Obesity and the NHS

[TooNice]

are you equally resentfull of people who have subsidised housing ?

Depends. I know someone someone who lives in a not-exactly cheap area in Central London, and openly admits that if he was to get employment, he'd lose the benefits and wouldn't be able to live in such area, so he might as well not bother. Not exactly a praiseworthy attitude surely?

I don't mind people getting subsidies/help for getting a roof over their head, in fact I didn't say anything about the idea of coaching. However, I have an issue of giving people what I consider to be luxuries (see next).

But surely going to the gym is necessary for them.

When I say privilege, I mean luxury. Luxuries are not necessities. A brisk walk down the street, kicking a ball in the park, rope skipping, pushups, there are plenty of exercises one could do without going to the gym. Yes, gyms are nice, comfortable environment (for what they are), but that's exactly why I see them as luxuries rather than necessities. I just don't see why people should be pampered for not taking care of themselves.

The real point of the suggestion though, was that I can imagine how it would be very hard for a fat person to go to a gym where everyone there is 'perfect' bodied - and having gyms set up toward weight loss might be a lot easier to persuade them to go to. Maybe it would make sense to do this at cost, rather than for a profit, but to me even if it was for free at the taxpayers expense it makes sense to me if it would save the taxpayer money overall.

What I am thinking is, does it really have to be a gym? Based on how much they charge, it can't be cheap to build/maintain. Given that you can lose weight/build strength using some of the methods previously listed, wouldn't you save even more taxpayer money?

Sooner or later they are going to have to learn not to be so self-conscious (in my eye few people including myself are "perfect-bodied"), and exercising in public will help with that. In this relatively PC society, anyone who points and laugh at overweight people exercising in the park are more likely be the ones getting shunned. People like to root for the underdog, and also, they are probably going to appreciate seeing that overweight who are genuinely trying and breaking their habits.

You can't shelter insecurities forever, let's say they graduate from a gym for overweight people with a BMI similar to yours (normal range). They go to a 'normal' gym and see what you see, feel worse than you feel (insecurities is all in one's head), then retreat back to their home leading to a relapse. Wouldn't that be a waste? And of course, you can't keep them in the overweight gym either, since you'll then put off those who are 10 stones overweight.

[Alex]

I guess the point is would they actually exercise with a home regime, jogging etc? It all works well until it's rainy for a few weeks, so you don't go out, then you lose motivation afterwards. Happens to us all, that's generally why people bother with gyms isn't it?

If your suggestion would work, then definitely it is a better one - and perhaps worth looking into organised walks to help people lose weight etc. If however it didn't have as good an effect as the gym then perhaps that would be better.

I'm not really interested in whether these people deserve free gym or not, just throwing ideas out there about how we can help to reduce it.

If just encouraging walking, jogging, weights at home etc works then by all means we should go on with that, but if a free gym idea worked better, to the extent that the burden of disease reduction was greater than the cost of the gym, then that would be a better idea. In my experience (I'm a hospital doctor in South Wales) encouraging patients who already have obesity related disease to exercise more just doesn't work, so was trying to think laterally.

Of course we know that the discussions on here are purely hypothetical anyway, not likely to change NHS policy.

[Barakka]

I guess the point is would they actually exercise with a home regime, jogging etc? It all works well until it's rainy for a few weeks, so you don't go out, then you lose motivation afterwards. Happens to us all, that's generally why people bother with gyms isn't it?

TBH IMO if they had the drive and control to go out to the gym regularly, they probably would have had the control to not get that overweight in the first place.

I think TooNice touched on the best idea talking about the health insurance idea.... instead of trying to work out ways to penalise people for having poor self-control, or offer them the facilities to not use because of that poor self-control focus on the opposite.

Instead reward those that do eat healthily and look after themselves, and thereby make it appealing.

[Lucio]

Ok, here's a question to everyone advocating going to the gym as the answer to obesity. How many of you go down the gym regularly? How many of you actually make an effort to keep at a certain weight rather than just naturally balance at more or less a healthy weight?


I'm willing to bet the answer is most of you don't and that most people just eat what they feel like.


