to think tackling obesity by sending people to the back of the NHS queue is bonkers?

[ICBINEG]

I have been obese. When you are obese you know perfectly well the damage you are doing, you know the extra hassle it entails on a day to day basis, you know the humiliation, you know that you aren't doing justice to your kids, and you know you are going to die early, and be ill and in pain.

I had all the motivation in the world to change.

What difference is it supposed to make that the NHS are preparing to treat the obese like second class citizens, if the motivation of an early painful death and missing their kids growing up isn't enough?

The actual net result of not treating the injuries of people who are obese is that there will be yet another hurdle to them getting back on their feet and being able to exercise etc.

AIBU to think this plan is a massive fail that utterly misses the point of why people don't change their lifestyles?

Christ confuestelling, your friends and relatives really are unlucky, aren't they!

Having seen how much my father's self-inflicted weight gain due to overeating and lack of exercise cost the NHS in terms of resources once he developed diabetes, heart disease, angina, circulatory problems, heart attacks, all while in his forties, he must have taken resources away from people whose illnesses and conditions were inborn or as the result of unfortunate accidents. In fact, there was an arguement that throwing the best of resources and all the attention in the world made him think that someone else would always fix his medical problems for him. Certainly didn't get him back to being a functioning member of society and put a huge toll on his family.

There are few operations/treatments for which the prognosis is not much poorer for severely overweight people.

Ah, x posts. Ridiculous. I've heard such rubbish spouted on Radio 4.

SO will anorectics be treated? Or just ordinary underweight people whose health might be better if they ate more?

OTT sorry to hear that, and I firmly believe you are in the majority. Most people with a weight problem,

a) know they have a weight problem.
b) know how to fix it
c) cannot sustain the method of fixing it due to mh/esteem issues

I don't agree that they can't fix it cos of esteem/MH issues

I think our society plays a big part too. It's how us humans are becoming.... We aren't designed to sit around all day/drive/ eat crap

How do we know that most people with a weight problem have mh/esteem issues?

Unless there's evidence to back that up, surely it's just an assumption? Like saying 'most people with a weight problem are just greedy'?

Well I was obese for a while, and then I fixed some mh issues and then I lost 3 and half stone in 6 months and am now a normal weight.

I still drive, I am still surrounded by junk food, I still sit on my ass all day.

Mysteriously none of this is a problem now that I am in control of my life.

Our lifestyle and the presence of crap food etc. leads to people putting on weight. The reason some people can't simply watch what they eat for a bit and lose that weight is to do with mh/esteem problems.

worra it's worse than that, it is anecdotal data taken from my own life....

Although research has been done in this area, and especially for obese children turning into obese adults, there is hardly ever a fix without fixing the brain.

Ott. I agree and am similar -really struggling with obesity and trying to control it. Unlike other addictions you can't just go cold turkey as you do need to eat.

I'm sure mind gr childhood issue related. I've been to nurse and doctor to no avail. I think for lots of us its an eating disorder that could do with treatment through one way or another but there are very few places that do this unless not ban access private counselling.

Addressing the problem would help a lot more than further punishing someone already suffering.

HeySoulSister

Indeed she did. She was very, very drunk and tried to shave her armpit one night. She realised halfway through that her nipple was hanging off.. She had to get stitches and dressings etc, it was pretty nasty. As far as I know though she didnt feel any pain til the next morning!

Ha, yes my friends/family are unlucky. But then I know of very few people who don't suffer some sort of chronic illness that needs treating by a GP or hospital..

I'm obese at something like 18 stone, size 22 trouser size and size 18 top size. I do try to lose weight, but I'm in a cycle of looking in the mirror and thinking "Jesus Christ, she's ugly. Why bother?" and so I don't. I don't exercise because I'm afraid that people will laugh!

That and for the last twenty years food has been my comfort blanket, fat has been the veil I hide under, so having that removed terrifies me.

I honestly think obesity - serious obesity - is an eating disorder. The ways in which I eat are not normal and I know that, I inhale my food, I eat past the point of feeling stuffed, I eat when I don't need to and I find it very hard to stop. I've made myself physically sick before after a binge.

I think to some extent it's like an addiction. With alcohol, drugs if you're addicted you can forever remove the source and receive at least some support through the NHS and charities. With food, if you're addicted you can't remove the source and that's what makes it so bloody hard to lose the weight. If that makes sense.

But I digress!

Cross posts.

IC that's really encouraging to hear :-) want to share how you fixed issues? I feel I don't know where to start!

Snap with confuse!

toteach I had counselling (self-funded of course)....although maybe the NHS will now consider reimbursing me as I will apparently be saving them all this money ?

conf of course it is a disorder. It almost sounds like you eat to hurt yourself. Anyone self-harming with a razor would be seen as someone in need of mh support, but sadly you live in a society to short sighted to see your particular form of self-harm in such a light.

I used to do the same thing. Eat past the point of pain and cycle between having a few days of 'dieting' and then hating myself so much I gave up again.

You will lose weight when you know with all your heart that you life, health and happiness are worth the pain that diet/exercise costs you. When you realise that you are truly worth the effort.

It is highly likely that you will need professional help to get to that point.

