/ The NHS is not fit enough to deal with obesity

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The Lemming - on 01 Jan 2013
A report says that the NHS can not cope with obese patients and that obesity is going to get worse as the years progress.

So, who's fault is this and how/why has this become such a world wide, in the western world at least, problem?

Only a hill - on 01 Jan 2013
In reply to The Lemming:
Because humans have evolved to gorge themselves with high calorie food when it is available. In today's world, these foods are plentiful and cheap, but we have not yet evolved to cope with our new circumstances. Without self control we would all eat until we became obese.

On the other hand, if we ate the average Western diet from 500 years ago, most of us would be malnourished...
abzmed on 01 Jan 2013
In reply to The Lemming:

Back in the 80's when the Government adopted the current "low fat good" thinking, food scientists crammed food with all the refined junk that our body is unable to process properly and converts directly to fat.
To quote Dr Chris Fenn "we have a stone age metabolism in a modern world . ." Another was "not all calories are the same".

Corn Syrup, Glucose fructose syrup, any of that sort of food scientists dream product will cause you to rapidly put on weight / fat.
In reply to The Lemming: With some exceptions, of course, we are mostly all responsible for the balance between calories in and calories out. I have no doubt whatsoever that that statement will be misinterpreted in some bizarre UKC way and I will be asked "so are you saying XYZ [some derogatroy and prejudiced thing]?" when XYZ does not follow from my statement, but where XYZ is a leap from what I have said. I am not judging anyone, I am just stating something about calorie intake/expenditure.
Uluru on 01 Jan 2013
In reply to The Lemming: The BBC is reporting that 25% of adults are obese and this is costing the NHS £5 billion/yr.

Maybe we should all have a new years resolution to adopt a fatty and get them exercising so this money could be put into something more useful.
vark - on 01 Jan 2013
In reply to The Lemming:
In children it is the fault of the parents. Adults have only them selves to blame.

People in general are lazy and stupid. They buy whatever crap is available and shovel it in until they only have room for massive amounts sugary drinks. They then do nothing to burn off any of the many thousands of calories.

Last nights highlight was a fat bloated whale of a woman who refused to put her packet of crisps down for a moment so a nurse could do her ECG. The armed police present in the department refused to lend we a weapon with which I could have resolved the situation.

There are a number of things we should do:
- refer obese children to social services so interventions can be put in place. It happens routinely for children who are beig under fed
- make mobility scooters presciption only. You get them for medical conditions but not because you are too fat and lazy to drag your arse around the shopping centre.
-Stop making evrything bigger to accommodate fat people and start making things smaller. I would include in this everything from cars to doorways and
ambulance/ ED trolleys.
- ban all of the programmes that promote being fat. People are being convinced by the likes of How to look good naked and other such nonsense that it is Ok to be fat so long as you feel good about yourself. It is not OK. If you want to feel better about yourself lose some weight
- finally, render down all of the obese people to produce some kind of human biofuel.
vark - on 01 Jan 2013
In reply to abzmed:
> (In reply to The Lemming)

> Corn Syrup, Glucose fructose syrup, any of that sort of food scientists dream product will cause you to rapidly put on weight / fat.

Only if you eat found that contains it. If you avoid eating processed crap you can escape a lot of these junk calories quite easily
vark - on 01 Jan 2013
In reply to nickinscottishmountains:
> (In reply to The Lemming) I am not judging anyone


I think that is part of the problem. As a society we are allowing people to beleive it is fine to be as fat as you want.

abzmed on 01 Jan 2013
In reply to vark: vark:
> (In reply to abzmed)
> >
> Only if you eat found that contains it. If you avoid eating processed crap you can escape a lot of these junk calories quite easily

I fully agree. I personally avoid the stuff like the plague.
It goes then off into a Social class type of thingy with the lower priced foodstuffs / garbage being the highest containers of said junk.
A sort of self perpetuating problem.
Healthy food is becoming out of the affordability of those over represented in the fat classes.

johncook - on 01 Jan 2013
In reply to abzmed: On the topic of corn syrup there is the non-PC joke which goes.
In 1945 the Americans killed half a million Japanese with the nuclear bomb. The Japanese have got their own back, peacefully, by inventing corn syrup!
johncook - on 01 Jan 2013
In reply to The Lemming: Recent research shows that in the NHS over weight and obese staff are higher in proportion than thay are in the general population. I will try and find the reference and post it!
In reply to johncook: As an NHS employee, I really wouldn't be surprised if that turned out to be true.
Philo22 - on 01 Jan 2013
In reply to vark:

> - ban all of the programmes that promote being fat. People are being convinced by the likes of How to look good naked and other such nonsense that it is Ok to be fat so long as you feel good about yourself. It is not OK. If you want to feel better about yourself lose some weight

Damn right. Couldn't have said it better.

vark - on 01 Jan 2013
In reply to johncook:
We also tend to drink more and Takes lots of drugs of abuse. It doesn't make it right.
If it was up to me the NHS would have a restriction on employing fatties. I have suggested it at work but we are apparently not allowed
vark - on 01 Jan 2013
In reply to abzmed:
> (In reply to vark) vark:
> [...]
> It goes then off into a Social class type of thingy with the lower priced foodstuffs / garbage being the highest containers of said junk.
> A sort of self perpetuating problem.
> Healthy food is becoming out of the affordability of those over represented in the fat classes.

I am not convinced by this argument. I would agree it is difficult to afford a healthy diet if you do not put any time/effort into sourcing and preparing food. It is also influenced by what you choose to eat. If you want to eat meat every day it will be expensive or you will resort to cheap processed crap.

What we need to do is equip people with the skills to prepare food and re-educate their palates.
vark - on 01 Jan 2013
In reply to abzmed:
Forgot to mention, one of the main dietry sources of corn syrup is fizzy drinks. This is nothing to do with class or affordability it is purely down to people drinking sugary crap all day.
rwong9 - on 01 Jan 2013
In reply to The Lemming: I agree 'the NHS is not fit to deal with obesity' and it shouldnt be considered the responsibility of the medical profession to 'treat' and medicalise everyone who is overweight/obese. It really should be a politically solved problem ie increased and cheap/free opportunities to exercise and mandatory 'trafic light' food labelling of fat content with perhaps the sort of messages attached to cigarette packaging to junk food.
Tall Clare - on 01 Jan 2013

I heard a rumour that allegedly middle-class people can be obese too. It can't be true, can it?

Yes, encourage individuals to take responsibility, but also make society take responsibility - stop encouraging people to be scared to let their kids play outside. Change the workplace so that the majority of people aren't doing sedentary jobs. Improve public transport so getting in the car isn't the most obvious choice. Discourage people from believing that playing golf will help you to lose weight. Disrupt the thinking that says we all 'deserve' to be 'pampered' and that we 'deserve' that bottle of wine. Bring clothes sizes back to what they were twenty years ago to frighten people into action, and close the 'big and tall' shops for men (why is it that you never see tall men in those shops, only big men?)

Yours,
A Fatty
Lesdavmor - on 01 Jan 2013
In reply to The Lemming: How many times on a flight have you had to slacken the seat belt from the previous occupant? In my case (c. 30 inch waist),never
Tall Clare - on 01 Jan 2013
In reply to The Lemming:

The reports I've heard today emphasise liver problems as a particular issue - it's not just about crappy food, but about the alcohol we drink.
vark - on 01 Jan 2013
In reply to Tall Clare:
>
Change the workplace so that the majority of people aren't doing sedentary jobs. Improve public transport so getting in the car isn't the most obvious choice.

Difficult to change from sedentary jobs because we haven't got much else. What about making provision of showers, changing rooms and secure bike parking mandatory when you hit a certain number of employees. There could then be a second level of compulsory on site gyms when you hit a higher level. I don't for a minute think this would be achievable in the current financial climate.

The fundamental problem though is one of input. The amount of exercise required to burn off excess calories is too great to be easily accommodated by most people. They will always be able to shovel crap in faster than they can use it up.

The formula here
http://www.runnersworld.com/weight-loss/how-many-calories-are-you-really-burning-0?page=single
suggest 88 calories per mile for a 10 stone runner. According to Mars' website a 58g mars bars contains 260. There is no way you can run off they excess calories many people consume


Orgsm on 01 Jan 2013
In reply to Tall Clare:
> (In reply to The Lemming)
>
> The reports I've heard today emphasise liver problems as a particular issue - it's not just about crappy food, but about the alcohol we drink.

The liver bit wasn't just about alcohol. It was saying that poor diet and lack of exercise also lead to liver disease etc., same as alcohol abuse...