It's very easy to turn round and say "oh so and so is fat because they don't try" or that "so and so would loose weight only if they exercised more". Every week I go to aerobics classes full of people beating themselves up over their appearance because they're made to feel sub-standard. Yes, some people really don't help themselves, but a far greater % of the people at my class really *can't* loose more than a few lbs of weight.

Sure, I've been fortunate, I was overweight because I over-ate, and once I've corrected that, I started loosing at a fairly rapid rate. My mum for example, had a serious hormone imbalance, and ballooned to 36 stone before she finally got a stomach bypass, but even under 24 hr medical supervision, she couldn't shed a single lb in weight on her own, because her body had broken down.


So please, when debating this, don't make such crass and offensive assumptions!

[Allen]

Fat people are fat. Ergo, they are fatties.

It's not a particularly derrogatory term, that's my point.

Oh please...

http://en.wikipedia.org/wiki/Fatty

A derogatory term for someone who is obese.

An insult is an insult, whoever it is aimed at and should not be advocated on Hexus.

[peterb]

Oh please...

http://en.wikipedia.org/wiki/Fatty

An insult is an insult, whoever it is aimed at and should not be advocated on Hexus.

Indeed, and while I dislike the tendency to be 'politically correct" (or as my youngest daughter once rebuked me 'culturally insensitive') HEXUS is a community with a diverse membership of all shapes, colours, sizes, gender and sexual orientation - and as many would deprecate aiming insults at some of those groups, those who have a problem controlling their weight - for whatever reason - deserve the same consideration.

[Alex]

Ok, here's a question to everyone advocating going to the gym as the answer to obesity. How many of you go down the gym regularly? How many of you actually make an effort to keep at a certain weight rather than just naturally balance at more or less a healthy weight?


I'm willing to bet the answer is most of you don't and that most people just eat what they feel like.


It's very easy to turn round and say "oh so and so is fat because they don't try" or that "so and so would loose weight only if they exercised more". Every week I go to aerobics classes full of people beating themselves up over their appearance because they're made to feel sub-standard. Yes, some people really don't help themselves, but a far greater % of the people at my class really *can't* loose more than a few lbs of weight.

Sure, I've been fortunate, I was overweight because I over-ate, and once I've corrected that, I started loosing at a fairly rapid rate. My mum for example, had a serious hormone imbalance, and ballooned to 36 stone before she finally got a stomach bypass, but even under 24 hr medical supervision, she couldn't shed a single lb in weight on her own, because her body had broken down.


So please, when debating this, don't make such crass and offensive assumptions!

Personally, I don't go to the gym as regularly as I could do, but I cycle for about 30 minutes a day, and I eat a relatively balanced diet.

That, however, is not the point I'm trying to make. I'm not saying 'fat people should do x to lose weight', more what I'm trying to say is that if people are obese and want to lose weight we, as a society, should do what we can to help. Free gym membership was an idea based on how much easier it is to motivate yourself to exercise in the gym than it is alone.

I have immense respect for anyone who has been severely overweight/obese and lost lots of weight because I recognise that it is a lot harder for some than for others - but at the same time it is possible for anyone who is obese to lose weight. If you expend more calories than you take in then it is an unavoidable consequence.

What I was originally trying to say is that we don't offer enough services to obese people, which is in itself really a disease (perhaps separate, though obviously on a scale, from being overweight). I have seen people die from morbid obesity in their 30s (well, OK, only one who died that young with obesity as a cause of death, but it tends to stick in one's mind).

[TheAnimus]

If you eat/drink more than you burn, you build fat.

If you eat/drink as much as you burn, you stay at whatever weight.

So fatties are fat because of their life choices / personal control. Been morbidly obese is what I'm talking about not someone who's 25 on the BMI. So someone who is fat only has themselves to blame, assuming of course they are responsible for themselves, if not then its their carer. Now there are a few exceptions people on certain medications for instance, they may find that it will alter their diet in a manner that is hard to predict or they have other more serious illnesses.

I'll be derogatory about heavy smokers, drinkers, drug users, the welsh, bad drivers and whoever else really shouldn't be behaving that way.

