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?

@QuertyGirl not everyone lived in an urban area though (I don't as an example. And there's one bus a day each way here - times to align with when the school kids need to be transported).

I need a car. (I can't even get to the village shop without it.)

I know. That's why I was talking specifically about urban areas.

Also regardless of where I lived, I need a car to get ANYWHERE.

My partner needs his car to get to work.

Even if we lived in an urban area that wouldn't change.

And?

You said

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

I was pointing out that even if I lived in an urban area, we would need two cars.

If you like.

You could get a BB, it's tough but doable

Tho I suspect that you're determined to be hard done by in this thread no matter what

I have a blue badge.

It's up for renewal soon - I did it online on Friday.

What have I said that indicates I wouldn't have a blue badge?

So not most then?

@pncr

Good for you.

Your situation really isn't relevant to what I said, no matter how hard you try to shoe horn it in

Did you follow the WHO link to this stat? Or just the headline. Because preventable doesn't mean personally preventable. The page mentions radiology, evironmental pollution, occupational carcinogens. Hardly something people can personally prevent. Even infections leading to cancers can be prevantable generally, but again unless you join a nunnery you probably can't be sure not to get HPV, not to mention others.

I think you need to be really a bit careful with these kinds of statements as it puts the blame on people with cancer which most often isn't really so simple AND is incredibly difficult to hear (as patient or family member).

My mum died of stomach cancer. Apparently - f not genetic, which it can be - this is "preventable" to some extent (so bascially reduced risk) by healthy diet. She grew up in impoverished rural poland and had absolutely zero choice in increasing fibre and vegetables in her diet. So in theory maybe preventable, or at least possible to reduce risk, but saying to her on her death bed "well you ought to have got your five a day in, you could have prevented this" isn't helpful or accurate.

Years ago, the programme Supersize vs Superskinny paired two people at opposite ends of the weight spectrum and gave them help. They both had disordered eating patterns but the superskinny people were treated much more compassionately than the supersizers, who, as usual, were fat shamed.

For those posters still spouting calories in/calories out, please read Why We Eat Too Much by Andrew Jenkinson, which explains very clearly why this doesn't work.

As for people saying that there were no obese people in previous decades, l would advise you to look at old photos properly. My mother and aunt always struggled with their weight from childhood onwards, despite living through wartime and rationing. I was a short, plump child, inheriting this from my mother, just as my brother and sister inherited the taller, slimmer build from my father. I also inherited lipoedema from my mother's side of the family but none of us knew about it until relatively recently as so little research has been done into it until the past decade. I have it all over my body. I also have an underactive thyroid. I berated myself for years on my inability to be slim and it really does not help when people think any form of obesity is all the fault of the person concerned.

I think workplaces can do more. My local LA is in such a shit location that you can't go for a walk at lunch time. Our average steps for the entire day is 2000!

The entire workforce are sitting at their desks, eating and not moving!

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

No, because historically poor people suffered malnutrition if anything? Did you see the program recently about the skeletons, dug up at Charterhouse, who died of the Black Death? Iirc, 6 out of the 13 showed signs of malnutrition.

Likewise, a big problem for the British Army in WW1 was that so many of the working class soldiers, joined up with malnutrition!

I remember one episode of SS v SS where the 'skinny' person basically had an alcohol problem - his diet was something like 5 pints of lager in the course of a day with a very small amount of food.

The 'supersize' person was given orange juice instead of the lager for the period when she followed his diet.

Ignoring the fact that if you spend your entire day on the piss, it's probably quite easy not to think about eating.

Not the responsibility of the NHS but the responsibility of those with influence yes. In my work I do a lot of consultancy for local authorities. Most have policies around a "healthy high street" and problems with obesity. This does not stop them granting planning for numerous take Away's that are in direct contravention of their own policy. Conversely they don't do a lot to encourage people to exercise either yet make these ridiculous claims about how their towns will be "healthy" as if there is a magic wand.

8% of U 5s are overweight and a third of primary age kids.

