Can we have a sensible discussion about obesity without shaming?

[BalloonCityBaseline]

I started another thread which got my thinking; why is it impossible to start any discussion about obesity without someone bringing 'will power' and 'personal choice' into it?
I always find on MN there is sympathy for those with addictions, people in poverty, people who stay in shitty relationships but there is no sympathy for those who struggle with their weight. For one, weight gain is seen as a personal struggle (you made yourself fat) rather than thought of as society's struggle (what can we do to address this and help people?)
Let's not forget that every country in the Western world is having an obesity crisis right now, yes even the Scandinavian countries and the skinny French. Also not one country has successfully managed to reduce their levels of obesity? Why?
The number one reason that we have put on weight has to be the shift to processed food and how available and cheap it is. God it's cheap! Easter eggs are now 75p in Tesco, the other day I saw a row of school kids all walking down the road munching a whole Easter egg each. But what's the alternative? That 75p would buy you absolutely nothing in the fancy health food shop across the road, and six of them would have to club together to buy one punnet of blueberries in the same Tesco so what choices do young people have?
Fat shaming just does not work. The number one reason kids are bullied in this country is because of their weight, with girls being likely to be bullied for being overweight more than any other factor. Do these kids lose weight when the bullies scream at them day after day? No, they often self harm and some end up depressed adults who take that shame with them for the rest of their lives.
As someone who has lost weight recently for the first time in their adult life I feel it coincided with a time in my life when I felt happy, busy, fulfilled, motivated and in control, which felt like the first time in my whole life. When I speak to others on the same journey they tell similar tales. The whole 'I couldn't fit into an airplane seat and everybody laughed' Take a Break narrative just doesn't ring true for so many people I know. Happiness and acceptance is much more likely to put someone in a mindset where they can change their eating habits and take control.

I'd be happy to hear other thoughts.

@Fountainsoftea

I'm not convinced the focus on exercise is right either. I'm fairly active. I run, do weights when the gym is open etc. But I only lose weight when I stop eating the nice things.

3x5k runs per week will only burn about 800calories. A glass of wine is 250. I cancel out all my exercise in a Friday night.

I think people think exercise will magically solve everything. I do think pe in schools need overhauling though. If you're an uncoordinated teen, team games are hell on earth. Most of my pe years were spent standing on the yard, waiting for a sniff of a hockey or netball to come near me. As an adult, I did c25 and took off from there. As a kid, 2 weeks of x country every year was torture.

Agree, exercise isn't a terribly efficient way to lose weight. But you can be fit at a bigger size, you see plenty of people of all shapes and sizes completing marathons and the like. People think intense cardio will shift weight but exercises such as running can actually affect cortisol production and cause you to hold onto weight. Weight training and building lean muscle mass is far more affective. I lost a stone after ds was born by weight training alone, it took 10 months but it worked and I've kept the weight off. I have 2 highly educated intelligent friends who batter their bodies with ridiculous diets as they want a quick fix, constantly doing no carb, detoxes, juicing diets. The minute they stop the weight literally piles back on. And now they're in their mid 40s when they do these diets they look like shit, gaunt grey skin and haggard. They may be skinny but they're depriving their bodies of essential nutrients and putting a lot of stress on their kidneys.

@amysteryforsaturday

@BalloonCityBaseline

Also if shame works then how come when a family member told me 'for gods sake put down the sausage rolls!' In a room full of people I thought I felt safe around I didn't lose weight for another 12 years? How come I actually got bigger after that? How come I immediately went home and ordered a take away?

That’s my experience every time too . I had a doctor once jiggle my belly fat - whilst examining me internally she intentionally wobbled my tummy fat and said, it’s gross isn’t it - I went home and ate a just eat !

However I think as a PP said I fat shame myself; every minute of the day, I’ve very very low self esteem and don’t see myself as like the rest of the world at all - so even if I’m not getting the insults from others I’m giving it to myself constantly . It’s a very difficult place to be in .

