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/

There's a drug already on the market that increases satiety - semaglutide. Indicated as an adjunct to lifestyle intervention in people with overweight or obesity. Look at data from the STEP programme.

Overly simplistic message. I cook from scratch, but have an uncontrollable thyroid disorder. My parents cooked from scratch too. I’ve still been a fatty since I was a teen. I was very physically active as well until the last few years.

Sugar , also known as glucose, sucrose, fructose, corn syrup - more names for sugar that Allah. All designed to confuse, and create misunderstanding

Oh fuck off!! 😂 Some of us have self control and only eat these things as a treat, in moderation. Why should we be punished?

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.

Because having a healthy workforce that contributes to society by paying taxes is essential.

I am not obese at the moment, but I have been. I suffer with Binge Eating Disorder which, like all eating disorders, is a serious mental health issue.

We have to move away from thinking that obesity is always down to people making the wrong food choices. WE also have to look into the diet culture whose businesses make billions by exploiting the vulnerability of people with eating disorders, brainwashing them into thinking that it is an issue of wrong food choice and lack of exercise while making them even sicker. A lot of people with eating disorders do not realise that dieting culture intensifies the ED.

Blaming people with eating disorders for the sorry state of the NHS isn't going to help.

I haven't yet read your attached article by the way but I look forward to doing so.

I dont get this thought at all. So, because you cannot lose weight it shouldnt be addressed at all? There are always going to be people who cannot lose weight through no fault of their own but that doesnt mean it isnt an issue that needs to be tackled. Obesity is costing people their lives.

Fantastic idea, I really would think it would be cheaper in the long run. Saying that I am obese and it is meds related.

I have been obese most of my life. I agree the problem of obesity desperately needs to be addressed. I am working hard to eat less ultra processed food. Unfortunately there’s lot of unhelpful mantras out there (eat less, more more). Undoing a lifetime of unhealthy eating, which is akin to addiction, is a long hard road. The research is clear that the vast majority who try to lose and maintain a lower weight, are unsuccessful. There MUST be a wider societal shift if we are to expect the population to become healthier.

This.

I see a lot of young people at the gym, but drinking those appalling protein drinks that wont help matters. It's a 1hr weights / cardio session, not Everest. Have some post exercise nuts and orange juice instead if you need a boost. I am old and grumpy.

I remember some fitness guru got some flak recently for posting gushing pictures of his mrs (who also works in fitness as I recall), post pregnancy and the shape she got back into. I think this is ridiculous. I’m totally against bullying fat people or being mean about it, but an attitude of wishing to hide away fit and healthy people for fear of triggering overweight people is absurd.

Now obviously few of us will attain the enviable health and figures of people who literally devote their lives or even a career to it, but there is nothing wrong with having people we can aspire to be more like. I’m currently working to shift some weight. I want to get rid of the dad bod, and I’ve lost a fair bit already. It helps to have inspiration.

I’ve been pretty lucky in that any weight issues I’ve had haven’t thus far cost the NHS anything, but the time fast approaches with age where that will doubtless be less likely. I would be mortified if my inability to control my snacking habits and calorific intake meant someone else suffered as the NHS was out of money.

How many women are wrongly categorised as “obsese” because they are actually built like Arnold ?

How many “ obsese” men are actually body builders? It’s not generally the case.

I’m part of a long term art group where most of the members have long term chronic issues.
Three of the members have not been diagnosed and have been fobbed off for the ten years we’ve known each other, some of them for longer than that.
All were prescribed antidepressants, as their GPs would not investigate the issues they had.
None were obese before their issues. One was overweight.
One of them has mobility issues, was put on mirtazapine and put on nearly 7 stone in the next 18 months. The GP wouldn’t change the prescription. After a few years of declining health issues and increasing weight gain she changed drs, to be told she was obese and anxious, no point in further investigations.
She eventually changed GP again and was finally taken seriously, was given several diagnoses, was taken off antidepressants and given the right medication for her conditions - she’s now lost 4 stone.
Until she found the right GP she was just one of the “overeating lazy” that people love to shame and lump together. Now she’s part of the “oh no, we don’t mean you” gang.
That’s the main story. The others are similar but so far still being ignored.
It’s very common for women to be fobbed off by GPs.

I know obese people who of course overeat and don’t do enough, but have underlying psych issues which means that the work to lose weight feels like the equivalent of climbing Everest, let alone base camp.

I also know people, like above, whose obesity crept up after the onset of chronic illnesses. One of these then started to dramatically lose weight, went to her GP who congratulated her for her weight loss, then took months to investigate the reasons and eventually it was found she had Graves’ disease.

In my (limited) experience of being obese and knowing many obese women, I’d say there are more with underlying issues that have either caused the obesity or that seriously hinder recovery from obesity. It then rankles when I’m told that it’s all down to overeating, when from where I’m standing it more often isn’t.