Tall Clare - on 01 Jan 2013
In reply to A Game of Chance:

Yep - but it's all part of the same picture. We shouldn't pick and choose the bits we don't want to apply to us - after all, even amongst the super-honed athletes that make up UKC's demographic, there are bound to be weight, health, mental health, social, narcotic problems.
Tall Clare - on 01 Jan 2013
In reply to vark:

An interesting point about a lot of your suggestions is that something similar happened in Finland in the late 60s, iirc, when the government decided to do something about the horrendous health of a lot of Finnish people - there were inter-town stopping smoking competitions, inter-town weight loss challenges, etc. I know there were some flaws in the programme, but ultimately it changed a mindset and helped to create a healthier population.
vark - on 01 Jan 2013
In reply to Tall Clare:
With social media there are great opportunities for competition. I have no reason to push hard when cycling to work other than to try and beat colleague's times on various Strava segments. It has been be far the best motivational tool I have come across in a long time.
Tall Clare - on 01 Jan 2013
In reply to vark:

My partner's a big fan. As he says, it's not necessarily about being the fastest, it's about beating your friends :-)

I know other people have found the likes of UKC's Fit Club and other forum-based weight loss/fitness threads really helpful.
Ben Sharp - on 01 Jan 2013
In reply to vark:
> The formula here
> http://www.runnersworld.com/weight-loss/how-many-calories-are-you-really-burning-0?page=single
> suggest 88 calories per mile for a 10 stone runner. According to Mars' website a 58g mars bars contains 260. There is no way you can run off they excess calories many people consume

I'm never totally convinced by those formulas, it's very difficult to calculate the extra calories burned by increased metabolism, muscle growth etc. so the formulas just tend to forget about it. Anyone who exercises regularly knows how much quicker you become hungry, even on days when you aren't doing anything strenuous.

The the OP:

Quite a lot of fat-haters on here, although it makes a nice change from the winging anti-smoking/"smoking is bringing down the NHS" lobby.

I think people should step back for a second and consider how many people are really happy to stand up and say they are 100% sure about the causes of obesity, sure enough to say that obese people have no one to blame but themselves. There's plenty to suggest that we don't fully understand the causes of obesity and it's far too easy to jump to the conclusion that it's all just a lack of willpower. Anyone who thinks it's just a case of putting down the fork is grossly misinformed. No one complains about depressed people costing the NHS too much money, be sure that obesity isn't an illness before you pass judgment.
Ben Sharp - on 01 Jan 2013
Another thing is that some people seem to put on weight incredibly easily compared to others. I know people who eat pitifully compared to myself and yet pile on the pounds while I know that even if I stopped exercising I could eat like a machine and probably only get slightly tubby.
deepsoup - on 01 Jan 2013
In reply to Ben Sharp:
Ha ha. You're seriously underestimating the ability of many UCK posters to be judgemental pricks, on this of all issues! :O)
Indy - on 01 Jan 2013
In reply to vark:
> (In reply to The Lemming)
> In children it is the fault of the parents.
What I find interesting in fat babies/small children is whats making them want to eat more or beyond whats healthy for there activity levels i.e. over eat.
ads.ukclimbing.com
Indy - on 01 Jan 2013
In reply to Ben Sharp:
>
> I think people should step back for a second and consider how many people are really happy to stand up and say they are 100% sure about the causes of obesity, sure enough to say that obese people have no one to blame but themselves. There's plenty to suggest that we don't fully understand the causes of obesity and it's far too easy to jump to the conclusion that it's all just a lack of willpower. Anyone who thinks it's just a case of putting down the fork is grossly misinformed.

I'm currently reading "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease" and your correct there seems to be far more to obesity than will power.
The Lemming - on 01 Jan 2013
In reply to Ben Sharp:
>
> The the OP:
>
> Quite a lot of fat-haters on here, although it makes a nice change from the winging anti-smoking/"smoking is bringing down the NHS" lobby.
>
> I think people should step back for a second and consider how many people are really happy to stand up and say they are 100% sure about the causes of obesity.

I am 100% sure that obesity is caused by eating too much continuously and excessively beyond your physical activities.

Don't know if you watch "I'm a celebrity" but this year there were at least two obese celebs in the jungle. During two weeks of no access to a ready supply of food beyond what the contestants won in challenges, Colin Baker lost 2 stone while Rosemary lost even more than that.

Here we have a practical experiment in the full gaze of the British masses that showed that if you eat less you lose weight.

Lets not go for any of that 'big boned' crap and call a spade a spade.
vark - on 01 Jan 2013
In reply to Ben Sharp:

> I think people should step back for a second and consider how many people are really happy to stand up and say they are 100% sure about the causes of obesity, sure enough to say that obese people have no one to blame but themselves. There's plenty to suggest that we don't fully understand the causes of obesity and it's far too easy to jump to the conclusion that it's all just a lack of willpower. Anyone who thinks it's just a case of putting down the fork is grossly misinformed. No one complains about depressed people costing the NHS too much money, be sure that obesity isn't an illness before you pass judgment.


Assuming human physiology conforms to the fundamental laws of thermodynamics then the underlying cause is simple- energy is being supplied to the system in excess of that which is used for work. There may be some debate to be had around why some people gain weight more easily than others but the fundamental problems has to be input vs. output.

The issue of some people gaining weight whilst apparently eating little may just be down to them not admitting how much they eat. The Secret Eaters programme on channel 4 was interesting as they followed people in secret and observed what they ate. In all cases there was a massive difference between the amount of calories the participants consumed according to their self-recorded food diary and they amount recorded through observation, in some cases it was almost twice as much.
vark - on 01 Jan 2013
In reply to Indy:
> (In reply to vark)
> [...]
> What I find interesting in fat babies/small children is whats making them want to eat more or beyond whats healthy for there activity levels i.e. over eat.

It is simply down to the amount of food provided and they way in which it is provided and it can start very early. Bottled fed babies tend to be more overweight than breastfed babies because it is much easier to provide excess calories in a bottle.

Once you start overfeeding a child they come to expect it and it is easy to get into a downward spiral.

The other key factor is the calories density of the food and drink supplied.
Ben Sharp - on 01 Jan 2013
In reply to The Lemming: So you're saying that if you take an obese person out of their daily lives and force them to exercise on a reduced diet they'll lose weight? Thank f*ck someone conducted that pointless "practical experiment" to tell us something we already know.

It's like saying that you are 100% sure that road deaths are caused by people driving cars. A true but pointless and small minded response, do you read the Sun as well as watch Im A Celeb*? Road deaths are sometimes caused by people driving badly, which in turn was probably caused by something else. Sometimes they're caused by road conditions, sometimes they're caused by badly maintained vehicles (again which was caused by something else), sometimes they're just freak accidents.

Obesity is the same, the only thing you do by saying that it's caused by people overeating is you fuel hatred towards people who are overweight, which helps no one. There is no other topic where one would so quickly settle on a single preliminary cause without asking what factors may lie behind it. There are plenty of causes of obesity and I think we should look at the physiological and psychological causes before looking at peoples will power and denegrating fat people on celebrity TV shows. What would happen if you turned up to a focus group on tackling drug abuse and said "it's so simple, people just need to stop taking so many drugs". You'd be laughed out of the room, with obesity it's ok.

There's a reason why they paraded overweight people on that filth, it's the same reason they fill those putrid magazines with similar stories - because the British public love pointing and laughing at people and watching a fat person forced to lose weight is exactly what we love to see. It's great to get that vindication that the only reason fat people are fat is that they all stuff their face, the only reason you're not is that you have the strength and will power to hold back. How we all love to point and laugh at others.

*sorry but this thread was painfully overdue a newspaper reference
hokkyokusei - on 01 Jan 2013
In reply to Indy:
> (In reply to Ben Sharp)
> [...]
>
> I'm currently reading "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease" and your correct there seems to be far more to obesity than will power.

Rubbish. I'll admit that the food we have easy access to is not necesarily the food that is best for us. I'll admit that psychology plays a large part in weight loss (will power over what we put in our mouths). I'll even admit that it's possible that some people can extract more calories from a given portion of the same food than another person.

But, the fact is, a certain portion of food contains a certain amount of calories. You cannot absorb those calories unless you put them in your mouth, and there are a maximum amount of calories that can be extracted from any given amount of any given food.

This isn't my opinion, it isn't some dietry fad, it isn't even biology or chemistry, it's just physics.

Calories in > calories out = weight gain.

The Lemming - on 01 Jan 2013
In reply to Ben Sharp:

Cock!
colina - on 01 Jan 2013
In reply to The Lemming:
so many fast food shops in the high street now so probably no incentive to cook a well balanced meal.
A bit extreme but maybe a "shoot on site" policy should be brought out on all salad dodgers ?
browndog33 - on 01 Jan 2013
In reply to Ben Sharp: Very well said.
Mark.
Ben Sharp - on 01 Jan 2013
In reply to hokkyokusei: That was quite a long post to say that eating too much is down to putting too much food in your mouth.

> Calories in > calories out = weight gain.

Calories in - affected by people's upbringing and food during childhood, food addiction, lack of education, hidden calories, advertising, depression, inability to cook, finances.

Calories out - societal lack of exercise, resting metabolism, sedentary jobs.

It's so simple, it's just physics.

I personally think there is more too it than that, when I was a student I did zero exercise and led a sedentary life, ate large amounts of unhealthy food, lots of fry ups, everything cooked in dripping etc. and drank large amounts of energy drinks and lots of alcohol every night. This was over 4 years and people still complained that I needed to put on weight. Maybe people do hide some of the things they eat but I know people who would put on massive amounts of weight living like that. The body isn't as simple as burning a biscuit and giving me the physics and calorie lecture, don't get me wrong, I'm glad you think you have a complete understanding of the complexities of the human body but it isn't a simple in/out machine and peoples bodies react differently to the same inputs.
hokkyokusei - on 01 Jan 2013
In reply to Ben Sharp:
> (In reply to hokkyokusei) That was quite a long post to say that eating too much is down to putting too much food in your mouth.

