Is obesity the responsibility of the NHS?

[snookspooks]

I've read a few posts lately where posters say the NHS isn't doing enough to combat obesity. As far as I am aware people are taught from pre-school age upwards about healthy eating and the importance of exercise and a healthy lifestyle. This continues through secondary school. I don't know about in further education but I don't remember any from my own FE days. We have access to NHS information online about healthy lifestyles, and the information is repeated in pregnancy and post-natal days by midwives and health visitors (that was my experience but I appreciate it might not be the same for others). We are given the information and it's up to us as individuals what we do with that information. The idea is we use it to prevent getting obese in the first place.

If people do get obese, through whatever factors, and there are many that contribute to this, is it up to the NHS to fix this or should the onus be on individuals? What happened in countries without an NHS style system?

Cancers are mainly preventable but the NHS provides treatment for those but then we can't fix cancers by ourselves, or heart disease, or strokes, but obesity is something we can treat ourselves. I'm not saying it's easy but it is possible. Of course obesity is linked to those diseases/conditions so it's not straightforward.

Is too little responsibility put on those who are obese?

I don't think it's straightforward and I think it's impossible to give treatment for some partially or completely self-inflicted conditions but not others. It's an ethical nightmare. What do other countries do?

I think banning margarine and low quality vegetable oils would go a long way to tackling obesity, or at least raising tax sky high on them, and on processed food.

These things are freely available children are eating them and no, I dont think the information on how badly they mess up insulin metabolism is widely publicised enough

Not the NHS, but certainly a wider government responsibility

If we say the NHS should not fix obesity related heath issues, we go down a slippery slope of not treating smoking related cancers, alcohol induced injuries and extreme sporting injuries. I don’t want to see that happen.

‘Cancers are mainly preventable ‘? Where the fuck did you get that idea ?

Better tell my Haematologist then and ask him to explain how I could have prevented it ?

There are many many causes of obesity, and it is often the result of past trauma, abuse, or indeed drugs prescribed for other illnesses.

i don’t even know why I am responding to you, your ignorance is astounding.

What do you mean by “an NHS style system”?

I would recommend reading a book called “The Miracle Pill” which explores the impact of our sedentary lifestyles on our health. here

Our whole economy is set up to make us incredibly unhealthy unless we take active steps to try and counteract that. So we have to actively exercise - and that is the problem. If movement and exercise was just part of life, then obesity would be a much smaller issue.

Things like - if we could walk more to work/school. If many jobs didn’t have us sat or standing as opposed to really moving about. If it was easier to use our two legs instead of jumping in the car.

But because these things are harder - then the very act of trying to tackle our weight is so tricky.

I think it’s a mix of personal responsibility but also we need a bit of a shift in how things are done. How towns are designed, how to make things more pedestrian friendly etc etc. then we wouldn’t need to set aside specific time and money to exercise.

I think there are things the NHS should be funded to do, and things other organisations can do.

It would be great to look at causes, and for example there is evidence that sweetener use in drinks can encourage a sweet tooth and greater consumption of sugar, so at a policy level it would be good if unhealthy industries weren't able to influence the government.

But where a pre existing condition is implicated, the NHS can help if it has funds available.
There are medical treatments for lipodema, for example, which you can access in Germany relatively easily. Treatment can greatly reduce the risk of obesity in those with lipodema.
But very little is done here other than prescribing compression garments.
It's a false economy as it gets much worse over time without treatment.
I eat around 1100 calories a day and still don't lose weight, even with exercise. It's quite irritating.

Yearly health checks for people who struggle to notice things like hunger and being full - for example, autistic people, would also be useful.

But we would need to properly fund the NHS.
I do think there is often a 'the NHS should fix everything' whinging which seems mean spirited.

Hmm. I think far more help is needed. Rarely does someone "choose" to become obese because they want to. Psychological support would be great. Unfortunately most diets don't work int the long run yet doctors refer to ww and slimming world.

It can seem an impossible task to recover and become "normal" again.

Obesity could be reduced by highly processed foods being subject to high tax. With that tax used to significantly reduce price of healthy food. A lot of NHS advice on diet and exercise is based on very limited evidence

I think this is an appallingly clunky wording by the OP. I assume she means that certain things increase the risk of cancer (eg smoking and alcohol), but misses out the fact that you cannot actively avoid it if cancer gets you.

