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/

@FourTeaFallOut I agree. What this data shows is that no amount of stigma, shaming, lecturing, neutral information, or encouraging people is making a difference to the increase in overweight and obesity. Body positivity is a red herring, that's people trying to counter the stigma and shaming!

It's clear that we don't just eat too much due to laziness, but because it's deliberately made that way to maximise profits, that's what hyper-palatable foods and UPF's do. It's like social media, it's inherently designed for over-consumption and to lure you into consuming more (e.g. deals).

The market is food, the market doesn't care if your chicken is poor quality, stuffed with chemicals and nutritionally inadequate compared with 50 years ago, they just care you buy it, consume it and then buy more.

The quality of food in this country is terrible, even if you try to eat 'healthy', the quality of ordinary meat, ordinary fruit and veg in terms of their artificiality is so poor. That's why 'cooking from scratch' isn't a full solution as your cooking is only as nutritious as the ingredients- so those sweet carby carrots, watery meat and so on don't make the high quality meal you think they are making.

Societal (as in legislative) level changes are needed.

The reason the government doesn't do that by the way is of course the lobbying of the food industry to keep things as they are. I'll never forget that crappy Change4Life health promotion that suggested we swap in things like butter for horrible margarine, or full-fat products for diet ones. Totally industry driven.

It's much better for the government to have us all blame each other for being fat than actually stop industry creating and promoting fattening foods.

I think this is very salient. No matter where you are these days, shopping, cinema, trains, even on walks, everyone always seems to be constantly eating and drinking. Coming out of school, the number of parents waiting with snacks is unbelievable, poor things are so bereft of nutrition, they need constantly topping up. On demand feeding for the entire population.

Just have three meals a day. And don't get me started on the size of meals. The size of meals when you go out, I never finish a meal. I would love a half sized, half priced meal. I was chatting to a friend who owns a restaurant, and his number one complaint, is from people who want more.

I have lost weight in my 50s. This is, of course, very difficult to do in the throes of peri-menopause. I have done it the usual way, by watching what I eat and upping my exercise. No rigid diet but definitely being mindful of sugar and carbs.
But I get constant comments from friends.
Gosh, that sounds boring.
I could never do that. I don't have any self-control.
Life is for living...

Yes, weight loss as you get older is boring. No one can make it exciting for you. But it's better than being in a diabetic coma at 50.

Who is saying we should do any of this? No one.

This thread isn't about genetic illness. If nearly two thirds of people are overweight do you really think they all have thyroid problems, pcos or are disabled?

Because a proportion of people struggle because of those conditions should everyone else just throw their hands up and say they can't help their weight issues. It doesn't make any sense.

If there were fewer people who didn't need treatment as a result of their obesity then there would be more money to spend on other conditions and treatments.

As for the lung cancer issue that gets trotted out as some kind of gotcha, yes we do treat these conditions but we also try and prevent them by measures such as the smoking ban and public information on cigarette packets. It's been proven to have a beneficial effect but there was an outcry from smokers at the time. Obviously we can't ban food but we can reduce the amount of fast food outlets, have tax surcharges on processed food etc.

Yes, the genetic illnesses have taken over this thread. 2 out of 3 people can't have genetic illness.

Snacking culture is a good example. People don't independently just decide to snack more, whole industry departments are created to develop snacks, offer high calories for low prices, make the snacks hyper-palatable, have the right mouth-feel, and advertise them. If you didn't have endless access to snacks and had to make them yourself at home, it's pretty obvious you wouldn't snack as much. Snacking can't just be seen about individual-level behavioural control, even if you control yourself 50% of the time, the sheer accessibility of snacks and the way they act on your brain to be delicious (even addictive? Pringles anyone) is deliberately made for you to eat more of them, more money for the company, you are having to fight that temptation several times a day. That's the problem.

All that is true @Highdaysandholidays1 but one can still choose not to buy them, no? I don't have snacks in my house. DC buy a few but keep them in their rooms ( they are skinny) so DH and I are not tempted. We eat nuts, fruit and cheese for snacks.

I realise this is a unfashionable view, but at a certain point, one has to take responsibility.

@KnittedCardi I don't eat out often but I often order off the children's menu. Cheap pubs are the worst for offering HUGE meat challenges🤢

I'd love a ban on eating on public transport except for long train journeys but only in a dining car. Medical conditions exempt of course. I'm autistic and the noise is unbearable for me.

At school a few weeks back I had a chat with one of the mums about the after school snack. It's over a mile for us and hilly and ds is hungry but can easily go without a snack until we get home and I do dinner. He wants crisps, sweets or chocolate after school but I've said no, not on a regular basis and that he'll be having fruit. This was met with grumbles but actually he's very happy if that fruit is strawberries and raspberries. The mum said if she'd brought her child fruit there'd be physical violence from him. He's 7. The family are all obese.

Check the ingredients of the "sugary" ones, very few won't contain some sort of sweetener.

I'm not overweight because I have a can of full sugar Coke once a week, I'm overweight because I couldn't be arsed to cook last night so had crusty bread and cheese.

But everything needs investment. Education, physical health, mental health, housing, the environment, benefits. Where do we even begin? The ‘answer’ to every problem on here is for the government to just throw more money at it, it’s like posters genuinely don’t understand money is earned, money is finite, it doesn’t grow on trees and as a nation we are skint.

Well done.

This thread is full of ‘reasons’ why people are obese - thyroid, medication, busy lives, tiredness, lack of access to exercise, even the weather! - but at the end of the day if you really want to lose weight you can.