Yes, it was long, but you don't seem to have read it.

<snip> - a lot of stuff that's actually covered by what I originally wrote.
stroppygob - on 01 Jan 2013
In reply to The Lemming: My missus had an interesting suggestion, in the same way as Australia has made plain packaging for fags mandatory, no fashionable clothes over size 16 should be made/sold.
vark - on 01 Jan 2013
In reply to Ben Sharp:
> (In reply to The Lemming) So you're saying that if you take an obese person out of their daily lives and force them to exercise on a reduced diet they'll lose weight? Thank f*ck someone conducted that pointless "practical experiment" to tell us something we already know.

So you agree that input>output causes obesity?

>

> Obesity is the same, the only thing you do by saying that it's caused by people overeating is you fuel hatred towards people who are overweight, which helps no one. There is no other topic where one would so quickly settle on a single preliminary cause without asking what factors may lie behind it. There are plenty of causes of obesity and I think we should look at the physiological and psychological causes before looking at peoples will power and denegrating fat people on celebrity TV shows.

We can medicalise obesity as much as you want. We can search for the underlying psychological reasons why someone is stuffing crap down their throat for all of their waking hours. Unfortunately if they are to lose weight they will have to reduce the imbalance between input and output.


What would happen if you turned up to a focus group on tackling drug abuse and said "it's so simple, people just need to stop taking so many drugs". You'd be laughed out of the room, with obesity it's ok.
>

Except in the case of opiates, drug and alcohol addiction is treated by abstinence. A lot of the treatment used alongside abstinence will address the underlying reason the person is using drugs and alcohol but they still have to stop using. Unfortunately there seems to be a reluctance to tell fat people they should consume less.


Ben Sharp - on 01 Jan 2013
In reply to stroppygob:
> (In reply to The Lemming) My missus had an interesting suggestion, in the same way as Australia has made plain packaging for fags mandatory, no fashionable clothes over size 16 should be made/sold.

There kind of aren't
Tall Clare - on 01 Jan 2013
In reply to Ben Sharp:

Someone from the Royal College of Physicians (from which the report originated) was on the radio saying 'let's sort out the causes, not just try to manage the effects' - essentially what you're saying, and it makes a lot of sense to me too.
vark - on 01 Jan 2013
In reply to Ben Sharp:
> (In reply to hokkyokusei) That was quite a long post to say that eating too much is down to putting too much food in your mouth.
>
> [...]
>
> Calories in - affected by people's upbringing and food during childhood, food addiction, lack of education, hidden calories, advertising, depression, inability to cook, finances.
>
> Calories out - societal lack of exercise, resting metabolism, sedentary jobs.
>
> It's so simple, it's just physics.
>
> I personally think there is more too it than that, when I was a student I did zero exercise and led a sedentary life, ate large amounts of unhealthy food, lots of fry ups, everything cooked in dripping etc. and drank large amounts of energy drinks and lots of alcohol every night. This was over 4 years and people still complained that I needed to put on weight. Maybe people do hide some of the things they eat but I know people who would put on massive amounts of weight living like that. The body isn't as simple as burning a biscuit and giving me the physics and calorie lecture, don't get me wrong, I'm glad you think you have a complete understanding of the complexities of the human body but it isn't a simple in/out machine and peoples bodies react differently to the same inputs.

I lead a similar student lifestyle. The reason I didn't gain weight was because reasonably frequently I would have such a hangover I wouldn't eat for 24hrs.


Your last point is clearly wrong. The reason we are able to treat patients in broadly similar ways and expect drugs to have similar effects in most patients is because there is largely the same physiology in all of us. There is genetic variation in most processes but in most cases this is not clinically significant. The variations in obesity is much more likely to be due to behavioural factors rather than variations in physiology
vark - on 01 Jan 2013
In reply to colina:
> (In reply to The Lemming)

> A bit extreme but maybe a "shoot on site" policy should be brought out on all salad dodgers ?

I don't think this would be very sporting unless done from a significant distance.
Ben Sharp - on 01 Jan 2013
In reply to vark:
> So you agree that input>output causes obesity?
Of course I do. My point was that you're saying something so blatantly obvious that it is pointless to mention, as I explained, I also think that people driving cars causes accidents, but that tells us nothing.

Please quote where I said people could lose weight without reducing the amount they eat in proportion to their calorific needs? I'm pretty sure I said no such thing.

You seem to be under the misapprehension that suggesting we should look at what causes overeating means that overeating is actually fine and people can still lose weight while doing so. I have no idea how you have come to that ridiculous conclusion and find it slightly baffling that you think anyone believes that.

We have an obesity epidemic on the horizon, tackling it without tackling the root causes is like tackling a drought with a watering can. If you think that the crisis can be cured by people eating less then you are blind to how humans behave, if eating less isn't making people thin now then what do you think it will do when we have another one, two or three generations who are obese. There are greater causes at play than greed and if we don't tackle them then dieting will not scratch the surface.

Fat people starve themselves all the time, they go on fad diets because they listen to people like you and yet they're still fat. Not because they've broken the laws of physics but because they're humans and they don't behave like a simple equation. Over simplifying the problem into calories in > calories out will not solve the problem of obesity.
Ben Sharp - on 01 Jan 2013
In reply to vark:
> there is largely the same physiology in all of us...The variations in obesity is much more likely to be due to behavioural factors rather than variations in physiology

I don't agree, peoples bodies change over time and it's naive to think that behavioral factors don't affect the physical body. I think even in my more egotistical moments I would ceed the fact that Sylvester Stalone could probably take me down in an arm wrestling competition-yet we share the same physiological make up. It isn't a huge stretch of the imagination to say that the way someone is brought up and what foods their body learns to tolerate as a child will have an impact on how their body handles it in the future.

You say that peoples bodies react to drugs in a similar way but that really depends on how far you stretch the word similar. Give two people the same dose of cannabis and you may well observe two wildly different reactions. I didn't say that people don't respond to food in similar ways, but that doesn't mean identical. People respond to food in very similar ways, in the ways it delivers nutrients and in the way it supplies energy. That doesn't mean that two peoples bodies can't respond to junk food in different ways, one by putting on more weight than the other. And it doesn't need to be much more, you only need to be storing a small amount of extra fat a day to end up obese.
nufkin - on 01 Jan 2013
In reply to Tall Clare:
> (In reply to Ben Sharp)
>
> Someone from the Royal College of Physicians (from which the report originated) was on the radio saying 'let's sort out the causes, not just try to manage the effects' - essentially what you're saying, and it makes a lot of sense to me too.

Agreed. Shooting fat people, limiting clothing sizes and other such suggestions here (I assume made in jest) aren't really very practical. Most people don't *want* to be fat, and although it doesn't seem a good idea to condone obesity unreservedly, outright hostility isn't very helpful either.
DancingOnRock - on 01 Jan 2013
In reply to The Lemming: There was a program a few months ago where they took 10 thin people and tried to make them fat by over feeding them.

It didn't work. One of them put no weight on, most of them put very little weight on.

There's more going on.

However, weight creeps up, you don't suddenly wake up obese one day.

If you put a pound on a month, after 3 years you'll be nearly three stone heavier.

The issue is that people believe they can just go on a diet and lose the weight.

It seems that by the time you have gained that 3 stone you have changed your metabolism. It's your metabolism that controls your weight. Your metabolism is pretty complex and individual, but for most of us if we exercise and eat properly, our metabolism and hormones stay in balance.
tistimetogo on 01 Jan 2013
In reply to nufkin:

I have a suggestion. Climbing. I've never met a fat climber.

But even with radical improvement this is still going to be a serious problem for NHS workers in the future (I've a number in the family). Big people bring so many extra problems.

The worst is if they happen to be a violent patient.It's pretty hard to stop an angry small person. But when they're big you need an army.
Eric9Points - on 01 Jan 2013
In reply to The Lemming:
can someone explain to me why I should care whether an adult eats too much or not?
Given that fat people die young I'm not convinced they are more of a burden on society than the healthy person who dies of old age after years of geriatric care.
Ben Sharp - on 01 Jan 2013
In reply to Eric9Points: Walk around any small town and you will see that fat people definitely do not all die young!
The reason you may care is that your taxes fund the NHS and if you believe the papers then obesity related illnesses will bankrupt the NHS in the not too distant future.
stroppygob - on 02 Jan 2013
In reply to Ben Sharp:
> (In reply to stroppygob)
> [...]
>
> There kind of aren't

Bollocks.

http://www.dreamdiva.com.au/

http://www.swishplussizes.com.au/

http://www.swishplussizes.com.au/

http://www.maggiet.com.au/

I could go on...

Alex Slipchuk on 02 Jan 2013
In reply to Ben Sharp: spot on. Not all cars do the same mpg
vark - on 02 Jan 2013
In reply to The Big Man:
> (In reply to Ben Sharp) spot on. Not all cars do the same mpg

No, but those of the same model and engine size have similar performance.
vark - on 02 Jan 2013
In reply to Eric9Points:
They consume much more resources before they die prematurely
ThunderCat - on 02 Jan 2013
In reply to The Lemming:

If you consume less calories than you expend but are still putting on weight then you have broken a couple of laws of physics and biology, and may just have found some magical way to solve the worlds hunger problem.

