Medical Help For Obesity

[DriedFlowersLiveForever]

I have been thinking about this recently, I am overweight but live a normal life (ie not bed bound and on an oxygen machine).
I tend to be in the cycle of lose it all, gain it back BUT get to a certain weight and start losing again.
Some people obviously don't hit that certain weight and keep gaining, this ruins their chances of a normal healthy life and I can well imagine they get to a point where food is the only thing they look forward to in a day.
Throughout their weight gain journey they will undoubtedly have seen many medical professionals that tell them how simple it is to 'eat less and move more' without taking into account the changes that have already happened to their bodies making the weight far harder to lose and keep off, not to mention the psychology behind it (no one willingly gets to the point they are bed bound by something preventable if they are fully mentally well).
Can you imagine the justifiable uproar if an anorexic sought medical help and was told to 'move less and eat more' before being sent on their way?
I think we will see more and more people becoming seriously overweight and unless we have adequate medical care to prevent them from spiralling into constantly gaining weight it will become an American style issue where we end up removing windows to get them out of their houses and into bariatric ambulances.
Just wondered what other people thought about this issue.

I think I agree with you, but I don't know what the answer is. Ideally, the answer is simply to take cake of oneself and prevent obesity from happening, but as you've rightly stated, it's not that simple.

My DH is overweight, has mild sleep apnoea and isn't disciplined with portion sizes. The sleep apnoea makes him feel too tired to exercise and he's essentially addicted to food because he's got used to larger portion sizes and eating junk. He's just had another assessment at the sleep clinic for worsening sleep apnoea, despite having done nothing at all that was recommended at the first assessment to remedy it (i.e. lose weight, improve fitness, sleep on his side, etc.). Part of me has no sympathy whatsoever because he hasn't helped himself, part of me thinks there should be more support (dietician, exercise plan, therapy) given.

I think we need far better education on nutrition in schools, to help people understand what constitutes a healthy diet.
The NHS will offer less weight loss surgery and more advice/pressure. Obesity will become so common that surgery will be too expensive and so unrealistic. Look at the US.
Anorexics tend to be teenage and so more 'worth saving' and with worried parents demanding help. Obesity is more common in 40s onwards when people are expected to look after themselves.
Think about how they persuaded people away from smoking in the 80sand 90s. Adverts, pressure, banning products or taxing them. Self help groups.
Not a cheerful thought.

I agree and think you make good points. Obesity isn't treated as a mental illness or symptom of trauma though. For some reason, losing weight is perceived as "simple" (if it was so simple then people wouldn't be overweight) and the result of character defect (which is interesting considering poverty plays a big role).
I've asked my GP for weight loss help before,I just wanted a 15 minute regular ish appointment with an obesity nurse (do they exist?!) Every fortnight then monthly,for a weigh in, nutritional examination of a food diary and perhaps some understanding and enthusiasm. But no. The GPs who have mentioned it have done so sarcastically (I cannot understand this level of bullying,as like you say, it wouldn't happen to an anorexic patient) and given no advice at all.
I'm currently trying AGAIN to lose weight, this time using My Fitness Pal but, I already have significant concern that the measuring and logging is not healthy for me and is potentially triggering for many people.
I think the answer to the obesity crisis is that there isn't a one size fits all (pun intended) answer.

Incidentally, I don't believe obesity is related to financial poverty, it is more closely aligned with poor education/food choices.

Healthy food is cheaper than junk in the U.K. But you have to know what to eat and how to prepare it.

I'm on a tight budget, recently had a friend stay for three weeks while he found a new home. He lost 9lb in 3 weeks without trying because he ate what we ate rather than his usual junk, and I spend £25 per person per week.

The U.K. made a disastrous decision, scrapping H.E. classes in the 80s and this is the result.

I completely agree that there should be more life skills taught in schools - how to cook, how to stay healthy, maintain a good diet, meal plan, understand the nutritional content, plan exercise etc. I think many other life skills should be taught too (budgeting, understanding interest rates, financial management etc) but that's irrelevant to this discussion.

