...to expect obese people to take responsibility for what they eat?

[Tabby1963]

"If I don't do this, no one's going to help me, and if I don't help myself I'm going to end up dying."

"I should have done something about this, I should have tried harder".

These quotes from a lady on BBC News this morning, and she hits the nail on the head.

As someone who has also struggled with weight issues for most of my life I feel that it is my responsibility what I put in my mouth, and expecting the NHS to fund my weight-loss op is very unreasonable. It is a waste of time unless I actually change my behaviour voluntarily, and if I change my eating behaviour voluntarily then I will solve the problem myself.

I'm obese because I overate.

I overate because food, for a little while, stopped the pain. I was sexually assaulted as a 4yo and until around the age of 30 lived with depression, little to no self-esteem, a sense of complete worthlessness and isolation for years. I've had support for my mental health issues and I am starting to overcome them and try to eat better and exercise more. It is going to be a massive struggle for me - I need to lose more than half of my body weight to reach a healthy weight - but I want and need to do it so my children don't end up without a mother.

Mental health issues are 'proper' illnesses. My issues aren't an excuse for my weight, they are the reason for my weight. I didn't care enough about myself for a very, very long time and maybe if that had been recognised and treated a lot sooner than it was I wouldn't be in the state I am now.

I have never been obese but I put on 20kg with beign prenant and alhtough a lot of it dropped off after birth quite a lot stayed on.

So I went on a diet suggested by a therapist.

He gave me a list of allowed foods and the next intstructions were:
go home and throw out, or give away all food that is not on this list so anything in your cupboards is ok
When you shop only buy the foods on the list, if you are tempted to buy stuff like crisps or chocolate, put them in the trolley, then go to anohter aisle then go back and replace any of the crisps, chocs, or non allowed food BACK ON THE SHELF
The act of doing that was so empowering

So the house conversations went:
DH: I really fancy some chocolate...where is hte chocolate?
Me: there isn't any
DH: Oh

No one ate any chocolate...and DH lost weight even though he wasnt on the diet.

I am now back to my re-baby weight.
Requires self control and a supportive DH
Hairy Biker's diet books highly recommended too.

That said, it will be a lot harder for people who eat as an ingrained habit or deep seated need for comfort- it is so hard to break habits, and hwat other comfort activity do you do???!!!!

I used to eat while watching TV - now I knit - keeps my hands busy.

towanda, so sorry

life the thing is that while not many people have suffered the terrible trauma that towanda has described ( ), it is easy to become stuck in the same trap of low self-esteem from more mundane common place problems as well. My weight didn't balloon until after I lost all self-confidence due to a miscarriage followed by HG pregnancy, a terrible birth and PND. It was nothing compared to towanda's experience but it dumped me in the same place. Not believing it mattered much if I lived or died....

And I believe the MAJORITY of people with serious over-eating issues have had this triggered by some either everyday or more extreme experience that has left them with little to no self-esteem.

I agree with you that not a penny should be spent on obesity. But I think we should be increasing the amount we spend on mental health by about 10 fold or more....which would likely solve the obesity epidemic in passing.

People who care about themselves at a 'normal' level don't eat themselves to death. People who don't care about themselves need help with their mental health!

not a penny should be spent on obesity until other 'proper', yes 'proper' illnesses are overcome.

Obesity can be a signifier of other things though. PCOS, depression, thyroid disease, hormone imbalance... even lack of sleep is known to make weight gain more likely. Medicine should take a more "all round" view.

Mental health issues are 'proper' illnesses. My issues aren't an excuse for my weight, they are the reason for my weight. I didn't care enough about myself for a very, very long time and maybe if that had been recognised and treated a lot sooner than it was I wouldn't be in the state I am now

Towanda that's a great summary, well said.

Money has to be spent on obesity though, because it has such a major impact on health on a population level. It simply can't be ignored. If gastric surgery is the most cost effective method for some people then that is the way forward.

not a penny should be spent on obesity until other 'proper', yes 'proper' illnesses are overcome

Once again, if gastric surgery is targeted at the right patients - ones who have been assessed as being ready to change - then this often turns out to be the most cost effective option.

Why? Because morbidly obese patients who've had gastric surgery are much less likely to wind up with chronic obesity related health problems that, in the long run, cost the NHS more than the surgery.