It really doesn't need to get any more complicated than that.

Odd how you rarely find many obese people in third world refugee camps, isn't it.

:)
ThunderCat - on 02 Jan 2013
In reply to ThunderCat:

It's bizarre how militant and defensive people get when you try to suggest that obesity is caused by an imbalance in calorific intake. I'm sure there are a whole range of psychological and personality 'problems' that make people overeat / underexercise, but that's not the root cause. The root cause is too many calories in, and too few calories out.

Change that balance, and the weight comes off. Guaranteed. No ifs, no buts, it's a 100% foolproof way to shed fat.

But suggest that, and you'll be shot down for being an unsymapthetic body fascist with no understanding of the 'real' causes of obesity (slow metabolism, thyroid problems, genetics, 'its glandular'....all utter bollocks).

Make an excuse for it. Give it a name and think up a syndrome for it, because that removes any and all responsibility from the individual to get up off their fat arses and do something about it. God forbid that the it may be the individuals fault.

Rant over.

Can I qualify this by saying I'm not some lean, toned athletic demi-god...I'm six foot three inches and at weigh in yesterday I was 21 stone 6 pounds. Very little of it is muscle. The majority of it is lard. I drink too much, I eat too much and I exercise too little.

All my fault. No one elses. Mine.



ads.ukclimbing.com
Rigid Raider - on 02 Jan 2013
There's an attitude problem: my MIL was brought up on a farm where they grew, raised then slaughtered and harvested and preserved everything they ate. Nowadays she has the world's worst diet and is seriously obese; her favourite food used to be Vesta packet curries because they were a novelty requiring no effort. I really do believe she eats rubbish because she has a sort of "famine" mentality and somehow wants to store energy "just in case". She certainly hoards food and she comes to stay with bags and bags of sweets, crisps, biscuits and other rubbish.

I see the same mentailty with African customers - put them in front of an "eat all you can" buffet and they will pile their plates up with food then go back for seconds and then thirds because they have grown up never being sure from where the next meal will come.
Queenie - on 02 Jan 2013
In reply to ThunderCat:

A good post.
Now get out off your butt, do something about it and demonstrate this with action (oh and report back in a few months). :)
sarahjk - on 02 Jan 2013
In reply to The Lemming:

I work with 40ish other women [teaching] so there is always someone on a 'diet' of some kind, I have given up asking about them, trying to understand or, god forbid, question the rational behind the choices....

At the end of the day we all buy our food from basically the same place. [Supermarkets and food manufacturers and their corrupt practices are a whole other thread.] So if we all use the same or very similar sources, surely it comes down to the choices we make about what to consume from what is available.
Carolyn - on 02 Jan 2013
In reply to vark:

> It is simply down to the amount of food provided and they way in which it is provided and it can start very early. Bottled fed babies tend to be more overweight than breastfed babies because it is much easier to provide excess calories in a bottle.
>
> Once you start overfeeding a child they come to expect it and it is easy to get into a downward spiral.

Or indeed, even earlier - I think there's some evidence that mother's diet in pregnancy can influence baby's weight (and even earlier, and, getting more tenuous on the evidence front, even a generation before).

But one thing the NHS could do here is make sure that its Health Visitors understand infant growth charts. At least half of them seem to think every baby needs to be on or above the 50th percentile, and advise formula top ups if it's not. And heaven forbid any child (let alone around 1 in 20) could be healthy on the 5th percentile. [/end of that rant]

In reply to others...:

Surely, at an individual level, it's indisputable that Calories in > Calories out = weight gain?

Sure, some people may burn (slightly) more calories at rest than others, allowing them to eat more without gaining weight.

And it doesn't mean it's straightforward to reduce the number of calories that go in, either. Some of the argumements about this being difficult, be it because of lack of cooking skills, physiological changes, etc, may be true for any individual.

But fundamentally, the only way an overweight individual is going to lose weight is still to either decrease the amount of calories that they eat, and/or increase the number of calories they burn. Although it's likely that reducing intake will need to be the more significant.

But don't worry, each local area's under government orders develop a multi-agency Health and Wellbeing Strategy to tackle just this kind of issue. Problem solved.......
Liam M - on 02 Jan 2013
In reply to ThunderCat: Why do you eat too much? Do you make a deliberate conscious decision to eat more than you know your body will need today? Or is it something more akin to your body craving food at a particular time, and so you respond to its desire?

If the former, and you are completely above cravings, then it's somewhat bizarre. If the latter, then you have to ask several questions about why the body demands more than it needs, and why if it is so trivial to over come these demands do so many people put on weight and fail when they try restrictive calorie diets.

Trying to identify why people may struggle with diets, and what physiological or societal factors may impact the success rate, rather than just an 'eat less, run more, fatty' attitude isn't dismissing physics, but trying to come up with a more useful and maintainable answer.

For reference, I weigh in at between 56-58kg dependant on training volume. Even when completely sedentary I'd struggle to reach 60kg. I almost immediately give in to food cravings, and would be surprised if I consume less than 3-3500 calories per day. I'm at the other end of the scale to most people, and don't believe matching intake to expenditure is at all easy.
mkean - on 02 Jan 2013
In reply to Tall Clare:
'big and tall' shops for men (why is it that you never see tall men in those shops, only big men?)

Because as well as making salad dodging acceptable modern society has taken a far too liberal view of "drafts around the ankles". Tall people often don't seem to be aware of the awful sartorial crime of the "ankle swinger": I work in a building that has at least 4 people over 6'6" (including myself) and there is a worrying quantity of ankle on show. We need to make tall people realise that wearing a 33" inside leg trouser when you've got a 38" inside leg is as unnacceptable as selling heroin to primary school kids.

;-)
Ben Sharp - on 02 Jan 2013
In reply to ThunderCat: It's bizarre how many people keep coming back with the too many calories in, not enough out argument. Everyone has agreed that that is the case, no one is disputing it and yet, we keep talking about it. You say that people suffering famine are thin as if it's some kind of epiphany, of course if you starve people they will lose weight but unless you want government sanctioned forced starvation centers it plays little relevance to changing our culture of overeating.

> Change that balance, and the weight comes off. Guaranteed. No ifs, no buts, it's a 100% foolproof way to shed fat.

If it is so simple then how come we have a problem in the first place? Are you just going to sit in your chair telling everyone how easy it is while the western wold expands, if it's so easy there wouldn't be a problem.

There are two things that we agree on, one there are underlying factors which cause over eating and two, overeating leads to weight gain. Why do you get so defensive when someone suggests we should look at the former? People have been treating weight gain with fad diets and short term fixes for decades and we still have an accelerating problem. As obesity becomes more endemic and widespread do you not think it might be prudent to entertain the idea that we could look at tackling obesity by tackling the many underlying causes of overeating?

I'm not getting defensive and I'm not being militant, I'm merely annoyed that people think they can solve a problem like obesity by quoting physics laws and appointing blame on overweight people. What exactly to you hope to gain by telling people to "get up off their fat arses"? It's shallow nonsense designed to make people feel good about themselves by denigrating others.

And on the point about legitimate medical conditions which cause weight gain, yes they aren't widespread but they do exist. The people who genuinely suffer from them have to put up with people like you looking down on them for their whole lives and being treated like some fat, lazy, second class citizens.
ThunderCat - on 02 Jan 2013
In reply to Ben Sharp:

I think you need to calm down a little.
seankenny - on 02 Jan 2013
In reply to tistimetogo:
> (In reply to nufkin)
>
> I have a suggestion. Climbing. I've never met a fat climber.

Does the phrase "selection bias" mean anything to you?
DancingOnRock - on 02 Jan 2013
In reply to Ben Sharp: More physics for you.

Inertia. A body will remain at rest unless acted upon by a force.

People eat if they are hungry. Hunger is directly controlled by your stomach 'feeling' empty. It gives off hormones that affect your mood. If you stretch your stomach it takes time to revert to it's original size. In the mean time even if it's three quarters full it will be telling you you're hungry.

People are over-eating, not because they have some psycological disorder but because they have a hormone imbalance.

There is no coincidence that insulin is a hormone.
Uluru on 02 Jan 2013
In reply to stroppygob:
> (In reply to The Lemming) My missus had an interesting suggestion, in the same way as Australia has made plain packaging for fags mandatory, no fashionable clothes over size 16 should be made/sold.

Quite a few years ago I worked in an outdoor shop. The owner would not buy women's clothes larger than size 16 and men's clothes larger than 38 waist.

pebbles - on 02 Jan 2013
In reply to Uluru: whats the point of that? surely if overweight people want to get outdoors and get some exercise thats a positive step?
Sarah G on 02 Jan 2013
In reply to vark:
> (In reply to abzmed)
> [...]
>
> I am not convinced by this argument. I would agree it is difficult to afford a healthy diet if you do not put any time/effort into sourcing and preparing food. It is also influenced by what you choose to eat. If you want to eat meat every day it will be expensive or you will resort to cheap processed crap.
>
> What we need to do is equip people with the skills to prepare food and re-educate their palates.

