NHS costs attributable to overweight and obesity are projected to reach £9.7 billion by 2050

[hellymissy]

So many posters keep banging on about people not wearing masks, spreading the virus and overwhelming the nhs, people breaking rules etc which is obviously an issue - but we also need to focus on some bigger issues around the long and short term sustainability of the NHS a d consider ways to fix them.

Extracts from government website shows that;

“UK and international evidence suggests that being severely overweight puts people at greater risk of hospitalisation, Intensive Care Unit (ICU) admission and death from COVID-19, with risk growing substantially as body mass index (BMI) increases.

The current evidence does not suggest that having excess weight increases people’s chances of contracting COVID-19. However, the data does show that obese people are significantly more likely to become seriously ill and be admitted to intensive care with COVID-19 compared to those with a healthy BMI.

The UK-wide NHS costs attributable to overweight and obesity are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year.”

If anything will cripple the NHS it’s the direct and indirect impact of obesity on ICU units, and long term pressure obesity puts on the NHS.

Seriously, What else can we do to tackle obesity?

**this is NOT a fat shaming thread, purely a thread to redirect some peoples attention towards some of the real issues around COVID

Some of the misinformation on this thread is scandalous and why is there no query on HOW the NHS spends. For example, little to no mention of bariatric surgery on this thread, NHS makes people typically spend 2 years pursuing bariatric surgery (group clinics etc, I’m not including waiting list time) only usually offering If another comorbidity is present. The cost of this time plus the surgery is surpassed by the cost of treating diabetes type 2 for a year. Gastric bypass is a long term solution, (studies show 10-15 years keeping weight significantly reduced), DTM often in remission within first week, sleep apnea, fatty organs, metabolic syndrome all corrected.

NHSnot using joined up drastic enough approach.

I would urge you to look at UCL’s research into obesity. Studied thousands of people over years instead of posters anecdotal evidence about greedy fat friends. After hitting BMI over 30, chances of losing weight and retaining that weight loss for several years become something like 2%, percentage decreases the higher BMI gets.

Intervention with healthy eating and exercise programmes as well as counselling should be useful up to BMI of 30, at that point start people on track for bariatric surgery.

Gastric band is no longer performed as unsuccessful and prone to complications but other options of sleeve or bypass, are proven to work, are more cost effective to the NHS and will address much emotional eating as prevent production on Ghrelin. Typically performed as laprascopy so serious down time is a few days. Such surgeries also shown results with PCOS and hyperthyroidism.

Combine this with national initiatives to target children and the future generations eg. change of food pyramid, ban on advertising, healthy school meals (with less bloody mumsnetters complaining their little darling doesn’t like it every day). Give up obsession with children learning languages at school which is something we are also shit at as a nation and increase physical activity each day.

It’s all very well banging on about willpower, but this is driven by your own sense of morality, there is no factual basis. We offer medical or drastic intervention for most other addictions. Sugar, especially refined, especially when combined with high fat foods is addictive. Physically addictive.

Also stop conflating fat and shaming. Obesity is a problem, it is a shame to be fat, I know from personal experience, but is no shame to have a problem. You should not feel shamed for having a problem Of obesity any more than you should for smoking, alcoholism or an OCD. It needs support to resolve not denial of the issue.

A gastric bypass or sleeve .. pays for itself within 2 years. It is STILL the ONLY long term, sustainable effective weight loss method available.

I find it quite chilling that the proposed response to the advance of obesity is surgery to remove part of the stomach. I suppose that it’s easier to disclaim personal responsibility for the food you put in your own mouth that way.

Sugar, especially refined, especially when combined with high fat foods is addictive. Physically addictive

The only way people really break addictions is by deciding to do it themselves. By all means get support, but ultimately the person has to do it themselves.

Transparent labelling.

Companies should have to put calorie content of the entire pack in big visible letters on the front of a pack or bottle. And on menus, including takeaway.

No more '40kcals per serving' * serving size 3 sweets, pack contains 50 servings nonsense.

And key is to label drinks. Booze has so many empty calories. A bottle of wine is 500 calories. A pint is 240 cals. People rarely think of this.