That’s not to say that nothing can be done, but the current approach of shaming and telling people to eat less is not working.
Like someone else said there is research showing a viral root to obesity, there’s evidence of gut biome, addiction, eating disorders, which all point to a necessity of a different approach.

So what would you prefer? Leave people struggling with obesity to suffer when there's a medication that could help them?

We can't win. For years we've been told being overweight is bad for our health. We've tried and tried, lost weight, gained it back again, tried again, failed again, gained more weight, on and on. When we try a medication that could actually help us crack this for good we're told we're cheating, we shouldn't need it, it's our own fault, we should just take the consequences. Clearly we should be made to suffer for the rest of our lives for the crime of being overweight.

Not everyone who is obese, most eat healthily but it's the portion size. I'm trying to cut down but if my husband dishes my meal up its far too large and then accuses me of wasting food.

if I dish his up he asks where the child is.t

We mainly eat healthily, last night I had a pepper and courgette omelette, half left over for lunch.

@Bananarepublic no? I can't say I've ever heard of it. Is it worth looking into?

NHS care sn's preventative, it's reactive. How much is spent on something depends on cost benefit analysis underpinning NICE recommendations. Obesity, especially extreme onesity, is almost always linked to trauma and psychological problems, it's not the case of lets make sweets unaffordable and all will be thin. The NHS doesn't like to spend on indirect stuff. Obesity in its own doesnt cause problems but there are associations with other comorbidities.
NHs love to spend on fuckwits with clipboards, unqualified management and HR consultancy services where one day's consultancy by one such bullshitter costs more than a nurse's monthly wage.
They import staff with no language or patient care abilities from places that have low standards of care instead of training staff to our standards here. These staff cause more problems than what they are worth but it's all indirect, the role is filled, and no followup and never mind what a liability such staff are.
And for the past three years NHS was being 'saved' from a virus, believe it or not, they themselves called mild (every 10 year old knows you can't avoid a virus) so lots of illnesses progressed, were missed, and as they can't continue misdiagnosing people from their living room sofas and kitchen islands, you have all sorts of shit erupting now.
Ultimately early help and treating mental health is what's needed as part of obesity management. Can't undo the damage of the last three years of restrictions that will bite the followers on the arse for many years.

It's a shitstorm made up of multiple different mini-hurricanes:

-car culture
-supermarket power
-UPF ubiquity
-snacking
-treats
-normalisation of overweight adults and children
-exhausted parents working two jobs
-portion size
-fizzy drinks
-instant gratification

I'm in my 40s and many of the above have changed in my lifetime. For example when I was a skint student, buying lunch was a rare, luxurious indulgence. I work at a university and we no longer have a Blackwells or optician on campus, but at least 5 more food outlets than when I started.

I honestly think our best bet is some benevolent alien overlords.

There are obviously people who massively struggle to lose weight because they are eg. on certain medication, have a disability or are literally addicted to food.

BUT I think the vast majority just eat too much and don’t do any exercise. Simple as that. Of my friends and family only a small minority do any exercise at all; they just can’t be bothered to find the time tbh.

I don't think it's about hiding away "fit and healthy" people. But it is about taking away the expectation that the quick return to a thin body is possible for all new mums - or for anyone. Some of those "fit" people you mention seem very healthy but the message they are putting out may not be so healthy. Also, if we are only going by outward appearance it is quite dangerous to think that thin equals healthy. I should know because I have been at both extremes - very thin with everyone exclaiming about how great I looked even though I was underweight and malnourished; and obese with no comments about how good I looked and still malnourished.

I am now trying to find a healthy median - and it does not involve dieting.

People are given such conflicting advice because the studies are supported by people with money to make from it. People think that lot fat is healthy then eat lots of processed, high sugar foods that send their hunger levels sky high when their blood sugars dip.

This combined with working so many hours, long commutes and easily available fast food. Who has the time?

I don’t know what the solution is. I cook from scratch 90% of the time. I workout 3/4 times a week but I am under no illusion that I can do that because I am single and so have lots of time to dedicate to myself and on a decent wage.

Our workplace sends us on millions of pointless conference calls about wellbeing but maybe encouraging using that time for a walk would be more beneficial?

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.

So more billions at the taxpayers expense then?

How many of these obese people would actually bother showing up to free gyms/sports facilities?

Public service announcements about walking? Everyone knows walks are free and most fat people still don't bother, so why would free, nationwide exercise facilities work?

Lol it doesn’t stop people becoming obese though does it? I don’t eat that crap due to illness and allergies and when my thyroid is being a pain I still put on weight. I managed to put on weight one time on 800 calories a day as my body was storing everything leaving my passing out from exhaustion. It was the most ridiculous example as to why the hormones and metabolism are actually aa important than what you eat.

“Normalisation of overweight adults and children”.

This is so true. When I was a kid there was maybe one fat child in each class and everyone else was pretty skinny. Now a lot of the kids in each class are either overweight and the skinny kids are seen as the odd ones out. It’s insane.