You're right, you've got it right on the button....I had a smilar discussion with a frined of mine about this subject and he found it hard to understand why people are incapable or unwilling to source the healthy stuff and cook it. I had to point out to him that he and I (in our mid 40's) are the last of a generation that routinely got taught domestic science at school and benefitted from mums and grannies who could properly cook and pass on those skills; so many people now haven't even experienced great home cooking, much less have have access to the teaching, the skills, the knowledge or even the time; when you are working, the last thing you want to do at 6pm when you get in in contemplate doing a healthy meal from scratch....hence the chicken nugget and chips generation.

So, I beliee we need to accept that it won't come from the home, we as a society have to take a bit of responsibility and educate our youngsters in proper cooking (pizzas do NOT count!) and what not.

Sxx

Bjartur i Sumarhus on 02 Jan 2013
In reply to seankenny: I always thought John Dunne was a bit obese. didn't seem to stop him climbing uber tough new routes though.Maybe he had a gravity belt ;-)
DancingOnRock - on 02 Jan 2013
In reply to Sarah G: No it's a bit of a red herring. There was an obesity epidemic in the 1800s amongst the rich. In fact throughout history people have been obese when there has been a cheap source of plentiful food.

We have to educate people that diets don't work and once you get fat you're fat. If it takes three years to put on excess weight then it will take three years to get rid of it.

I put the blame entirely on the dieting industry and myth that just restricting calories for a couple of weeks will fix your weight problem.

Fat climbers? Well it's kind of self selecting isn't it. If you're too fat to see your toes it makes footwork challenging and if you're not strong enough to lift your own bodyweight you've got problems there too.
Caralynh - on 02 Jan 2013
In reply to Sarah G:

Agree totally. I had weekly cookery lessons in the first 2 yrs of secondary school (I am 39). Nothing fancy, just things like fish pie, shepherds pie, and things involving the very basics like pastry, roux sauces etc. We would arrive at school with all ingredients in our wicker cookery baskets, covered with a little cloth. The finished meal was kept to be taken home in the basket to the family for that night's dinner. At least it gave an idea of what works well together, and basic techniques, cooking times and temperatures.

I don't believe people want to eat badly, but rather that they don't know how to do otherwise and therefore choose the quick option, and that follows down the generations. These days though, would parents have enough respect for schools to bother to get the ingredients for their children? To agree their kids cook what the school said? In my day veggies and religious diets were taken into account, but no fussiness and dislikes. Schools need to have the balls to say this is what you are doing, end of story, and compel parents to comply.
deepsoup - on 02 Jan 2013
In reply to Ben Sharp:
> but unless you want government sanctioned forced starvation centers it plays little relevance to changing our culture of overeating.

This being UCK, someone will probably come along and advocate just that before long. :o/
ThunderCat - on 02 Jan 2013
In reply to Caralynh:

I'm not far behind you in terms of age. Had a school term broken into three parts - 1/3 metal work, 1/3 woodwork and then 1/3 home economics.

After 2 years you made a choice...girls plumped for home economics, and lads went for the former two

I wish I'd had the bollocks to go for home economics because I loved it, but at a rough arsed comprehensive, it just wasn't an option.


deepsoup - on 02 Jan 2013
In reply to stroppygob:
> no fashionable clothes over size 16 should be made/sold.

It seems a bit out of character, to say the least, for you to be advocating heavy-handed government regulation of the marketplace.

Being rather more of a lefty than you are, I think that might be a good idea - but why on earth you'd choose to leave the food industry alone and concentrate on telling Top Shop what frocks they can sell is beyond me.
jonnie3430 - on 02 Jan 2013
In reply to Sarah G:
> (In reply to vark)
> [...]
>
> the last thing you want to do at 6pm when you get in in contemplate doing a healthy meal from scratch....hence the chicken nugget and chips generation.

TV probably has something to do with it too, we don't use one and are happy spending an hour or two (with a drink or two and munchies to take the edge off,) getting dinner ready then eating at eight or ninish. It seems that some friends want to get their food quickly so they can settle down in front of the TV for the night and don't want to miss much.
digby - on 02 Jan 2013
In reply to The Lemming:

I was simply going to say too many calories in, not enough out, just to annoy Ben Sharp; but I wonder if there's a feedback mechanism at work. If you put too few calories in, your body partially shuts down to conserve energy. It would be unusual for a feedback mechanism not to regulate the opposite position of putting too many calories in. So eating a little over what you need will not result in a large weight gain over a long period.

Food being very attractive it is usually the second proposition that is put to the test.
DancingOnRock - on 02 Jan 2013
Seriously guys?

It's nothing to do with the type of food.

A slice of pizza from pizza hut is fine with some salad. A whole 4person pizza at one sitting with all you can eat buffet of potato salad, coleslaw etc isn't.

People know they're getting fat and do nothing about it. They think there is an easy solution around the corner. Now with surgery and gastric bands etc they care even less.
deepsoup - on 02 Jan 2013
In reply to Game of Conkers:
> I always thought John Dunne was a bit obese. didn't seem to stop him climbing uber tough new routes though.Maybe he had a gravity belt ;-)

I very much doubt that John Dunne, even at his biggest, has ever been obese.
deepsoup - on 02 Jan 2013
In reply to jonnie3430:
> TV probably has something to do with it too

I watched a bit of this, on the telly last night: http://www.channel5.com/shows/50-shocking-facts-about-diet-and-exercise

Shocking is right - it was presented as a factual programme but had a few nuggets of useful information stirred into a huge pile of misinformation, hyperbole and just plain rubbish. No doubt the producers would say it wasn't intended to be taken seriously, but was for entertainment only.

A not-very-well informed couch potato thinking about their body, as you do at this time of year, and watching that couldn't entirely be blamed for just giving up imo. So that kind of TV certainly doesn't help.
mkean - on 02 Jan 2013
In reply to deepsoup:
I very much doubt that John Dunne, even at his biggest, has ever been obese.

A BMI of >30 (Obese) isn't hard to hit if you are carrying a lot of muscle. I've met a few rugby players and weight lifters who are over BMI35 while carrying virtually no fat.
deepsoup - on 02 Jan 2013
In reply to mkean:
> A BMI of >30 (Obese) isn't hard to hit if you are carrying a lot of muscle.

It isn't, but BMI isn't a very reliable indicator of obesity in people with an athletic physique. You can't be obese because you're carrying a lot of muscle, you're only obese if you're carrying a lot of fat.

rallymania - on 02 Jan 2013
In reply to deepsoup:
> (In reply to Ben Sharp)
> [...]
>
> This being UCK, someone will probably come along and advocate just that before long. :o/

oh oh oh... is it my turn yet?

(ahem)

The Lemming - on 02 Jan 2013
In reply to Caralynh:
> (In reply to Sarah G)
>
> Agree totally. I had weekly cookery lessons in the first 2 yrs of secondary school (I am 39). Nothing fancy, just things like fish pie, shepherds pie, and things involving the very basics like pastry, roux sauces etc.

I too loved mu cookery lessons at school but then the world changed with Maggie leading the helm.

Its all Maggie's fault?
No it isn't her's and hers alone but its the capitalist concept and the seeds well and truly sown in the early 80's.

In my simple mind cookery wasn't considered a profitable course to teach a country going through a massive industrial and economic upheaval caused by the previous governments, mostly Labour, feking up the economy and infrastructure. Yes the unions have a lot to answer for as well, especially Mr Scargill taking on Maggie, who was always going to win and win with a crushing victory that would send shock-waves through our society for decades.

During this brave new phase of change from an industrialised country to one that has become dependant on the service industry and the Golden Mile within the centre of London, schools and councils sold off land, used to teach PE and other leisure activities in the quest to save money and cut waste from expenditure and budgets.

30 years down the road we have at least two generations that don't know how to cook or how to exercise because they are no longer taught in schools because there is no profit in it or that they are considered not good enough for what ever academic reason you care to think of. We then have the viscous circle that progressive parents can't even pass these skills on to their children because they too don't know how to do it.

After the Second World War we had the seeds sown of Fast-Food chains invading the west and becoming all consuming on the high street, our homes and ultimately out mindsets.

After fast food took a hold then so to did TV dinners and ready meals. Here capitalist companies could pump as much fat and high calorie ingredients as they want to maximise profit for share holders.

Today we have a nation of families who work too long and hard to want to come home and cook a meal from scratch. They are too tired that they shove a box full of calories into a micro, wait for the ping and gorge.

So after my ill-informed rant the reasons for obesity are:
1 Poor education on eating, now several generations along
2 Poor eating habits, now several generations along
3 Poor exercise habits, now several generations along
4 Fast-food too easily and cheaply available compared to healthy ingredients
5 Too easy to graze on cheap fast food while watching 'mind bleach' TV
6 People too tired from work to take the time to cook from scratch
7 Fast-food chains selling bigger and bigger portions for profit
8 Governments with no idea on how to tackle obesity
9 Political correctness not to call fat people what they really are, which is fat.
10 Fat people not taking personal responsibility for what they ingest but rather blaming society or on fancy scientifically sounding disorders which personally divorce them from their responsibility to eat less and move about more.

End of the day, nobody is force fed in this country with a gun pointing at their heads if they refuse to eat.
mkean - on 02 Jan 2013
In reply to deepsoup:
It isn't, but BMI isn't a very reliable indicator of obesity in people with an athletic physique. You can't be obese because you're carrying a lot of muscle, you're only obese if you're carrying a lot of fat.