IC that's really encouraging to hear :-) want to share how you fixed issues? I feel I don't know where to start!
That's exactly what I was going to ask! confustelling, I could have written your post exactly except that at 18 stone I'm a size 24 at both ends! (What's that about?) And I do think that on some level I'm afraid to be a normal weight. Being fat is like being invisible, it's reassuring. If I was normal people would look at me and I don't like that.

crazy If it is any help I have found that I am still invisible, in fact I feel more invisible at a normal weight than when I was obese.

Here is part of Bevan's speech to the House of Commons 30 April 1946, on the occasion of the second reading of the National Health Service Bill:

"It is cardinal to a proper health organisation that a person ought not to be financially deterred from seeking medical assistance at the earliest possible stage ? The first evil that we must deal with is that which exists as a consequence of the fact that the whole thing is the wrong way round. A person ought to be able to receive medical and hospital help without being involved in financial anxiety ? If it be our contract with the British people, if it be our intention that we should universalise the best, that we shall promise every citizen in this country the same standard of service ? the nation itself will have to carry the expenditure, and cannot put it upon the shoulders of any other authority."

I could sob. I could just lie down and bawl that politicians do not speak like this any more. There is no moral authority, just weaselling and whining.

"But then I know of very few people who don't suffer some sort of chronic illness that needs treating by a GP or hospital." Really? Because I know of very few people who suffer some kind of chronic illness that needs ongoing treatment and I don't think I am unusual in this.

You are right curryeater. We are also in an environment where everyone is under pressure so everything is someone else's fault. Everything is tribal. Every human variation is a pathology. That's why people are so vile about fat people and bang on about how awful it is sitting next to them on an aeroplane as if the very worst thing that could ever happen in anyone's life is that you should have to interact with someone who isn't like you. Or people who are vitriolically anti children on a plane. Or who rage about old people who dare to get on the tube in the rush hour when it should be reserved for important people like them. Who do we all think we are? We have lost the sense of all being citizens together (if we ever had it).

I can definitely relate to the feelings of invisibility. I'm socially awkward, have a hard time with meeting people, popping out of my shy shell and my weight is a way of keeping others at bay. I'd love to know what it feels like to be a normal weight. I literally have been overweight/obese since I was a child but apparently that desire has never been enough for me to sustain motivation to lose all the weight. I go in spurts where I lose some weight, then lose momentum and gain it back and then some. Nasty, nasty cycle.

But of course, it's all my fault, since all I need to do is eat less and move more. Simples!

I definitely don't think that most people who are fat have mental health issues. Again that just pathologises it. I do not have any mental health issues at all - I am fat. I have been really quite fat and now I am just a bit fat. I would like to be less fat but it's difficult to lose weight (statement of the bleeding obvious) and it's really not my biggest priority. Sometimes I think being fat is just very, very sane. If, like many people, you are lucky enough to be fat and healthy and obviously with a genetic predisposition to it to add to the issue, you could become obsessive trying to fight it or you could think, you know what, life is pretty good, I eat well, I keep well, this is not top of my list of priorities.

Obviously this doesn't apply to people who are seriously overweight and having health problems as a result - it would help them to do something about it but we all know how hard it is. Do we really find it that hard to understand that it's difficult?

Aside from all the moral and ethical arguments after a 6 months maybe a year it would actually cost the NHS more.
Example: obese but working person needs hip replacement. Gets sent to back of queue.

6 months later hip has degenerated so (a) person can't work due to pain so money coming out of NHS for painkillers. (b) 'routine' op has become a more complex one costing more time in theatre, longer recovery, more physio etc.

If I had time I could come up with more possible examples all of which would end up potentially costing more money.

Just not a feasible option

drjohn yes that is also true - that many people may not prioritise their weight until it gets serious.

I also hear what you are saying about making people 'other'.

It is most obvious to me on MN when people talk about criminals as being subhuman. As if there was no way in which a 'normal' person could commit a crime....

But I don't think that acknowledging the mh/esteem aspect of weight loss is pathologising. It is putting a name to why the problem exists which is surely the first step to getting people actually useful help (as opposed to diet plans).

The NHS really seem to have a problem with a lack of joined up spending decisions.

A labouring woman can't get the pain relief they need as it cost too much, but down the line that lack could cause far greater spend.

People aren't getting proper MH support, which down the line cost tonnes in chronic illness.

On the radio at the weekend, there was someone trying to sell a kit that improved the rate of accurate urine sampling. They can't sell it because the person spending money on that isn't the person that has to pay when a repeat test is ordered...so for the sake of saving pennies in one department, pounds are lost in another.

Basically a consistent pattern of early interventions that can't get funding that lead to far more expensive care later on.

I have no esteem/MH issues.... Yet have just lost 2 and a 1/2 stone...

Hmm difficult one...

If an alcoholic won't stop drinking should they be given a liver transplant so they can fuck that one up too? I think before they get a transplant they have to be sober for a period of months or years.

As someone said upthread, is it reasonable to repair joints in a hugely overweight person, knowing that they will give way almost immediately due to the strain?

I think in that circumstance it is not unreasonable for the overweight person to be offered the operation on the condition that they lose weight and keep it off for a period of time before they are operated on.