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 work in medical research there is a fair amount of literature about the inadequacy of BMI as an indicator due to not accounting for body shape, build or percentage of body fat

BMI is a scientifically acknowledge bad measure of weight and obesity; it is useful on when fat is too low but terrible for high weight - there are many many better measures but its commonly used as its simplistic. Arnold Schwarzenegger, Sylvester Stallone, Dwayne Johnson, etc are "obese" according to BMI.

I said " at an individual level"

This is key. I bet they’re ordering black coffees or herbals teas too, not mochas with all the extras.

I went to a talk the other day by a doctor working on a drug aimed at increasing feelings of satiety with minimal side effects and the preliminary results from Phase I testing are very positive. I think it's becoming clear that we need to treat obesity as an illness in its own right: we've tried telling people they're too fat and we've tried telling people it's okay to be fat, but our society is getting bigger, and I think we need to start accepting it's okay for this to be medically managed. Yes it will cost the NHS money to give people weight loss drugs but it will cost them far less overall if we can decrease cardiovascular admissions and the incidence of Type II diabetes, for example.

I went from significantly overweight to a healthy size for my height despite having a painful joint condition, PCOS, and being from a family of overweight people.

I did it by making adult decisions about my food and activity habits, because I'm a grown-up, adult individual. I didn't sit around waiting for "society to fix itself" and moaning. Well, I initially did, but I got better.

The most important thing for me was de-programming myself from myths like "starvation mode" and "fat genes", and the idea that losing weight is impossible because x y z. It's like a dangerous cult.

Excuses or reasons that need to be addressed? I'm not overweight myself (although I could lose a few lbs but my BMI is healthy) however I do have a lot of empathy for people who struggle whether that's financially, time-wise, emotionally, health-wise or any other struggles that might make it more difficult for them to lose weight than another person. I also don't think any change is going to happen by berating and judging those who are finding it difficult either.

It does affect others as well we it puts additional strain on the health service.

@dumple some healthy food doesn't require prepping. I'm also ASD and I can't abide some food. I'm on steroids too.

But then I have support from my consultants and I'm guessing you don't which is awful.

I wonder if this would actually save any money though, if that's the aim? Obese people die sooner, they don't receive pensions for decades or live in expensive care homes for years.

I think developing public transport/cycling routes is the key. People spend too much time in their cars. I think the whole lifestyle where you use your car every time you need to get anywhere and then rely on occasional gym to keep you fit is completely unhealthy. People need to walk daily. Even more, more people on streets make neighbourhoods safer and boost local businesses.

It's a very useful indicator for most people. Just because it doesn't do a good job of measuring outliers doesn't mean it's bullshit for typical people.

I'm coeliac, and gluten free bread and gluten free cakes are stuffed with fat and sugar. I keep myself from eating much of either as my cholesterol levels are already high (hereditary), I'm post menopausal and Long Covid fatigue has now put an end to the long walks I ised to do. I want to look as good as I can for as long as I can, so I'm incredibly careful with my diet. It's a lifestyle choice for me.

Why should we medically manage people who have brought upon their own health issues? We are perpetuating the problem by "medicalising" it and avoiding the root cause ie overeating and lack of exercise/good lifestyle choices.

I'm not including the people here who are obese owing to medication. But to say "let's give everyone surgery to help weight loss" or give them this pill, is saying it's ok not to own your choices for the consequences of your poor lifestyle.

It's a very useful indicator for most people. Just because it doesn't do a good job of measuring outliers doesn't mean it's bullshit for typical people.

Its not though, and it is good for low fat level outliers, its crap and has been by-passed by all but the insurance industry due to its inadequacies.

No excuses needed. Everyone is free to make their own choices in life.

Did you ever think that the dieticians advice may not be right for you?

Recommended reading - The Obesity Code by Dr Jason Fung, The Ketogenic Bible by Dr Jacob Wilson & Ryan Lowery PhD, The 800 Calorie Blood Sugar Diet and The Clever Guts Diet both by Dr Michael Moseley. All are great for how the body uses the fuel it is given. I have to reread all of these and get back on track but it is easier said than done.

If you look at who makes the decisions on the 'eatwell plate', it is a load of food companies who obviously have vested interests.

BMI is a scientifically acknowledge bad measure of weight and obesity; it is useful on when fat is too low but terrible for high weight - there are many many better measures but its commonly used as its simplistic. Arnold Schwarzenegger, Sylvester Stallone, Dwayne Johnson, etc are "obese" according to BMI

This always gets trotted out, a bit like "but technically some athletes are obese according to BMI". It happens on every thread about weight.

BMI isn't perfect, but more people are overweight and more people are obese. Overweight is quite a wide window so by the time someone is in the obese category they're either an outlier with lots of muscle, or they're carrying lots of additional weight. Let's be honest most obese people are not built like athletes who follow nutrition plans and have intense training programmes.

Exactly. People such as you are the example of how taking control of your health is the key. We need more of you to set an example of what maturity towards health issues can achieve.

Exhaustion is part of it - I never gained weight until I had a baby. This baby did not sleep. I was eating fat, sugar, carbs in order to function at a basic level. Once they started sleeping, I lost almost a stone without even trying because I didn't need something to get me through.

Prior to experiencing this myself I wouldn't have understood or would frankly have been judgey.

I also think it's mental health - people self Medicate with drugs, drink, sex but also food.

I don't see it as excuses, I see it as denial of personal responsibility. I speak as someone who used to blame 'society' for my being overweight until I realised I was the only member of society buying my food.

Have you looked into your gut biome? There is some evidence that unbalanced gut bacteria can affect weight gain. It may also be worth going on an anti-candida diet as well.

Thanks for this, I have struggled with my weight for YEARS and tried everything without success, so you have inspired me to sign up for the next release

Same here, when I managed to come of them for while the weight fell of

Devised by the insurance sector not clinical.