Unfortunately a lot of people including a very large number of health professionals use BMI as the single defining characteristic. (The WHO labour it a fair bit!):
One of my climbing partners is a 63 year old former gymnast who was told he urgently needed to lose weigh as he was obese; he has a single digit body fat content, washboard abs and can knock out several 1 armers. A kayaking friend who is similarly built was told the same thing by both his GP and a private consultant during a company provided "Health MOT".



andic - on 02 Jan 2013
In reply to all:

okay lets see how easy we all find it: http://www.ukclimbing.com/forums/t.php?n=532894

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Liam M - on 02 Jan 2013
In reply to mkean: For the WHO BMI probably is a good measure, as they're likely to be looking at populations and larger samples rather than individuals (unless you have a demographic entirely consisting of lumps of muscle)
mkean - on 02 Jan 2013
In reply to Liam M:
The problem with the WHO using it is they don't say in big bold letters "We are using BMI as it is really quite good when dealing with starving natives, however it is actually pretty poor when dealing with Westernised populations who are typically taller and carry more muscle".

Then everyone and his dog says "well the WHO use it and they must know what they are talking about" and the myth that the BMI is the be all and end all of monitoring weight spreads to the point where people come out with stupid statements like "The whole England front row are clinically obese" which dilutes the perfectly sensible messages on healthy living that people are trying to spread.
Mike Stretford - on 02 Jan 2013
In reply to Liam M: I don't think so, as a more athletic population would be classed as obese. It has me as borderline obese which is ridiculous.
Caralynh - on 02 Jan 2013
In reply to The Lemming:

I don't think long hours are an excuses. You and I both do the same job, and can easily be out of the house for 14 Hrs. Yet I am sure we both cook from scratch and eat healthily. If I am on a run of shifts I batch cook in advance, which is cheaper, and takes no time to reheat.
From what I see at work, it is often the people who don't work, who actually have more time, that have the poorest diet.
The Lemming - on 02 Jan 2013
In reply to Caralynh:

We may be the exception to the norm. ;-)

I am just about to batch cook Pasta Bake 10 portions, 8 of which will go in the freezer for work and the other two portions will go into Miss Lemming's and my bellies tonight.


Then its off to the local wall to catch up on the festivity news.
Liam M - on 02 Jan 2013
In reply to Papillon:
> (In reply to Liam M) I don't think so, as a more athletic population would be classed as obese. It has me as borderline obese which is ridiculous.

I doubt that would be the case unless a very large proportion of a population came to indulge in essentially weight lifting activities at the expense of other athletic disciplines. If there is a reasonable distribution of sports, then those that result in much higher muscle mass are likely to be largely counteracted by those who engage in activities that develop little excess muscle (e.g. distance runners or cyclists).

I'd be very surprised if you could find any nation or even city where increased activity levels have resulted in an overall increase in BMI across the population, and so for large scale samples it will be a useful measure.
DancingOnRock - on 02 Jan 2013
In reply to Liam M:

Mo Farah has a BMI of 21.1, Haile Gebrselassie 20.5.

I run 40-50miles a week and mine is 25.1. My doctor does not think I'm overweight contrary to what my BMI says.

Every program I've ever seen on TV about weight loss has said the same thing. Quantity. Even when people keep food diaries they still underestimate the number of calories in their 'portion', and miss record the snacks like biscuits. One guy I saw drank several cans of Lager a night and not one of them went on his list.
Rollo - on 02 Jan 2013
Interesting thread and something I am very interested in.

Ben Sharpe thanks for talking a lot of sense!

I'm starting as a trainee teacher next year and am hoping to do my bit with the next generation (not sure it's going to be easy though!)
DancingOnRock - on 02 Jan 2013
In reply to The Lemming:
> (In reply to Caralynh)
>
> We may be the exception to the norm. ;-)
>
> I am just about to batch cook Pasta Bake 10 portions, 8 of which will go in the freezer for work and the other two portions will go into Miss Lemming's and my bellies tonight.
>
>
> Then its off to the local wall to catch up on the festivity news.

By doing this you are exercising portion control. Once cooked you're not forced to eat the whole amount. You serve into sensible size portions and freeze what is left over.

mkean - on 02 Jan 2013
In reply to Liam M:
I'd be very surprised if you could find any nation or even city where increased activity levels have resulted in an overall increase in BMI across the population, and so for large scale samples it will be a useful measure.

We aren't talking about large scale samples we are talking about it being applied to individuals which is erroneous: I'm quite happy for the WHO to use it as a measure and bury it in their methodology but I find it being waved about as some sort of statistcal fix all is rubbish because it then spreads to applications it is unsuitable for. :-)

While I'm bashing the BMI it is also fundamentally flawed in the mathematics. Using X^2 is a poor relationship which is acceptable for shorter people but starts looking increasingly ropey as the height increases: Taller populations will have a heigher BMI than shorter populations leading identical lifestyles because body weight goes up faster with height than the X^2 term suggests.

Anyway rant over! ;-)
DancingOnRock - on 02 Jan 2013
In reply to mkean: it''s reasonably good for your average person though. A 5'8" guy between 120lbs and 165lbs is 'normal'.

It's then got to be down to a human to interpret the figures. Any doctor going just on figures needs to be spoken to...
mkean - on 02 Jan 2013
In reply to DancingOnRock:
it''s reasonably good for your average person though. A 5'8" guy between 120lbs and 165lbs is 'normal'.

I'm a gnats whisker shy of 6'8" so it is a personal peeve! Also average height is going up so it is only going to get worse ;-)

It's then got to be down to a human to interpret the figures. Any doctor going just on figures needs to be spoken to...

Do you want half a dozen phone numbers? I think every medical I've had since leaving uni has featured standing on some scales and a doctor looking at the chart and saying "ooh a little over" or some such. One or two have had to guess a bit because I'm off the scale on quite a few charts :-)

Carolyn - on 02 Jan 2013
I'm not sure of the benefits of Home Economics lessons - given the only things I remember being taught are a full cooked breakfast and lots of varieties of cakes ;-)

Tongue in cheek - I'm well aware that lack of even really basic cooking skills is a big issue in people's ability to make basic food choices. Although it's generally not easy to find healthy food to buy in the middle of a deprived area - when I worked in one, the choice of food in the local Spar was enough to remotivate me to make sandwiches the night before....
SAF - on 02 Jan 2013
In reply to Ben Sharp:


> Obesity is the same, the only thing you do by saying that it's caused by people overeating is you fuel hatred towards people who are overweight, which helps no one.

There is not such thing as fat "alchemey" and the sooner the government and uk population accept this the better.

Like others have said it's calories in vs calories out...the factors that matter are what influence the wrong number of calories in, compared to the wrond number of calories out.

There are a number of medical conditions and drugs that will increase the appetie and thus the number of calories consumed... steriods, hormonal contraceptives, depression, pituitary problems, certain chromosomol disorders etc...
but even in these people, they must still consume the excess calories in order to gain fat and weight...it doesn't appear by magic!!

Likewise there are conditions that cause people to be less able to burn calories, limb loss, paralysis, depression, MS etc...
but in these people they will only gain weight if they have eaten more calories then there condition allows them to burn..

SIMPLE!!
Mike Stretford - on 02 Jan 2013
In reply to Liam M:
> (In reply to Papillon)
> [...]
>
> I doubt that would be the case unless a very large proportion of a population came to indulge in essentially weight lifting activities at the expense of other athletic disciplines. If there is a reasonable distribution of sports, then those that result in much higher muscle mass are likely to be largely counteracted by those who engage in activities that develop little excess muscle (e.g. distance runners or cyclists).
>
> I'd be very surprised if you could find any nation or even city where increased activity levels have resulted in an overall increase in BMI across the population, and so for large scale samples it will be a useful measure.

Correction, I was talking rubbish, it has me as borderline overweight (when most would say I was slim).

Still, I think you'd be suprised, several cyclists appear to be in the upper side of normal and one is overweight (gues who?)
stroppygob - on 02 Jan 2013
In reply to The Lemming: The subjct of metabolism has been raised here, and it is amusing to say the least how many "people of size" will claim to have a "slow metabolism" Of course, this will be a self diagnosis and have no real evidence to support it.

I've had some correspondence in the past with Dr Susan Jebb who had studied obesity and metabolism.

Obese people have high metabolic rates.

ranger*goy on 02 Jan 2013
In reply to Carolyn:
> (In reply to vark)
>
> [...]
>

>
> But one thing the NHS could do here is make sure that its Health Visitors understand infant growth charts. At least half of them seem to think every baby needs to be on or above the 50th percentile, and advise formula top ups if it's not. And heaven forbid any child (let alone around 1 in 20) could be healthy on the 5th percentile. [/end of that rant]
>

Agreed. I got a bit of stick from health visitors because my son wasnt following the chart. He kept growing out of his clothes, he just wasnt a tubby baby.

KellyKettle - on 02 Jan 2013
In reply to The Lemming: I think we're missing a big part of the issue... It's fitness not fatness that's the real issue, it's actually possible to be reasonably fit whilst eating unhealthily and also whilst carrying extra weight (albeit, it decreases your fitness relative to what it could be); it's easier to develop a greater level of physical fitness (thus alleviating some of the major strains on people's bodies) than it is to shed lots of weight, indeed the former is a good warmup to the latter.