But at some point people have to take some responsibility for themselves. If the NHS helped everyone with every problem resources would be used up so quickly. There are free exercise groups in place - walking groups, couch to 5k etc but it relies on people actually going and following plans. The NHS site provides diet advice and also provides free workout videos you can do it your own home. But like every other addiction - the Individual has to be the one to make the change.

Also - I'm not sure what help you think people with eating disorders get but I think you may be surprised because it isn't much. Really you need to pay privately or rely on charities.

But you are right - the problem will get worse. People don't move as much as they used to because less jobs are manual. People spend too long looking at screens. Food is so over processed and most people don't cook from scratch so have no idea what is in what they eat. It's quite sad and frightening really.

I was really surprised when I recently went to see my GP for a bit of support to help lose weight. I was just looking for maybe a short dietician appointment or a referral to one of the apps which I've heard of. There was surprisingly little apart from being prescribed some Orlistat.
I asked about a dietician and was told that I didnt meet threshold as my BMI isn't 40. Luckily I'd read a little so asked her that as my BMI is over 30 and I have High BP then shouldn't I qualify? She checked and I was right so referral made but she said she didn't think there was much they would do as it was mainly for surgery which I don't want.
So that was it really tablets or surgery.

I came home feeling like I'd wasted both her and my time.
The tablets have remained in the box and I've lost 1.5 stone since under my own steam and various fitness clubs which I've found out about myself

I work with a very overweight man in his mid 50’s who is often encouraged by his GP to lose some weight as he’s beginning to develop health issues related to his size (guessing it might be high blood pressure, diabetes…?). However, this man openly tells me that he just does not have the inclination to go out for a walk or do any exercise. He sits behind a computer screen all day and, when he gets home, he sits down with a cup of tea and that’s pretty much it for the evening. He is adamant he won’t make any changes.

It’s really fascinating - I am trying to understand why he doesn’t want to help himself when his life is at risk.

Believe it or not my weight gain is not through lack of knowledge as to what constituted a healthy diet!
I don't live off junk food at all and didn't grow up in poverty.
I gain on eating home cooked food and having a sedentary desk job, I also have a health condition, the main symptom is fatigue (so after a day sat on my arse at a desk a trip to the gym for a work out or a run in the evening are out of the question, I go into energy preservation mode to cope with the next day!) One of the other symptoms is weight gain/struggle to lose weight.
I totally understand there are people living on Iceland chicken nuggets and chips and McDonald's etc but shockingly there are also people that are overweight because of health conditions, medication, trauma etc etc.
Telling them to eat less and move more is utterly futile.

I’m overweight not obese technically. Whilst I know it can be challenging to lose weight I think there’s only so much the Gp can really do. You do have to eat less and exercise more. I know I could be thinner but I like food. I also know I could be fatter if I hadn’t stopped booze and the late night snacking it leads to. It’s a bit like stopping smoking, you know it’s bad for you but you have to want the change.

We live in an obesogenic society, not as intensely as America but getting there. Junk and snacking everywhere, advertising, special offers - all hard to resist, and much less prevalent in European countries. In addition we are overworked, anxious and in need of comfort, and food has been super cheap and fits the bill. Obesity is strongly linked with povertyand inequality, the Marmot review identified this many years ago.

Read: Why We Eat (Too Much): The New Science of Appetite https://amzn.eu/d/0RfG9MO

Beat me too it birthdaygirl. I'm reading that at the moment and it is fascinating and eye opening.

@Badbudgeter I understand but you are not really the kind of person I mean.
For example, if you got to say 30 stone + surely something else is going on, either physically or mentally.
I am not in this category thankfully but your point about late night snacking got me, I don't snack!!! Everyone assumes if only fat people cut out the snacking we would all be size 0....if only!
I have 3 meals a day, I have some fruit inbetween and no food after my evening meal.
Obviously lots of overweight/obese people could cut down (if they are living on takeaway foods in massive portions then it's obvious where the weight gain is coming from) but for a lot of people, myself included it is much more nuanced than that.
I eat very similarly to my sister, she is 5'11 and a size 12. I am 5'10 and a size 20, both have similar lifestyles- the difference is I have a health condition that affects my weight and she doesn't.
No amount of being told to eat less and move more would level out the playing field for me, I have to eat much, much less than most to lose weight and considerably less to maintain it when I have lost the weight.
It is a miserable existence thinking about ways to keep calorie intake so low, is it surprising when people like me fall off the wagon and gain weight back again....or is it a moral failing of mine that I can't just starve my body into submission?

