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?

The government just decimated the funding that was supposed to help with this:

www.disabilityrightsuk.org/news/government-criticised-huge-active-travel-budget-cuts

We should be following in Finlands footsteps but we're becoming more like the US.

Why is this country so bloody stupid?

Sorry but what has any of that got to do with the obesity problem in the UK ?

We eat too much, we don't know how to cook and are inherently lazy, these are the main issues.

As i said, of course the NHS should treat people who are obese but the preventative side is down to public health teams.

It's so weird to read this thread and see how bafflingly confident the 'calories in calories out' posters are in their own dazzling ignorance. In particular, the dogged insistence from some that very few cases of obesity are for medical reasons...as though mental health conditions are less valid than physical ones? It's such a disconnect to reality and so interesting to me to see that there are people who truly have no understanding of compulsive, self harming behaviours and how powerful they are. I'm well educated, middle class and have plenty of resources and money to throw at the problem and yet, at age 40 with more than three decades of dieting behind me (yes, I started dieting pre-puberty) I've only ended up fatter than ever. I've paid for medical weight loss treatment, gym membership, diets, therapy, private healthcare, have done every single imaginable diet and eating plan and exercise regime. I have time in my day to address the problem, but I still haven't succeeded. There is no 'excuse' for my weight, but you might as well ask a gambling addict or an alcoholic why they don't just pull themselves together. Or, more closely linked, ask an anorexic why they won't just eat more. Eating disorders don't all involve starving yourself. I project the impression of someone who has it all together and under control: successful and well put together but I have been struggling to fix myself for almost my whole life. I have deliberately harmed my body in multiple ways, not just through food. Shame, disgust, 'tough love' and logic don't make any positive difference. Mental health problems aren't less significant than physical ones and they aren't easy to cure. There are some which manifest themselves in bingeing behaviours and weight gain; you can't just stop them because someone on the Internet told you to eat less and move more.

Or people just eating a healthy diet?

Too many people live on fast food because they're too lazy to cook.

@Howpo the treatments I get for my conditions that would have killed me have weight gain as a side effect.

I eat healthily - today I am having a small slice of home made wholesale toast for breakfast. Lunch will be a chicken salad and dinner steak and salad. Snacks today are oranges and grapes.

In addition, I wouldn't be an obesity problem for the nhs - I'd be dead. That's why it has to do with the obesity "problem". I wouldn't be a problem. I'd be dead.

With the deepest respect for what your going through, none of this is relevant to public health policy which is conducted on a population level.

You are a minority who of course has an absolute right to the care and treatment you need.

That does not mean we shouldn't try and solve the obesity crisis.

The problem these days is people regard fitness and health as something you buy by going to a gym and becoming veggie/paleo whatever other bollocks rather than something you have and should preserve by incorporating exercise and a balanced but varied diet into your lifestyle. The more people who drive to work/school/ wherever, the more others have to because the roads become dangerous to do anything else and the air become thick with cancerous chemicals so spending any time longer than necessary walking or cycling becomes a hazard in itself. A bloody vile society.
Of course the NHS should help obese people, but the government should do more to make the roads better for exercise rather than polluting and should look at making healthier food more affordable because it's currently a LOT cheaper to fill yourself with empty calories than it is to fill yourself with protein and vegetables.

Yes. One example is BRCA 1 gene that causes breast cancer and I think ovarian cancer. I'm pretty sure Angelina Jolie had that gene and had a preventative mastectomy and hysterectomy

Why are people so fat when our parents were not, is perhaps a better question.

As far as my parents’ generation went, it was partly because women smoked to stay slim, and men smoked because it was a normal thing to do. DH says his grandmother forced his father to smoke, and my father started smoking at 11, because his friends did! Before that, in Victorian times, they seemed to have used laudanum like it was going out of fashion; and afaik, cocaine could be bought over the counter.

People have self medicated with tobacco, drugs or alcohol for centuries, partly to make their lives bearable, or because they believed it was healthier! These drugs have become illegal or socially unacceptable, so now they self medicate with food. Until our society eliminates poverty, poor housing, chronic ill health, etc; then people will continue to eat whatever comes to hand - and for the poor, it’s ultra fast foods!

They also walked.

