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/

Movingroovin- possibly but this narrative that everyone enjoys over eating is not true

But this has always been the case. Whereas the uptick in obesity is a very, very recent phenomenon. Not recognisable from my youth (born in 1966).

True, more food everywhere now & parents were generally stricter.

Weather def a factor making it harder but you’re right.

Well, I certainly know people who aren't too fussed about food and will stop once full. But most people who stay slim do it through concerted effort even if it looks effortless.

Yes, food is everywhere. I noticed the big change in the early 1990s. suddenly you couldn't move in London for a Starbucks and the like selling lattes with syrups, and any amount of muffins and pastries. We Brits lapped them up but didn't up our activity; rather the reverse. I left home in 1984 and even then cannot recall food being so readily available everywhere. And we were all slim - not thin (which is as judge a word as fat) - as were our parents and their generation.
Food is just too damned easy, and sadly is used by many as a panacea to make them feel better - a 'treat' if you like. What to do? I dunno. But as I said upthread I think we all need to be encouraged to confront our own health weight and health. There is so much denial. I have a relative who is a GP. She is obese, and so is her family. It's not poverty or lack of knowledge doing that. It's something else. So there is no one size fits all solution.. the starting point is for individuals to recognise their problem. Without that they cannot start to address it.
My DD is a recovering from an ED. Recovery was impossible until she (rather like an addict) voiced the words and accepted she had a problem. Slow progress, but there is progress. Thank goodness

I've not yet read the full thread but it is interesting what I have read so far.

I'm obese, always have been. Growing up, my family were too even though we were active - no car, swimming every week with a smimming club (actual swimming, lengths (very long distances) not just splashing around), would be out playing on the garden every day, thought nothing of walking a couple of miles each way to college sometimes a couple of times per day in all weathers.

Our diet was rubbish though, mum would collect us from school and would bring us a chocolate bar and packet of crisps every single day. We would have a pudding after dinner every single evening, and on a Sunday, we would have a roast followed by pudding (crumble/pie and custard, spotted dick and custard, syrup pudding and custard) and then have cake after dinner too. Portions were always huge. We'd have breakfast and supper, white bread toast with syrup and cereal.

I know people moan about school nurses coming in and weighing and measuring their children and people opt out of it. I don't think school nurses did that when I was a child but I wish it had happened (I didn't often go to the GP as a child as I was never ill). I wish someone had weighed and measured me as a child and told my parents I was overweight, looked at my diet with my parents and encouraged a healthier diet. Because now, those are the foods I like, I enjoy sugar even though I know it's bad for me. I can eat healthily and dropped nearly a stone doing so with ease. But as soon as I was stressed and had a difficult day at work, I turned back to the rubbish food and stuck to it again.

I think treating self to massage with a lovely oil or whatever you love - self-care/love.

Highly tax ultra processed food and heavily subsidise whole foods. Educate about health from a young age and cooking classes available for all for free.
I considered myself an educated person as a health professionals but Ive only started recently learning about blood sugar, insulin, how the body stores and conversely taps into fat stores. I thought eating little and often was healthy, its not. There is so much misinformation out there. The food companies are tricking people that ultra processed foods are healthy, I mean FFS slimming world and weight watchers recommend and sell their own UPFs which are fake food and have a horrific effect on the body. Education and cheap whole foods is the only answer.

Educate about health from a young age and cooking classes available for all for free.

So much comes from parents. If children only get UPF and no cares about weight at home it’s a tough cycle to break

I suppose, in the end, it comes down to respect - respect for our bodies, respect for our lives and respect for the lives of those we love and people in our society as a whole. If we don't respect these, we won't care enough to take care of our bodies in the best way we can.

I wonder if a lot of these problems are due to the snacking culture. People no longer eat just at mealtimes - you see people eating large portions of fatty/sugary food on public transport, at the cinema, in the evenings watching TV. Even if they eat relatively healthy food at mealtimes, they are bound to put on weight.

I understand your point and agree with it from an idealistic perspective, but I think the important thing for now is minimising the impact on the NHS. I don't think sending people for bariatric surgery is necessarily the right thing (surgery is expensive and it doesn't have brilliant long-term outcomes). However, as more "anti-obesity" medications come onto the market, I think that it's something that could be a much cheaper option than simply telling people to make better choices and then having to spend hundreds of thousands of pounds when those people then need admissions for cardiovascular events etc. when this inevitably doesn't have the desired impact on their weight and overall health.

Obviously in an ideal world, everyone would make good lifestyle choices: people wouldn't smoke and then require expensive lung cancer treatment, people wouldn't do extreme sports and injure themselves requiring surgery, and people wouldn't drink excessively and damage their livers. However, people DO do these things and the NHS can't simply say "not paying, it's self-inflicted", so I don't see why obesity should be any different.

Wouldnt it be great if we could give a faecal transplant to all those on this thread saying it's so easy to lose weight. Then they might find out just how difficult it can be!

@anyolddinosaur would fat poo make a thin person fat though if the thin person continues to eat healthily and exercise regularly?

All these debates about processed Vs home cooked meals is totally redundant.

