AIBU - With this new data on obesity and the NHS is it time to have some honest and difficult conversations?

[IAmADancer]

New data from a ‘landmark study’ has show that obesity costs the NHS around 14billion a year and that 2 out of 3 adults are obese.

I know this is a difficult subject but the numbers are pretty clear. With the cost of living crisis and a general requirement for both parents to work now to support themselves how do we support people to make the right choices and tackle a growing problem?

Im really interested to hear people’s opinions on what we can do with such stark figures laid bare.

https://www.telegraph.co.uk/news/2023/05/17/cost-of-obesity-twice-those-who-are-healthy-nhs/

I'm obese but I'm disabled and my weight gain is due to the drugs I take to manage my conditions.

What would you suggest is done in my case?

We’ll move to an increasingly insurance-based / private funded system, like in Europe, soon enough. Fewer people will want to deal with obesity-related problems if they’re having to pay for it.

I think it’s fairly clear that obesity can no longer be considered a problem of greed in an individual. The fix cannot be individuals just deciding to lose weight, which study after study has shown does not work.
Change needs to come from top down as it did with smoking.

Because that approach has definitely worked in the US...

15 minute cities would help a lot more than fat shaming.

@dumple i sympathise. It must be very hard to manage that when you have medication that causes weight gain.

Life expectancy in the US is dropping; I’d expect that trend to continue and start happening here too as a result of obesity.

YANBU. This is well overdue. A high tax on ultra processed foods; alcohol, sugar etc, and the money used to reduce cost of healthy food.

Yes. And US has had insurance based system for ages. It doesn't work to address obesity. Encouragibg cycling and walking does.

I think also as nation we have been told calories v calories out is what we should be monitoring, regardless of the food you are putting in your body. With all the research and evidence on UPF’s coming out and the gut micro biome we are starting to understand what is actually causing a lot of the problems .

@dumple it’s not about individuals though, at this scale it’s a public health problem. And as PP says the solutions aren’t about individual Chico’s but the societal factors that have created this health crisis: sedentary lifestyles, poor quality food, and (probably most of all) poverty

• choices

The USA would disagree I’m afraid.

Some people (the minority) gain weight due to illness or medication. They should be supported by doctors to minimise the gain, and stay as healthy as possible.

for everyone else - people need cheap or taxpayer provided sports facilities which are clean, safe and easy to access.

People need to be encouraged to go for walks. We need to return to public service info announcements about the benefits of getting out and about.

We need it to be possible not to work so much without ending up struggling. so people have time.

Cities need to prioritise walking and cycling.

Children need to be able to play out in the street or some nearby space that’s safe and fun so they get in the habit of being outside (would help eyesight too).

we need, frankly, to fundamentally rearrange our society.

I was told to just eat less. Because I've never thought about doing that

The obesity problem is an absolute disaster and a total nightmare to fix

Out whole economy is based around people being overweight and obese (think the food supply, retailers, medical industry, entertainment industry) and unpicking that is going to be horrific

I would predict what will give first is the health service - it certainly won't be the food manufacturers or the 'obesity drug' manufacturers or the diet industry - and at that point individuals will have to decide what they want to consume so they are not obese (costing them money to be treated) and the market will have to adapt and provide better food - a proper bottom up culture change

@Lcb123 i wholeheartedly agree with you on the sugar tax. I know politicians worry it then becomes a nanny state but we have to start somewhere

I’ve been obese since I was a child, I’m finally losing weight because I’m prescribed metformin, which makes me feel full, and I don’t feel starving all the time.

After 35+ years of blame and shaming, I’m finally able to lose weight.

Gaining significant weight is generally not just boredom eating, or something you can easily deal with, but the approach seems to be that we can just easily cut things out and move more, when there’s plenty of evidence now to show that for many people, particularly women, it’s not as simple as this.

Being morbidly obese is often through disordered eating from one of many potential psychological causes, so should be treated as such, but as the NHS is so stretched that many anorexic teens cannot access support until they’re so underweight they’re at real risk of dying, this is unlikely to be addressed.

Unfortunately as rates of mental illness amongst children skyrocket due to pressures of school and life, this will lead to more problems in the future.
Unless there is a drastic overhaul of the way schools are run, and the pressure everyone is under, and the lives we end up living, things will not change.

Basically most food that we love is bad for us, but it tastes delicious and the more bad stuff we eat the more we crave.

Currently it’s easy and pleasurable to become obese. Just need to eat the easily available plentiful and delicious and addictive food that is everywhere, drink some of the delicious easily available plentiful and addictive alcohol that is everywhere and avoid the litter strewn dog shit covered green spaces near you which is easy to do as they are disgusting and we are working like dogs anyway so time for walks avoiding the nitrous canisters and needles.

Humans seek out the easy and pleasurable. It’s now much harder and more expensive to be slim and eat healthily and cook from scratch.

Make it hard, labour intensive and expensive to be fat, as we’ve done with smoking, and we will see the rates fall.

@PtarmisanCheese whilst I agree with you to an extent and also agree that for some people this is the case, I don’t believe this is true for everyone. I think it’s easy to make this assumption when it’s what you have personally gone through.

That ^^
Also I'm shattered and not always able to afford the healthier food I want . If I was able to work less and earned slightly more then it would be a lot easier
Have chronic illnesses and when I finish work sometimes my choices are between cook and eat well or exercise or go straight to bed

But obesity isn't that simple.

I've been a gym goer for 20+ years. Literally 4-5 times a week, lifting weights, cardio, pilates etc. My average daily step take according to my fitbit is 15,000 steps.

Pre-covid, I spent a year working out with a PT who also had nutrition expertise. I was seriously strong and fit and healthy, but my weight put my in the 'obese' category. I needed to lose about a stone to a stone and a half. No matter what we did, I literally couldn't lose weight. I came off the pill to see if that made a difference (it didn't). For an entire year, we tracked my macros and micros and monitored literally everything I ate. I had a whole spreadsheet (devised by my PT), that tracked all inputs/outputs and nothing.

I went to the doctor, and said that I had all this data that showed what movement I was doing. They sent me for blood tests, all of which came back clear. The GP then referred me to the hormone clinic at the hospital, saying that they felt that there was something clearly strange because on paper, I was doing everything "right" but nothing was working.

You want to know what the hospital's response was? "Well, her bloods are clear so you should tell your patient to try doing some exercise once in a while". I remember the nurse apologising to me, saying she couldn't believe that was their comeback.

Now, I've probably put more weight on. I'm still doing 12-15k steps a day, working out a lot. I burn around 2,600 cals per day, but only eat 1300-1400 cals a day but still cannot lose weight.

Yet I know that the doctors will ignore me if I say its a problem.

I am currently in the obese category. Pre children, I went to the gym/pool 3 or 4 times a week. As a single mother now, I don't have the time or money to do this. Perhaps if gyms were cheaper and had onsite childcare facilities that would help a lot of obese people...

I think there are lots of things the government could do along the lines of increasing the sugar tax or legislating around takeaway/readymeal/junk food portion sizes (eg salt, fat, sugar, artificial colours etc could all be controlled to impact the health of the general population.

Gym memberships could be subsidised.

Councils could spend more money on outdoor gym equipment so everyone has access.

Offices could have free fruit available for people to snack on or could offer exercise classes or gym equipment on site so people could do something at lunchtimes.

I do think there are a lot of people who genuinely don't understand how bad some foods are. They're happy to consume meals that are crap with no nutrition and happy to feed their kids that.
They trust the food industry.

This attitude is ridiculous. Nothing needs to be done for you. You decide to do something for yourself surely. Or don't. It's no one else's responsibility.