A big problem is that there is fuck all to do and the weather is crap. Most jobs are sat around. We’ve got these huge estates of houses all over the country with nothing else there but rows and rows of houses. Posh or not. It’s miserable. All we have to do is shop and even that we do with Amazon now. House builders are in such demand they can get away with building mass housing estates without even providing for schools or health services. Why wouldn’t they just get rich from that? People are so desperate to live here that they don’t even have to put in a proper playground and the houses fly of the shelves.

In some other countries I’ve lived there’s been purpose. Whether it be beautiful places to go where you can’t get away with being fat, to local activities with tennis courts and big playgrounds. Industrial jobs, people making things, investing in the future. Engineering, new tech, space programmes, things to inspire. Real jobs to do. Our whole culture for the most part is for most people around the services of shopping and food. We ship in everything else from China. The UK is depressing, why wouldn’t most people be fat?

Yeah, you are right OP. There's an idiot on the other thread shrieking at people about "take responsibility" and "will power!" and I wrote a long rant in response, but then deleted it before posting as I couldn't be bothered dealing with what would have been an unpleasant response from a not very pleasant individual.

I'm a recovering alcoholic. I can clearly see that sugar can be an addictive substance like any other.

There's a reason why recovering addicts of any sort can NEVER rely on will power for sobriety. You need tools/strategies and massive lifestyle changes. Usually you need counselling or therapy to unpick the psychological reasons behind your addiction. It's just the same with food for people with an issue.

That's how I see it anyway. You wouldn't get a thread started by someone with an alcohol problem where posters piled in with, "I just don't understand. I have one glass of wine and then stop. Why don't you just do that? Have you tried making healthier choices like water?" But you see it on here with food threads all the time. People who don't understand that food can be a hugely complicated addiction are just tedious with their, "eat less move more... take responsibility.... just use will power" responses. Arrogant addiction deniers, basically.

@amysteryforsaturday

One of the most interesting things I found this week was that I had to do a big presentation on zoom .

Fifteen clients, ten colleagues, two senior managers .

I did it without a problem, had a great time and got high praise from management .

All because they couldn’t see me - in rl I hardly leave the house as I’m scared I’m being judged every step . I’m crippilingy lonely, cried and cried after that presentation because I thought; oh this is what it’s like to feel happy and confident .

I asked my GP if she could point Me in the right direction re exercise (at 21 stone) and she suggested I start jogging and long distance walking . Have tried the latter (I can’t run) and now my knees are fucked . It would be great if there was a good, accessible, holistic service for morbid obesity - NHS don’t give a shit, but more than happy to remind you how far you are - just don’t want to help you lose (once you’re morbidly obese - there’s no support or guidance or advice) .

This sounds awful. I'm so sorry you were dismissed by the GP like that, the NHS services for obesity are shit. I've spent the last few years developing an eating disorders treatment pathway and there are very very slow but gradual movements towards what you describe, ie obesity being seen as something that needs holistic comprehensive treatment. Ideally an obesity specialist team will have a medic, some psychological therapy, an occupational therapist, nurses and a dietitian. This approach works well with eating disorders and addresses the whole issue.

I have to talk to student nurses when I'm teaching them about obesity in relation to the meds people are on (anti psychotics cause massive weight gain). I'm very mindful that out of the nurses in front of me at least 2 thirds are overweight/obese. It's a really hard topic to address.

OP, this is someone I've seen recommended a few times on MN and you may be interested. Dr Rangan Chatterjee take a very sensible, pragmatic and compassionate approach to all things health. His latest book is about weight (Feel Great Lose Weight) and he has a free podcast drchatterjee.com/blog/category/podcast/

I am overweight but not obese, weigh just under 11 stone. Now 59. I was very slim throughout my 20s even though my diet was awful. But I drank a lot less alcohol and walked a lot more as I didn’t pass my driving test until I was 26. I began to gain weight in my 30s and was diagnosed with underactive thyroid aged 40. I did manage to lose weight once doing Weightwatchers but eventually regained it. I eat a healthy diet these days, but I do like my wine. I don’t drink more than the recommended number of units though.

