@PaddyF0dder

I really want to hear some evidence that you can be obese and healthy. That just seems very unlikely!

It depends what you call healthy I guess.

I know someone who is clinically obese, but teaches spin classes. And is bloody good at them! Can easily keep up with/ if not outshine the other instructors as of course you take part in these classes.

He is still more likely to die of various diseases than people half his weight.

If you want to tackle obesity then realistically we also need to pour an absolute fuck ton of cash into mental health services.

We also need to put more money into respite for carers. my carers group every carer is overweight or obese, me included, because finding the time and/or energy to exercise is impossible.

Actually throw into that better mental health support for children. My food issues stemmed from childhood abuse and neglect where I wasn’t fed enough and simultaneously told repeatedly I was fat and lazy. If I had the right support then I wouldn’t be here now trying to shift the weight I’ve gained.

I used to be so fit and healthy but combination of childhood and my caring duties (3hrs a day in school for the child) meaning I can’t attend sports clubs like I used to and the intense isolation and lack of sleep of caring here I am 5stone overweight. I’ve managed to shift 1stone and 4lbs since the end of September but with the lockdowns, isolations and zero respite it’s incredibly hard. Much more so than in a normal year and that isn’t easy either.

So yeah, you want to tackle obesity start with mental health services. Start with pouring money into clubs to get girls especially to stay in sports clubs. More free /low cost/subsided gyms and put back those outdoor gyms in council parks and fields ffs.

Tackle poverty. Buying cheap food due to calorie count rather than nutrition is setting up our poorest to fail and there is a huge link between poverty and obesity. We need to pay better both in work and out of work benefits so people can eat well. Healthy start vouchers aren’t good enough.

We need to reduce working hours so people actually have the time to exercise especially when their daily work is sedentary- office etc.

Better work life balance = better mental health= Able to exercise and self care.

It’s not hard to fix this but it will cost money.

Its mentioned in every appointment. Broken toe? Lose weight. Nosebleeds? Lose weight. Itchy mole? Lose weight. If anything they can't stop going on about it in appointments that have nothing to do with it

I understand what you're saying but it could be relevant in all those cases. Nosebleeds associated with high blood pressure, a broken toe is less of an problem for someone carrying less weight and I don't know about skin cancer but I've been really shocked to learn about the huge numbers of cancers where the risk is significantly increased by being over weight.

As I said, I've done a lot of reading about immunity and weight seems to be the one overriding thing that makes a differenc.

I live my life always hungry.
I think you've hit the nail on the head. For many, many people if we want to be slim we have to accept being hungry most of the time. That's the thing the study I mentioned found. And being hungry is miserable. I live in constant hunger three days a week just to remain a normal weight. If I were to eat enough just to satisfy my hunger, which wouldn't be huge amounts or anything like that, I would be massive. We actually need a really small amount of food to fuel our bodies.

@NeonIcedcoffee I really don't know where you've got "mouthfrothing hatred" from. Nowhere have I said obese people are at fault, I've laid the blame entirely at the feet of the system and am asking for a proper conversation about how that can change.

One thing I wonder about it prescribing metformin. We do for patients on antipsychotics which cause weight gain, would it work for others that struggle to lose weight? And would the side effects of being on it be worse than the affects of obesity?

@EveryYouEveryMe Yes, I absolutely completely agree. This is exactly what I was asking for.

Also to all the people who day ‘being on a diet makes me miserable’ I’m not having the time of life eating my third helping of mashed potato. That’s not happened either:

We live in a society where people think that there is a pill for every ill. Any healthy or obesity related disease has a pill to fix it. Even obesity itself, a friend of mine who is overweight by her own self admission of eating shit, constant takeaways, no exercise, went to her GP and was given pills to make the body absorb less dietary fat.

I'm also on a group on facebook due to a medical condition that I have. The amount of posts containing that a doctor or nurse has dared to mention their weight, even in an appropriate, compassionate way, is astounding. They get outraged if a health professional dares to do their job and educate people in regards to their health.

People just don't want to hear it. But anyway, back to your original point. Yes, a massive campaign by the government needs to be started. It would be good if we could just all decide to take responsibility ourselves, however I think that people just won't do that.

I don't know about skin cancer
I would bet obese people are more at risk of skin cancer as well. Just because there is more skin to go wrong. I heard once that women with big boobs are more likely to get breast cancer, just because theres more breast tissue to go wrong, maybe the same applies to skin? On the other hand, they might be less susceptible to skin cancer because they might be more likely to cover there skin from the sun, not were a bikini etc?

There’s also the economic factor. I’m on an extremely tight budget and cheap food is unhealthy. Every night I could go to the local McColls at the end of the road and pick up sliced white bread for 20p, sausages rolls, ready meals, ham, chocolate yoghurts all 10p. Grapes and apples are three times the price of Aldi.
If I didn’t drive and had kids with me all the time and wasn’t lucky enough to have the £30 necessary for delivery then I would have to buy crap like this to eat everyday. Add to that boredom, MH issues, caring responsibilities and lack of sleep due to living in a rough area I’d be huge.