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.

@MeringueCloud

I agree.

BMI is incredibly quick, and probably gives a relevant answer for a massive proportion of the population.

For example, my BMI hovers around 24-26, often slightly in the overweight range. But I eat very carefully and regard myself as very fit - I can run a 10k without issue, and I do spin most days. I’m not sure that my BMI of 25.7 means much, compared to one of 24.7.

Measurements like waist-to-hip ratio (and others) take longer but are probably more valuable.

The reality is that a BMI of, say, 35 is fundamentally bad for you, UNLESS you are indeed a rugby player of bodybuilder. And I think it’s fairly easy to spot the difference.

But I'm not going to waste my lovey Saturday morning on here with a group of people who think fat people are the scum of the earth (don't pretend you don't all the pp's) I just hope that you don't have to experience the complex physical and mental health issues and the side effects of medication which lead to weight gain. It's very easy to judge when you don't know what it's like. The thing I can be greatful for is although I'm fat which is obviously a moral crime I'm not one other the many pp's lacking in understanding an empathy.

This is why it's not possible to have a proper conversation about weight. No one has said or even remotely implied that people who are overweight are anything other than at risk of certain health conditions. The OP is asked repeatedly if they're fat.

I get that it's hard to hear negative things said about something that we identify with but the conversation is important.

a group of people who think fat people are the scum of the earth (don't pretend you don't all the pp's)

Honest question- do you actually think that anyone who expresses concern about the obesity crisis, or about dangerously overweight loved ones, 'thinks fat people are the scum of the earth'. Because that's pretty obviously not true. I'm not sure why anyone wouldn't be at least a bit concerned about it tbh.

@AmelieTaylor I understand why people don't like it if their doctor prioritizes their weight in a conversation about their medical conditions, but if it is a significant factor, the one thing most likely to make a difference, does that mean the doctor shouldn't mention it?

For me the problem is that the doctor doesn't have enough tools to help deal with it, not that he wants to talk about it.

Poster 1: If you want to tackle obesity then realistically we also need to pour an absolute fuck ton of cash into mental health services

Poster 2 :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.

And this is exactly the point. Obesity is like cancer. It’s called one thing, but it’s a number of diseases.

Obesity caused by mental health issues, obesity caused by inequality (affordability of food etc), obesity caused by hormonal imbalances. It needs to be treated individually like the different cancers.

PS. I am fat, BMI 28 as that seems to be required as a qualification to some here...

I understand why people don't like if their doctor prioritizes their weight in a conversation about their medical conditions

No, I really don't think you do understand at all. If the weight is relevant to the condition then most overweight people I know wouldn't take issue with the doctor mentioning it. And you know that, yet you're still pushing at this point with your feigned naivete to try to get a reaction. Stop it, you know what you're doing.

Fat people are NOT angry that weight is raised in consultations with doctors. We actually DO want help to lose weight and talking about it is FINE.

Fat people are angry when doctors can't discuss ANYTHING ELSE and use it as a catch all diagnosis , therefore missing very serious conditions that could have been easily treated with medication. Conditions that are left to spiral out of control because the doctors see weight loss as an easy alternative to doing their fucking job.

On the doctor bring weight into the discussion every time, I have wondered recently why my doctor has NEVER mentioned my weight.

I’ve been in the obese and very obese category for a number of years and seen multiple doctors about related and unrelated things.

I feel it should have been raised with me, as it is not doubt affecting my health. Not raising it is to me failing me medically tbh.

Having seen some of the comments here I can see why! I don’t think there would be anything wrong with raising it if help was then offered.

You've decided on your position MrsM but it is becoming increasingly clear that very many health issues are best dealt with by managing weight. Of course people want the doctor to make them well and in so many cases a very good place to start is by helping them lose weight.

It really is shocking how many conditions we've come to think of as common (and many more that aren't) are affected by obesity.

This is simply not true OP, in fact, fat people often get told to lose weight when they go in to talk just about anything

Also, research shows that fat people's symptoms are taken less seriously bu medical professionals who often just assume the weight explains everything

Medical [professionals also often just blame fat people, and assume they are n to following instructions, are cheating and lazy

It is truly demoralising

We do need to have a conversation, but the conversation we need to have is about poverty, inequality, mental health and our shitty industrial food production

But that is for many just not as much fun as fat-bashing, I am afraid!

