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/

It is important to clarify that 26% of people are obese. The 2 of 3 the OP references is overweight or obese.

I got obese following a life changing accident where I had to rely on carers and ready meals. And I could not move for months. The carers were provided by the state ironically.

The weight is coming off slowly. I need further surgery and I currently can only walk with crutches. I will need a wheelchair but I am trying to put that off as long as possible. I currently need three joint replacements possibly four. I'll know about the fourth when I get my next review.

I have regular reviews with my medical team and I am proactive myself - the nhs physio, for example, only has seen me twice in the last year but they know that I pay for my own physio and I NEVER miss a session apart from if I cannot be there due to lack of transport, once when I was on holiday and occasional breaks when the physio is not working that week, which is about 4/5 times a year.

I am permanently depressed by this and it's fucking annoying when im told I should be doing more.

My consultant has told me I am not allowed to go to the gym. I did go, but did more damage because no one knew I had an issue with something - I ended up with injections of steroids and a ban on the gym - so im allowed only to walk in the water at the pool, and I tried going to the local public pool and was made to feel crap so I pay for a private pool membership as it's usually quieter especially in the morning but it costs me £50 a month for that (there is an attached gym but I can't use the gym)

I am going my fucking best and I don't know what more I can do.

dontlookbackyourenotgoingthatway
i don’t see that it’s a question of morality. I just have an issue with people saying the State (which is of course financed through taxation) should solve every problem when it doesn’t seem to be able to do basic stuff that a compassionate society should; look after people who are disabled, the elderly, those with medical conditions etc. who simply cannot help themselves. Since seeing the parents feeding fish and chips through the school fence to their children after the Jamie Oliver initiative some years ago, I despaired of some people’s common sense.

That hasn't worked in the US. It's really hard to make people lose weight as food = instant gratification whereas weight loss requires big changes over a long period of time.

And 15 minute cities

The demand certainly is there because the food is cheap, addictive, convenient and tasty.

People aren't going to change unless it's made more difficult to get hold of these foods and easier to make decent healthy food.

But to do this it would need a huge shift in values, attitudes, culture.

After struggling myself with weight in the last few years and it stubbornly not moving even with only eating 1200cals and everything I thought was right, I did Zoe project testing. It’s been eye opening and I have significantly changed my diet in the last month since getting my results.

I am eating on average 2500-3000cals a day and I have lost weight. I have cut out refined carbs and instead have pulses and beans, hardly any fruit but more veg, lots of nuts, dark chocolate, eggs, protein etc. I feel healthier now than I have in a while.

As I said up thread, we have been told for years and years you need to need restrict calories and exercise. Turns out exercising doesn’t help you lose weight, although it is good for your health. What we put in our bodies is what makes the difference.

Now I know that not everyone can afford to pay for the testing on Zoe project, although in the longer term I would love for the nhs to adopt this as it think it would be a game changer. But there is so much information out there now to help people understand this research and try their own version on the diet. The Zoe podcast is brilliant, you can gain so much from just listening to that.

Because fat has become normal. The new Sure and Dove adverts on TV both feature grossly overweight women as "role models". That wouldn't have happened 10 years ago.

What we need to do is stop treating obesity as a medical condition. It's a lifestyle choice.

I track literally every mouthful I eat.

Today I've had two slices of hovis granary bread with flora lighter, three cups of black coffee and 1/8th of a melon (the yellow one I forget what it's called) and 8 grapes as a snack.

I'm looking into paying for that weight loss injection (I don't remember the name of it) but I'd have to pay for it privately - thankfully I'm a high earner and can afford it.

People need to take responsibility for themselves. My mum was a GP and said so many people are in denial about what they eat and how much. Just put the biscuits down.

If only it was that simple.

Not only do people "have to make better choices, but also food production has to change. Obesity was less of a problem decades ago not only because there was less "junk food" but most foods across the board were produced in a generally better way, without aiming to bulk it up at the lowest possible cost.

I got obese following a life changing accident where I had to rely on carers and ready meals. And I could not move for months. The carers were provided by the state ironically.

The food provided in hospitals is a national disgrace, but also representative of the value we, as a society, put on food

It sounds a horrific ongoing experience for you, and you can't do any more. As said upthread, this is a nuanced argument. I am sure you must see able bodied people who are obese and not looking after themselves and think things about them and wasting the opportunity they have for a healthy body?

You are doing the right thing if the number on the scales is going down - it's a slow process!

Weight loss is massively about diet, exercise isn't the primary mechanism at all, so focus on what you're eating, remembering that your daily calorie requirements will be drastically reduced if you can't move. It's shit, and really hard, because your body will only need a small amount of food to keep ticking over, so don't beat yourself up for it taking a long time or for having the odd day of over-eating.

I am sure you must see able bodied people who are obese and not looking after themselves and think things about them and wasting the opportunity they have for a healthy body?

I have honestly never thought like that.

It's rare that an obesity problem is down to a health condition, it's more likely with some medicines, and mostly people are obese because they simply eat the wrong foods and too much of it/drink too much alcohol. If the bad foods weren't so cheap and readily available, you wouldn't have so many overweight people ala Japan. 3% roughly are obese there, about 25% or so in the UK. Japan's obesity rates started to climb when western junk food/more fried foods started to be introduced after WW2, but on the whole the rates are so low because the food people have access to is so healthy and "clean". In this country it's not so easy to have access to that kind of quality food.

@dumple maybe you are eating foods that are wrong for your body. Low fat spread is awful and highly processed which will just inflame your body further.

I can only say I am sorry you are in such a difficult position, it’s must be incredibly frustrating. Have a listen to the Zoe podcast, I sound like one of those people who have been sucked into a cult but it really was life changing for me

Maybe the NHS could update its guidelines to more modern understanding of how insulin resistance and fat adaptivity affect weight gain/losss.

Also update their recommendations on calorie intake. 2000 for a female is ridiculous- I am 5’4” and am a size 10. I work out hard for at least 30 minutes every day, plus walking and running twice a week. My maximum calorie use on a high exercise day is around 1800 including maintenance calories. If I ate 2000 calories a day I would be fat.

I agree that there does need to be better education. I don’t believe 80% of the population are unable to lose weight because of mental health or physical illness. I see a lot of people eating the wrong stuff because they have been misinformed by the NHS and media about what really affects our weight.

I've also drunk a pint of sugar free flavoured water.

Sorry but I'm going to follow the advice from my dietician at the hospital and my consultants.

I am glad it has worked for you though.

If you’re vegetarian and eating loads of fruit you’re probably getting too much sugar and not enough protein. What are your macros?

I’m average height and weight and my BMR (to maintain weight without any exercise at all) is just over 1300 calories. The whole “women need 2000 calories a day” thing is only applicable for large, active women.

What we put in our bodies is what makes the difference

^This 100%, however exercise does play a vital role in keeping healthy. It's good for flexibility, muscle tone and even lifts your mood.

All these factors will contribute to quicker recovery in the case of illness.

@dumple sugar free water is full
of sweetners, it’s a trick to get you to drink because they tell you it’s healthy when it isn’t.

Have a look on the ingredients list on the back of the low fat spread versus what’s in butter. I would not be putting all those chemicals in my body if you paid me.

Blimey @dumple surely you can see that you are a very extreme case? No point in getting sidetracked when we all know a huge cause of obesity-not all!! - is people eating too much of the wrong foods and drinking loads of Coke.

eat at the table with your family

Not if your family enjoy eating unhealthy foods 'at the table' together. But you can still eat healthy meals even if not 'at the table with your family'.

In other words, where you eat and with whom isn't the problem.