I don't think all the "salad dodgers" rhetoric and outright distain towards fat people does much good at all, it's just picking on people who are different to you; Sure people are fat and sure they've made choices that put them there, but experience teaches that relatively few people are happy being overweight, even less obese... Berating, dehumanising and shaming them is probably only going to encourage them to get even fatter!


I'll be honest, I'm a poster child for poor eating habits; I drink fizzy pop regularly, am fussy about what veg I eat, have a predilection to using cream, butter, cheese, ghee and animal fat in my cooking, eat a lot of red meat and consume a solitary meal of epic proportions at about 21:00 each day*. This is all counterbalanced by the fact that living in rural north wales gives me the opportunity to do some kind of strenuous exercise every day... In spite of my poor habits (fizzy drinks being by far the worst) I'm actually stable at about 13-14% body fat, which is not too bad at all!

*This has conditioned me to willingly accept feeling hungry without needing to eat, which has made me more and more resistant to snacking, which may well be a major factor in why I'm able to stay healthy in spite of myself.
SAF - on 02 Jan 2013
In reply to KellyKettle:

>
> I don't think all the "salad dodgers" rhetoric and outright distain towards fat people does much good at all, it's just picking on people who are different to you; Sure people are fat and sure they've made choices that put them there,

Since the original title is "the NHS is not fit enought to deal with obesity"

You say thet is is their choice and distain towards fat people is so aweful, but whmany people in the NHS have had career ending injuries from having to get these "salad dodgers" down stairs, off toilets, out of bed... one lad I trained with ended up on the operating table for 3 1/2 hours after some 28 stoner grab his arm whilst falling. It is very easy to have distain towards these people when your backs gone!!!
vark - on 02 Jan 2013
In reply to KellyKettle:
> (In reply to The Lemming) I think we're missing a big part of the issue... It's fitness not fatness that's the real issue, it's actually possible to be reasonably fit whilst eating unhealthily and also whilst carrying extra weight (albeit, it decreases your fitness relative to what it could be); it's easier to develop a greater level of physical fitness (thus alleviating some of the major strains on people's bodies) than it is to shed lots of weight, indeed the former is a good warmup to the latter.
>

It is possible to have a reasonable level of aerobic fitness and eat a crap diet. The reason it doesn't work becomes apparent in the long term though when the ishcaemic heart disease, cancer etc. finish you off.

vark - on 02 Jan 2013
In reply to SAF:
I suspect many people on here have never had the joy of trying to shift a morbidly obese person in cardiac arrest. Nor will they have experienced the joy of needing an assistant to hold the apron of fat out of the way whilst you take blood from someone's groin.

All of these activities divert staff away from dealing the non- obese. Massive amount of resources are being expended on equipment to deal with these people. It cannot continue as we are doing at present

The Lemming - on 02 Jan 2013
In reply to SAF:

I recently paid for 6 private physio sessions to fix my back, rather than take sick leave from the stresses and strains of work because I did not want to be disciplined for being sick because of work.

Call that a catch 22 situation.

H&S states that people at work carry items around 25kg but what do they do when somebody is on the floor weighing just shy of 300kg?

They quite rightly call 999. There are many lifting aids, but in the real world most of the time these items are as much use as a chocolate fire guard. At the end of the day NHS have to resort to putting their backs at risk on a job by job basis.

When your back is gone, its gone.

Obese people, and I mean the 300kg variety, aren't just putting their health at risk but those in the NHS as well.

SAF - on 02 Jan 2013
In reply to The Lemming: My sympathies are with you, I'm nursing a neck/shoulder injury at the moment, worked my new years eve/new years night shifts none-the-less and managed to dodge any heavy lifting, although looking left and right whilst driving the ambulance was a challange... fear of the sickness policy, and what people would make of me having hurt my self on new years eve made me continue!!!

having said that, my injuries were self inflicted...and I still didn't manage to tick the V3 that cause it :-(
Boar of Badenoch - on 02 Jan 2013
In reply to The Lemming:

Actually, all this "ooh, being overweight is really bad for you" is an oversimplification. A significant peer-reviewed study was published recently showing that being moderately overweight is actually good for you:

http://jama.jamanetwork.com/article.aspx?articleid=1555137
SAF - on 02 Jan 2013
In reply to Boar of Badenoch: Do they say why they think this is the case, or could it just be correlation between being slightly overweight and living a bit longer that actually reflects other life style factors? Maybe it just means they need to tweek the BMI range used to define obesity. I would be happy if they did as I have hit a BMI of 25.1 after all the christmas food and drink!!!
Oceanrower - on 02 Jan 2013
In reply to Boar of Badenoch:
> (In reply to The Lemming)
>
> Actually, all this "ooh, being overweight is really bad for you" is an oversimplification. A significant peer-reviewed study was published recently showing that being moderately overweight is actually good for you:
>
> http://jama.jamanetwork.com/article.aspx?articleid=1555137

But if that were the case, people who are moderately overweight would become the right weight, and the people who are the right weight would be underweight. Or something.
wilkie14c - on 02 Jan 2013
In reply to Carolyn:

> Tongue in cheek - I'm well aware that lack of even really basic cooking skills is a big issue in people's ability to make basic food choices. Although it's generally not easy to find healthy food to buy in the middle of a deprived area - when I worked in one, the choice of food in the local Spar was enough to remotivate me to make sandwiches the night before....

Bang on there
We took the kids to Haven a couple of years ago (WTF was I thinking) and everything on every menu came with chips so one night I'd had enough and went to the onsight shop to get some shopping and make us a decent meal. I swear its true but the only vegetables they sold were tinned! We went out for dinner, out of the complex that is.
While a pack of supernoodles costs 29p and a lamb chop costs 2 quid people on the breadline ain't ever gonna eat well
KellyKettle - on 02 Jan 2013
> (In reply to Boar of Badenoch)
> [...]
>
> But if that were the case, people who are moderately overweight would become the right weight, and the people who are the right weight would be underweight. Or something.

The 'or something' being that we've oversimplified our model of how body fat and weight affect long term health...


> Douglas Adams:
> "If you try and take a cat apart to see how it works, the first thing you have on your hands is a nonworking cat. Life is a level of complexity that almost lies outside our vision; it is so far beyond anything we have any means of understanding that we just think of it as a different class of object"

If you consider that, it's not exactly shocking that our understanding of even apparently basic concepts in medicine, physiology and anatomy sometimes needs revising.
bootsie - on 03 Jan 2013
In reply to vark:
> (In reply to The Lemming)
> In children it is the fault of the parents. Adults have only them selves to blame.
>
> People in general are lazy and stupid. They buy whatever crap is available and shovel it in until they only have room for massive amounts sugary drinks. They then do nothing to burn off any of the many thousands of calories.
>
The fact is, the gov't don't give a shit about obese people.If they did they would do somthing about it, but they don't because they are in the pay of the
multinational fast food lobby, the owners of which, have a different agenda,like doing the government a favour so they won't have to pay all those fat people a pension, because they won't be around to draw them

bootsie - on 03 Jan 2013
In reply to vark:
> (In reply to The Lemming)
> In children it is the fault of the parents. Adults have only them selves to blame.
>
> People in general are lazy and stupid. They buy whatever crap is available and shovel it in until they only have room for massive amounts sugary drinks. They then do nothing to burn off any of the many thousands of calories.
>
The fact is, the gov't don't give a shit about obese people.If they did they would do something about it, but they don't because they are in the pay of the
multinational fast food lobby, the owners of which, have a different agenda,like doing the government a favour so they won't have to pay all those fat people a pension, because they won't be around to draw them

stroppygob - on 03 Jan 2013
In reply to bootsie: Codswallop.
KellyKettle - on 03 Jan 2013
In reply to stroppygob: Maybe not entirely; The food industry certainly wouldn't go quietly if they were going to be forced to eliminate the unhealthy but alarmingly common ingredients that make processed foods as we know them today possible.


The Govt. knows that if they pushed to say ban high-fructrose corn syrup, it would affect the cost and taste of some very popular products... A clever PR firm working for the food conglomerates could subtly twist that part of the overall picture into the government victimising the ordinary consumer from up in their ivory tower and thus whip up a political backlash.

Therein lies one of the big problems with direct intervention; it would be politically unpopular, yet wouldn't show positive results quickly enough to win the public over before they next voted...
deepsoup - on 03 Jan 2013
In reply to KellyKettle:
> (In reply to stroppygob) Maybe not entirely; The food industry certainly wouldn't go quietly if they were going to be forced to eliminate the unhealthy but alarmingly common ingredients that make processed foods as we know them today possible.

Indeed. And they spend a *lot* of money lobbying.
Sarah G on 03 Jan 2013
In reply to The Lemming:
> (In reply to SAF)
>
> H&S states that people at work carry items around 25kg but what do they do when somebody is on the floor weighing just shy of 300kg?
>
No it doesn't. This is a massively and commonly misunderstood part of the filters for a risk assessment system for the manual handling of loads, as described in the Manual Handlling Operatins Regulations 1992 (as amended 2004).

Everyone gets it wrong.