As has been pointed out on this thread our Gvt will not take the actions most likely to address national obesity. I would ban all child specific marketing and packaging. All cartoon characters. All foods sold in animal shapes. All lunch box high sugar convenience foods, all UPF lunchbox (individual portioned) foods, etc. No promotions, codes, Club Card price on biscuits, cakes, crisps, UPF or high fat high sugar foods.

Where in the world has this reduced obesity?

Read the Finland link.

I am obese. I got to a whopping 21stone almost (296 pounds) and finally in 2021 I decided to do something. I have a history of depression, anxiety and panic disorder. I was SA as a child by a family friends son. I have hated my body forever. I have always been fat.

However something clicked and I started boxing classes and pole fitness classes. I calorie counted and slowly I lost 56 pounds. But it just kind of stopped. No matter what I did, no matter what changes I made. It took a year and a half, which was frustrating, and I still weighed 17 stone. I had some tests and my testosterone level was raised. My ovaries didn’t show as polycystic on the scan I had. My periods are normal for me. The hair growth on my chin is ridiculous. I have been shoved into this PCOS box that I’m not sure I exactly fit in. Due to work pressures my exercise classes became less - I was doing 2-3 boxing and 2 pole fitness a week. I kept within my calories, which at 1900 might sound high but with the exercise I was doing they weren’t, and I’m currently 20 pounds heavier. I’ve still lost 36 pounds in total, but I am increasingly frustrated and seem to have lost all motivation. I am consistently tired and can’t even fathom the thought of going back to how many classes a week I used to do. I have a lot going on in my personal life too, and I’m finding things quite stressful in general.

I hate being fat. I currently fit into a 16-18, which amazes me with my weight. But I hate my body and I hate being this way. Yes, some of this is my own fault, however if you look at everything combined and some other things I’ve gone through in the past few years which I cannot mention here for fear of being more outing, there are so many different factors at play. I hate the thought that I’m judged to be a “lazy fatty” because of my weight. Even when I was “just” 17 stone I was working harder than many people do exercise and diet wise, but was still judged based on appearance alone. I don’t know what the answer is, but people really should not judge when they have no idea how a person got to where they are.

What is it you do for a living? and how far do you need to travel?

I have seen you on other posts and you seem to have the opinion that everyone should work in the town they live and just walk or cycle.

Just wondering how this works practically.

If your Husband got a new job 40 miles away - what do you do? Do you abandon your career, move to his new work town and get a nice wee job in the local supermarket.
Does he have to give up his work?

Are you a single parent on benefits so the reality of 2 people in a household working in towns 100 miles apart completely alien to you?

What if your work is at a motorway service station? you still gonna cycle?

To be honest there are probably few places in the world that have reduced obesity (except Finland). It's a modern day problem.

This is all spelt out in the National Food Strategy. We are effectively trapped in a junk food cycle where "treat" foods like sweets, cakes, fizzy drinks and processed dinners are cheap, heavily marketed, widely available and more appealing to tired/stressed/hungry people and children. Because this stuff is popular it sells well and is big, influential business - see how loud the opposition to the sugar drink tax was. Go into any supermarket and you are met with a wall of cans and packets. We have developed a snacking culture where it's completely normal to be eating these foods all day as well as main meals.

If people are going to eat more healthily and not get fat in the first place, they have to really go against the tide. You have to ignore 80% of the supermarket, school dinner menu, places to eat out or social opportunities. Also spend more money and time planning, shopping and cooking for fresh ingredients rather than just reaching for a frozen pizza. And be complained at by your kids who want the "nice" food their friends have. It's pretty obvious why the poor, stressed, ill and busy among us aren't winning the fight.

As for people already significantly overweight, I think obesity should be treated as an illness, with compassion and acknowledgement that not everyone can be "cured". I bet if we surveyed MN users there would be very few long-term successful dieters and lots of stories of short term success with weight regained as your metabolism compensates. In fact I think we would be a very interesting research study!

@kitsuneghost

I have a stalker! 😁

Actually yeah, just a little bit cause you are hilarious. 😁

Well you'll know all about my stance on pigeons then.

My apologies, I don't remember you at all.

@QuertyGirl
You haven't actually answered the question. I am curious

Coo coo!