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.

@BecomeStronger

I do understand your frustration but in so many chronic conditions it's not "go away and prove yourself" it's "prescribing" the one treatment that is known to work.

And yes the toe will heal quicker if there's less stress on it.

But there are conditions for which it won't make a difference, yet the attitude is try it and see because it's easier and cheaper for the NHS to kick the problem further down the line. Its also withholding tests from overweight people to obtain a proper diagnosis because the doctor has a hunch and wants to try something, meanwhile the patient lives in chronic pain because they aren't taken seriously.

You seem brainwashed to think that every ailment in the human body can be solved by weight loss. Let's deregister all the thin people from their local surgeries and ban them from A&E then, as their clearly superior healing powers will work without ever needing any medical intervention.

I’d love it if there were more sophisticated conversations about obesity. Out there, and in here, it’s mostly fat shaming (which has been proven over and over to be ineffective and feels just like the last acceptable prejudice) or ‘eat less, move more - simples’.

Obesity is going to cost a fortune so we need to invest a fortune to sort it out, and we don’t. We look for platitudes and quick fixes.

I’ve been overweight all my life. I was born hungry. For years now though I have eaten exemplary food, with a calorie deficit on most days. I don’t snack, I avoid processed food, I limit sugar etc. I am still overweight and can only lose if I eat fewer than 500 calories a day. If I say this on here, I am always told that I don’t know what I’m eating, that I am fooling myself etc. But that’s not true. I suspect for various reasons that I have some sort of hormonal inbalance, like PCOS, but I can’t get referred to an endocrinologist because I don’t have fertility issues, nor will my GP trial me on metaformin.

I’m just one person. Every overweight person has their own story, their own complexities.

Interesting how you seem to want a discussion around obesity but aren’t listening to those that are overweight.

Thin people - ‘just stop eating’
Obese people - ‘we would if we could, despite being well educated and living a healthy life style we find it impossible to regulate our calorie intake enough without being constantly starving, moody and craving food’
Thin people - ‘just stop eating’

I'm not sure why I'm bothering because people don't want to hear it, but I'll try (yet again) just in case someone actually listens or feels supported.

I am now very fat.

I didn't used to be fat.

I had a virus that attacked my liver and caused a lot of issues. Including metabolic ones.

Despite feeling utterly crap, they couldn't do anything for me. I tried a few HO's specialists, most every 'path available yo no avail.

The issues caused me to become diabetic.

I got fat because of the metabolic issues (incl diabeties). The weight didn't cause the diabeties.

The medical profession (in enlightened circles) is finally coming to realise that.

A huge part of the problem is people not being taken seriously/helped when they feel shit. Our medical guidelines for getting help are far too wide. Fir example my B12 was 201 last time it was tested. Guidelines say over 209 you can't get the injections (I take it orally, but it doesn't really help). Same with thyroid levels etc.

No one is interested in looking at the overall situation and helping. If we all had access to much better health care (like the tests they run on various TV things like Michael mosely etc.) we'd all be much better off.

I eat very little
I eat low carb (basically only carbs from vegetables)
I exercise

I don't need patronising adverts going on about obesity. I need better healthcare.

Maybe some obese people live on cheap junk food, in deprived areas, & had poor education, but for the love of fuck stop assuming every obese person does.

You seem brainwashed to think that every ailment in the human body can be solved by weight loss.

I don't think so but as I said, I have read extensively around immunity this summer and have been surprised and interested to learn just how much it is affected by weight and how many conditions that impacts.

And BecomeStronger the toe thing was a random example because I don't want certain aspects of my medical history on an account that people in real life know about. You're getting hung up on that and it is completely besides the point. Let's change my example to a broken finger instead of a broken toe then, that's something that losing weight won't change.

My point was that doctors DON'T have an issue with raising the subject in appointments, so much so it's gone to far the other way and weight is all they can see when presented with a non-weight related ailment.