This is interesting because my BMI is 43, and I have been to the GP many times over the past 2 years to request support with this.

I've consistently been told that no help is available.

I went on Weds this week to ask AGAIN and STILL the weight management service is closed for all referrals due to a staffing crisis. There is no waiting list. All I can do is "keep regularly checking in".

My blood tests don't show any pre-diabetic markers so I can't be prescribed any medication/surgery by the GP directly, it would all have to be via this impossible referral.

There is no longer any access to free gym memberships or weight loss nurses via the GP. There is no funding for these interventions.

Given the data that prompted this thread, that my obesity costs the NHS more, isn't it madness that there is absolutely zero access for any weight loss support via the NHS?

Also, to reiterate - no one chooses to be obese. Every single obese person desires to be a healthy weight. I've spent thousands of pounds over decades trying everything I can think of - up to and including specialist eating disorder counselling.

The hatred and disdain for fat people displayed by some on this thread is very upsetting.

There are so many contributing reasons to the obesity crisis, it's difficult to know where to start.

First and foremost a huge majority of people don't enjoy being obese. People saying ' I'm big and beautiful, get over it' are saying it as a defence mechanism. Behind every obese person is mental health issue.

If we keep thinking - and when I say 'we' I mean the NHS as well - that it's down to education and telling people to eat healthier and move more, nothing is going to change. There is not one obese person that does not know what is healthy food, and that exercise is good for you.

Our society needs to change. The way we promote fast food, the chippy, the way supermarkets are laid out with treats at every counter. The huge selection of chocolate and crisps everywhere. The price of fruit. The fired breakfast - is anything as cheap , easy or filling as a bacon or sausage sandwich for breakfast? why isn't it?

Slimming clubs need some serious bringing in line. They don't work as long term solutions, if they did they wouldn't exist. They rely on repeat custom. People go for years and just treat them as social clubs.

Also, if we can't save ourselves, we need to save our kids. To me - as an obese person - there is nothing quite as upsetting as seeing a very obese kid and realising bad parenting has led to that. Some kids you know just wouldn't be able to get to the size they are without adults doing it to them.

@WoolyMammoth55

I think in the long run the NHS will have to invest in major infrastructure of weight management clinics. But in short term the money’s not there - and what do you really expect medics to do? You need to take responsibility for yourself and eat less. You don’t need a gym, I have maintained my weight with walking only for 30 years.

With you on this one OP.

You don't just get fat overnight. It takes a very long time to pile in the timber. And being fat isn't contagious, it's not like you bumped I to a friend and "caught" obesity.

People need to grow up. They got fat because they were too lazy to pay attention to how much they were eating. Why should we pay for it?

The amount of fat people I see is alarming. Also, in the UK and America we seem to have this fucked up belief that certain things "make" you fat.

"Oh I put on so much weight while pregnant, I just can't seem to shift it now lol!"

"Well we're just big boned, my nan was huge"

"It was the depression"

Basically ANY excuse we can think of.

There's nothing more depressing and embarrassing than being on holiday and sitting next to some slim, tanned, toned and well behaved EU kids, then seeing Dave from Dudley with his MASSIVE, hairy belly, his two fat children and his fat wife, all just sitting there, scoffing ice-cream and slapping on the factor 50.

We need to end the fat.

I've had periods of poverty and wealth, and what I eat at home has pretty much stayed the same, but then I love veg and pulses etc

I tend to agree. I also think it's sad that we'll probably as a country go down the route of prescribing Ozempic to obese people rather than making real, long lasting societal changes.

Yes, it's true that fat doesn't appear overnight (and conversely getting rid of it isn't quick either).

I'm curious why warning signs that they are putting on weight get ignored by people. My own weight fluctuates and my warning sign is when my clothes get too tight or I try on a dress I've not worn in a while and think shit I can't wear that because I look like a badly stuffed sausage or because I'm genuinely concerned I'll rip it or because the bastard thing doesn't do up.

That's the point at which I do something about it. I don't go out and buy new clothes in a size up - apart from anything else I don't have the money to.

So how do people get to the point at which they are significantly overweight or obese without pausing to try and stop it? Why doesn't the need to buy new clothes act as a wake up call? Whats the barrier to realising there is a problem and addressing it early and how can our govt / medical services / society help? Prevention is better than cure and the more weight you put on the harder it is to lose it.

Until I find something more academic:

motionhealth.net/2021/08/18/big-boned-big-myth/

Further googling of pictures has made me queasy.

I'm surprised at all the obese people (without any medical condition reported) on this thread who seem to eat healthy, exercise, etc and are still obese, same with their family. Are we talking 'obese-obese' or The Rock and Stallone 'obese' because it's hard to believe the former is so widespread, even if only on this thread.

So how do people get to the point at which they are significantly overweight or obese without pausing to try and stop it? Why doesn't the need to buy new clothes act as a wake up call? Whats the barrier to realising there is a problem and addressing it early and how can our govt / medical services / society help?

I was bedbound for months and then only in pjs for more months.

I do have input now but I have to pay for some of it myself.

I knew I was putting on weight but it was more important to heal.

My clothes size doesn't change much
At 17/18 stone I'm a 16
At 14/15 stone I'm dropping to a size 14
So it takes a good 3 stone for me to change dress sizes

I thought this thread might differ as the stat in the op was stark

But it’s the same as the previous ones. It’s someone else’s issue to solve when really it’s just our own.

Medical issues aside