What should the government do to reduce obesity at the societal level?

[waistchallenge]

We're the fattest country in Europe and the upshot is what you see here: people posting threads in desperation about their weight loss struggles. I think we can probably all agree it would be easier to never have gotten overweight in the first place and to never have had to go through these weight loss efforts and experiences.

Apart from the sugar tax, I cannot see that the government has done much, if anything, to reduce obesity in this country; it's higher than ever.

I'm asking here because we all have experience of this to be on here, what-if anything- should the government do to reduce obesity in this country? What would have helped you? Or is it all just ultimately a question of personal responsibility?

Working from home is one of the worst things for my weight management. I snack, I am constantly within reach of food, and I'm alone so I don't have the restraint of not wanting coworkers to think I'm a greedy fuck if I eat half a dozen biscuits on the trot.

I think it helps to remember that you’re probably a far nicer person than those who judge overweight people as being lazy, greedy and not clever enough to understand how calories work.

I am not surprised, some of the comments have been awful.

I bet you are an awesome person and the world would be a far worse place without you.

Overall people are way fatter than they used to be...and honestly I think a lot of that is society saying it's OK to be fat. It didn't use to be.

Having spent time in Japan, I can definitely see how being overweight is more socially acceptable in the UK (and the US) than in countries like Japan and South Korea.

In Japan, for example people care greatly about what other people think of them and are reluctant to break cultural taboos related to food. Walking down the street chomping on a huge packet of crisps, for example, is a big no-no and most Japanese people would feel embarrassed to be seen eating in that way. You will also very rarely see people eat on public transport. In addition, parents are generally quite strict with their children about eating between meals.

So I do think that as a society we've become too accepting and used to many of us being overweight.

But how do you know whether the fat person you’re judging has a medical condition? Huge numbers of people (15% of the population) are prescribed antidepressants which are notorious for weight gain. Similarly, women on HRT or hormonal contraceptives. I have a testosterone implant, my specialist warned me that I’d probably gain around half a stone. I’ve managed to stay level but only by eating 1000 calories a day, which is really bloody hard. My DH was on drugs for a brain tumour and lost 3 stone without dieting when his treatment stopped. My DM is routinely prescribed antipsychotic that cause huge weight gain - to the point where she ended up with type 2 diabetes. Her weight fluctuates massively depending on her current treatment regime. There are thousands of conditions and drugs that cause weight gain, not just steroids.

Similarly, women on HRT

There's very little evidence that taking HRT causes weight gain.

it would be illogical to centre discussion about reducing the country's obesity problem on a small subset of the population with largely unavoidable weight gain due to medical issues

I don't think this is a 'small subset of the population' though.

8.6 million people in the UK are prescribed antidepressants.
2.3 million people in the UK are prescribed HRT
1 million people in the UK are prescribed steroids each year
15 million people in the UK (1 in 4) experience mental health problems each year
20 million people in the UK (1 in 3) suffer with a musculoskeletal health issue
13 million people in the UK (1 in 10) suffer with IBS

These aren't a 'small subset' by any means.

Really? It’s listed as a common side effect on the advice label of mine, along with fluid retention.

On the one week l spent on HRT l ate my weight in crap. It was crazy.

HRT doesn't cause weight gain, but during peri and menopause the bodies metabolism changes hugely and millions of women are caught unawares and pile on weight very quickly before they realise.

I put on 2.5 stone in 2 years after been a totally steady weight my entire life 18 to 46.

I have now nearly lost it all now but it was definitely perimenopause that changed my metabolism.

Quite, it's mad that this conversation isn't happening when so many drugs list weight gain as a side effect

The poster I was referring to was discussing people on steroids.

Again, I'm not judging anyone.

On the one week l spent on HRT l ate my weight in crap. It was crazy.

Many of us are on HRT and have to reduce what we eat as our metabolism slows. I have certainly vastly reduced my food intake and try to exercise more. It's not easy.