[TooNice]

How many of you actually make an effort to keep at a certain weight rather than just naturally balance at more or less a healthy weight?

You can only really do the later. If someone has a big meal, he'll be two kg heavier than in an open stomach. If I down a litre of water now, I would be 1kg heavier for the next few hours.

But I do monitor my weight often enough that I will know if I have packed 5lb of fat. That has happened, and I did something about it. Those 5lb didn't make me overweight, not even near, and even though it took a long time to accumulate, I knew it wasn't the correct direction, so I re-adjusted my diet and found a new caloric balance. It doesn't mean that I am eating the same amount of calories day, if I eat more one day, I'll eat a bit less the next, and the level of exercise also comes into play. Those are of course imperfect estimates, but good enough so that I won't get on the scale one day and be shocked that I am suddenly overweight.

A UK male of average height has about 40lb to play with between underweight and overweight (going with BMI - imperfect, but again basic estimate). Someone with fairly big bones should still have some leeway to do something about weight gains before they are classified overweight.

Yes, some people really don't help themselves, but a far greater % of the people at my class really *can't* loose more than a few lbs of weight.

In your class, maybe. And yes, there are people who genuinely can't help it. But take a look at this chart: http://www.nationmaster.com/graph/he...health-obesity

First of all, note that this is a chart on obesity. If you were that include those who are 'overweight', the numbers would more or less doubles. When the rate of obesity in this country is more than twice most of our European neighbours, or over 7x more than the least obese countries in the world, it's hard not to conclude the majority of the people who are obese in this country are simply letting themselves down. And while I can believe that once you reach a level of obesity, it'll be harder to go back down for numerous reasons, why leave it that late anyway? For the average male, it takes an additional 34lb to go from overweight to obese.

Yes, some people may have to work harder to maintain their weight. Just as some people have to study harder to make the grades. Yet if we were to compare ourselves with other countries, it's clear that we have more people who aren't trying as hard (unless you play the 'genetics' card).

[Rave]

I really don't care about fat people- help them to get thin if they want to by all means, but don't moan about them. The only time I've been vaguely offended by fatness was when I saw a story about a bloke who was so fat he needed a full time carer- whose job, it seemed, was to feed him a large pie and chips three times a day at the taxpayer's expense. That's taking the mick, but I'm sure it's an extremely rare example.

If an obese person sat next to me on an Easyjet flight I'd just make my elbows as spiky as possible if they didn't have the decency to keep their bulk on their side of the armrest to the best of their ability. But it's never happened. I can honestly say that I've never once been inconvenienced by a fat person.

I am of course accutely aware that our country's finances are in a mess, and lazy fatties on benefits aren't helping. But they're not the cause of our country's current malaise, any more than single mothers on benefits are.

The cause of our problems is that housing in Britain has become insanely expensive, to the extent that nobody on the minimum wage can expect to ever buy a house or accumulate any savings at all.....so lounging on benefits is the only sensible option for many people. Being unfit for work through obesity is as sensible a lifestyle choice as having two kids by the age of 18, or being an alcoholic/ drug addict.

I really hate this idea of 'nudging' people towards a supposedly healthy way of life by taxing foods that apparently contain too much fat. I eat a lot of fatty food, but I'm not fat. Please, all those who think they know better than me about what I should be eating.....bugger right off.

[Blitzen]

http://www.bbc.co.uk/news/health-12287880

Its quite shocking to see the cost, and their crude statistic about the weight and size of the average customer of an ambulance.

Obviously these costs have to come from somewhere, but where? Should we simply not provide emergency healthcare for anyone who is over 25stone? Not very platable option, but why should the rest of the NHS be seeing resources taken away from helping others to shift to people who are creating massive health problems for themselves by lack of good diet.

Taxing un-healthy foods is an idea that is often been tossed about, and actually I think so long as it wasn't just targetted on 'junk food' but instead on indeivdual catagories, ready meals / pizzas depending on the fat/sat content etc. Almost in the same way all supermarkets have different symbolic raiting systems, with a simple forumulea for tax catagory.

