Are you a "fattie"?

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startrekker

Joined: May 13
Posts: 85

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Posted: 16 Oct 2013, 18:15
Posting this article from this week's Spectator magazine about obesity and Britain's National Health Service, to share a perspective from this side of the Pond...

***


Max Pemberton, 'Obesity is not a disease: pretending otherwise will stoke an epidemic and crush the NHS' (Oct 12, 2013)

'Well, what diets have you tried so far?’ asked the GP (general practitioner/family doctor), flicking through the patient’s notes. I was an innocent trainee doctor on my general practice placement at the time and watched the interaction carefully, sensing a row was about to ensue. ‘Look, I don’t want to go on a diet, I want you to prescribe me these,’ snapped the patient, bringing out a neatly folded page she had torn out of a magazine. The GP, rolling his eyes at me, took the paper but didn’t read it. I suspected he’d read it before. This was yet another example of what’s becoming a very British epidemic: obesity being self-diagnosed as disease.

The doctor attempted to explain that tablets really aren’t suitable in her case. As well as having some potentially nasty side effects, they’re expensive to prescribe, and don’t offer a long-term solution. This was clearly not what the woman wanted to hear. ‘Fine then, don’t help me, see if I care. I’ll get my sister to get them off her GP — he gives her whatever she wants’; and she stormed out. It struck me as bizarre that while some people using the NHS are dangerously malnourished, other people are desperate to take tablets to ensure that their food passes through their body unabsorbed, while the taxpayer foots the bill.

It happens all the time. The patients who are not interested in changing their diet in any way, demanding to have their cake, eat it and then pop a pill so that the calories never touch their waistline. And as a result, Britain now combines austerity with obesity. The majority of us are now overweight or obese — a third of children are considered too heavy. It costs an extra £5 billion a year, and 300 hospital admissions a day are directly due to obesity. To pick up the newspapers is to witness a country adjusting itself to losing a national battle of the bulge.

Take the East Midlands Ambulance Service. It emerged this week that it has been picking up so many fat patients — weighing in excess of the 28-stone maximum — that it needs a new fleet. It has, hitherto, been struggling along with just one ambulance for fatties (a ‘bariatric’ vehicle), but now thinks all 272 of its ambulances need to be upgraded with double-wide stretchers for patients who (it says) can weigh in at 55 stone. The plan will cost £27 million.

Once the obese patient is in hospital, a whole new set of equipment is required: reinforced operating tables, sturdier trollies, longer needles and even wider MRI scanners. There is a great demand for bariatric surgeons. One of them, Sally Norton, recently wrote in the Royal College of Surgeons’ house journal that without special equipment for the obese, there may be ‘enquiries into the potential use of veterinary or zoological scanners, with resultant loss of dignity for the patient’. There is a cost to all this: in the kit, and in operations like gastric bypass operations, which have increased sevenfold over the last seven years.

Moving obese patients out of their house can be too difficult for the NHS. Recently the fire service had to demolish two walls of a house in south Wales so that a 63-stone teenager could be taken to hospital. This required more than 40 emergency service workers at an estimated cost of £100,000. Over the past five years, fire services have been called to more than 2,700 incidents to assist ‘severely obese’ people, including some who had got stuck in the bath. Rescuing fatties is now a routine operation, with its own entry in the Fire Brigade incident reporting system (filed under ‘bariatric persons’).

So what to do? The government spends money asking us to eat ‘five a day’ fruit and veg, but it seems to have no effect. Nottingham, the fattest region in Britain, recently decided to spend £500,000 on replacing pavements in areas with particularly fat pedestrians, to try and encourage people to walk more. Our landscape is being, quite literally, reshaped in order to accommodate the obese. In the past few years, we have moved from being outraged about the epidemic to just planning around it. Like a middle-aged man deciding to eat what he wants and let himself go, Britain is pulling on a pair of tracksuit bottoms and heading to the fridge.

