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?

Also, as someone as already said, good luck with finding someone on the NHS that will acknowledge and treat thyroid issues correctly. The blood test they do is inadequate, only testing one of the hormones involved, and the range for normal is much wider than it is in other countries, leaving people undiagnosed when they should be. Once diagnosed, people are often under-treated because of the inadequate blood tests. This is why there are thousands of people on an online thyroid community having to take advice from each other, do private online blood tests which they monitor themselves and try to source the medication they need from counties that don’t require a prescription, so you never know quite what you’re getting. If the NHS did what it was supposed to in the first place, at least some obesity and other long term health problems could be avoided.

@Tekkentime what would you suggest I do? Please do tell me.

Ooo good first comment!

@weststreet

Not as silly as not being able to get a point being made.

Are you really incapable of buying and eating a fruit in its original form? You really need someone to cut it up and put it in plastic before you can eat it? This is probably the most ridiculous post on this thread, which is saying something. If you don't understand why the prepared pot of fruit cost more than the packet of biscuits, you must be quite hard of thinking.

Obesity is now considered a disease. Humans up until the last 40 years haven't had access to very cheap calorific food. Our jobs are much more sedentary, evolution hasn't caught up with today's lifestyle. The human body is designed to store fat and hold on because it used to be periods of feast/famine. It's definitely a multifaceted problem and not a moral issue.
I don't think anyone chooses to be obese and I hate society trying to frame obesity as a moral issue it's not. You need food to live one simply cannot give it up like alcohol or drugs.

Have they suggested physio or rehabilitation exercise? Genuine question.

Going to get flamed for this, but there's always a medical excuse for someone who's obese these days.

Given 37% of people are in the U.K. are overweight, and 26% are obese, I think some accountability needs to be taken.

Many a obese person seem to validate their weight because of medical reasons or medication. I agree with PP, sometimes it really is down to 'eat less, do more'

Or at least, eat less.

@maceroniinapot

Why do obese people need to justify their weight at all?

No that is nonsense. It is around 3 in 10 cancers that may be preventable. Most of those are due to smoking.

Calorie deficit?

obesity is something we can treat ourselves

yes, fat people should just eat less, the same as alcoholics should just not drink, drug addicts should just not take drugs, people with depression should just laugh, anorexics should just eat, self harmers just put the blades away...…the list is never ending.

How many people do you know who are genuinely happy being fat? Many want help with something that too complex for them to deal with alone, but don't seek it due to fat shaming and being dismissed as just greedy and/or lazy.

f 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?

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.
*
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.*

The above are taken from my OP. At no point have I said a lot of the things some very angry posters have accused me of.

A fair few posters have totally misinterpreted my post or have misread it and projected onto it things I have not said.

Saying cancers are mainly preventable was clumsy of me and I apologise. I should have said some cancers are mainly preventable. My dad and sister in law died of smoking related lung cancer. In my dad's case industrial exposure didn't help.

I have says that this is a not straightforward. I've said it's impossible to treat some things and not others. At no point have I said that certain conditions or diseases shouldn't be treated, I have asked for opinions on this. I maintain that obesity is treatable by ourselves if we are obese. Not easy, but doable with support. What form that takes is up to the individual concerned and to their preference and what is available from the NHS. I think there needs to be a big focus on mental health support with obesity but I've seen it vigorously denied on the ozempic threads for example that there are any psychological issues at play with obesity.

From my own personal point of view-I have ASD and many, many food restrictions with that because of sensory issues. I've had severe anxiety and depression and was hospitalised with same as a teen. I was on medication for those for decades. I have several chronic conditions that affect my day to day life and I'm on both long term inhaled steroids along with about 6 bourses a year of high rise oral steroids. I'm on high dose opiates for chronic pain, I have back and knee issues due to tendonitis, arthritis, chronic muscle spasms, along with severe endometriosis and severe asthma. I'm a single parent to 3 children, 2 of who have additional needs and I'm a carer for my elderly disabled mother, and am on purely benefits due to these circumstances. So please don't make out I don't know how various factors can affect individuals. I know very well and deal with these daily. However, I choose to eat as well as I can afford to and what I have time to make and to exercise within my own restrictions. My BMI is around 22 because I choose not to eat too much and keep as active as possible.