And there's a whole long list of health conditions that can be caused by, or worsened by, obesity. Including 'proper' illnesses such as cancer and heart disease.

Lifeisaboxofchocs Tue 21-Jan-14 12:32:56

"And in my opinion, not a penny should be spent on obesity until other 'proper', yes 'proper' illnesses are overcome."

What about other dangerous and destructive behaviour caused by MH problems? My dd's repeated suicide attempts- should they not have been treated until other "proper" illnesses had been overcome?

Of course, the responsibility was hers and we have never denied that: ultimately she chose to throw herself out of that window. She was not delusional, just extremely anxious and ready to do anything to take away an emotional pain she couldn't cope with.

Not really that different to somebody in the same situation stuffing their face with unhealthy foods to deaden the pain.

After extensive psychological treatment and appropriate medication she no longer feels an uncontrollable urge to behave destructively. Given that she may live another 80 years and (one hopes) contribute to society in all sorts of ways I think that was money well spent.

"Obesity can be a signifier of other things though. PCOS, depression, thyroid disease, hormone imbalance... even lack of sleep is known to make weight gain more likely. Medicine should take a more "all round" view."

I agree. But popular medical opinion is that most people are overweight just because they eat too much. I asked earlier and I will ask again - what proportion of people are overweight due to medical/psychological issues compared to people who just enjoy their food a little too much?

I don't think we can know that Bunbaker, at least not when it comes to psychological issues. Personally I would guess that quite a lot of people are obese because they enjoy eating, just as lots of people drink because they enjoy it. We do have a culture of self indulgence in our society.

Personally, I would suspect that lots of people are overweight because they just liking eating but that people who are morbidly obese, to the point where it impacts on their lives, often have more deep lying issues.

Big difference between being rather podgier than you should and being so obese you can't get out of the house.

"We do have a culture of self indulgence in our society."

I think you have hit the nail on the head.

"Personally, I would suspect that lots of people are overweight because they just liking eating but that people who are morbidly obese, to the point where it impacts on their lives, often have more deep lying issues."

I also think you have hit that nail on the head.

I've had experience of a family member who had bariatric surgery. The underlying issues are still there and when he realised that drinking fizzy drinks with his food allowed her to binge without vomiting he regained several stones. The positive s are that his diabetes was reversed and he lost about 8 stone.My only criticism is that not enough is done to discuss the relationship with food.

What a horrid attitude some people have.
Obesity is clearly an illness with good research that there are genetic elements that affect ability to lose weight. Add in mental illness. Add in high dose steroids. Add low thyroid levels. Add conditions that reduce mobility. It’s really not as simple as saying don’t eat burgers.

Then should we stop treating other conditions that are brought on by lifestyles? No bowel cancer treatment where someone has a diet high in processed meats and alcohol? No treatment of alcoholism? No treatment nt of lung cancer when a patient has ever smoked? No management of skin cancer where someone has sunbathed?
Anorexics should, perhaps just be told to eat. Make those with STDs suffer the consequences. Where on earth would this extreme view end? The obese are an easy target for vitriole and probably suffer enough all ready. Compassion might just be more effective.

Your post really annoyed me. It’s very naive and judgmental. As others have mentioned over eating just like not eating enough usually stems from mental health issues. All you are doing is victim blaming. Of course most obese people don’t want to be obese but for you to say “take responsibility “ you are assuming they’re in full control and just need more will power. Instead they are probably battling with demons you have no idea about. Maybe they were raped repeatedly by a family member, maybe they are victims of domestic violence, or maybe they have other health issues. Obesity, Anorexia are called multifactorial diseases for a reason. Get your head out of the sand!!

And in my opinion, not a penny should be spent on obesity until other 'proper', yes 'proper' illnesses are overcome.
So what about people with Prader Willi Syndrome. People on steroids, people with genuine eating disorders; they do exist you know. You sound spiteful and somewhat limited in your thinking.

A problem can happen due to antidepressants which can cause weight gain and metabolic issues. Combine this with issues of binge eating which may already exist...also antidepressants are not easy to come off, sometimes, it can cause withdrawal symptoms. Another link between mental health and obesity. and of course the obesity makes people feel worse so can be like a vicious circle. other meds such as antipsychotics can be even worse for this. take olanzapine.

Zombie thread Not many attitudes have change since 2014.