It need not be this way. For too long, my fellow doctors have pussyfooted around their obese patients, too scared to confront the, er, elephant in the room. They don’t want to cause offence. Unbelievably, draft guidelines announced last year by the National Institute of Clinical Excellence and Health (Nice) suggested that doctors should even avoid the use of the term ‘obese’ for fear that larger patients might be upset. Instead, Nice recommended advising corpulent patients that they should seek a ‘healthier weight’.

But nice euphemisms mean that people don’t confront reality. I’m not going to stop diagnosing cancer just because people don’t like hearing the dreaded word. So why should it be different when informing people that they are obese? Sometimes morbidly so. What Nice is delicately skirting round is what many doctors, nurses and dieticians will confirm: people don’t like being told that they are overweight, even if it’s objectively clearly the case. And by pretending that this is a disease, the doctors are making it even worse.


There’s something comforting about blaming obesity on genes. It enables people to relinquish responsibility for their weight, which can be seen as outside their control. It’s nothing new, either. Years ago, fat people blamed their ‘glands’. When I started medical school, I patiently waited for us to be taught about these magical ‘glands’ that made people fat. I’m still waiting. Even when people have problems with an underactive thyroid, which can slow the metabolism and result in weight gain, this can be treated with thyroid replacement tablets and the metabolism returns to normal. As a rule, however, fat people have one thing in common: they eat more than they need to.

Certainly some people metabolise food at a different rate to others, meaning they are more likely to lay down fat stores than other people. But this is a reason to eat less, not to become fat. You cannot get away from the basic biology of the human body — fat is simply stored excess energy, and weight gain is only possible when the total amount of energy consumed exceeds the total amount of energy expended. Even those who have a genetic predisposition to become fat are not slaves to their DNA.

An in-depth study published last year, which looked at the genes of more than 20,000 people and was conducted at the Medical Research Council’s epidemiology unit in Cambridge, found some people are predisposed to be overweight. But an active lifestyle and reducing food intake can counteract that. Simple. While some will be annoyed by this research, I find it empowering. The idea that our genes control us is profoundly depressing. After all, there is more to being human than a few strands of DNA.

The rate of people considered clinically obese has risen from around 1 to 2 per cent of the population in the 1960s to over 25 per cent now. Why? A simple answer would be lifestyle, but it’s actually a little more complicated. A fascinating survey conducted by the Department of Health compared data collected from 1967 and 2010. It showed that, while people back then were slimmer, they ate fattier foods and had access to far fewer gyms. We eat better now, we work out more. But we live relatively sedentary lives. Only three out of ten households had a car then, compared to seven out of ten now. While 75 per cent of people walked for at least half an hour a day in the 1960s, this is only about 40 per cent now.

What really stands out, more than the lifestyle differences, is the sharp contrast in the attitudes towards obesity between the two different eras. The 1967 survey found that nine out of ten people had attempted to lose weight in the past year, compared with barely half of adults questioned in 2010. Perhaps most tellingly though, 40 years ago only 7 per cent of those people who considered themselves overweight had failed to do anything about it, compared with nearly half now.

It would be easy to blame Britain’s fatness on lifestyle changes, but the worst of it is attitude. People just aren’t bothering to lose weight any more. Perhaps obesity is viewed as more normal. But this is also down to the attitude that we doctors increasingly encounter in our consulting rooms: the reluctance of patients to accept that ailments can be blamed on their behaviour, for which they are reluctant to take responsibility.

Patients blame obesity on the government, cunning food manufacturers, their parents and their genes. They demand fat-loss pills on the NHS and stomach-stapling surgery as a right. In a world where health care is becoming consumerised, patients see themselves as customers. There’s not much demand for hard truths.

