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/

Do you think ‘the jab’ re: eliminating this, will become increasingly widespread?

How much of a factor does age play, do you think? In that it’s possible to be relatively inactive, but skinny as stick & later, when metabolism inevitably slows, a tipping point?

I lived in a food 'desert' as a kid, as in there were no takeaways anyway near us, we couldn't have afforded them anyway, there are cheap ways yo feed families without takeaways involved

Can I ask, how does the medication make you gain weight? Does it slow metabolism/increase your appetite/affect how your body deals with calories?

I think the NHS guidelines about 5 a day needs to change - it needs to be 10 a day, of VEGETABLES. Not fruit. Fruit is a treat.

When I was obese I thought I was being healthy eating my 5 a day - 2 bananas, grapes, orange juice, some sultanas in cereal and some sweetcorn with dinner.

I shudder now!! I educated myself and lost 6 stone, kept it off the past 15 years because I eat a mostly healthy diet. If you eat a variety of vegetables, stick to wholefoods and healthy fats and complex carbs, it's so easy to stay slim AND be at less risk of cancer, heart disease etc.

Eating healthy food should be a huge priority for everyone, not a convenience.

Sadly proper education is not taught!!

The NHS needs to stop blaming people's health issues on the fact they're fat and look at the underlying reasons. Obesity is often a symptom not a cause.

I am obese. I have been overweight or obese my entire life. Once I was an adult My old GP spent years telling me the reason I suffered with with dizziness and a high heart rate when I stand is because I'm fat. GP would then send me on my way with a reminder to lose weight. There was no advice on how to work around it. I didn't exercise because it would send my dizziness and heart rate wild for days. I Moved house and got a new GP. Was sent for referrals. It turns out I have dysautonomia, and there are various triggers that make my autonomic nervous system forget to constrict blood vessels in my legs, leading to high heart rate, dizziness and fainting/collapse. Triggers include exercise, tiredness and being too warm. I have been given lifestyle and dietary changes and support specific to my diagnosis and I can now go for a walk in warm weather without feeling like I'm going to collapse.

My old GP also spent years telling me I could break my food addiction by just eating less. And that my neurodivergency was anxiety caused by obesity. After seeing a psychiatrist It turns out I have ADHD and it's caused me to dopamine chase my entire life, leading to food addiction. Now I'm medicated and have enough dopamine in my system, I no longer constantly crave food. I don't have a disordered eating pattern and food doesn't rule my life.

I'm gradually losing weight, but I doubt I would have become as fat as i am, if I'd been given the support I needed when I first asked 10 years ago, when I was "only" overweight.

I'm not saying there aren't other factors. But the NHS insistence that obesity is the cause of everything, and the consequent lack of support for people who need it is a big factor to the UK obesity problem.

The threads I read about lunchboxes were always because school were putting higher standards on lunchboxes than their own school meals, and very often it was taken to extremes - eg I remember a case where a school would serve a typical meal (maybe pasta, or pizza) followed by chocolate pudding, but those with lunchboxes had a frube yoghurt taken away because it was deemed too sugary (it might well be sugary, but as part of a mainly healthy meal it’s better than the chocolate pudding and custard that the school was serving up).

My son has a very limited diet and ended up not eating at all at school for years, because well meaning lunch staff always commented on what he had to the point where he refused to eat at all until after school, not even breakfast as he was too anxious. He has an awful relationship with food, and that’s on lunch staff, even after a firm letter from the paed they carried on picking at him and drawing attention to his anxiety based eating disorder.

Too much advice around diets is plain wrong, and starts the process of yo-yo dieting, or bingeing, or a poor relationship with food. It circles around the crap eatwell plate, or change4life advice (with their known links to nestle, and their, quite frankly, awful diet advice) - and this is the problem when you allow government initiatives to lead the advice - it’s not done to help people, it’s done to benefit those in charge.

And then fucking awful people think it’s hilarious to laugh at the fat people, oh they’re so stupid, they’re so lazy, and it just exacerbates the problem, and completely ignores the societal problems that have set up 2/3 of people to be overweight or obese.

This is the problem - it's an extremely emotionally loaded issue so it's so hard to have a sensible conversation about. @dumple obviously every case is different, and OP isn't trying to have a go at you.

I was obese and it led to me having type 2 diabetes. I lost all the weight in the end after being scared for my future and I'm not obese anymore and I don't have diabetes. That in itself scares me into staying healthy, that I could literally have got diabetes because of the way I was living.

Not saying that to judge anyone at ALL we all have different reasons and causes for being overweight and some cases are impossible or extremely difficult to resolve - my own case is surely what a lot of people face, though, failure at diets, not shifting the weight, not really committing until there was a big scare and something finally clicked. It's a major cost to the NHS that it can't afford to support.

Yes I have read about something called “set point weight” where your body basically fights you to maintain a weight.

Yes it’s calorie dense but people don’t tend to overeat it, like the would crisps, chocolate, cake etc. I think those are the things that cause the issues rather than olive oil.

Obesity is the new smoking. It takes along time to change people's believes and habits but it can done.