At the start of the year my BMI was 43.6 and I weighed 139 KG, had been at this weight for years. My weight was only mentioned in passing when I had to visit the doctors. Which to be fair was not very often. My problem was that I knew I had to lose weight but didn't know where to start. Tried WW once but didn't get on with it.

Then Covid hit and I decided to try again, due to the scare of BMI and outcomes of getting really ill with covid. I have been working from home since March so I have my own kitchen to hand. No temptation from coffee and sandwich shops and its working. No doubt that the Covid risk has been my main driver. I also exercise more by walking and had started the gym for cardio and weights.

My BMI is now 35..8 and I have lost almost 25Kg. Still a long way to go but I am slowly but surely getting there. Being at home has helped massively.

It's a slow old process as I didn't get to that weight overnight so likewise the weight is not going to disappear immediately. Think it will probably take me another 10 months to reach my goal weight.

I haven't rushed to rapid weight loss I am plodding along with 3-4Kg a month but I think this will help me learn new habits and bed them in for the long term and that to me is very important.

I get frustrated that I can't do more exercise-wise at the moment due to the weight I am still carrying and the length of time it will take but I am in it for the long-haul now.

I am not sure why I got so large in the first place but I do know for definite that once I got there I continued eating because I was unhappy with the situation. I didn't know where or how to start.

You've decided on your position MrsM but it is becoming increasingly clear that very many health issues are best dealt with by managing weight

There you go again with your prejudice. At no point did I say this wasn't the case, in fact I've repeatedly said there are times when it's completely appropriate to discuss in a consultation, but you conveniently ignore those parts of my comments. I guess in your mind fat people all want to stick their heads in the sand so I must also come under that umbrella.

I'd like to bring my personal experiences here if that's ok?
I'm obese, I'm mid 20s have always been obese since I was little. My parents are as well. When we grew up there was no money for food and we really struggled. We tried on family to buy food for us which was very kind of them but we got what we were given. Most things were pasta, meat and ready meals. This obviously is wasn't the healthiest!
In secondary school I was relentlessly bullied about my weight. Doctors would bring it up at any appointment even when it was due to a broken wrist. I turned to self harm and stopped eating at school. I lost weight and was miserable.

When I moved out and started earning money I spent it on takeaways because I could and we hadn't had them before, I was excited that it was something new!!!

In the last 2 years I have had a baby and have a new job. Currently I work 8-6:30/7 I have an hours commute each side of that. Add to that a toddler who doesn't sleep. I am exhausted, when I get home the last thing I want to do is cook a meal! So again I turn to takeaways, pasta and ready meals.

I feel a better work life balance, an increased living wage and better access to mental health services would be a start in the right direction for those, like me who want and need to loose weight.

@Newbeginningforme

That’s phenomenal. Congrats.

You’re right to take it slowly. Diets and quick solutions are part of the problem. What you’re doing will create lasting lifestyle change.

@squiddybear

I'd like to bring my personal experiences here if that's ok? I'm obese, I'm mid 20s have always been obese since I was little. My parents are as well. When we grew up there was no money for food and we really struggled. We tried on family to buy food for us which was very kind of them but we got what we were given. Most things were pasta, meat and ready meals. This obviously is wasn't the healthiest! In secondary school I was relentlessly bullied about my weight. Doctors would bring it up at any appointment even when it was due to a broken wrist. I turned to self harm and stopped eating at school. I lost weight and was miserable.

When I moved out and started earning money I spent it on takeaways because I could and we hadn't had them before, I was excited that it was something new!!!

In the last 2 years I have had a baby and have a new job. Currently I work 8-6:30/7 I have an hours commute each side of that. Add to that a toddler who doesn't sleep. I am exhausted, when I get home the last thing I want to do is cook a meal! So again I turn to takeaways, pasta and ready meals.

I feel a better work life balance, an increased living wage and better access to mental health services would be a start in the right direction for those, like me who want and need to loose weight.

I feel for those who’ve been brought up with bad habits I really do. However, there are numerous ways to eat quick and easy foods without eating more calories than you need. Ready meals come in diet/weight watchers brand. There are also lots of fairly healthy options “veg pot” type ones. Also soup or dried couscous with tuna and sweet corn, just some examples.