This is about weight set point theory. In the book he talks about genetic predisposition to obesity and environmental factors. He dispels the energy in energy out theories. Disclaimer, I'm still reading it!

I agree entirely with this and society isn’t willing to restrict junk food so it’s not going to change in the foreseeable.

Japan has a huge culture of convenience foods, but it’s rice balls and bento, not Nando’s and grab bag size crisps.

@Birthdaygirltoday33 @nancyglancy I will definitely read this thank you!

Please share your recipes! I really struggle to know what do cook that will be both cheap and healthy. Usually ends up being one or the other. I’m not a great cook though 😫

Obesity is a disease. Read up on 'obesity - the big truth'. The pathway through the NHS to get medical help is failing so many of our population. You're better to get surgery younger to prevent diabetes or bowel cancer plus get your weight under control. The links of obesity to being the cause rather than the result are proven. Our current system is failing. 100%.

Also, obesity is not just linked to diet. It's just our population is undereducated in this regard.

I recently attended a medico legal lecture about bariatric surgery. Current projections are that, by 2035, there will be more obese people in the uk than not. The average BMI they treat is 57 with the highest being 103. 😳

We all know obesity is associated with increased risks of cancer, cardiac conditions, and diabetes. It's not called morbid obesity for nothing!

The increasing availability of convenience food, busy lifestyles and lack of education about nutrition have brought us to this point. I also think the diet industry is to blame... most fad diets don't teach sustainable healthy eating habits.

It's no coincidence that the rise in obesity corresponds with the explosion of fast food joints and dessert cafes and on top of that you now don't even need to get out of your chair. Just order on just eat or delivered and viola!! Here it comes!!
GPS can only do so much, they cant wave a magic wand and people miraculously stop eating too much and start walking and exercising more.
However since there is such a big culture of victimhood now in the UK I don't hold out much hope.
And before I get my arse handed to me I'm well aware that some people have health conditions and disabilities that prevent them from exercising.
Most people have a smartphone nowadays so it's not that difficult to find healthy low fat recipes that don't cost a fortune.
People need to take responsibility for their own health and well being. Nobody else can do it for them

I had Anorexia Nervosa and was told to move less and eat more in an off-hand way. I was also told by a therapist as a teenager that there were people far thinner and far sicker than me. Obviously, that just makes you think you don’t deserve the help, so when different doctors then tell you they’re worried, it’s difficult to understand. Just to say, don’t assume someone with an Eating Disorder that causes weight loss doesn’t necessarily get taken seriously by doctors either, especially initially. (This was in the 2000s.)

I think the difficulty is there are many reasons people are overweight. Sometimes it’s Binge Eating Disorder, sometimes it’s a genetic tendency or even a physical health condition, sometimes it’s mental health issues combined with certain medications (for example, agoraphobia or schizophrenia combined with an anti-psychotic), sometimes it’s lifestyle, sometimes it’s to do with lack of variety of foods and bigger portions, sometimes it’s trauma or lack of food due to neglect as a child, sometimes it’s down to another issue like certain drug or alcohol use or even a gaming addiction contributing to lack of movement. There’s no one solution. Education helps. Childhood exposure to variety and healthy eating and exercise helps. Lifestyle factors help, including people having both the time and energy in their lives to cook and include exercise helps. Access to good eating disorder support for binge eating and similar issues helps, equally access to other support for other issues helps (such as addictions and gaming addiction and other mental illness). There’s no one answer, really. There are huge links to poverty in the UK and with our current government, that isn’t going to improve.