When I was in Singapore, most people buy breakfast lunch and dinner from outside the home. V slender population

There are also huge advertising billboards reminding people what the optimal BMI is. The government actively, and very publicly, discourages obesity.

I cycle 50 miles a week and limit calories to about 1600 mon to fri.
Yes I eat more at the weekend but am still active.
I seem to have settled around 14st 10 which makes me obese.
I've walked 300 miles extra since jan 1st. I'm half a stone heavier and permanently hungry, most days I behave.
I can see why people find losing weight difficult.
I'm 49. Perfect blood pressure, cholesterol and blood sugar. And would call myself healthy. I'm still obese.

I always think - if it’s just willpower, why aren’t I living in a filthy house with a pile of debt, not managing to get out of bed let alone hold down a responsible job which I do well. I don’t especially like getting up on a cold winter day but I do. I would love to spend more of crap which makes me temporarily happy but I don’t. I’d love to ignore the housework but I wouldn’t. So I know I have will power. But still, I’ve spent most of my adult life overweight.

I forgot to add that Singapore regards a BMI of over 23 to be outside the healthy weight range.

I thought Tim Spector's message was much less about "evil industry" or "hopeless genes" and more about agency -- people can choose healthier diets and when they start eating a lot of fruit & veg in their diet they get a healthier gut micriobiome which leads to better appetite balance. There's no magic cure, but the factors aren't purely unmodifiable, too.

Apparently, in war, two things happened regarding food:

Because it was scarce and expensive and rationed it was not wasted, and whatever people could home-grow, they did:
Also, the standards of the population's health shot up, not least because the dietary needs were calculated, published, and there on the ration books for all to see, every day.

Effectively, there has been a mass mis-education brainwashing of the population, by commercial interests. If for two or three generations, people have been presented with huge portions and huge calorie-count foods and drinks, how on earth would they have any idea they are taking in far too much, let alone that the intake is nutritionally unbalanced? (There are t.v. shows displaying people's food intake, and invariably the people seem astonished they are overconsuming. They are also amazed at how cheap, easily made and enjoyable the healthy alternatives are.)
Post war, and for a long time, sugar was not freely available, nor the other useless and unhealthy mass marketed processed foods which are constantly on offer to profit from ill-health. Tobacco was promoted, mainly to men but also to women. Alcohol was not so relatively cheap and universally available, and was also considered mainly suitable for men, thus inadvertently saving women from not only the liver damage but also the calorific load.

Could the junk food and sugar and alcohol sellers be taxed, by alcohol units and by calorie content, and by sugar and salt content, and whatever else is agreed to be bad for people to consume in large amounts, and could there be an advertising ban on the main offenders, all with the intention of discouraging consumption just as tobacco, eventually, was? The I.H.T. (Ill-Health Tax) could be hypothecated, ringfenced, and circled back to the N.H.S frontline services (excluding their managers and desk-jockeys), to avoid N.H.S. resources for obesity, diabetes and alcohol related harm being an unintended government/tax-purse subsidy to the health destruction industries.

@Nuitsdesetoiles, that service sounds like it could be a huge help! I stopped going out and exercising for a good eighteen month and Inoften think i could have done with the help of others than just GP, but if you can’t pay for it there isn’t that option ! Funnily enough if I was smaller they’d pay for me to go to weight loss services like WW but won’t do that now . Did offer Alli . I’ve lost a lot of weight before- I think the sticking point now is I’m on a high dose of propanolol and mirtazapine, with background anaemia that’s going as yet untreated, making me feel very sluggish, sleepy and giddy !

I agree with you to a point.

I've lost 6 stone, 3 more stone to go to get to my ideal weight, and it has definitely only worked because I've been happy. I don't believe there's is anyway shaming or embarrassing people is ever going to help them lose weight, it's only going to exacerbate the problem.

However, since eating healthier, making healthier choices in general has nearly halved our family expenses. Unhealthy food isn't cheaper, it's easier and more convenient.

Breaking everything down, it wasn't unhealthy food I was craving, it was convenience. Reaching for quick snacks when I was hungry, rather than preparing healthy snacks, eating freezer food or takeaways instead of cooking, choosing meals with minimal washing up. Also eating when I was bored. Learning to cook (and enjoying it) and finding other hobbies to fill boredom helped.