I used to do work for one of the big beer companies and they were hugely relieved they hadn't yet been blamed for obesity & it had been mostly the snacking companies under attack. But their mitigation planning had the risk that the link between booze and weight became widely known very high up the list.

Put food tech back on the school curriculum until yr11 with a focus on cooking health food (not fruit salad and toast pizza like mine did).

Make therapy for overeating/emotional eating more widely available on the NHS or cheaper.

I find it quite chilling that the proposed response to the advance of obesity is surgery to remove part of the stomach.
Yeah. And I am obese

Unless you have a medical problem like hypothyroidism why is it the nhs job to fix obesity?.

Type 2 diabetes is reversible & preventable but takes a huge chunk out of the budget. When dh was in hospital a lot of the other patients had diabetes too and his blood sugar was always commented on because it was lower than the other patients which is why he’s still diet controlled after 14 years, & it’s not surprising when the man next door to him had a carrier bag of chocolate bars, biscuits and cake bars delivered to him by his dw. He’d just had heart surgery.

The government doesn’t tax junk food, it should do really like it does with sugary pop, but it does get revenue off the taxes paid by the staff of big firms like 7 sisters but on the other hand junk foods a big employer in this country so it’s swings and roundabouts. I don’t want to see people out of work but I don’t want to see patients with type 2 diabetes at 17yo.

A gastric bypass or sleeve .. pays for itself within 2 years. It is STILL the ONLY long term, sustainable effective weight loss method available.

I also find this statement chilling.

The long term impact of having some of your intestines being unable to absorb sufficient nutrients is now starting to be clear. Short term success, long term failure is how I view these operations.

In my opinion that’s a very high personal price to pay for the failure of governments to properly regulate the food industry

Overweight and obesity are not caused by diseases they are another symptom of metabolic syndrome just like type 2.

No. You're trying to find a medical reason why some people are overweight, but metabolic syndrome is the effect of overeating and obesity not the cause.

They are not a symptom of metabolic syndrome, the are the cause. Eating too much sugar, too many simple carbs which the body almost immediately turns into sugar, means that the pancreas has to keep making more and more insulin until it gets knackered and can't produce enough. Without sufficient insulin to regulate the body's use of the sugars, metabolic syndrome is the result.

If low fat, calorie control diets and exercise worked we’d all be slim.

If people stuck to that it would work, but they don't. Low carb is better than low fat, something we've learned relatively recently, because low fat inevitably results in eating more carbs (so see above) and because they cause a sugar rush which doesn't last long and then the body craves more, so it's harder to resist taking in even more sugar and more carbs. But for people without an underlying mental or physical health condition (which doesn't include metabolic syndrome) calorie control will result in weight loss, whatever form those calories take. It's not that they don't work, it's that they are are hard work and once the weight has come off you have to adjust your lifestyle to keep the weight down. A lot of people seem to think that when they've lost the weight, and finished the 'diet', they can go back to eating in exactly the same way as they did before - the way that got them to that weight in the first place - but somehow magically won't pile on the pounds this time, because they've been on a diet.

And what many dieters aren't prepared to accept is that if weight went on over a period of months or years, it can't be lost in a week, whatever the magazines tell you about dropping a dress size in 7 days. But people who've put the weight on over say, five years, don't want to spend anything like that time to lose it. If they haven't lost a stone in five days they give up and then complain that it's the diet's fault for not working.

Of course things are different for those with health and mobility issues, who are on drugs that increase weight as a side effect. But that is not the whole of the overweight population. And what some people find hard to acknowledge is that sometimes it is down to eating three Greggs' pasties for lunch (with a bottle of coke and a bag of crisps or four).

I would happily have surgery. Tomorrow.

Or support that goes with it.

I don't have co morbidities like diabetes or heart problems or thyroid etc. Just mental health problems due to sexual abuse. So the doctors just say all of the "truths" listed here and put me on anorexia meds.

I have begged to change meds. They won't allow me to. So I might just do it myself.

Oh and despite having a high enough BMI to qualify, I wouldn't ask, because I know that this is my fault. I don't need you all to say it.