@maceroniinapot I already pay for private physio once a week as the waiting list for nhs is too long.

The physio can do nothing for my bad leg - the physio is to try to improvement movement on my good side. Exercise makes the pain worse so it is not advised.

I am on the waiting list for injections in my hips and tendon surgery on my good leg.

Obviously the NHS should just refuse to treat obese people because what do obese people do for society? It's not like they are taxpayers or work in important roles like healthcare, education etc. and obviously no obese person has ever been one of magical six-figure salary earners.......

They don't.

But at the same time they don't need to lie about it and put it down to medical issues.

(I know some obese people are obese because of medical issues, but it's rare, not anywhere near as common as what is told.)

You’re being utterly ridiculous. People don’t become obese because they haven’t heard about salad being healthier than chocolate and exercise being better for you than sitting in front of the tv. Nobody looks at a pizza and thinks it’s the nutritional choice.

It can be poverty or medical but there are also very often deep rooted reasons for obesity. I think the NHS would do better to recognise it as an eating disorder in those cases and treat the cause, rather than telling people to eat less and move more. If it were that easy to just stop what you’re doing and do what healthy people do, there would be no obesity, no addicts of any kind, no anorexia or bulimia and no depression. As it stands, they’re just fire fighting the physical effects of obesity and it’s not working.

And if we’re talking about the cost to the NHS of self inflicted conditions, then I hope you don’t drive, do any sports, drink any alcohol, take any medication, smoke or eat any food which has the slightest hint of a chemical about it? We ALL do stuff everyday that result in accidents and illnesses that could have been avoided if we hadn’t driven or done diy or walked over a bumpy terrain.

Exactly this. I'm not obese, but have experienced addiction. If UPFs fundamentally change the wiring in the brain and cause a constant hunger and need for the next hit that slim people just don't 'get' or want to understand, what hope is there.

Personally I think the food companies need taking to task in a big way. Making sure their foods have the exact same fat to carb ratio as breastmilk which directly hits an instinct that makes us want more and more is despicable.

It's the cigarette industry all over again.

@weststreet I restrict my calories to 1500 a day averaged over the week.

If I don't eat regularly I become nauseous and vomit and have been advised not to cut it any lower than this by the hospital dietician.

I haven't even opened the box of chocolates my kids got me for Mother's Day.

The NHS doesn’t help the obesity problem because they cling on to some very outdated ideas (that stupid “plate” and ignoring proof that diabetes can be reversed via diet rather than being a lifelong condition for which there is only really a medical treatment) but the food we are being sold is the biggest issue.

Ultra-processed food, designed to target your brain’s reward centres and bypass your satiety mechanisms is the biggest issue. It’s cheap, it’s heavily marketed, it’s often products we’re not designed to consume and we’re all told it’s our fault for getting fat after eating it because we lacked willpower.

Excellent article here: https://www.thetimes.co.uk/article/britains-diet-is-more-deadly-than-covid-jc33p0krj

@maceroniinapot

So how do you know who is lying?

Why not just take their word for it?

What is does do is make fat people (I'm a bit overweight, but not obese ) feel even more shit than they do and ashamed of something that is often not as simple as eating too much/eating the wrong things.

What is also does is drive young women like my daughter to develop eating disorders.

And not to mention the shaming of cancer patients. So many lung cancers are diagnosed too late for any curative treatment to be tried because the early symptoms are dismissed and patients feel like it is their own fault for being a smoker.

I doubt many other people, let alone those glibly saying just ear less and move more, restrict their calories to that extent. You are doing well to do that.

Yes ofc obesity is something we need to deal with on the NHS! Obesity is a chronic disease just like COPD, asthma, auto immune conditions. It’s not just about “eating less and moving more” - we know from animal and human research that is it has multiple causes. Simply telling people to eat less isn’t going to cure their overweight or obesity and it is foolish to think that. Most people (if not all) with morbid obesity have genetic obesity and will not be able to “fix it” alone. Untreated obesity also carries with it all the complications of the metabolic syndrome such as type 2 diabetes and cardiovascular disease which costs millions to treat so yes, prevention and treatment of obesity should be on the NHS.