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?

Do you want to be morally right, or solve the obesity crises? You cannot be both with that stance.

So fat people are just a bit dim?

Honestly

Brill idea, I think a lot of people would appreciate something like that.

If you make me do starjumps I will eat you @Bucketheadbucketbum

You have no idea how much I'd love to be active.

Not even running or star jumps. Just going for a walk would be amazing.

You sound ignorant.

Start with two limb at a time star jumps. Left arm and leg, both arms, right arm and leg. Does wonders for your balance

Does MN have a rule about eating fellow posters?

Poverty is more than having a low budget for food. The Royal College of Physicians says “a myriad of socio-economic factors – including income, housing, education, access to space, exposure to advertising and sale of unhealthy foods – impact upon whether we can be active or eat healthily and thus ultimately our risk of developing obesity.”

But it does seem like any consideration that it might be more complex than ‘people choosing to eat junk food’ is shut down as ‘excuses’. It’s not excuses, it’s facing up to the reality that it is multi-faceted and if we actually want to reduce obesity, as opposed to just shaming fat people, we need to tackle more than ‘people choosing to eat junk food’.

Nom Nom Nom 😁

@maceroniinapot I agree. There obviously are people with illnesses and disabilities that cause weight gain but it can't be everyone in the UK.

Most people just eat too much and don't move enough. And it's never their fault.

I put on weight when I had cancer, steroids and lack of exercise. Soon as I felt well enough, I lost it again. Just took a bit of effort.

Exactly. Exercise should be part of everyday life- not something you have to pay to do

Does MN have a rule about eating fellow posters?

As long as its with a massive salad it should be fine ?

Prof Chris whitty did a gresham college lecture about this. Very interesting

https://m.youtube.com/watch?v=hekEMqUiyIo

@Pestispeeved I will try your alternative starjump, thank you

Try having an underactive thyroid and see how you go from a size 12 to a size 20 while they try to get the level of thyroxine you need correct. They only move it up in 25mg doses and make you wait 3-4 months before blood test. Then move it up another 25mg then wait another 3-4 months for another blood test. All the whole you are piling on the lbs. Thanks for your thoughts OP. You clearly have no idea what shit you talk.

Theres a huge link between child abuse/trauma and obesity later in life.

Not only do people survive horrendous childhoods with all the associated mental health problems but also get blamed for the obesity etc which is really common.

Shame doesn't motivate anyone really but just makes most people feel worse. So shame isn't the best approach. We need to find approaches that work...

Just wondering if you think they should treat anorexia and bulimia. Are there some eating disorders deemed more worthy of treatment then others?

This is exactly what I tried saying earlier in the thread but I didn’t word it very well.

I don't think we should do this as OP is saying.

However being over weight isn't an eating disorder a lot of the time though. It is a choice and it's not always comparable to bulimia not even remotely.

Because highly processed food is CHEAPER PER CALORIE than fresh fruit and vegetables.

if you’ve got 2 average adults and two 8-10yolds to feed whilst on minimum wage

that’s
one man on 2000kcal
one woman on 1700kcal
one 10yo boy 2000kcal
one 8yo girl 1600kcal

on average. Minimum wage jobs are typically more physically active (cleaning, caring, labourer etc) rather than desk based so you may have to add more calories to cover the extra physical activity but for clarity will stick to the above

you’d need to buy enough food to need 7300kcal for the family per day.

getting those calories from vegetables is going to cost significantly more that highly process food

Half a pizza from Iceland = 383kcal 50p
to get that from chicken breast at approx 300kcal would cost you over £1 (average across sainsburys and Tesco from packs of chicken )
To get a similar level of calories from carrots for example you’d have to eat over half a KG of carrots.

now can you see why poverty has a lot to do with it? And I haven’t even taken into account cooking costs here.

if people don’t have enough money they’ll buy that pizza every single time because they’ll be fed. It’s not nutritionally great but they’re fed.

now I know how to cook and even I can’t make a nutritionally sound meal plan for two adults for the week (meeting all macros - protein carbs and fats, plus hitting 7 veg portions a day) for less than £75 a week and I’m substituting some meals with beans as the protein.

if you’re on benefits, as I have been previously, the money isn’t there to do it.

The "it just takes more effort" is actually a huge thing too. If you're in an overcrowded house or exhausted from a difficult job and maybe catching the bus home. Not got money to throw at time saving things in life, stressed about 10001 things then the re may not be capacity for "just takes more effort" either.

Threads like these always attract the saint like size 8 MNers, proclaiming with wide eyes that if everyone took personal responsibility and only ate a few teaspoons of chia seeds a day like them we wouldn’t have an obesity crisis.

Of course the NHS should fund treatment for obesity and obesity-related conditions. Not everyone with obesity is a lazy greedy lardarse cramming their gobs with pies every second of the day. It is a multi factorial problem. More than 50 genes are associated with an increased tendency toward obesity, and that’s just the ones we know of. What about people with hypothyroid, people with no legs who can’t exercise, people who were brought up on junk food by ignorant or uncaring parents and those habits are so deeply ingrained they can’t escape them. What about those who can’t afford to spend hundreds of pounds on high protein, high fat foods? What about psychological disorders? What about people on medication with weight gain as a side effect? Most obese people don’t want to be obese, and have circumstances which make it more challenging to not be obese. It’s absolutely disgraceful to say they shouldn’t be treated on the NHS.

The NHS could do a lot better. My DH was diagnosed with type 2 diabetes which is a condition often reversible and definitely improved by weight loss and low carb diet. He was BMI 27 when diagnosed but is one of the skinny-fat types where carrying a bit of extra weight causes accumulation of visceral fat. He is completely diet controlled but it’s expensive to eat low carb - more protein, more fresh veg - low carb bread is £££, same for pasta alternatives and there is nothing on prescription. If he had followed the NHS advice he would still be diabetic and costing them £££ on metformin et al, but I can see why someone on a low income would take the free prescription and continue to eat the food that was killing them. Far too shortsighted when investing in support for people to address root causes would save money in the long run.
I don’t think the NHS can refuse to treat disease that’s due to lifestyle factors but they could take a more proactive approach - but I suspect it’s down to funding. We spend less on healthcare than most developed nations so it becomes firefighting rather than prevention.

And how do you plan to differentiate what kind of fat someone is?
The stupid lazy greedy kind
The binge eating disorder kind
The emotional eating kind.

The hormone imbalance kind
Any other kind

Which ones do we treat and which ones do we not. Many more overweight people fall into disordered eating category than people think.

The issue is opinions like some of these posters are also rife in doctors surgeries so makes people with issues scared they will be laughed at.

This post doesn't help.