@Iamthewombat people who have surgery are personally responsible, they seek out and consent to surgery as they recognise they need this help and support. The majority undergoing this in the UK, pay for it themselves.

Be as chilled as you like. This logic can be applied to supplying methadone to opiate addicts, putting alcoholics in rehab facilities or tube feeding anorexics. Similar if not higher levels of mortality in the seriously obese.

If you have spent any time with people who have had bariatric surgery, you would know that although it isn't without complications, people who undergo the procedure are generally not chilled, they are relieved.

Malabsorption of nutrients is treated from early stages. Yes, this is a downside but evidence based, peer reviewed studies show that without bariatric surgery, the same people with die from an obesity related illness still having failed to lose or sustain significant weight loss. Ironically, many of the seriously obese suffer malnutrition and vitamin deficiency. If the NHS provided such procedures more expediently, the numbers of people going abroad for surgery which have little to no follow up would reduce.

Move more, eat less, mainly fruit and veg, no snacking is all great advice with long term benefits but at a certain point becomes ineffective. Following significant weight loss a person can then adopt those principles.

Everyone wants to have their cake and eat it and be slim ....have a 'gym body' without the hassle and discomfort of going to the gym etc etc
We all want what we want, and would like to get it without having to pay the proper price

[quote Glassythighs]@Pukkatea you make a very good point. My husband just paided £10 for 4 lamb steaks the other day because anything cheaper is rubbish and mostly fat and water. Its very easy for those of us with a bit of money to make those sorts of choices to judge others who buy the sort of low cost food we'd recoil from because they can't afford the choices we do.

The way this thread is going though people will come on next and say "well they shouldn't be poor then, it they male the sort of choices that lead to poverty then why should my taxes go towards helping them, people like that are just too lazy and set in their ways to be well off"

People really are too kind, too sympathetic in modern day UK, Thatchers legacy is alive and well.[/quote]
I wouldn't say that at all, but eating lamb steaks is a choice you and your husband made, and certainly not necessary to maintain a healthy weight. There are hundreds of cheaper options. I know, because I've made those choices, and continue to.
Really, if you have access to a supermarket (or even Icelands, often thought of as the 'poor person's shop, due to the crappy ready meals ) in the UK you have access to cheap basic ingredients.

And what many dieters aren't prepared to accept is that if weight went on over a period of months or years, it can't be lost in a week, whatever the magazines tell you about dropping a dress size in 7 days. But people who've put the weight on over say, five years, don't want to spend anything like that time to lose it. If they haven't lost a stone in five days they give up and then complain that it's the diet's fault for not working.

I think the "it didn't take weeks/months to put it on, it will not take weeks/months to lose it" message should be promoted, but then that would ruin fast diet business (yay). This is one of the big problems. People try, it doesn't move fast enough so they lose motivation. It can be very hard work to
keep motivated when it slows down.
Which also brings me to a very important point earlier ina thread. No one says "eat less, move more, it's easy". They say simple. Simple doesn't mean easy.

I strongly believe that if people were more aware and accepted that if it took you (my example) 7 years to put that weight on, you just simply won't drop it in few months without doing some damage to yourself physically and psychologically. It will take time.
All these "drop size in a week" should be banned.

Anither problem is that it's rarely explained taht you just cannot go back to your old habits. Often people diet, lose and when they reach weight they wanted, they go back to before. Because diet is finished. That before is what got us here. It needs to be better explained that good habits have to be adopted for ever.
Have your fish and chips or a pizza. It's absolutely fine. But think about overall eating. If someone eats majorily well and adequate amounts, pizza or kebab once a forthnight won't do anything to them.

This logic can be applied to supplying methadone to opiate addicts, putting alcoholics in rehab facilities or tube feeding anorexics

(from a poster, above, arguing that using bariatric surgery as the default method of addressing obesity is not frightening or dystopian at all, no.)

No. The direct comparison - mutilating one’s body to attempt to fix an addiction - would be performing surgery on the brains of opiate addicts, or surgically altering the stomachs and glands of anorexics. Both are equally horrifying. As was the practice of sewing some sort of anti-alcohol pellet into the stomachs of chronic alcoholics (I think that George Best had that operation).