America has severe obesity problems, and seems resigned to them. But Britain has a National Health Service, and therefore a far higher capacity to change. It ought to be easy. Doctors should be required to tell patients a blunt truth: if you’re fat, eat less, exercise more, or both. And if you keep guzzling the tasty treats, you will die earlier. It’s not a disease, it’s a mindset — and that means it can be changed. We doctors need to be a little less understanding, a little more judgmental, and realise that our oath — ‘do no harm’ — must come before our desire to save the feelings of our patients. The truth can be the hardest drug to administer. But holding our tongues, prescribing the fat pills and bankrupting the NHS in the process is the worst solution of all.
"There's no secret. You train a lot and eat right" (Mo Farah, British Olympic marathon runner).
kingkeld

Joined: Sep 09
Posts: 1,995

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Posted: 17 Oct 2013, 01:26
This is an absolutely brilliant article. I have to agree with it. Obesity is NOT a disease. If anything, it can be THE RESULT of having a disease. By far the most of these would be in the mental department, and most just minor things.
The main kicker for obesity is that we generally eat too much and move too litlle - whether we like this fact or not.

I have no doubt that hearing someone mention me as "the fat guy" instead of "the heavy set gentleman" has step by step pushed me to do something about it. Sometimes kindness doesn't get us anywhere - and if your physician can't tell you the truth about your (over)weight, then who can?

Fact is, the world is getting fatter, and it's not because we're all getting sick.

Visit my website: www.tabdig.info

"Losing weight is never about eating as little as possible"
- Kingkeld.
"You wouldn't worry so much about what others think of you if you realized how seldom they do.
― Eleanor Roosevelt
"Do. Or do not. There is no trying."
- Master Yoda.

I went from morbidly obese to being the owner of TABDIG - a weight loss coaching service that helps people worldwide losing weight. It's been an amazing journey. From October 4th 2010 to April 3rd 2012 I lost half my body weight - 80 kilos/170 lbs. Since then, I have had two cosmetic surgeries to remove excess skin. I have now quadrupled my strength, gained several kilos in muscle mass, and today I focus on building muscle, optimizing my diet, living healthy and helping people to reach the very same goals. I am stronger, healthier, thinner, happier! If you feel that you need help losing weight, don't hesitate to send me an inbox message.
mummydee

Joined: Feb 10
Posts: 2,399

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Posted: 18 Oct 2013, 04:41
What a wonderful article, thank you.

It's amazing how society has become more accommodating to the obese. Escalators in malls etc are being made wider, seats in theatres and on planes and even clothing manufacturers are changing the #'s of the size of clothes so that people can say "i'm into an 8" when really they're a 10 or 12.

We not only eat too much but too much of the wrong unhealthy foods.

I wish more Dr's had this attitude.
mars2kids

Joined: Mar 11
Posts: 1,295

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Posted: 18 Oct 2013, 14:13
This is an interesting article. I'm an American and see how easy it is to get sucked into the super sizing, instant gratification world. I'm not overweight, but I do have some health issues. My doctor does encourage me to exercise, I have the beginning of arthritis in my knees and he is telling me he's going to be harder on me if I start gaining weight because it will be harder on my body. I'd much rather have him be like that then let me gain and just complain about the pain and take pills for it. The mindset does need changed, it is just hard to do. It would be easy for me to gain 100 lbs., but it seems so hard to lose 5 lbs. Like I said instant gratificaiton is hard for weight loss, because it takes time. Hopefully, if we try to live healthier lives then our children will live healthier lives.
Goals for 2014:
Complete Couch to 5K- DONE!!!
Sign up for and complete a 5K- DONE!! 35 mins.
Plan at least 3 outings with the family that involve being active- 2 done
mummydee

Joined: Feb 10
Posts: 2,399

      quote  
Posted: 18 Oct 2013, 15:19
OH, Mars, don't feel so disheartened. I'm 58, didn't start with the arthritis till in my 50's and said no way, absolutely not will i let my body dictate my life. I stopped all whites, white sugar white flour and white starches, then I completely quit all processed foods,
Now it's all real foods with naturally grass fed and raised animals and guess what, no arthritis, no health problems , no b/p pills, nadda!
Healthy has a side effect.... weight loss! so don't think there's not a cure.
Dr's don't know/ or believe in the power of going back to our natural way of eating.. it's all 'oh well' here's a pill...

try it and see, you've got nothing to lose but the pain!
ClassicRocke...