Partly true..but by the same token, what about..........
Ban fatties then ban:
1. Smokers
2. Drug Users
3. Immigrants (who haven't contributed a minimum 10 years income tax payments for example)
4. Alcoholics
5. People who partake in dangerous sports
6. Unemployed
7. Old people
8. The Welsh
etc
etc

Demonise one then you have to do them all.

[peterb]

Partly true..but by the same token, what about..........
Ban fatties then ban:
1. Smokers
2. Drug Users
3. Immigrants (who haven't contributed a minimum 10 years income tax payments for example)
4. Alcoholics
5. People who partake in dangerous sports
6. Unemployed
7. Old people
8. The Welsh
etc
etc

Demonise one then you have to do them all.

You have left off

Access users
Mac users
Windows users
MySQL users
PHP programmers
Financial sector programmers (do we have any of those? )

On a more serious note - wasn't an airline proposing to charge people an airfare based on their weight over a certain amount? After all, I weigh about 65Kg and if I fly (say) Easyjet) I get charged for a 20Kg suitcase. But someone of heavier build than me (say 150Kg pays the same basic fare although they have more mass on their own than me my case combined.

And a colleague of mine had to complain when sat next to someone taking up 1 !/2 seats - they physically couldn't lower the armrest between the seats - the upside was that he got an upgrade!)

[TheAnimus]

Partly true..but by the same token, what about..........
Ban fatties then ban:
1. Smokers
2. Drug Users
3. Immigrants (who haven't contributed a minimum 10 years income tax payments for example)
4. Alcoholics
5. People who partake in dangerous sports
6. Unemployed
7. Old people
8. The Welsh
etc
etc

Demonise one then you have to do them all.

Ah but we already do demonise these people don't we.

Smokers, ask them how they feel about the tax on ciggies.

Drug users, well its meant to be illegal.

Immigrants, have you any idea how much it costs to get a visa, and a work permit. Also even people who are on highly skilled can find it hard to move jobs etc, this is very worrying if you believe in freedom of employment and mobility to ensure fair treatment.

Alcoholics, they are heavily taxed, very much so.

Dangerous sports, the cost of the insurance for them (which is often mandatory) is really quite high, ask someone who runs an airsoft site how much of the green fee goes straight on insurance.

As I was saying should we try and put some of the cost on some of the causes? In the same way someone who just has a tipple of brandy twice a year will pay for someone who is irresponsible, you've slightly changed the scope of it. As without any tax on products everyone is paying evenly regardless of how responsible they are (this is hardly fair), a tax on the product, on the other-hand will mean people who consume more are taxed more.

Now we are derogarty and taxing to smokers, so why not the salad dodgers?

[oolon]

Junk food is kind of taxed already. Luxury food such as biscuits are subject to VAT as is takeaway food, and eating out. Only cook at home food is VAT free. So thats a 20% tax already.

As to fatties, ok I am not exactly light myself, being 6'2" in height I would be well over the average weight even if I wasn't. Ok not 25 Stone, however thats less of a "stretch" for some people than others. People are also taller on average than they used to be, particularly Females as it was common to give girls drugs (even 30 years ago) to stop them growing when they reached "normal height". As it was seen it could be a problem for them finding a husband... !??!!?!?

[tiggerai]

Please note I have NOTED the reported posts... I don't see anything here particularly derogatory (along the lines of "birds" for women etc)

I'm not going through this thread correcting every term. That's not a good use of my time.

We have established that "Fatty" is a derogatory term for those who are Obese. This can be applied from now on, people have learnt from the thread so please curb your use for those who seem to be finding it offensive.

On the flop side, we can't be catering to everyone... if we censored every little thing that could be sensitive to anyone on Hexus, then we would have very little to talk about.

[Allen]

On the flop side, we can't be catering to everyone... if we censored every little thing that could be sensitive to anyone on Hexus, then we would have very little to talk about.

Not true at all. You can have a perfectly good discussion without using insults and derogative terms to group all types of people together without knowing the reasons as to why they are the way they are.

I have no problem with the discussion going on here, people are allowed their own opinions, but I (and some others who have posted the same) do have a problem with the insults. There is simply no need for it and is against the forum rules.