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?

I agree. And a lot of time and resources would surely go into deciding whether or not a condition is definitely obesity related, if that is even possible.

How do you know whether somebody might have got a condition anyway if they weren't obese?

You'd be in danger of turning all obese people away from all treatment because they are obese.

Equally, people might get type 2 diabetes because of terrible lifestyle decisions without actually being obese - do they get to be treated?

It's just not a workable model.

It's not one factor though is it? It's diet and exercise and food environment and cultural shift and mental health and affordability...

It needs a joined up approach or people will just fall down gaps. There's not one magic bullet.

Also I strongly believe change needs to be both top-down and bottom-up at the same time.

So people need to personally choose to eat more healthy, reinforced by govt supporting better available of healthy food and disincentives on junk food, for example. The best choice needs to be easy

@NotMeNoNo

Look at the places that have achieved it would be a start.

Plenty of studies on what needs to be done. We know what we need to do. We don't need to reinvent the wheel.

We just need to stop prevaricating and do it.

See the Finland link

reinforced by govt supporting better available of healthy food and disincentives on junk food, for example
Our government does not care about the well-being of ordinary People, the more stressed and ill we are the easier is for them to exploit us. Furthermore the food industry will lobby hard against anything which hurts their profits.
Junk food is highly addictive, the food industry spends a lot of time and money making it so, that's the way they like it and they will put pressure on the government to keep it the same.

Obesity is the current disease of the poor, but it's not the first. Rampant typhus, occupational sicknesses from mining and factory work, scurvy and other diseases of poor nutrition... These don't strike at random.

Until we have a society where people have adequate time and income to take care of their health, the health service should continue to help people with diseases of poverty.

Plenty of very well off & educated people are over weight/obese.

Lazy to suggest otherwise.

I WFH now but
Drive to work (there's no public transport)
At your desk unless you're on a break
Break is long enough to get a drink and toilet
Lunch is 30 mins so eat, toilet, make a phone calls, it takes ages to get out the building so most people stay in
There's no moving between breaks, I mean you can stand at your desk but you can't wander off

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.

Look at the article about Finland. It's very challenging, yes, but it's not impossible.

What article? I’ve scrolled back pages and couldn’t find it so I googled and it said that in 2022, 70% of men and 60% of women are overweight in Finland.

www.theguardian.com/befit/story/0,15652,1385645,00.html

This is the study pp posted from Finland

https://wisevoter.com/country-rankings/most-obese-countries/#finland

This is saying 22% and a dramatic drop down world rankings

Ah, I saw that. But that’s from 2005, and the figures I saw were from 2022, so what happened?

At least we are in the top 5 for something in Europe.

https://news.sky.com/story/uk-ranked-fourth-for-having-most-overweight-and-obese-adults-in-europe-according-to-who-study-12604643#:~:text=Across%20Europe%2C%20being%20overweight%20or,behind%20Israel%2C%20Malta%20and%20Turkey.

The childhood figures are quite shocking & here is the reason....

https://news.sky.com/story/government-food-tsar-quits-blaming-insane-inaction-to-tackle-obesity-12838255

I just posted a source from 2023

I was looking at ‘overweight’, rather than ‘obese’ which is why I wasn’t getting the same. Our obesity rates are approximately 5% more.

It’s obviously good that the Finnish government did what they did and it sounds like it could be the way to go, but (and I could have missed something), those figures don’t necessarily mean that the original population surveyed lost weight and kept it off. It’s potentially that the new population didn’t become obese to begin with. Not that I’m saying anything against that - as I say, it sounds good all round what they did.

My point was, once overweight/obese, there’s no long term way to lose weight that works for the majority of people. And unless I’ve totally misinterpreted or misunderstood that hasn’t been proven with the Finland information.

My point was, once overweight/obese, there’s no long term way to lose weight that works for the majority of people. And unless I’ve totally misinterpreted or misunderstood that hasn’t been proven with the Finland information.

Well, I don't have actual figures, but I don't think they could have gone from one of the most obese nations in the world to number 77 in the space of 20 years without a reasonable proportion of people simply losing the weight and keeping it off.

More generally, we know that long term weight loss is possible, though very challenging. I know several people who have done so.

You’re potentially right of course but most scientific studies still show the opposite. There aren’t many (if any) long term studies that show weight loss maintenance is possible, I believe most of them don’t go past 5 years. And conversely, I know a lot of people who have had the opposite experience as what you say (as in regained weight).

At a population level, what Finland have done is obviously significant and it could of course be the ‘blueprint’ for the future. But, while our government hasn’t done the same sort of thing as the Finnish government, then it’s a bit of a moot point.

My fear is the studies that show its virtually impossible for most m. obese people

So you have people trying and failing being told by society they're failing and it's their fault and yet it is an impossible task.

I'm large and it's so disheartening knowing there isn't a real solution.

there are solutions, probably not one sure way that works for everyone who needs it, but it can be done, there are ways out of these problems
I think eating habits and activity levels can be very ingrained and that makes it harder to change.
But any positive changes that you can make are a step in the right direction.

Studies do tend to show the opposite in fact. And any short term gain is largely replaced by further weight gain. I imagine the body is keeping itself in a sort of homeostasis.

I am genuinely fearful that surgery os the only way and I dint want anything that drastic!

@3littlebeans
Stephan Guyeney talks about the homeostasis thing quite a lot, I've found his work very interesting, here's his website if you're interested
guyenet www.stephanguyenet.com/thehungrybrain/

I am learning about intuitive eating. Learning about hunger cues , leaving diet culture, tuning into to your body, It not easy. I've been on a journey with it for last year. But I learning to unlearn all the toxic diet behaviours we have been fed and start to learn how to eat how our body intended.

This is what I’ve been doing. My weight is still the highest it’s ever been but it’s consistent. No weight cycling. I learned all about this while being treated for bulimia. My eating habits are the best they’ve ever been too. And contrary to what people might believe of a fat person, I don’t sit stuffing my face with pies and crisps all day!

@Howpo choices for some people sometimes.

I don’t have a choice about exercise- I’m wheelchair bound with 2 conditions which make any exercise dangerous and painful.

I can’t control my sleep patterns- it is sort of controlled by medication but this is hit and miss.

I have to eat what is easy and convenient at the times I can.

Plenty of people aren’t waltzing around the world able to do whatever they like when they like!