Joined: Jan 13
Posts: 957

      quote  
Posted: 18 Oct 2013, 15:30
Mars... we can gain because it doesn't require us to think, pay attention and do what is the best for our bodies. It's mindless existence. Losing and dieting to reach a healthy body weight takes, time, energy and brain power. We have to think, plan and follow through.

My son was in Sweden a few years ago and complained that their portions were miniscule compared to what is served in this country. But most of his fellow students admitted everyone was thin or thinner then they were. Now he understands, being 40lbs. down. We all eat off smaller plates. The humongous plates are no longer used unless we have company then they ask why we're not eating because we don't fill them up.

Super size the portion, super size the person.

***It just means being more independent and not allowing your happiness to be dependent on someone else's demanding and contentious attitudes and actions.***

Wisdom from a friend


I am willing to release the need to be unworthy. I am worthy of the very best in life and I now lovingly allow myself to accept it.
2ManyCurves

Joined: Jan 12
Posts: 189

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Posted: 18 Oct 2013, 19:10
As a fat American, I'm going to go ahead and be the first to say that I don't care for this article. Fat people know we are fat. If all you have to say to a patient after a minimum of eight years of college is "You're fat", then congratulations for being able to make the very same observations as any kindergartener. Many of us fatties avoid going to doctors out of shame that we will be treated in the very way the author of this article believes physicians should interact with their patients. Most of us fatties know how to lose weight too as we have generally been successful on diet after diet after diet. We can lose weight and gain it right on back better than any skinny person. It doesn't take an M.D. to realize that for many of us, it isn't a matter of not realizing we are fat or not knowing that we have been sedentary. Really, it takes our fat little minds to be motivated not by being shamed by the very people we actually get the courage up from which to seek out help, but to learn ways of dealing with our emotions and our reactions to life. It may take medication for some of us to get a jump-start on track. And, some of us may ultimately have to turn to gastric bypass or stomach staples. Granted, neither of these interventions will be successful longterm until the underlying cause of over-eating/sedentary lifestyle is addressed. But, if we are there in the doctor's office seeking out help and the only response a physician can give us is shame, then perhaps said doctor is in the wrong profession.
NCNOLE

Joined: Feb 11
Posts: 1,218

      quote  
Posted: 18 Oct 2013, 20:17
2ManyCurves wrote:
Most of us fatties know how to lose weight too as we have generally been successful on diet after diet after diet. We can lose weight and gain it right on back better than any skinny person.


And that is the problem - you have not been successful until you have tackled the situation, learned what caused the weight gain, and learned how to keep it off. It does not require a "diet" but a change in your thinking, your behavior, your lifestyle - you must commit to a new lifestyle. You can not simply go on a diet, lose weight and stop there. You must figure out what caused you to overeat, learn how to manage those behaviors, and then live a healthy lifestyle.

Doctors must say something b/c too many of us live in a state of denial and need that push. They probably should do more - they should refer their patients to professionals that can help them. Obesity leads to so many other health problems that the doctor must address the root cause and not ignore it b/c they don't want to offend or b/c they figure the patient already knows. Sometimes, it is easier to see it in black and white, on paper - which is probably the only benefit of the BMI scale.
bugzbetty

Joined: Sep 09
Posts: 88

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Posted: 19 Oct 2013, 04:04
And where do you find the smaller plates, Classic Rocker? I have looked and there doesn't seem to be a ready supply of salad sized 9 inch plates on the market. I have a couple of old chipped ones, but most plates now are 10 inches. An inch really does make a difference in how much food you can pile on.
ClassicRocke...

Joined: Jan 13
Posts: 957

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Posted: 19 Oct 2013, 09:50
Truth be told... Dixie paper plates. 9" total diameter, 8" eating area. Flimsy too. So you know you can't add a whole lot of food without doubling or tripling the plates.

My dinner ware plates are 11". And you know how much food you can pile up on that.

Take that inch on the total circumference of the plate and imagine the amount of potatoes you can pile up on it. I could build the Berlin Wall.