We drive everywhere.

There's plenty of studies about this.

We know why everything is fat now. It's not a great mystery

So why are there so many fat primary school age kids?

When i went to school in the 70s, a fat child was rare, now its the norm and these aren't kids from poor households.

Yes many things contribute but we drive instead of walk/cycle, a ready meal instead of cook, a once a month treat at the chippy has become a 2/3 times a week trip to Macd's.

Bottom line (quite literally) is we have become fat and lazy with sedentary lifestyles and large portion sizes.

Of course there are medical reasons for obesity but genuine ones are rare.

@Howpo define rare.

They also walked.

We drive everywhere.

Why do so many people drive though? Because they are lazy? Or because work is further away & longer hours?

Spot on @TodayInahurry

Or is work further away because we can drive and it's normalised?

As soon as you expect both members of a household to work you will find it very hard for both to live within walking distance

This is such well written post. I agree with all of it and have same issues. The thing that really upsets me if I had anorexia I would be seen kindly there would be no way anyone would just tell me to eat more calories! But if someone has binge eating disorder, they are apparently entitled to have people tell them to eat less. We have spent a life time on diets and they still don't work. Guilt and shame doesn't work. Maybe it's the diet culture and disorded eating and the continuing guilt and shame we should feel about how awful we are to be in bigger bodies and how much we are a burden on the NHS is why the population is getting bigger and the many other reasons why people overeat. It's not as simple as calories in v calories out.

The nhs literally gives me the drugs that make me fat. They keep me alive and with a semi quality of life such that I can work and live on my own.

The alternative is I'm in a care home and pretty soon dead.

The attitude of some on here makes me feel that they'd rather I was dead. Or in a care home. And that it must be my FAULT I'm fat.

It's not my fault I need daily steroids.

It's not my fault I need anti depressants.

It's not my fault I had an accident and can't walk. That's why it's an accident not an on purpose.

Why do you judge me when you haven't walked a foot in my shoes or tried to live the way I have to.

What do you get from judging me? What does it do for you?

My consultant says I'm doing well to be doing what I'm doing. And he sees me regularly. I've been seeing consultants since I was 12. We aim to keep me out of hospital as long as possible before needing joint replacements due to compensating for my bad leg.

Honestly this has made me so upset. What's it got to do with obesity? Me. That's what. And the option is I'm here as I am or I'm dead. So if that's the question, posters here would rather I was dead. By the logic of what they're saying. Well. That is just charming.

Ffs the majority of fat people are not fat because of medication

There is a major health crisis happening in front of our eyes

It needs to be talked about

https://www.theguardian.com/commentisfree/2023/mar/11/obesity-jab-may-save-food-industrys-bacon-should-it

As this article says, diet and exercise only works for 10 - 20% of the population, and for the rest, obesity is as much to with genetics as behaviour.

Says the food industry?!

deflecting blame from themselves?

Historically most people were not fat so it's not as simple as saying it's just genetics. We are getting fatter and fatter

Perhaps it's how genetics interact with the crap the modern food industry pushes to us ? Perhaps they just lie ?

I think it's a societal issue, but of course the NHS end up picking it up as the imapct is on health.

I was talking to a european colleauge whose daughter came to the UK for a 3 month exchange and put on 15kg in that time. When she got home she went back to her normal weight within 6 months of normal eating and activity. The daughter was young(ish) - 15/16 - and said that there was rarely healthy homemade meals available in the home. I think that's probably fairly typical for many households. There is also a huge take away culture here, perpetuated through relatively cheap junk food being available. Schools - especially primary - generally don't take real food edcuation and physical activity very seriously either, and if you are 11 before you might enter a school with a serious commitment to sports, that's not a great start in life re activity unless parents are willing and able to commit to lots of outside school activity.

Obesity IS something we can fix by ourselves (diet, lifestyle change, possible bariatric surgery etc.), it’s just incredibly hard work over a long period of time, and people tend to give up.

Sorry, should also have added psychological help for some of the trauma/ emotional issues that may have led to that person eating the amount that makes them obese.

Because they can.

We need to make driving more difficult and walking and cycling easier.

Carrot and stick.

Bikes and public transport exist.

In urban areas, it really should not be necessary for families to have two cars.