How would any of those methods be better than deciding for yourself to stop your particular vice, with support?

Move more, eat less, mainly fruit and veg, no snacking is all great advice with long term benefits but at a certain point becomes ineffective.

Why?

Be as chilled as you like. This logic can be applied to supplying methadone to opiate addicts, putting alcoholics in rehab facilities or tube feeding anorexics. Similar if not higher levels of mortality in the seriously obese.

It's not the same. It would be if you did a surgery so heroin addict can't access their veins (i know, impossible, just an example), implanting something in alcoholic what would physically prevent them from drinking more than small amount and putting feeding device into an anorexic permanently for ever.

That would be more accurate examples because we are talking about actually surgically removing the option of eating a lot.

Snap, @SchrodingersImmigrant!

@chickenyhead I would urge you to speak to your gp, look online, look on mn even. There is support, and if your BMI is over 40 you can qualify for bariatric surgery on the NHS without a comorbidity- this can depend on your NHS trust. Raise NICE guidelines with your GP. A referral is no guarantee as you will be subject to psychological assessment and a committee as well as needing to attend groups and classes for up to two years. I expect this will be longer under pandemic circumstances. That being said you are never committed until under anaesthetic and you can change your mind at any time.

Look at your options, I have no skin in the game but I have worked with many people who have undergone surgery through the NHS and since stopping the gastric band which was main culprit for complications, I have seen many positive stories. It is not a panacea to all one's issues but is an option you are entitled to pursue.

I just want to note here that some people genuinely need the surgery and it's absolutely understandable.

@Iamthewombat aah x posted

@Iamthewombat Why? Statistical analysis shows this.

Volume of weight to be lost, when far greater means these habits would need sustaining for years without error, look at UCL's work, look at the study over 10 years done using UK health records. Likelihood of obese achieving normal weight by percentage. We are talking 1 in a 1000 being able to achieve without surgery.

Its wrong to keep telling people all they need is healthy eating and willpower. Too linear an answer, not achievable for most people once surpassing certain BMI.

I can understand surgery is drastic and unappealing but it is too often dismissed by people with nothing but anecdotal knowledge and a fear of the procedure.

@Iamthewombat @SchrodingersImmigrant (btw sorry to keep @- ing you, want to make clear who I am answering)

I appreciate these are not directly comparable procedures. The points I am trying to make, seemingly badly, are:

1. That for the majority of people who are obese, this is not a solely physical issue.
2. With obesity being tied up with circumstances, emotions and physicality it needs a treatment that can target all three incisively. Bariatric surgery changes the physical element, overrides the circumstances and addresses emotional eating through changing hormone production.
3. Food issue differ from other addictions as to sustain life you have to eat, you don't have to use heroin, smoke to gamble etc so the battle never actually resolves fully so needs almost a more aggressive treatment.

However, there is a lot of misinformation about bariatric surgery, the main myth being that it is permanent in terms of its reach.

Weight can be regained following the procedures, it is a reset to bring people back to a healthy weight, after which they need to adopt a healthy lifestyle.

In the UK, you cannot have this surgery, even privately unless your BMI is over 30, maybe some abuse the system and go abroad where criteria can be less discerning, but for many many people this improves their quality of life and their life expectancy. Its not without risk, not a choice for everyone and not everyone will support its provision by the NHS but I implore people to fully understand whats involved, the research behind these procedures and actually be supportive of the people are brave enough to undertake this decision.

Disclaimer: I've not had bariatric surgery but I have worked with many people who have although it is not financially beneficial to me in any direct way for more people to have this surgery.

Volume of weight to be lost, when far greater means these habits would need sustaining for years without error, look at UCL's work, look at the study over 10 years done using UK health records. Likelihood of obese achieving normal weight by percentage. We are talking 1 in a 1000 being able to achieve without surgery.

So actually, it’s not that healthy eating and following a more active lifestyle ‘become ineffective’. It’s that some people can’t, or won’t, stick to it. Plenty do, though. To suggest that cutting away half of your stomach is a good idea because it’s not easy to form new habits is insane, in my opinion.