***It just means being more independent and not allowing your happiness to be dependent on someone else's demanding and contentious attitudes and actions.***

Wisdom from a friend


I am willing to release the need to be unworthy. I am worthy of the very best in life and I now lovingly allow myself to accept it.
kingkeld

Joined: Sep 09
Posts: 1,995

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Posted: 20 Oct 2013, 07:42
We usually eat from 6" plates in my house, if we're just "us" eating. If there isn't enough food in one plate full, then there is always the option of seconds. It's rare that anyone goes for another serving though.

I never went to look for smaller plates. I just grabbed the ones we already had.

Don't let the trouble of finding a one inch smaller place keep you away from eating right. Smile

Visit my website: www.tabdig.info

"Losing weight is never about eating as little as possible"
- Kingkeld.
"You wouldn't worry so much about what others think of you if you realized how seldom they do.
― Eleanor Roosevelt
"Do. Or do not. There is no trying."
- Master Yoda.

I went from morbidly obese to being the owner of TABDIG - a weight loss coaching service that helps people worldwide losing weight. It's been an amazing journey. From October 4th 2010 to April 3rd 2012 I lost half my body weight - 80 kilos/170 lbs. Since then, I have had two cosmetic surgeries to remove excess skin. I have now quadrupled my strength, gained several kilos in muscle mass, and today I focus on building muscle, optimizing my diet, living healthy and helping people to reach the very same goals. I am stronger, healthier, thinner, happier! If you feel that you need help losing weight, don't hesitate to send me an inbox message.
kingkeld

Joined: Sep 09
Posts: 1,995

      quote  
Posted: 20 Oct 2013, 07:43
ClassicRocker wrote:

Take that inch on the total circumference of the plate and imagine the amount of potatoes you can pile up on it. I could build the Berlin Wall.


Many of us could have had an amazing career in construction! Very Happy

Visit my website: www.tabdig.info

"Losing weight is never about eating as little as possible"
- Kingkeld.
"You wouldn't worry so much about what others think of you if you realized how seldom they do.
― Eleanor Roosevelt
"Do. Or do not. There is no trying."
- Master Yoda.

I went from morbidly obese to being the owner of TABDIG - a weight loss coaching service that helps people worldwide losing weight. It's been an amazing journey. From October 4th 2010 to April 3rd 2012 I lost half my body weight - 80 kilos/170 lbs. Since then, I have had two cosmetic surgeries to remove excess skin. I have now quadrupled my strength, gained several kilos in muscle mass, and today I focus on building muscle, optimizing my diet, living healthy and helping people to reach the very same goals. I am stronger, healthier, thinner, happier! If you feel that you need help losing weight, don't hesitate to send me an inbox message.
ClassicRocke...

Joined: Jan 13
Posts: 957

      quote  
Posted: 20 Oct 2013, 08:30
Actually worked in demolition and construction for 4 years.Laughing

***It just means being more independent and not allowing your happiness to be dependent on someone else's demanding and contentious attitudes and actions.***

Wisdom from a friend


I am willing to release the need to be unworthy. I am worthy of the very best in life and I now lovingly allow myself to accept it.
kingkeld

Joined: Sep 09
Posts: 1,995

      quote  
Posted: 20 Oct 2013, 08:48
LOL! Proves my point! Very Happy

Visit my website: www.tabdig.info

"Losing weight is never about eating as little as possible"
- Kingkeld.
"You wouldn't worry so much about what others think of you if you realized how seldom they do.
― Eleanor Roosevelt
"Do. Or do not. There is no trying."
- Master Yoda.

I went from morbidly obese to being the owner of TABDIG - a weight loss coaching service that helps people worldwide losing weight. It's been an amazing journey. From October 4th 2010 to April 3rd 2012 I lost half my body weight - 80 kilos/170 lbs. Since then, I have had two cosmetic surgeries to remove excess skin. I have now quadrupled my strength, gained several kilos in muscle mass, and today I focus on building muscle, optimizing my diet, living healthy and helping people to reach the very same goals. I am stronger, healthier, thinner, happier! If you feel that you need help losing weight, don't hesitate to send me an inbox message.
mummydee