@Amelietaylor I hear you and 100% agree with you. You've had a shit time and you've been let down by doctors and I'm so sorry.

@Dailyhandtowelwash

I’d love it if there were more sophisticated conversations about obesity. Out there, and in here, it’s mostly fat shaming (which has been proven over and over to be ineffective and feels just like the last acceptable prejudice) or ‘eat less, move more - simples’.

Obesity is going to cost a fortune so we need to invest a fortune to sort it out, and we don’t. We look for platitudes and quick fixes.

I’ve been overweight all my life. I was born hungry. For years now though I have eaten exemplary food, with a calorie deficit on most days. I don’t snack, I avoid processed food, I limit sugar etc. I am still overweight and can only lose if I eat fewer than 500 calories a day. If I say this on here, I am always told that I don’t know what I’m eating, that I am fooling myself etc. But that’s not true. I suspect for various reasons that I have some sort of hormonal inbalance, like PCOS, but I can’t get referred to an endocrinologist because I don’t have fertility issues, nor will my GP trial me on metaformin.

I’m just one person. Every overweight person has their own story, their own complexities.

🌷. I hear you.

It's because people don't want to hear what we're saying, they prefer to just judge & condemn. Accepting that's it's not just mainlining fatty food & sitting on lardy arses that cause obesity would be like admitting their high horses have faulty saddles.

To be clear, I don't think losing weight should be the only treatment but it surely a valid approach in most cases and will help support other treatments, giving the best chance of success.

Better healthcare over the last 100 years (which we absolutely do have, even if it could be better) is only actuall credited with a out 3-4% of the increased life expectancy. Most of it is down to reducing accidents at work, better hygiene in food and water supply, reducing smoking. Lifestyle changes. Plus antibiotics of course.

My point was that doctors DON'T have an issue with raising the subject in appointments Pergaps not, but their patients clearly take issue with it.

[quote MrsMigginsMate]@Amelietaylor I hear you and 100% agree with you. You've had a shit time and you've been let down by doctors and I'm so sorry. [/quote]
Thank you 🌷

... you're right about everything being blamed on being overweight - even down to something like 'a broken finger'

@EveryYouEveryMe

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

Maybe fir some people. But for me, I don't need MH services, I need proper diagnostic medical help to see what my body needs help with. It's clearly not working properly. A car gets better diagnostics & repairs than I do.

@BecomeStronger

My point was that doctors DON'T have an issue with raising the subject in appointments Pergaps not, but their patients clearly take issue with it.

Perhaps if you paid attention to people's lived experience you'd understand why, but it would spoil your judgey session really wouldn't it.

Stop being so disingenuous.

@NeonIcedcoffee where are you seeing this frothing cesspit of hate for fatties?!

There have been lots of posts on both sides. Not one person has said anything even remotely akin to "fat people are the scum of the earth" and have expressed concerns at obesity risk or suggestions as to ways it should be managed.

They may be right, they maybe wrong, the science is muddy but can we just remove the extreme level of vitriol and emotion? This is why no one can have a bloody discussion about it, the only person spouting those comments is you that I've seen!

I am obese, very obese. In fact I'm now 22 stone and hating myself because I cannot stop comfort eating. I also have several weight related health issues that make exercising almost impossible. I am completely exhausted all the time. I am severely depressed and an coming out of a recent crisis where I nearly killed myself.

I am trying to find someone or something to help me control the comfort eating, because sometimes I do it without even realising I am doing it.

I don't mind being told I am obese. I don't make excuses for myself but I do need help to tackle the issues because over the years I have tried and failed to deal with the comfort eating.

@AmberAndAlexsMum

I am obese, very obese. In fact I'm now 22 stone and hating myself because I cannot stop comfort eating. I also have several weight related health issues that make exercising almost impossible. I am completely exhausted all the time. I am severely depressed and an coming out of a recent crisis where I nearly killed myself.

