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?

True. But given that most other countries are faring better than the U.K. on this point, it's worth thinking about what's the differences are
Great point, I don't know the answer, why are the Brits so fat, why do we have the perfect obesogenic storm?

We are more like America in the support of individual choice and capitalism

Shit food, long working hours (causing shit food) and sedentary lifestyles (driving everywhere).

It's well known, but we have a stupid, cutting nose off to spite our faces, culture war about 15 min cities and cars vs cyclists.

www.bbc.co.uk/food/articles/britain_diet

We are getting that way.

No community, no collective responsibility. People pay astronomical rents, mortgages, car loans and childcare bills by working long hours. This means they have to tear about in cars driving like idiots because they're so stressed with it all.

Tackle housing costs, cut working hours, cut childcare bills and give people time to commute by bike and cook dinner.

That needs to happen at a population level.

Tho some people are so wedded to this lifestyle (they see it as an achievement to be that busy and stressed) but they'll burn out eventually

All of these play a role. Another issue is norms and etiquette around food. In other countries, there's more social disapproval of things like eating on the street and excessive snacking, subtle censure when weight is gained.

But this stuff is very hard to tackle. Getting moving more would be a better first step.

This means they have to tear about in cars driving like idiots because they're so stressed with it all
I have long felt that in the UK things are heavily weighted towards the 'needs' of the car, feels like that's something we have in common with Americans?

Getting moving is the most important thing.

Oh we're heading that way.

There's a name for it: carbrain

www.urbandictionary.com/define.php?term=Car%20brain

Obesity is a complex metabolic disease, but you keep on peddling the rhetoric that it's a lifestyle choice if that's your agenda, I won't be able to change your mind.

There's a name for it: carbrain
Very apt!
There is also what I think of as 'the car arms race' i.e. cars are getting bigger and bigger ....as are the occupants 👀

No, for most people its because they eat too much, become over weight, find it even harder to control weight/what they eat and become obese, once your in that pattern, its very hard to break it.

Obesity is a complex disease that occurs when an individual’s weight is higher than what is considered healthy for his or her height. Obesity affects children as well as adults. Many factors can contribute to excess weight gain including eating patterns, physical activity levels, and sleep routines (ref cdc)

i.e choices.

Getting moving is the most important thing.

Im not sure I agree entirely. The food culture is an enormous part of the problem.

But getting people moving more is a less controversial starting point and has many benefits.

No species would survive without a deep rooted and very powerful drive to eat all the food that is available to them as quickly as they can.
In the presence of an obesogenic environment obesity is a trap into which we very easily fall, the points of no return whoosh by very quickly, you often don't even register them
Once you are caught in the trap it's very hard to get out, the more of a population that are fat the more it feels normal to be fat. We tend to instinctively feel that if everyone else is like it then it must be okay and so there is less pressure to do anything about it.

Those are very good points. Also there are two issues to be addressed here. How to stop people (particularly children and young people) becoming obese in the first place. And how to help those who already are.

Once you become obese thats it, the damage is done.

On prevention, again, if the parents don't give a stuff, very hard for the state to get involved.

Personally, i'd limit fast food outlets, shutting them down & a full ban on any form of fast food advertising, including the delivery services, jeez we are so lazy, we wont even walk to to stuff our faces.... but the Govt seems determined to have even more.

Even Cancer Research encourages eating and sharing cakes to help cure cancer. Hospitals serve unhealthy food most of the time.

Govt is too frightened to spread the message that we should eat as little processed food as possible. Fruit, veg, grains tubers, legumes, buts and seeds should form the main crux of meals.

I can see two big problems
1-constant presence and promotion of highly palatable processed food.
2-lack of access to enjoyable exercise activities

Govt is too frightened to spread the message that we should eat as little processed food as possible. Fruit, veg, grains tubers, legumes, buts and seeds should form the main crux of meals
I agree, basic plain food is very disappointing and uninteresting when compared to 'highly palatable food like substances'
And of course 'big food' will not easily relinquish its profits

There’s not really any way to ‘fix’ obesity though. Most scientific evidence points to intentional weight loss being unsustainable. Most people regain any weight lost and often people regain even more.

Obviously, encouraging and facilitating healthy habits (eating well, exercising, not smoking and drinking in moderation) can help. But it’s not always straightforward in the money and time poor world we live in.

One way to ‘help’ would be to actually treat fat people better overall, instead of shaming them and making their lives hard. For a start treating fat people with medical issues the way slimmer people are usually treated. As in fat people go to the doc with a symptom and get told to lose weight, whereas their thin counterparts get investigations and relevant treatment a lot quicker. This leads to poorer health outcomes for fat people because they either avoid or are ignored. A lot of people who believe the ‘fat is always bad’ narrative never take this into consideration when it has such a big impact.

Most scientific evidence points to intentional weight loss being unsustainable
I suspect that for many people the internal mechanism which incentivises them to lose weight goes something like this:
'I will suffer the discomfort of not having the food that I enjoy because at the end of the diet I can reward myself with the food that I enjoy'
This might not be a conscious thing, rather something which is trained into the unconscious mind because food has always been the thing that they reward and comfort themselves with?

Oh it's incredibly controversial- see all the fuss about 15 minute cities.

Radio 2 right now

This is quite basic and not totally up to date in thinking but it explains really well why.