Joined: Feb 10
Posts: 2,399

      quote  
Posted: 20 Oct 2013, 13:53
2manycurves,
I really don't think this dr is giving 'shame' he's doing what i call 'Being Real" Quit coddling and being politically correct and simply stop looking for that 'extra help' whether in pill form or an operation from the dr. In today's day and age with the internet and other media there is no excuse for not educating yourself and making changes yourself.
I don't agree with your comment that fat people know they're fat. Too many overweight people are using the 'i'm okay with myself just the way I am" and accepting it as their normal.
As Ncnole says DENIAL ! We are on this site because we have acknowledged the fact that we needed to lose weight, but thousands are doing nothing about their weight problem at all.
2ManyCurves

Joined: Jan 12
Posts: 189

      quote  
Posted: 21 Oct 2013, 08:05
Mummy,

I am not looking for that "extra help" in the pill form or an operation form the doctor. However, I am not so arrogant to think that my way is the only way. That is all.

Much love on your journey.

2MC.
mummydee

Joined: Feb 10
Posts: 2,399

      quote  
Posted: 21 Oct 2013, 08:20
Sorry 2MC Those comments were not aimed directly at you personally, I was talking in general re what dr`s have to do regarding the patients.

I can imagine the dr`s dilemmas and have spoken to a few about it. So many come for that pill or procedure but when told that they first have to try all options and gastric bypass is the last resort, they storm out of the office.

I in no way think my way is the only way. I lost my weight on LC and i will continue it for life. My best friend lost 150 on WW and I support her completely.







FullaBella

Joined: Oct 12
Posts: 1,081

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Posted: 21 Oct 2013, 15:48
The article kind of had a 'chicken or egg' question like feel to it - which came first? Are ambulances and furniture being supersized because we gained or did we gain because we're encouraged for ten cents more we can get an extra 8oz of soda or and extra potato serving of french fries.

And in our instant gratification, live streaming video, microwaved, immediate downloaded life, we are not accustomed to doing things the hard way. I grew up watching movies predicting the future were things get even easier. Doesn't seem to be happening. We seem to be victims of our own progress.

My physician prescribed RX for my high blood sugar and high cholesterol last Aug; when I told her I wanted to try to lower it with diet, she was skeptical. Very warily she replied, "ok, I'll give you 90 days but if you don't keep it up after 30 days phone me and I'll get the RX to you."


I'm not losing WEIGHT. I'm converting FAT to MUSCLE to be healthier.
mummydee

Joined: Feb 10
Posts: 2,399

      quote  
Posted: 21 Oct 2013, 16:30
FullaBella wrote:


My physician prescribed RX for my high blood sugar and high cholesterol last Aug; when I told her I wanted to try to lower it with diet, she was skeptical. Very warily she replied, "ok, I'll give you 90 days but if you don't keep it up after 30 days phone me and I'll get the RX to you."

I was on bp and water pills and when my dr wanted to put me on statins for slightly high cholestrol I said no way, I'll do it with diet. I could see his eyes roll and said the same thing as your fulla, but he gave me 4 months.
Funny thing was that at the time I was almost a complete vegetarian but still eating a little chicken and fish.
I went back to my old eating plan of LC high protein.
When I went back, I not only did not have to go on Statins, but he took me off the water pill and 2 months later lowered my bp meds.

He was very surprised and this is when we got chatting about how little true effort people put into their own health. They might leave his office with good intentions but lose momentum as time goes on . Or as you said fulla... they get caught up in the food industry that sabotages you at every corner.

ClassicRocke...

Joined: Jan 13
Posts: 957

      quote  
Posted: 21 Oct 2013, 16:40
Your last sentence...food industry that sabotages you at every corner. Wish I could remember the post where someone made the statement the food industry is making healthy food. My thought was, "no, they're in the business of making $ at the expense of our health and pockets. I did get a good laugh out of it but didn't respond. Too bad. Should have. Made me wonder where they worked.

***It just means being more independent and not allowing your happiness to be dependent on someone else's demanding and contentious attitudes and actions.***

Wisdom from a friend


I am willing to release the need to be unworthy. I am worthy of the very best in life and I now lovingly allow myself to accept it.



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