However, your points about the extremely large patients are cogent. I have recently had some communication with some firemen regarding their being called in to assist the paramedics with medical rescues of extremely large people from their houses. The firemen concerned are part of a regional brigade with no equipment, no manual handling training, no format for any kind of risk assessment regarding risks to the firemen or the patient, and no will to acknowedge this growing problem (it's all about money, innit?)- the fireman i have had contact with says that they now get this kind of call out at least once a fortnight- and it becoming more frequent. The regional brigade concerned has no published bariatric person handling policy.


Sx
SAF - on 03 Jan 2013
In reply to bootsie:
> (In reply to vark)
> [...]

> multinational fast food lobby, the owners of which, have a different agenda,like doing the government a favour so they won't have to pay all those fat people a pension, because they won't be around to draw them

I agree there is an issue with the processed food industry, but to say the government want this to continue to save money is ridiculous... they may die younger, but they don't just get fat and then drop dead, there is a very expensive period between the too with cost to the NHS and incapacity benefits due to being too fat to work.
SAF - on 03 Jan 2013
In reply to Sarah G:
> (In reply to The Lemming)

>
> However, your points about the extremely large patients are cogent. I have recently had some communication with some firemen regarding their being called in to assist the paramedics with medical rescues of extremely large people from their houses. The firemen concerned are part of a regional brigade with no equipment, no manual handling training, no format for any kind of risk assessment regarding risks to the firemen or the patient, and no will to acknowedge this growing problem (it's all about money, innit?)- the fireman i have had contact with says that they now get this kind of call out at least once a fortnight- and it becoming more frequent. The regional brigade concerned has no published bariatric person handling policy.
>
And it's not just NHS, or fire service, a relative who runs a building firm ended up assisting with the collection/funeral of one morbidly obese women (joiner for reinforced coffin, flat bed truck with tail lift etc)... there are currently no fridges big enough in the mourge she was in, no cremetorium big enough in the region, and they had to get the local crane hire company out to put the coffin in the ground.
Liam M - on 03 Jan 2013
In reply to Boar of Badenoch:
> (In reply to The Lemming)
>
> Actually, all this "ooh, being overweight is really bad for you" is an oversimplification. A significant peer-reviewed study was published recently showing that being moderately overweight is actually good for you:
>
> http://jama.jamanetwork.com/article.aspx?articleid=1555137

It doesn't claim it's good for you. It looks at a link between mortality rate and BMI. It doesn't make any claims about quality of life or health prior to death.
The Lemming - on 03 Jan 2013
In reply to Sarah G:
> The firemen concerned are part of a regional brigade with no equipment, no manual handling training,

I'm sure that Firemen get manual handling training seeing as their job is hands-on.

Sarah G on 03 Jan 2013
In reply to The Lemming:
Nope, not as a matter of course, and certainly nothing to do with the handling of humans as a load. it alllooks to be a big postcode lottery-type of mess that the FB just hasn't got their collective head round yet as a national organisation, and it's even patchy within the regions.

Perhaps this is however the start of something getting it all sorted out though. As much as the FB wasnt ostick their head in the sand and mutter about costs and funding, it is an issue that ain't going to go away and they can't get out of.

Sx
Offwidth - on 03 Jan 2013
In reply to The Lemming:

It's mainly a government problem. They treat Public Health like a cinderella subject for decades and more recently shake it about like a rag doll and then wonder how things could have gone so badly wrong. There is tons of research evidence to suggest that well funded research based public health initiatives run by experienced experts work and that too much organisational/staff changes can mess such initiatives up.

Whats happening now: well Public Health departments after redundancy slimming exercises and on-and-off recruitment freezes are being moved from PCTs (arguably not the happiest home but at least with a ring fenced budget) to local government often carrying the wrong staff balance into much financial uncertainty. This in turn is forcing some less than imaginative PH directors to skimp further on important areas as leaving budget gaps to fix real problems might cost them their cosy jobs. Ask how much your local PH department spends on Tobbacco Control, Alcohol or Obesity measures compared to its neighbours.
Eric9Points - on 03 Jan 2013
In reply to Ben Sharp:
> (In reply to Eric9Points) Walk around any small town and you will see that fat people definitely do not all die young!

Oh I don't know. I was basing my case on what I saw the last time I visited a hospital ward. It was full of old people and fat peaople but no old fat people. Further, my recollections of geriatric wards are that they're full of thin people.

> The reason you may care is that your taxes fund the NHS and if you believe the papers then obesity related illnesses will bankrupt the NHS in the not too distant future.

I don't believe the papers. Do you have any facts and figures to show that fat people cost substantially more over their lifetime than thin people? I'd be interesting in seeing some numbers rather than adjectives.

If it is indeed the case then the government could levy a tax on fattening foods in the same way that they penalise alcohol and tobacco.

Oh aye, be careful about this argument about penalising people who do something which is potentially hazardous to their health. Why should a fat person pay to put a broken climber back together or why should I pay for a lifetime's care for a rugby player who broke his neck in a scrum?

Ben Sharp - on 03 Jan 2013
In reply to Eric9Points:
> (In reply to Ben Sharp)
> [...]
>
> Oh I don't know. I was basing my case on what I saw the last time I visited a hospital ward. It was full of old people and fat peaople but no old fat people. Further, my recollections of geriatric wards are that they're full of thin people.

That's because obese people either go down fast and bypass the wards or they go down in nursing homes and bypass the hospital altogether (sorry, no fact to back that up but I read this thing in the Sun...). I get your point about figures though, maybe it doesn't cost that much but all the papers say it does, so it must be true.
Ben Sharp - on 03 Jan 2013
In reply to Eric9Points:
> Oh aye, be careful about this argument about penalising people who do something which is potentially hazardous to their health. Why should a fat person pay to put a broken climber back together or why should I pay for a lifetime's care for a rugby player who broke his neck in a scrum?

Climbing and rugby injuries aren't inevitable and rarely result in a lifetime of care. Obesity will definitely cause you long term health problems of some sort and I would imagine would more likely incapacitate you to some extent that requires care.

Also, who'd climb all the mountains without climbers, who'd push the limits of sport without sportsmen. Who'd eat all the pies without the obese...nah, doesn't have the same ring.
jas wood - on 03 Jan 2013
In reply to The Lemming: "Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.[1][2] People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilograms by the square of the person's height in metres, exceeds 30 kg/m"

If this is the means of determining obesity everbody who isn't ordinary is at risk of 'obesity'
25% are obese apparently, last time i was in public i didn't notice 25% of the people around to be what i would term as obese.
Carolyn - on 03 Jan 2013
In reply to jas wood:

> If this is the means of determining obesity everbody who isn't ordinary is at risk of 'obesity'
> 25% are obese apparently, last time i was in public i didn't notice 25% of the people around to be what i would term as obese.

A few years ago I heard a local councillor declare similar in a health group meeting. If he's actually opened his eyes and looked round the table he'd have noticed the figure was about right for the meeting...

But I think we're not very good at guessing what a normal body size is any more. I frequently get told I'm thin/skinny or even that I need to eat more. My BMI's bang in the middle of the "normal" range and I have plenty of spare body fat at the moment.
Carolyn - on 03 Jan 2013
In reply to jas wood:

Sorry, the other bit I meant to say is that's the very way the bands of "normal", "overweight", "obese", relating to BMI were defined. They were based on life expectancy at that BMI. So by it's very definition, having a BMI of over 30 reduces your life expectancy (although obviously some people will live longer than expected, and some will die sooner than expected).
SAF - on 03 Jan 2013
In reply to jas wood:

> 25% are obese apparently, last time i was in public i didn't notice 25% of the people around to be what i would term as obese.

I've never seen any of the super morbidly obese patients I've been to anywhere other than there own homes or in hospital largely due to the fact that there obesity makes there mobility so poor they can't get out, many become breathless/ have angina attacks simply walking from room to room, some can barely get out of there chair. You'd be amazed the people that exist in the town you live in that you don't even realise are there.
Bobling - on 04 Jan 2013
In reply to The Lemming:

I think as others have hinted climbers may not have the most objective viewpoint of others' weight - to illustrate this I was at a New Year's party and someone asked me how Christmas was. I said something about over-eating and consequently feeling "fat and weak". I then did a check of who I was talking to and removed my foot from half way down my throat - shortly before someone asked me "if I'd looked in a f**cking mirror recently?". If nothing else perhaps this story will cheer up this rather depressing thread!
stroppygob - on 04 Jan 2013
In reply to The Lemming: Friends and neighbours claim Mrs Davis, 57, bought all her daughter's food which included processed ready-meals, sandwiches and packs of peanuts and crisps. She is also partial to sausages, pasties, chips, chocolate and chunks of cheese with bottles of coke or pints of milk.’

She has previously spoken of her guilt over the teenager’s obesity. She has said of Georgia’s weight: ‘I feel guilty, of course I do.’ In an interview, she said she and her daughter had started comfort eating after her husband Geoff died when Georgia was five. But she said she had later made a determined effort to change their diets – such as making her own chips instead of buying them from the takeaway. She said in the interview: ‘I wish I could turn back the clock. But if you’ve never had food addiction, you can’t understand. You try to fight it but it’s like a drug.’

http://i.dailymail.co.uk/i/pix/2012/05/24/article-2149609-0D58F4B3000005DC-63_634x654.jpg

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