Of course there was an emotional eating side to it as well, but when I broke it all down, most of it was laziness and lack of motivation (which obviously has an emotional connection too).

I had to have a complete overhaul of thinking, in all aspects of my life. My goal has only worked this time because it wasn't just about losing weight - i had to adjust it - it wasn't even about being healthier, its been about making better choices full stop. Creating good habits, solid routines. This spilled over not just to my diet and my physical activity, but to my finances, my self care, my mental wellbeing, how I parent my kids.

I'm not convinced the focus on exercise is right either. I'm fairly active. I run, do weights when the gym is open etc. But I only lose weight when I stop eating the nice things.

This is true Fountain but actually exercise is more nuanced in weight control than this.

Exercise releases endorphins & makes us feel better about ourselves, breaking that link with poor self image & rewarding with food.

Exercise also helps our metabolism - we continue to burn calories in the hours following a high intensity session, and if we refuel well, we'll effectively require fewer calories / burn more.

But to try & see exercise as a route alone to losing weight will not work, or to do bursts of exercise & then not move for the rest of the day, will bring no benefit. The incidental movement we do throughout the day is nearly as important as structured exercise.

I also think people are incredibly misguided about exercise. I see people out running - & I'm all for running, slow or fast, I love it - but they are moving so slowly, they are effectively achieving nothing but they think they've 'done a run', and that this will impact weight loss, it won't.

Equally, especially for women, mixing up HIIT, core, strength building & less intense cardio is very important. This is poorly understood.

@PADH massive well done to you

It’s interesting about willpower. I have been on a diet/trying to lose weight at some point every year of my life. Every time I fail and come back a bit heavier than when I last started. I’ve paid ww/sw thousands over the years. I’ve tried diet after diet. I’ve tried exercising, they all start off working and I get really excited and then at some point I fall off the wagon and it all goes to pot.

I have just totted it up and worked out I’ve probably lost close to 50 stone in total over my 35 odd years of dieting. I normally lose a stone and a half or similar each year and gain two stone back. 😓

So I can demonstrate willpower, but not indefinitely. And I am definitely addicted to the rush from bingeing on junk food. I fight it every day. I get the point a pp made that all slim people have to work at it, and I understand it but it is such a fundamentally different mindset. My sister, who has always been slim but not skinny can eat a piece of chocolate and put the rest of the bar back for another day. I have tried to do this, and for the rest of the day that chocolate will be calling to me. I’ll distract myself for a while but then it becomes an obsession. From discussions with my sister and other slim people it isn’t like that. She’s forgotten about the chocolate, and will next have a piece when she stumbles across it. That will never happen to me, I’ll think about it and it will grown in importance in my mind until it’s gone.

My slim friends will be full after half a portion of chips - they’re not deliberately depriving themselves to stay thin, but they can read their body signals and stop without an issue. I’ll be stuffed and still want to empty the plate.

Last story, my great aunt (built like me but slim and a ballet dancer) never, ever stopped being hungry. She starved herself all her life to maintain her figure. I remember my dad telling me how she used to cook these amazing meals for everyone and she would have half a plain chicken breast and some vegetables. I think all the similarly shaped females in my family probably have/had PCOS and insulin resistance.

So yes, everyone has to use willpower but, for some, it’s a whole different ball game.

@DorisLessingsCat yes and ot goes for veg too. They were breeding sweeter brussel sprouts for example so kids eat them.
I saw on a tv once how long it takes to breed the perfect satsuma people want. Sweet, easy peel, no seeds. Fascinating.
Wven without ton of breeding, growing the plants itself is quite a money exercise. Space, plants, pesticide care, herbicide care, staff, equipment etc and it's quite limited compared to mass production.
Interestingly, it's always berries people compare to "crap" food in prices. Never the cheap aldi apples or bananas.

Haven’t rtfs but the Singapore example jumped out - people do eat out, they eat sweets etc but the portions they eat are really small.

