"NHS approach to obesity 'patchy' " « CityCyclingEdinburgh Forum

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"NHS approach to obesity 'patchy' "

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Started 12 years ago by chdot
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chdot
Admin

"

Obesity services across the UK are "extremely patchy", meaning valuable opportunities to help obese patients are often lost, doctors say.

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"Obesity is not only caused by how much we each eat or drink: if tackling it were as simple as telling people to eat less and move more, we would have solved it by now.

"Our chances of being obese are also affected by factors like whether we have easy access to affordable fruit, veg and other healthy foods, and if it safe to let our kids play outside."

"

http://www.bbc.co.uk/news/health-20876530

And

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Health experts call for a review of specialist obesity services claiming there is "inadequate" provision in the NHS to treat overweight patients.

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The Welsh government has set up the Change4Life Wales programme to support people's healthy lifestyle choices.

And it is also trying to find 1,000 NHS staff to lead by example with a Champions for Health scheme.

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http://www.bbc.co.uk/news/uk-wales-20878210

Also

http://www.dryjanuary.org.uk

Discussed on radio this morning.

Must be the time of year people make resolutions...

A lot of discussion about a) 'GPs are expected to do too much' b) 'by the time the NHS gets involved it's a bit late'

Lots of talk about 'activity' - particularly lack of and dangers of sitting down too much (esp at work).

Some mention of walking, didn't notice 'active travel' or cycling.

Posted 12 years ago #
minus six
Member

If I remember correctly, NHS are a major national car park operator, with some fringe health services occasionally tacked on the side ?

Posted 12 years ago #
wee folding bike
Member

Heck some clown just brought out a movie called the Life of Pie.

Posted 12 years ago #
chdot
Admin

http://www.meetup.com/edinburgh-walking/

http://www.meetup.com/EdinburghWFH/?set_mobile=off

Posted 12 years ago #
chdot
Admin

http://www.guardian.co.uk/society/2013/jan/01/uk-needs-michelle-obama-obesity

Posted 12 years ago #
Claggy Cog
Member

We never had a problem with obesity when cars were not so common and food was less available, i.e post war rationing, fewer exotic imports, and food shops/supermarkets not open 24/7. It is easier to buy fruit and veg and types of such than it was say in the 80's. The people that I work with that are truly obese do not eat fruit and veg because they don't like it and/or cannot be bothered to prepare healthy food. We have become a very lazy nation, not unlike the States, where people prefer to take the car to the drive-in, supermarket, and eat pre-prepared/ready meals, full of salt and carbs, and also too many fizzy drinks. Obese people already absorb huge amounts of money in a groaning, broke NHS, and need to do something for themselves and not be mollycoddled, and being told the truth will hurt. Orthopaedic services for arthroplasties in the obese costs huge amounts of money, as do the diabetes services. Other costs incurred by obese patients are for things like hoists to get them out of beds and chairs, which are bariatric to accommodate their enormous bodies and weight. People need to eat less and exercise more, fact...no getting away from it, end of. Sounds like a lot of excuses being made for those not prepared to help themselves.

Posted 12 years ago #
gembo
Member

@claggy cog

Need to distinguish between the deserving fat and the undeserving fat

Posted 12 years ago #
Claggy Cog
Member

@gembo...and the difference is? One can afford to be fat the other can't?

Posted 12 years ago #
Calum
Member

If only there was some way we could provide the opportunity for people to build exercise into their everyday lives. Someone should invent some kind of vehicle that people can propel using their own bodies. The Government and councils could then provide paths dedicated to the operation of such a vehicle.

Posted 12 years ago #
Cyclingmollie
Member

Claggy Clog: "food was less available, i.e post war rationing"

Yep, the government demanded that farmers produce milk, cream, butter and (Cheddar) cheese during the war - energy dense foods with a high fat content. After the war, subsidised dairy production continued with the associated rise in health problems.

Posted 12 years ago #
Claggy Cog
Member

@Tom - that may well be true, however, "fat free" alternative dairy products or "low fat" have huge amounts of sugar/sweeteners and salt added. The dairy industry is not solely responsible for the rise in obesity and most farming is subsided, and if you listen to the dairy farmers they would tell you that they get a raw deal in comparison to other types of farmers. Also to blame in that case is the common agricultural policy employed in the whole of the EU. Blaming someone else for the problem is a cop out. As consumers these days we are supposedly very well informed and we have never had choice as much as we do now, and the choice to make those informed decisions.

Posted 12 years ago #
kaputnik
Moderator

People need to eat less

Not just less, but better also.

Posted 12 years ago #
gembo
Member

@ claggy cog

Deserving fat, born with low metabolism, eat well, exercise but are still heavy?

I was being satirical as you sounded to me like George Orwell in Road To Wigan Pier where he shows that if the northern poor ate whole meal bread and raw vegetables for the thirty shillings they had to spend they would be healthier and live longer compared with the diet of white bread, lard and potatoes they preferred. This was in 1930s so the idea that the poor eat more unhealthy food now than they did 80 years back is possibly inaccurate.