The reason why obesity is a problem is because we eat too much, end of. The average woman needs about 1800 calories a day. That is so little when we add it all. An average healthy main meal will be about 400 calories. Add breakfast, lunch, a treat or two, a glass of wine, a Starbuck coffee and you are likely already over 2000 calories.

Exercise also doesn't burn as much as we'd like to think for the effort. An intense high heart raised 45mns exercise will burn 350 calories at most.

There's no need to be an expert to know what to do to lose weight. We just need to reduce portions, to half for many, and cut down the 'treats'. Doing so really does reduce the food budget.

The problem is the more we eat, the more we feel hungry. We also don't drink enough water to feel us up.

I grew up with strictly controlled food intake and no crap. Forced activity regularly. I absolutely despised it, I put on weight irrespective of what I was fed or how much exercise I was forced to do.

all I remember from back then was being hungry and being sore. I’d be sent to school with an inedible lunch and it was eat it or starve. I was constantly accused of secretly eating despite having no money to do such a thing. Forced into activities that were both humiliating and painful.

it really gave me an awful relationship with food, I associate healthy eating with things I don’t like and I do it day in day out because I know I have to, but it is a miserable experience.

I also received so much joint damage from the activities due to an undiagnosed condition (turns out I wasn’t just whining I was seriously Ill) I now need crutches to walk. I eventually found the only activity I do enjoy which is wild swimming, which I do regularly. I’m still fat. I still have the absolute shame of being fat, I still am confronted by it on a daily basis, I still deal with comments about being fat and maybe eat less on a daily basis.

shaming people and being super strict isn’t the way to go, and you can still be fat on whole foods.

being told by doctors and dieticians to do things you’ve done since child hood is demoralising, doesn’t help my thyroid is trashed and I can’t tolerate any treatment so swing from high to low on the regular. Or pcos, or being disabled, or any number of things. Some of us are born with genetic illnesses that make it hard from the get go to be a healthy weight, and all the bullying and nastiness does is make you absolutely determined to not seek help for it.

or being congratulated on losing a huge amount of weight in a matter of weeks due to being so desperately I’ll I hadn’t been eating and was hyper thyroid. My heart rate was over 150 lying down, I could have died but everyone was so happy for me as my ass was smaller. Now I’m less at risk of dying but weight increased everyone whining at me again. Really couldn’t make it up.

Of course not, it’s just gut flora at the end of the day.

I think this thread is the perfect demonstration of OPs point about difficult conversations.

It's full of people saying "but it's too hard, I don't have time, not my fault" and so forth. And a lot of the time they're right, it may well be difficult to lose weight. But that doesn't mean it's not doable, albeit not fun.

People want an easy solution and that's understandable too, but at the moment there isn't one. At some point we collectively have to start taking personal responsibility - and the government can help with that with public programmes to encourage healthy eating, higher activity levels, more walking and less car use, better education on health and more focus on sports in schools.

Obesity should be an occasional aberration. It should not cover 26% of the adult population!

I haven’t eaten 1800 calories a day since I was a teenager 😂

you get that some of us have been on restricted diets our entire lives?

no Starbucks here, the village doesn’t even have a coffee shop, I don’t drink, don’t eat dairy, am allergic to pretty much anything out of a tin, or processed, and I’m still fat. Stopped eating meat now as well, stopped eating breakfast years ago. Don’t eat fruit because of the sugar content 😂

have dangerous allergy to tomatoes so basically I’m stuck eating a small number of dishes on weekly rotation and they are all absolutely miserable.

if I never saw a mung bean or cauliflower rice again it would be too soon. But no doubt I’ll be eating them at least once again next week. Such is life.

I worked with a woman briefly who was very over weight. She always had been.

As a child she would see a paediatrician because she was so overweight, her sister saw the same paed because she was under weight.

Her parents were reported to social services because the neighbours thought they were starving one child.

Not all slim people eat a healthy diet, not all fat people don't.

This is true but I think a lot of people are in denial about how much self loathing and hatred they have, not helped by a barrage of media and advertising encouraging us to hate ourselves even more so we buy whatever solution is being sold.

It is too hard. We are genetically driven to seek out calorie rich food and we live with it in great abundance. If the country wants society wide change then we need a society wide solution. Berating people for lack of will power clearly isn't working.

We have ruined our food environment. God knows how we recover it at this point but, while it might scratch a superior itch, finger wagging at individuals won't fix it.

It would be very interesting to be able to take some of the people who insist they cannot lose weight and put them in a controlled environment where their food and drink intake is completely set out - I don't mean a starvation diet, just sensible meals - and they get decent amounts of exercise every day (not marathons or hard labour or anything stupid, just walks, gardening etc) and see what the results are after say 8-12 weeks.

I do genuinely mean that, I think it would be an interesting experiment.

Lockhart - They did do that with celebrities some years ago. I can't remember what the programme was called but they all stayed on a farm and did work on the farm. It was all natural food they had to eat and cook themselves. I remember Ann Widdecombe and Gemma Collins being two of the celebrities. It did follow up on them after the programme to see how many of them stuck to the new diet once back in their normal routine. I think Gemma Collins did, Ann Widdecombe definitely didn't.

@Lockheart me too. I've seen it mentioned before ;might have been by me even) and the replies were that of course they'd lose weight. For some reason the connection isn't made to real life though 🙄