Absolutely this! Very good points! Glad you have the right diagnoses and treatments now Sconesandgravy

So often obesity is a symptom not a cause.

Fruit is a treat....fucking hell. I eat lots of fruit - not fat. Stop spreading misinfomation. Fruits are full of vitamins, fibre, antioxidants etc. The key is moderation like with everything.

Chocolate is a treat. Cake is a treat. Fruit...it's a whole food that humans are supposed to be eating. Bloody hell.

Lots of people need to be careful with fruit as it’s basically sugar - natural sugar, but still sugar.

You only have to look at what’s changed over the last 50 years-it ain’t human physiology. It’s the rise in ultra processed foods. We’re all slim in my family and we eat pretty much what we want. We just have minimal upfs in our diet. I grew up in one of the most deprived boroughs in the country. Barely anyone was fat-but we were all poor. Now, the majority of people living there are fat.

I eat lots of fruit and I agree with pp. If more people ate fruit instead of chocolate/biscuits/cake they might not have such weight issues.

The NHS guidelines are correct.

Fruit does not make you fat - the bananas, grapes and orange juice you ate daily is not why you were obese - I eat a comparable amount daily in the summer, less in the winter, and I’ve never been overweight.

But when places like schools try to encourage healthier eating, they get called lunchbox nazis.

Imo, it’s because they enforce rules without thinking! DD had a BMI of 13, aged 16 and no puberty. (She had been previously in the first stages of an eating disorder, treated by Camhs) The consultant endocrinologist said she needed to gain 2 stone for her periods to start. She was referred to a dietitian, who recommended 4 meals a day, high calorie snacks mid morning and mid afternoon and no healthy eating, because DD could not increase the volume much of what she ate at meals. She was told for instance to buy a cookie to go with her school lunch.

The school said she couldn’t buy a cookie, unless she had a piece of fruit too - which was all too much extra volume for DD!

Why did school staff not look at her and think “She’s extremely thin - she doesn’t need healthy eating!” Why are rules arbitrarily applied, by people who were not HCPs, without thinking, when DD was under medical supervision and had a tendency to eating disorder.

There was an article in the BMJ talking about the failures of government messages for decades on calorie counting, risking eating disorders in those prone to them:

https://www.bmj.com/content/370/bmj.m3084/rr

You might not be eating enough. I am doing slimming world and see it all the time. People who lose weight fine, then they get near target, start exercising more and being more restrictive and they stop losing weight. Apparently, your body works out that it needs what you do eat and doesn’t let go. Also, make sure you are drinking loads of water, or your body will hold onto it. It happened to me when I was near target. I just ate protein, fruit and veg and didn’t have any ‘syns for a week. I put on 3lb and was gutted. The next week, I used my 15 syns a day, drank lots of water and ate loads of pasta; I lost 8lbs.

feeding a family is expensive. It is also time consuming and labour intensive. Planning/ thinking of ideas/ shopping/ unpacking/ practising or learning recipes/ cooking/ making packed lunches/ 3 meals a day plus everything in between / washing up/ clearing up, cleaning surfaces etc.

No one has time to do all this well whilst working to earn the necessary money, raising a family, having some kind of pleasure- social life/ hobby/ downtime.

So we take short cuts. Which are generally not healthy. Convenience ingredients, ready meals, processed foods, the car, the bus, saying no to exercise/ activity.

Humans have made a rod for their own backs having to work 5 days a week to pay for food and shelter. And any spare money wasted on useless material goods we're manipulated into wanting.

Is suppose the question would depend on your disability. People can still be active and live an healthier lifestyle and be classed as disabled. It's about finding what works for the individual and the disability in question of course. Everyone is different and what works for someone may not work for someone else

I’m classed as mobility obese and I don’t want to be, but having pcos and then having 2 children has taken a toll on me, I cook healthy meals I don’t buy junk food as I know I’ll eat it. Every time I’ve asked for help there isn’t any due to the pcos, all I was told is that it will be more difficult for me to lose weight that an average person and sent on my way. And also I’m now suffering from long covid which means I can’t just exercise or go for a walk and again I was told nothing they can do to help me

@AutisticLegoLover I understand it's possible to loose weight my point was if I was eating basically the same amount of calories and doing the same level of exercise how is it possible that they remained super slim and I did not loose weight. Surely if it is all kcal and exercise based they would have gained weight/I would have lost!

I have been thinking this too. I don't want fat-shaming as such because it's unkind but perhaps the more we accept obesity and applaud it, the problem just gets worse. I have a friend, very obese; who says if people don't like what they see they can look away. On one level, brave; but she is ignoring potential health issues whilst consuming another cupcake. Perhaps we can never sort this out, sadly.

This would only be right if both individuals had the same tdee (total daily energy expenditure) ie identical body mass, muscle mass, quantity of activity and exertion in activity. It’s impossible to be sure that these things are the same.
It would also need both people to be 100% accurate in weighing all food consumed, also unlikely.
Theres a further argument that the “quality” of the calories may also have a part to play in weight loss.

You can't equate coming down hard on smoking with coming down hard on fatness. You have to eat; you don't have to smoke