morbidly obese,

[ladysybil]

was having a discussion about this, and the best treatment option for people with BMI's ove 40.
My friends were of the opinion that people who are morbidly obese should be managed medically, and be given support and encouragement such as nutrition advice and cbt to help them lose weight. whilst i was of the opinion that you dont become so overweight overnight, and they must have already had these options, which havent worked, so for people who are so overweight ,they should be offered bariatric surgery, such as gastric banding. (i want to stress taht i am not talking about cosmetic surgery here)
the discussion was fun, and continued until my friend said something that just struck me dumb. she said that most people who are in this category are extremely isoloated and never leave the house if they can help it. so how do they get the food that makes them so overweight i countered.....tesco.com she said

I would appreciate mn thoughts on this. maybe this should be in aibu, coz i think tesco should be anwerable to this.

As an "enthusiastic particpant" of the Dutch mental health system, it was explained to me that eating disorders are just an external sign of self-harm and mental instability. For me, I ate my feelings. I'm not stupid - I understood nutrition but if someone made me feel bad rather than saying "fuck off, I don't agree with you because x, y and z" then I'd buy a tub of ice-cream, a kit-kat, packet of crisps, and, and ,and. When you're swallowing food you can't speak up for yourself and are literally swallowing your feelings. Next time someone says something absolutely ludicrous in your vicinity, see if you can notice how easy/hard it is for you to physically swallow.

Anyway, any look around any mental health facility will reveal the very fat and the very thin. Dutch psychiatry like to fix from within - i.e., heal the head before dishing out meal plans.

I have a gastric band btw, which I got fitted without the knowledge of my psych team - because I knew they'd not approve. But, it wouldn't have worked without getting my head fixed. I'm currently overweight right now (had the band loosened for surgery and then pregnancy) - I have to figure out right now whether to get the band tightened up again so I can barely swallow saliva - or learn to love myself again because I'm in a bit of a funk.

Tesco.com perhaps is not at fault here - I'm not sure all overweight people are immobile - although there are always those widely-reported, but, I think in actuality, quite unusual cases of the 65 stone person getting pizzas delivered. My question would be - why are the family facilitating the payment of this rather than why is the pizza place delivering?

That's very interesting Alpinepony, in Belgium they often go for the surgical option first, even when the patient's BMI is under 40 and they are not actually morbidly obese.

When I see people having this operation I think to myself there has to be another way of dealing with the problem.

Thank you for your reply alpine. It sounds as if you are managing your problem well.
I understand exactly what you mean about not tasting the food you are eating, because its self harm, in exactly the same way as if it was drugs or anything else that a person can become addicted to. and to kick start any addiction, i think we need a some sort of major event, and then the follow up, which here i believe is surgery followed by the diet and other support.

I think the family should take some responsibility, but how to get them to? what if the person is on benefits because they cant work because of their weight problems, so its not even thef amily that is paying for it.

belgo, any suggestions? coz i wasnt particularly swayed by my friends suggestions. they seemed a bit wishy washy ideal world type to me.

belgo Yes, I had mine done in Vilvoorde (AZ Jan Portaels) - there was a girl there having it given by her parents for her 18th birthday present, she was not overweight - it was a "just in case" - you know, guaranteeing her figure in to adulthood. And a girl who just couldn't shake that final 4kg.

re: tesco.com well how do they earn the money to pay for the food? Surely whoever is paying for the food (whether the government or the family etc) is more answerable than the shop!

It's an interesting point you make about Tesco.com because I think that society does have a responsibility - the media portraying ridiculous ideals of women; the shops that use vanity sizing; the supermarkets that make it so easy to buy fattening food that I put on weight every time I go to England.

We are designed to survive famine and fast, we are simply not designed to resist temptation eating too much when the food is available, and of course the famine never comes.

belgo - ain't that the truth! Just back from a 5 day trip to the UK and my jeans are snugger than they were before I went. :(

Even if a person is on benefits, food is not free. If the person in question is using their benefit money, who's paying the bills/rent? You do not get to the size of being physically immobile without somebody else facilitating this! 65 quid a week (plus topping up the water/gas/electricity bills) would not be enough to eat myself in to a wheelchair!

Alpinepony I'm glad you've received the help you need, a mixture of Belgium and Dutch health care!

I've seen young women having that operation, and I know one young woman had severe complications when she unexpectedly became pregnant.

Alpine if you're reading see my fred!

My wife had BM of 38 and had a gastric ballon fitted. Our fear over lapband surgery was that there is a small but real danger of death, plus its more expensive (cost was £1500 for balloon in Poland). Surgery may have a genuine, proven advantage of keep weight off in the long term, but to be honest she lost 26kg in 8 months and has lost another 8kg since on a protein diet. I'm not very sure about this, she obviously isn't getting the nutrients she needs from her diet, she hasn't had a period.

The ballon was hell, quite frankly. A week or more of agony and a lot of vomiting and pain over the period, the weight loss seems to be largely down to the enforced bulimia, not 'reduced appetite' as they claim. Wife is adamant this is the only way she could have lost weight becuase she is addicted to food, pure and simple.

I am morbidly obese according to my BMI but I can run up and down several flights of stairs, I go to the gym 3 times a week (and work out hard), my wii fit age is around about the same age as I actually am, and I really don't gorge on food. So I find it difficult to think that my weight is unusual and I am far from housebound. I can fit into an airline seat easily and do the seatbelt up. Obviously I would like to lose weight. My GP has never suggested a gastic band.

I have a BMI of well over 40 and I can manage to get to the shops quite well In fact, I walked 8 miles yesterday quite easily. You can be fat and fit you know.