Just chewing the fat as it were but coming up with methods to encourage people to be healthy is tricky. Fat people are an easy target. Some folk eat as they are greedy, others as they are sad, some are downtrodden in a learned helplessness scenario

Posted 12 years ago #
Claggy Cog
Member

To paraphrase;

"Annual income twenty pounds, annual expenditure nineteen [pounds] nineteen [shillings] and six [pence], result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery."

Think in terms of calories instead of money...expend just 1200 calories and eat 1200 worth, equilibrium/happiness.

Expend 1200 and eat 2,000+, makes for a burgeoning waistline and eventual obesity if you continue...result misery.

Posted 12 years ago #
gembo
Member

In my mind the deserving fat have read Wigan pier and david copperfield and enjoyed WC Fields portrayal of Micawber, plus kept there calorie intake at 1200 or 2000 and cycle a bit. They are also going to cycle more in 2013 and develop further their discipline of mind to resist pudding when not hungry. Of course they are merely the tip of the fat iceberg

Posted 12 years ago #
Kirst
Member

Claggy Cog: fatshaming on a forum near you.

Posted 12 years ago #
neddie
Member

It is the duty of the NHS to treat all patients, regardless of what they have 'done' to themselves. Like it or not, that includes all fat people, smokers and those that have broken their collarbone while mountain biking,etc...

Part of the problem is that in the government/NHS/media, the link is still not being made between exercise and activity as part of daily life. When they talk of exercise they always talk about gyms. Gyms are boring, and most are not motivated to go to them for any significant length of time.

Posted 12 years ago #
Claggy Cog
Member

@gembo - at least the top 20% floats above the surface and 80% hidden from view!

After a fair number of miles on the bike, one has the reward of the possibility of cake, it may even be considered deserved, but not entirely necessary.

Posted 12 years ago #
Claggy Cog
Member

@Kirst - where?

Posted 12 years ago #
kaputnik
Moderator

NHS would do better to live up to the name "health service", currently it's operated largely as an "illness service". With attached carparks.

Posted 12 years ago #
steveo
Member

To be fair to the NHS the approach to all services can be seen as patchy given that all health care franchises operate slightly differently.

Posted 12 years ago #
SRD
Moderator

kirst - I've really appreciated the times in the past when you've challenged our unthinking pathologizing of fat and fat people, and even more when we've simply stereotyped and/or been rude.

So, maybe on this topic, you could actually give us your take - professional or personal - on how this topic should be approached?

I am very aware that issues of weight, obesity, inactivity, and food choice are complicated, and coloured with assumptions and bias. But I am wary of 'medicalizing' everything, which our culture seems to do - whether that is childbirth, parenting, mental health or weight.

My entirely unscientific take is that much of what now becomes a 'health issue' could be prevented by lifestyle 'choices'. The problem is, that for many, these aren't 'choices' at all. But I don't know where to go from there - other than to campaign for making streets safer and easier for active travel, community gardens, etc etc

Posted 12 years ago #
gembo
Member

The guardian newspaper have just e-mailed me an invite to join their Eat Right club. First month free. Looks to be sensible advice I already know. Walk don't drive, take the stairs, eat wholemeal pasta, cycle. The website has much text, a list of excuses for not becoming healthy etc but back to our original topic, it is preaching to the converted or to those how want to change. The tricky thing is to get people who are not even pre contemplative about changing their lifestyles to adjust their habits

Posted 12 years ago #
lionfish
Member

I'm sure minimoth and Edinburgh Community Food will have something to say about all this :) Will link this thread to minimoth...

Posted 12 years ago #
kaputnik
Moderator

There's a club you can pay to join that tells you to take the stairs and wat wholemeal bread?

Where do I sign up?!

Posted 12 years ago #
chdot
Admin

"Where do I sign up?!"

You're already signed up - CCE is the whole meal cycling club.

Members probably take the lift to conserve their energy for cycling home.

Posted 12 years ago #
Lezzles
Member

Take a look at the scary stats in this link. Strong strong link between deprivation and obesity. Also strong ethnic links to obesity. http://www.noo.org.uk/slide_sets

Posted 12 years ago #
kaputnik
Moderator

Strong strong link between deprivation and obesity

If that's slide 13, I didn't interpret it that way, (and was surprised by it somewhat).

Given the error bars, there doesn't appear to be a link for males between deprivation quintile and obesity prevalence (least deprived to most deprived - 23.8% / 26.7% / 25.2% / 26.4% / 25.5% prevalance)

For women there is a bit of a difference with the bottom two quintiles of most deprivation (30.3% and 31.5% prevalance) vs. the upper three (21.5% / 21.8% / 25.5%), but it's not a mahoosive difference.

The links between highest level of education are far more apparent, as are the differences between ethnic groups (for Pakistani, Bangladeshi, Black Caribbean and Black African females vs. their male counterparts of the same ethnic background).

Across "social class", it is interesting that there isn't much difference for males, but it is much wider for females.

Posted 12 years ago #
Baldcyclist
Member

EDIT:

Post moved to Edinburgh takeaway thread, seemed more appropriate there. Feel free to delete, sorry!

Posted 12 years ago #
SRD
Moderator

yes, clearly complicated things going on with gender, which prevent easy interpretation of correlations between 'class' 'ethnicity' and weight.

I'd like to see what happens if they hold class constant across ethnicity or vice-versa.

Posted 12 years ago #

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