I am trying to find someone or something to help me control the comfort eating, because sometimes I do it without even realising I am doing it.

I don't mind being told I am obese. I don't make excuses for myself but I do need help to tackle the issues because over the years I have tried and failed to deal with the comfort eating.

Yes, this is it exactly. Treating the cause of your obesity and supporting your MH would be so much better for you and likely cost the NHS less in the long run.

@PaddyF0dder

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

Most rugby players are obese (apparently). Lots of "muscly" people are.

We need to provide our teens with the support they need to grow up healthy. Unfortunately, there seems to be next to no support available for a teen whose overeating is linked to mental health. Bullying at school just exacerbates the issue. If they self harm, they can overeat as a way of hurting themselves as well.

I agree MH services might not be the only solution. But they are an important part of it. Even if your needs are all physical rather than psychological they fact remains the neglect if your physical needs will impact on your MH. We really need to stop the disconnect between the two and treat both.

There’s an assumption that once someone is thin they’re Ok and actually when someone has lost the weight is probably when they most need the MH support because they are a ‘different’ person and those around them will react to them in different way.

For example when I lost 3 stone pretty quickly it caused a big gallbladder issues that wasn’t picked up and I required an op.

My own sister didn’t congratulate me but made me feel like I’d done something wrong by crying I had made her the fat one purely by losing weight. I really needed psychological support then having lost the weight to cope with people’s responses to the ‘new’ me

Most rugby players are obese (apparently). Lots of "muscly" people are.

No they're not. They have a high BMI that would suggest obesity in a sedentary (or normal) person but no one is going to suggest they are obese.

It is mentioned a lot, usually followed by numerous posts saying to shouldn't be.

I agree that it's talked as about all the time. If you're expecting to reach a point where nobody will say it shouldn't be, I wouldn't hold your breath.

With a specialty Starbucks cafe being approx 300 cals it doesn’t take much for people to go over the amount of cals someone needs in a day.

To combat it needs six things:
1.acceptance that this is where I am at and I need to change.

1. A commitment to keep my promises to myself.
2. A plan for eating and drinking water.
3. A plan for exercise.
4. Time spent on weekly food planning and preparation based on eating plan.
5. Social support so you are not doing it alone.

Eg weight watchers group, making arrangements to see friends to go for walks- it has to be something external where you will let someone down if you don’t show/is fun.

There is variation within those steps eg food plan can be IF, WW, SW - the best diet is the one you can stick to but they are all going to shift towards eating more whole foods.

With weight loss you don’t actually need to go into a ‘root into your psyche to find out about emotional eating’ - what you need is consistent action.

@BecomeStronger

Most rugby players are obese (apparently). Lots of "muscly" people are.

No they're not. They have a high BMI that would suggest obesity in a sedentary (or normal) person but no one is going to suggest they are obese.

If your BMI is high, (can't remember the number, 30?) you are in the obese category. So just looking at the BMI score they are obese. What other definition of obese is there?

No doctor is going to have a conversation with a muscle bound rugby player about their obesity. It's about body composition and BMI is a good indicator for the vast majority of people but it's clearly not the only one.

The “lots of muscle can make you obese” argument is factually correct but not very useful.

BMI is what we use. It’s very flawed, but it’s a quick and reasonably useful metric.

Almost all people with a BMI above 30 are obese. Very, very few are muscly beefcakes.

@BecomeStronger

No doctor is going to have a conversation with a muscle bound rugby player about their obesity. It's about body composition and BMI is a good indicator for the vast majority of people but it's clearly not the only one.

Of course not. But if we're going to have the discussion the OP suggested we need to have we also need to know how to measure someone's "fatness". My point was that it's not an easy to tell who needs to lose weight unless we look at a lot more factors than just "obesity" according to the BMI scales. A thin person who survives on crisps and wine is not as healthy as a larger person who only eats foods that are generally considered healthy and drinks water, for example. And medical conditions play a role too.