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?

Re poverty, there's massive amounts of research done on this. Across Europe there's a clear link to poverty and obesity, that can't be denied. Part of it is needing cheap pleasure, that you can still carry on your life with. Sugar and fat combined gives your brain that. That's how it is linked, not just the cheapness of a £1.50 pizza, crisps, six packs for £1. Wonderful flavoured carbs, they lift your mood when all you've got to look forward to is the next free series on ITV/BBC. It's easy to deprive yourself when you're saving/dieting for a holiday etc, not so much so you don't get judged walking to farm foods.
When I was seriously ill my consultants told me not to worry about my weight. That might have worked out ok if I wasn't left with CF and being skint thanks to having to fight for PIP. The DWP did me out of about £7k, as they do many others. We are being shafted all ways, how does that prompt people to take personal responsibility to save the NHS money?

What obese people are those then? Ones like me?

Oh dear @LondonPretty You haven't read the thread have you?

I'm one of those very few who has medical issues. Loads of them.

Why have you joined the thread just to be down my throat????

I have commented twice and stated we shouldn't exclude anyone with any particular condition. However what YOU didn't like is I am saying its a CHOICE.

The doctor has your medical records so if it was that you have listed it would be different. You ought re read my post I didn't even suggest that people should be spoken to about there weight.

Can you clarify what you are including and excluding in the term 'medical issue'

Also this

Can you clarify what you are including and excluding in the term 'medical issue'

Because depending on what you're including or not I might just be a fat lazy bastard.

My BMI was 22 when I got cancer.

A lot of cancer patients are on very powerful steroids, and put on a lot of weight - I think you need to be very careful when talking like this - obesity is often a RESULT of cancer, not a CAUSE of cancer, and the amount of judgement and superiority can be totally sickening, as if cancer patients dont have enough to worry about

people look at you like dirt because they are a few pound lighter, and they think its all your fault, but they themselves are far heavier than lots of patients are when they are diagnosed

However I see that @snookspooks has apologised for their wording, so thank you

Read the link about Finland

The menu you quote from Iceland doesn't meet any of your 7 veg criteria either so you're not comparing like for like, and you're also wrong about the prices. You can get cheap healthy food, just not in iceland

You can get 2.5kg of potatoes for 90p, tinned fish for 40p, tinned beans 20p, tinned tomatoes, lentils, frozen veg etc

Are developing countries full of Iceland? Do poor people there stuff themsleves wirh frozen pizza to get by? No, people cook low cost meals from scratch

There are ways to do it, but people don't want to make the effort. Ultimately, in most instances (genuine medical issues aside- which are v v rare) it IS their fault they're obese, but apparently we aren't allowed to point that out because they don't want to hear it

Parents of obese children, who aren't obese due to medical conditions, are neglectful.

I agree.

There is a lot of research on obesity, and a lot of it is related to insulin, and the foods that mess up your insulin metabolism most are margarines and vegetable oils, and the other major issue is processed food. we all need proportionally more omega 3, which is not long lasting, and does not survive in processing or storage.

The research is there, cut out sugar, artificial sweeteners, processed food such as ready meals, white bread, white pasta, margarine, vegetable oils. Eat fresh greens.

It is all known, and it isn't really acted on, or publicised

In many developing countries malnutrition and hunger are commonplace
And once Mac Donald's and a bit of cash arrives, they flock to the unhealthy western food and develop the same health problems

It tastes good, it's cheap, it kills much more slowly than hunger

I think the main problem (aside from people who are obese due to medical reasons) is that it takes more effort (not necessarily money) to eat healthily.

I don’t think anyone would argue that it can be hard to lose weight (for the vast majority of people), but in my experience an awful lot of obese people can’t be bothered to educate themselves or put in the effort .

It’s easier to eat junk and take aways than plan meals and or cook from scratch. I think this may be a lot easier for some than others.

Anyone (aside from people with disabilities) can educate themselves and plan a diet, go and buy the right foods and learn to cook and eat healthily.

Society doesn’t make it easy though, we are constantly bombarded with adverts and promotions for high fat alternatives.

I thought it was a well known fact that obesity can cause some cancers as well as a whole host of other obese related illnesses and diseases therefore reducing life expectancy and putting additional strain on the NHS.