I’m sorry, but I don’t think you can use lack of time for the main excuse in eating too many calories. If anything, if you’re busy you have less time to snack and eat in general!

I do agree that cars often get better diagnostics than people.

I also agree that obesity is an umbrella outcome for many and several different underlying root causes. It’s the root causes that need looking at.

God help anyone with unhealthy eating habits that are due to poor mental health as MH services are on their knees and have been for years. It’s not good.

@squiddybear

It’s hard. It definitely is. I’m not judging.

Eating healthily takes the same amount of time as eating unhealthily. It just takes different choices. I eat a lot of diet ready meals. Some brands are excellent, and bring dinner in at less than 400 calories.

Exercise can be 30 minutes a day. I guess if you’re a single parent that is close to impossible with young children. If you have a co-parent, it’s not. It’s about make the choice to use that 30 minutes.

From 40 they give people a health check which includes cholesterol, BP and blood sugar, this can be useful along with weight to check metabolic health. It is with the nurse but they were lovely I am slightly overweight but everything else was good. Had a chat about e.g. intermittent fasting which the nurse was trying.

I am still overweight and can only lose if I eat fewer than 500 calories a day.

This is me. I know that I have to be sub-600 to lose weight. I can push to 800 as long as I've done a full workout that day (which I do. Cycling, swimming, weights, and if all else fails in lockdown, getting out for a walk, almost every day). Low-carbing works, but is tough when you also have a family to feed. One meal a day is how I'm managing right now, as it's the least invasive way of keeping calories down whilst not worrying the kids, and still being able to eat dinner with them.

What brought it home for me is that I watch those survival shows, and there was a Naked and Afraid, where they have to stay in the wild for 21 days. This woman, the same height as me (albeit skinny), barely ate (as is normal for the shows - plants, bugs, the occasional snake I seem to remember). She lost 3lb. Other people lose stones. She lost 3lb. Her body took soo little to run, that even virtually starving for 3 weeks, she lost virtually nothing.

The metabolic system does not care where foods come from or symbolic meanings.

Just if it is a fat, or protein or carbohydrate.

It does react differently to processed foods as this impacts metabolism. For example, so called healthy foods are low fat but increased carbohydrate (sugar). This impacts metabolism from an objective POV, even if you think it is the healthy option.

It is perfectly possible to not be obese but have a metabolic disorder because you are consuming the wrong proportion of fat, protein and carbohydrate.

Cutting back carbs leads to constant hunger. For carbs. It's craving, not hunger. Every time you feel the craving that you identify as hunger, eat protein and fat. Snack on peanuts. Unlimited bacon, eggs, chicken, steak, lamb etc with full fat Mayo and butter but no bread, rice, pasta etc. I guarantee you won't be hungry. You may lose weight. Your metabolic health will improve.

I was diagnosed with PCOS before doing this 25 years ago. Carbs = insulin. Insulin is a powerful hormone that effects systemic function. Insulin disregulation is not always visible as excess fat although excess fat is associated with insulin resistance.

Unlimited bacon, eggs, chicken, steak, lamb etc with full fat Mayo and butter but no bread, rice, pasta etc. I guarantee you won't be hungry. You may lose weight. Your metabolic health will improve.

Its also a one way ticket to gallstones and bowel cancer to name but a few. I tried this on the advice of my GP, now I need a major operation to correct the damage it did to my body. I'm glad it's worked for you but it is rather dangerous diet advice to give other people.

I recommend the book 'How not to diet' by Dr Michael Greger.

It's an in-depth look at the science behind weight loss and contains lots of scientifically proven practical tips to help people lose weight.

How much might thinking about how stressed, how busy, how tired, illnesses, how you need more support , how you were brought up to comfort eat etc enables you to excuse yourself from tackling your weight? Constantly thinking if only about lots of things You can't affect gives you a believable excuse

Yet many people in the same situation manage to eat healthily, exercise, hold down a stressful job with no family , by accepting that all those external things won't change, the only thing you can control is yourself.

People say they want a conversation but then fail to listen.
Seems that they mostly just want to talk.

• I’m thin but know a conversation when I (don’t) see one.

@WhoseThatGirl and specifically what part of what I have said is "sanctimonious bollocks"? None of it, that's what.

You are basically saying people are overweight because the refuse to take responsibility for themselves and just want a pill to fix it.
How is that contributing to a productive debate?