Again, it's taking personal responsibility rather than blaming HRT.

Unrelated, but what a revelation!!! HUMAN ONLY PARKS!!! I am so goddam sick of dealing with dogs and having to be hyper vigilant whenever I take my 1 year old to the park. Dogs running in the kiddy play area, dogs running wild, risking knocking little ones over, jumping up etc. I AM SO SICK OF DOGS (More so actually, their entitled owners)

Medication prescription has massively increased over the same period that obesity has increased so it should definitely be part of the discussion. I say this as someone with a long term condition that requires medication. I just question why we are now taking so much more medication than we were 50 years ago.

I wonder how Japan compares for prescriptions of steroids, hormones, antidepressants and antipsychotics?

I sense that those who are overweight on this thread are judging themselves far more harshly than others are judging them. Self-worth should not be tied to weight.

I don't know what the answer is and from reading this thread there is no answer. Everybody is arguing for and against the sane points so how can government policy effect change?

How other countries prescribe is definitely a question worth asking.

In my case their are drugs for my condition that are more expensive but don't cause weight gain ... That's why the NHS /public health needs to acknowledge the role of prescribing

I'm not overweight any more (now I am off steroids) and I think the tone of the thread is unpleasant so I don't think people are being insensitive.

Cynically, I think there's big bucks for big pharma in getting people onto medication. The more pills the doctors prescribe, the more money big pharma makes.

Agreed, but equally for many of us we would have just died of these conditions or been severely restricted by them.

People with my condition were generally bed bound and died very young until medication became available

I sense that those who are overweight on this thread are judging themselves far more harshly than others are judging them. Self-worth should not be tied to weight

Just a skim read of this thread sees overweight people being described as not able to cook, not able to take personal responsibility, as lacking willpower, as too lazy to walk to places instead of taking the car, as making excuses for their weight, as not understanding how calories work, etc etc. It reeks of gaslighting to me to then say that they’re judging themselves more harshly than others are judging them.

If you're saying patients would have died without these prescription drugs, then there's not really a conversation to be had, is there? I mean, what's the conversation going to be: shall we let people die or let them become overweight?

Good choices can be hard. Today I have bad period/endometriosis pain and feel queasy on and off. I've been gardening for my mum-digging out plants and replanting them in sodden clay soil, weeding, planting new stuff. Not ideal with the backache I've got but necessary. Anyway, I really fancied a chip barn drowned in vinegar and salt from the chippy on the way home. It's a detour and the longer way home but worth it. Instead I've come straight home and have my usual Greek yogurt, fruit compote, chia seeds and honey with a satsuma and a cup of tea. My choices are not always virtuous (not at all)) but I've been trying hard to make better choices especially after 2 serious health scares. It would have been so easy to get that chip barm.

I've been on multiple courses of steroids over the years, antidepressants, hormonal contraceptives. Yes, they all made me hungrier. It sucks, but the choices of what to eat were mine. When I made poor choices I ended up with a BMI of 26.8. Since making better choices it's 21-22. It's hard and feels like a case of constant vigilance but it's worth it to me. I aim for balance generally and try to demonstrate good habits to my children.

I would say it's definitely a conversation to be had. A vital one.
If a doctor is prescribing a medication they should also be discussing feasible ways that patients can mitigate certain side effects. Patients should be referred to health support to assist with improvement to all aspects of their health, bespoke help - personal to the patient.
This is happening in a few places with social prescribing but not nearly widespread enough yet. It works too. What's the point of taking painkillers for a painful elbow for years when some well timed physio and maintenance exercises could irradicate the pain forever?

I am hoping and waiting for GP surgeries to become 'health centres' with a physiotherapist, dietician and mental health support team on hand without the need for lengthy waits for hospital referrals.

My children's primary school has not brought back the sports clubs after lockdown. My 10 year old has been begging to reinstate the boccia team but they won't do it. We live in a deprived rural community and for some children, the after school football club was the only out of school sports their parents could afford.