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?

Cancers are mainly preventable

Right, I'll let my mum know that one.

And when the fat your body builds is non metabolic? What then, Oh wise one? 🙄

There needs to be more investigation in to medication that causes obesity, at least two of mine cause weight gain & I'm on a hiding to nothing because I'm disabled & unable to exercise, I've gained 4 stone since I started on them.

The problem is that much of the advice and education is incorrect and counter productive.

Teaching low fat diets contributes to obesity

You want me to magic up solutions to something that is fictitious? I'd let the starving people of the world know that you can defy basic physics. We'd be one step closer to resolving world hunger, we'd just need to figure out how to replicate those pesky metabolic disorders.

I'd love you to come and critique my lifestyle op. But that comes with all my medical conditions and medications.

I drive to the shop because I can't walk it. Judge away. You're welcome to my left leg that doesn't work properly, my right leg that I need a new hip on due to compensating for the other bad leg, and the trochanteric pain due to the muscles being absolutely screwed as well. And you can have the sciatica in my good leg. And the nerve pain that I get in my bad leg constantly that feels like my whole leg is on fire and has spiders crawling out of it. And my back pain.

And you can have my thyroid issues. My arthritis. My depression and anxiety.

And you still have to go to work to earn money.

Please do answer me op. I'd love to hear how you'd manage being me and stay slim with side effects of medication (including steroids).

It isn't fictitious, I and thousands of women live with it every day. I suggest you go and educate yourself a but further before you spout your own fictitious nonsense. Off you pop.....

I had a croissant for breakfast. I need to eat with some of my medication so I can't do skipping meals.

I had a bacon and salad mock Caesar salad for lunch (no croutons and low fat dressing) and an orange for lunch.

I'm having a steak sandwich for my tea later. I will have a pudding of a slice of cake as it's Sunday.

I don't drink except when I'm out and I don't hardly ever go out so my drinks today are orange squash and coffee with milk no sugar.

I wfh and my usual breakfast during the week is 2 slices of home made bread toasted with spread. Lunch is usually left over from the night before reheated. Dinner is normal healthy food - my kids are normal weights and I was positively skinny as a child. I have intolerances and certain food I can't eat due to ASD.

Please do come and tell me how todo better.

Obesity isn't a lifestyle choice. But as long as we have these threads on MN we will have a significant majority of posters who are quite content in their belief that it is - they enjoy something you can "other" individuals for - "them others over there, they're not like us, we're better". Easy win.

Or you could get 6 organic apples for £2.35, or if you were just looking for a quick snack,
Single banana = 27p
Single apple = 30p
Single pear = 40p

It's not a binary choice between pre-prepared fruit or biscuits.

We could put it simply and say that we are responsible for our own health, sadly it isn't as simple as that.

However, if someone chooses to knowingly choose a life that will ultimately destroy their health, knowingly, then it is their responsibility.

Smoking, drugs, drinking, eating crap to the extent that surgery is impossible, if you choose that lifestyle, you should not expect a miracle cure from the NHS.

I am aware that poverty can mean that people have to eat crap food or nothing, but I have seen obese people filling a trolley with cakes, buns, crisps and pop etc. Lots of it, enough that could be replaced with actual food, and with an equally fat child. Those were certainly a choice. Buying cigarettes instead of food, never walking anywhere...and expecting the NHS to deal with the outcome.

Do you expect people to starve to stay slim? Yes, all starving people are slim or skinny, and also malnourished. There are some medical conditions that make it extremely hard to lose weight and it require starving to do it, but they should not be expected to do this.

I haven’t read the full thread. CBA.

there is a level of personal responsibility for weight loss BUT you’re also expecting people to be able to override base instincts in a society where everything is easy, where everything is as efficient as it can be. Even foods now deliver maximum calories at maximum efficiency and they are plentiful, taste good and are designed for us to crave them.

Our activities are lower. There’s a lot of things we take for granted now that have reduced our activities levels - dishwashers instead of hand washing , petrol mowers rather than push mowers , leaf blowers rather than rakes and brooms, steam cleaners over elbow grease. the former burned more calories. Not huge amounts but added up of the course of a week or year added up to significant levels of activity. Plus the bigger things like car ownership etc

we’re also getting better at understanding the genetic components behind weight loss.

calories in calories out does work

but now we know it’s going to be harder for some people more than others.

i found this podcast really informative and interesting on the subject of fat loss and how different genetics, living environments , accessibility to different types of food can leave you significantly behind in the ‘race’
https://m.youtube.com/watch?v=BKX59Rour-I&t=3033s

conditions like PCOS make it harder to lose weight. Having parents that are fat means you’re more likely to be fat. Having mental health disorders like depression are linked with obesity.

then there’s the data ZOE are doing around gut microbiome and how shifting your gut bacteria specifically to a more diverse microbiome can help weight loss and keep it off. Basically our diet diversity is significantly reduced compared to our ancestors. Most of us eat the same handful of veg rather than eating whatever is seasonably available which used to be a great changing variety.

and this great conversation with Giles Yeo, that calorie counting is tricky. The takeaway I got from this personally is it isn’t necessarily the food that you’re eating but how they’re prepared as cooking, fermenting, processing of any kind makes more calories much more easily accessible to our body. Cooked tomatoes have more available calories than raw but with cooked you have readily available lycopene which is a great antioxidant. There are trade offs and finding the right balance between isn’t always straightforward. And let’s face it the majority of our western diet is very easily accessible palatable food that does a number in the brain and body

https://m.youtube.com/watch?v=Gy_vcL1cpP8&t=2299s

It's calories in vs calories out.

Not always. Please read my posts and tell me how I am supposed to stop a side effect of medication being weight gain and bloat?

The NHS should be there to treat obesity as much as it is anything else. Yes, some factors that cause obesity could be controlled by sufferers by themselves. But that's true with so many things - car accidents could be avoided by staying away from roads, workplace stress could be avoided by not working, childbirth could be avoided by not having sex. Travel, work and children are the everyday reality for many, and so is obesity. If we go down the route of only treating "deserving" sick people then we may as well go down the route of only paying benefits to "deserving" people who cannot work or only giving free education to children who show early academic promise.

Think i've touched a nerve, wonder which bit of what I said has upset you so much...

Don't flatter yourself. I'm more upset at my lost youth to anorexia/bulimia and therefore feel the need to silence ignorant fuckwits spouting rubbish that may trigger the young women of today to do what I did.

I think food and nutrition should be taught in school - right from the get go. So everyone knows and learns how to make balanced meals from scratch. What is a carbohydrate? what is a protein? Which fruits and vegetables have what vitamins etc. Food is a life skill and should be taught as such. Not just a short burst of cooking for x weeks.

Then maybe going forward, more people will make healthier choices rather than just getting a ready made unhealthy choice from the supermarket or take away.

Of course you can fix it 😂 it's very rare to be obese for medical reasons.

The way to fix it, is eat less and healthier and burn more calories. Surely you're not silly enough not to know this.

Apparently everyone and their mum is obese for medical reasons.

@weststreet do you want to tell my consultants that? And laugh in their faces when they tell me that they can't suggest anything for me to do to lose weight because I am doing really well to be functioning as I am?