We live on a street near a high school and invariably see kids walking to school swigging from 2l bottles of coke and eating family size packets of Doritos. I
They probably won’t have a weight problem while they’re growing, but they are setting eating habits that will be difficult to break once their bodies can’t process a post breakfast snack of 1500 calories while maintaining a healthy weight.

Food manufacturers and retailers need to take some responsibility in not discounting processed high sugar/fat foods, multipacks of unhealthy food etc.

I think it's the way we don't move anymore. Sure, we might go for a walk for an hour in the afternoon, or take our bikes out once a week or hit the gym a couple of times a week. However, we don't prioritise everyday exercise. We take the car to the shops even if we're just getting a couple of bags of shopping, we have cleaners cleaning our houses, gardeners mowing our lawns and weeding our borders, valet service to hoover the car, window cleaners, oven cleaners, dog walkers etc...

All these things add up.

I have made a conscious decision to do there things myself (except exterior window cleaning) these days, and I feel like I am much less sedentary.

Pheasantplucker that sounds sooooooo familiar.

Obesity is incredibly complex, a lot of it emotional. I always ate to alleviate my mental condition which is similar to schizophrenia. Then I had private bariatric surgery to lose all the weight without any counselling and ended up having a psychotic epsiode because I wasn't able to eat like that any more to relieve stress, so that led to increased medication which led to all kinds of other problems.
Then I started drinking and that didn't end well so I'm now teetotal and do crafts in my spare time to deal with the problem.
Losing all that weight has not been the wonderful thing I thought it would be, all of your problems are still there.

I am overweight. In fact I am morbidly obese being 5 foot 2 and 16 and a half stone.
I am 53 and have been overweight since my early 20s.
I have tried many.many, many diets. The F plan, Slimming World, Weight Watchers, Slimming Magazine Club, The Hay Diet, 5:2, Calorie counting......
And yes, when I am ruthless the weight does come off BUT I spend the entire day thinking about food, becoming obsessive and as soon as I slip or have a'normal' unobsessed day I gain weight.
I have no idea why I eat too much. I suspect at the start it was comfort eating but I am not unhappy or stressed now - I have a fabulous life and am generally happy.
I am a sloth though.
My childhood was traumatic.
But up until the age of about 22 I was a normal weight for my height, top end probably and curvy. I read a magazine article that said my 'ideal' weight was about 7 stone. I went on my first diet and got to 7 and a half stone. I looked awful and I was hungry all the time. It was unsustainable and I stopped dieting. I ended up half a stone heavier than I started out within a couple of months. This cycle has repeated my whole adult life.
Fat shaming certainly doesn't work - my mum tried that and I shame myself every time I see myself in a mirror. What I see disgusts me.

I am currently doing some NLP to change my relationship with food and I am looking very closely at sugar. I am a total addict. Bread is my 'gateway' food and I am going to have to ditch it.
This is a typical day:
Breakfast - rasher of bacon and 1 egg scrambled with a cup of tea.
Mid morning - handful of almonds and 3 dark chocolate drops
Lunch - either oatcakes and speadable cheese or some left overs. If its left overs then it will be something like a chilli and will be about half to 3/4 of one of the smaller microwave soupbowl things.
Then I get home..........
If I catch myself i will have a cup of tea and some nuts and be fine until an evening meal.
If I don't catch myself then I find myself with some fruit toast and then all hell breaks loose and I end up inhaling anything I can find with sugar in it. It is a frightening experience. I will be full and have a sore stomach and yet my brain will have me prowling the kitchen looking for a 'fix'
Evening meal is generally something from Pinch of Nom.
I drink maybe 2 or 3 glasses of wine a week.

In terms of activity - when they are available I do 2 or 3 dance classes a week. I walk a mile most lunchtimes (no time to go further). I used to do karate but the class folded due to lockdown and I don't feel 'safe' to try a different teacher due to my size. Same with dance classes actually - my teacher and my classmates don't judge but I don't trust that another place will be as accepting.

Why am I fat? In all honesty I eat too much, have an issue with sugar and I firmly believe my metabolism is screwed by years of dieting.