If obesity was something we could fix by ourselves no one would be obese

4 in 10 cancers are preventable according to this

https://www.cancerresearchuk.org/about-cancer/causes-of-cancer

Approx 1 in 3 cancers are due to lifestyle factors, so are essentially preventable. The OP is correct to say that.

I know it's not easy to hear, but you're far, far less likely to experience cancer if you're a normal weight.

I think it's important to remember it's called the National Health Service.

I mean, we all know it's the National Illness Service really, but while it's called that, some of what it does should be health promotion (evidence based).

Yeah yeah, onus on the individual etc etc, so far so heard it all before, but you clearly haven’t read the research. You want the NHS to not treat obese people? You think the advice they give on weight loss is just fine? Whatever, you’re not unusual.

this is a good diagram which gives an idea of what would actually be more likely to work to reduce obesity rates, but the government would never do any of it because of the reaction of food manufacturers. So you’re left with the shaming individuals tactic (“we have given you all this information, why are you too thick to use it?!”), which has obviously failed.

There are complex reasons for obesity. But trauma/mental health issues aside , if we compare mentally healthy people for a fairer comparison... not all of these people are overweight. I have been slightly overweight and I have been healthy weight - the difference, for me, is personal responsibility. So yes, people with no underlying 'cause' should bear responsibility.

BUT the government could do a lot to make it easier to maintain healthy weight. Legislating against UPFs would be a start. Make them hugely expensive so they are only affordable as occasional treats, and use the money raised to subsidise fresh food. They could also legislate to encourage walking to work, and improve walking routes and cycle paths. But none of that is the NHS' responsibility. The NHS is for fixing health issues, not societal problems. Unfortunately the NHS just gets to pick up the pieces.

I think the role of the NHS in tackling obesity could possibly lean more heavily on counselling, CBT, etc to tackle underlying causes of overeating in individuals where they exist.

just reread where you said "most cancers are preventable"

no they are not

I have cancer

what do you think I could have done to prevent this?

Health problems caused by being overweight is a draining on NHS resources but so are diseases caused by smoking and alcohol consumption. But these addictions too can be caused by mental health issues, past trauma and so on. Cnancers aren't mainly prevenrptable as things are. We don't know what extentb pollution insecticides and food additives and so on are contributing to increase in cancers.

Where did the OP say all? They're right - some cancers are preventable

The biggest drain on the nhs is currently care of the elderly and lack of social care

Our entire capitalist lives are set up to make the maximum output for the least cost

We don't live in a country that gives a fuck about how you live or die

That's why the NHS is poorly funded

That's why benefits are low

That's why people can't afford to heat their homes or insulate them

That's why we have the LONGEST WORKING HOURS, the HIGHEST STRESS LEVELS in all of Europe

Combine that with a low waged, shitty service economy with all the fucking leisure centres shut or incredibly expensive and ...

You will die

So just get on with it and die. That's literally what they want from you.

Once you become useless to capitalism take the pill and fuck off.

Signed
The fucking cunting government

I actually think people should take more responsibility for there own health and weight. I am genuinely astounded by the amount of people that live 5 to 10 minute walk from the kids school and never walk it. Yet it takes longer to get the kids in the car, drive, find a parking space, get them out and into school as parking is really difficult. Some people have no concept of portion control, eat endless junk food, constant snacking etc.

Before you get ready to stone me please read the whole thing. I really don't like the fat is beautiful movement. Some fat woman are incredibly beautiful but it's not healthy for your body and life expectancy is far less for seriously overweight people so to me normalising obesity is a really bad way to go long term. Obesity also comes with health problems that cost the NHS a lot. However I say all this and actually think junk food should be taxed really highly and healthy food like fruit and veg subsidised with these taxes so they are very very cheap.

www.nejm.org/doi/10.1056/NEJMsr1606602?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov

TL/DR - Obesity increases the risk of most cancers.

@Fundays12

Fat being beautiful has nothing to do with health.

Most slimmer people aren't that healthy either.

Looks are separate to health

The OP says cancers are mainly preventable- which is complete rubbish, and a very medieval mindset.

and I am waiting for your answer @snookspooks

come on, tell me what I should have done to prevent cancer, as you clearly know more about it than my oncologist

Anyone struggling with weight loss should be in therapy it's a comorbidity.

So we also say that people who smoke, people who have children with cousins, people who drive cars or motorbikes, people who have children, people who have children when they know there are family genetic issues, people who refuse to get vaccinated, people who take drugs and alcohol etc all deserve not to have NHS treatment and could easily be more responsible?