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?

Glad that you have that option. The vast majority of people can walk, cycle or use means other than cars.

I saw three patients one morning last week and clocked up 67 miles, rural area so people are spread out. That was in under three hours, buses in rural areas are very limited, I don't have a bicyle or the ability to do 1 in 4 hill climbs and most people I know can't cover that distance in 3 hours by foot and see another lot of people in the aftenoon plus call outs ?

Most people are lazy, too lazy to cook or learn, too lazy to exercise, even a simple walk to the shops.

Then there is poverty and lack of education, you can't make healthy choices if you don't know what they are.

Public health is the governments responsibility, not the NHS but they ve slashed that too, along with the very limited council run leisure centres.

People don't actually care about other people's heath or what they cost the nhs. If they did they'd be clamouring to euthanise everyone over 75.

@Botw1 That's a false equivalency. Nobody can control their age, but the vast majority can control their weight.

This is ridiculously over simplistic even ignoring people with illnesses causing weight gain. For example, sleeping less than 6/7 hours a night has been linked to obesity. There was also a study where prisoners weren't allowed to exercise and had to eat a ridiculously high amount a day and that showed that people did not gain weight in the same way - so it seems logical they wouldn't lose it in the same way either.

All calories are also not equal. Calories from UPF affect weight differently to the same calories from fresh veg as they are metabolised differently.

Even smelling food can lead to weight gain!
https://news.berkeley.edu/2017/07/05/smelling-your-food-makes-you-fat/

your honesty is refreshing. Do you know why you eat such big portions of food that is not great nutritionally? Apart from being time poor the same as a lot of people. I'm not asking you to share that reason here, just asking if you know yourself.

Honestly ? Being time poor is a rubbish excuse ( for me anyway ) but it was the only relatively decent one I could think of ! I eat too much because I am used to eating too much, my appetite has changed to fit with this level of food and the type of food I put in ( I can merrily eat 2-3 peoples portions of pasta with a lovely ragu) . If I go low shit carb's and eat a lot of veg, some protein and a little good fat, and drink a lot of water, my appetite reduces significantly. It takes at least a fortnight to reset but it does reset. The key is doing it long term and finding something to replace the exercise I used to do, which didn't feel like 'exercise' because it was essential !

What report is this please?

@Lovelyring that's really interesting re the sleep. I have very poor sleep due to pain

You are clearly an exception, most people don't have to travel 67 miles in three hours.

They're obviously talking about the people who could easily walk or cycle to work in the mornings in half an hour, probably not people like you moving all day.

The irony is that natural selection is exactly why we have obesity problems.

People genetically predisposed to store fat even on meagre rations survived better than those who found it easy to remain slim right up until the mid twentieth century

Yed, I found it really interesting! It was a study that hypothesised that watching loads of TV caused obesity, but it was shown not to be true. It turned out that people in the study (school pupils) who watched loads of TV still did a similar amount of physical activity to the non-TV-watchers (running around the playground etc). The TV watching replaced time sleeping rather than time being active, and it was the lack of sleep affecting how they processed food.

People genetically predisposed to store fat even on meagre rations survived better than those who found it easy to remain slim right up until the mid twentieth century

I am that hardy hill pony ! Except I have been put in a paddock of lush grass and told to only eat a bit ! I need a grass muzzle

You are clearly an exception, most people don't have to travel 67 miles in three hours.

Nationally possibly, if you live in or near a city this won't effect you, but in lots of areas of the UK it isn't actually unusual.

OP, my thoughts are that -

1. some obesity is the responsibility of the NHS. People with medical issues that cause weight gain for example.

2. some obesity is the responsibility of the individual. I do know a few obese people who just eat massive portions (although the food is quite healthy) and have made no effort at all to change their lifestyle. They always plan to change "tomorrow" .

3. some obesity is the responsibility of the government. I agree that UPFs should be taxed or banned. There are surely changes that could be made to make a healthier lifestyle easier/the default option.

@Dymaxion you'll get laminitis 😂🤦‍♀️

This might be controversial but Sometimes I think that we are part of the problem. A lot of schools are accused of ‘dictating’ what is put in lunchboxes. Many comments ive seen are along the lines no one has the right to tell me what I can feed my child, and whilst this is obviously true, the schools are trying to encourage healthy eating. So if we aren’t going to accept ‘guidance’
from schools then why should it suddenly become an NHS problem? Surely this is something we should aim to combat as early as possible in order to try and reduce the likelihood of kids turning into adults with poor eating habits. People complain about the school cakes served as part of school
dinners but the ingredients in the chocolate cake as an example contained beetroot and the sugar content much lower so I do think they are genuinely trying to make overall improvements with some ‘naughtier’ options as a treat?

Are you sure you can't exercise?

Yes, you may not be able to run or do conventional exercise but surely there is something you can do that would help you keep your weight down?

Also eating healthily should be a priority.

@Chesneyhawkes1

I didn’t know most cancers were preventable. Where did you get that fact from? Maybe it’s not factual.
The NHS are not responsible for obesity but they are responsible for helping those that are obese.
Why is there such an obesity problem? Life style, screen time, emotional issues, medical problems, I could go on…
Obese people don’t want to be obese. Some people are better at losing weight than others.
I think u should think before you write. Your post helps nobody.

30-50% of cancers are preventable.

Your cancer may not have been preventable. Or maybe your drs don't know - often there is a chance it could be / chance it might not have been. Maybe your drs didn't tell you it might have been preventable due to the toll it may have taken on your mental health.

Yes there are many causes of obesity. The main ones being eating unhealthily and not exercising enough.

@TubieWubie108 I'm absolutely sure I can't exercise. I asked my consultant on Monday of last week and he told me not to exercise it would make my condition worse. To carry on with the (private) weekly physio and walking in the pool and he will see me again once I've had some further scans done (including an MRI) and we will discuss exercise at that point - he did say he was unlikely to recommend it until I'd had the surgery that it looks likely I need (won't have a definitive answer until after the scans and MRI).

30-50% of cancers are preventable according to WHO.

Surely walking in the pool is exercise?

I'm not asking from a place of ignorance. I myself have a severe disability and have found my only exercise option is hydrotherapy.

@TubieWubie108 I do eat healthily. Clearly you haven't read the thread. My only "treat" day is a Sunday where I have a small treat. Today I had a slice of chocolate fudge cake. Other than that I count calories and keep to a daily limit of around 1500 (averaged over the week). I don't eat take aways and I don't remember the last time I drank alcohol.

I have multiple medical issues that have weight gain as a side effect.

30-50% of cancers are preventable according to WHO.

Just out of interest how many of these preventable cancers are related to pollution, especially air pollution ?

Air pollution is only linked to roughly 1% of cancer diagnosis. Therefore also not linked to many preventable cancers.