It’s not a black and white (simplistic) issue but I believe a lot of people can avoid being obese and therefore reduce the strain on the NHS

There's a whole host of reasons
For myself
Yes I probably eat some of the wrong things
I do exercise regularly

Before I was on my miracle drug I couldn't exercise at all because I'm allergic to it
I also have hashimotos and am immunocompromised
Once a week I inject myself with a drug that gives me flu symptoms for 24hrs, then a sort of "flu hangover" and bone pain for another 48hrs
Work 40hrs a week FT
Between the meds, the working and the conditions which give me fatigued I'm fucking tired but I can't drop any hours as live alone

If I worked 4 days I would probably have more energy to cook and eat better. But then you come to cost and everything going up
A "treat" for me used to be prawns in a salad or something expensive but healthy like that. Can't afford them now and yes chocolate is cheaper

You can say it's excuses but the fact I manage to batch cook and exercise at all is as my consultant put it "a giant win"
And no I can't claim PIP

Could we please stop equating obesity with uneducated
It is rude and unhelpful

@Doingthedeed I'm disabled. And I can tell you there are a lot of days that I'm incapable of planning and making healthy food and I have beige food.

Because I'm in pain or worn out or brain fog or just not coping.

I think there should be high tax on takeaways and Deliveroo say 50% also vast bottles of sugary drinks, MacDonalds etc. it is too easy to get unhealthy deliveries rather than cook your own food. Most people don’t walk more than they have to. I think the obesity rate in the UK is the highest in Europe and still rising. It is sad to see obese teens and young children

Completely agree with this. Our food is laden with ultra processed ingredients, even stuff that appears benign like a loaf of bread. The manufacturers have a lot to answer for and it would be easy enough for government to address if it had the appetite (excuse the pun).

As an obese person I'd say no, it's not the nhs responsibility to fix it. Help and advise maybe but not fix it.

That said, there are a lot of reasons why someone may be obese. And generally it's the poorer parts of society that are obese. The fresh, healthy foods generally cost more than the carb, fat laden cheaper foods. And those who are less well off financially also tend to me more time poor too, longer working hours, more responsibility towards child care so less time for working out etc.

It's not as simple as some may think. I wish I knew the answer myself

The whole thing is very complex and very emotive as the responses here prove. I do think obesity should be treated on the NHS

If the NHS is going to treat the diseases related to obesity (diabetes, cancer, heart disease, etc.) then it’s in their financial interest to treat the obesity itself. I think the difficulty is that it is complex, as you say, so they don’t know how. Many people still think of it as a moral/willpower issue, and it might be to some degree, but there is more to it than simply eating less/exercising more.

I don’t think anyone sees the full picture at the moment. The science in this area is constantly moving forward and it’s a truly intricate problem, including:

• food being used like a drug to paper over emotional problems/trauma
• gut microbiomes changing how food is used by the body
• highly processed food causing changes to the brain
• body weight set points that are very difficult to change
• a culture of fast food due to lack of time/energy
• insulin resistance due to lack of knowledge around how to eat
• high stress levels due to a competitive marketplace, lack of community, family dysfunction and being “plugged in” 24/7
• poor quality sleep - related to stress levels and light pollution

I don’t really see the government catching up with the multifactorial problem of obesity any time soon. They might put a plaster on the issue with weight loss surgeries and medication. I think anyone that wants to be healthy needs to take responsibility for it, do the research, find the support, and just do their best with what we know at the moment.

I'd love a new thread that is sympathetic to the issues a morbidly obese person night have (ptsd/trauma/poverty/etc) that sets out a path out of the condition.

When I Google so much says only 5% of people can escape it.

Imagine selling anything with a 5% cure rate and then blaming the patient if it doesn't work!?

I think you should try to educate yourself a bit on this topic. Do most people have a choice of exercising and eating well? Yes. But this choice is much easier and requires less sacrifice for some than others.

Out of people struggling with obesity, many will have an eating disorder like BED, or use food to cope with trauma and emotions.

Poverty plays a huge role - if you're working 60 hours a week and have a family but little money, making the choice to exercise isn't as easy as when you're 20 and have no responsibilities.

Eating well and cooking will be easier for someone who has the time and disposable income.

Personal responsibility does play a part but the government is failing us by setting us up for failure with things like:

• poor infrastructure - cycling is very unsafe in most UK cities
• general safety - as a woman I feel like my time and place options for walking are limited, going off to the woods alone or going somewhere when it's very dark doesn't sound very appealing
• long working hours & shit childcare options - many people are simply very burnt out

The list really doesn't end here. I'm a healthy weight but have been obese and while I agree that ultimately it was up to me to make the choice, it shouldn't be this hard.

Johns Hopkins did an experiment where they worked out base metabolism and fed volunteers 1000 calories over their requirement for a month. The weight gained over that month ranged from 3lbs to 15lbs. So statements like this

My BMI is around 22 because I choose not to eat too much and keep as active as possible.

Are just stupid and unnecessary. If you are at the upper end of that range, managing your weight is going to be a greater challenge than for those at the lower end of that range.