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Perhaps we should start by getting the numbers right

‘I’m a doctor – here’s how I would solve Britain’s obesity crisis’
From a GP to the head of the behavioural ‘nudge’ unit, three professionals give their opinions on how to tackle our weight problem

OK, interesting.

At the same time, obesity now affects two thirds of UK adults, at a cost of £6 billion to the NHS each year.

Fat people dying young saves the NHS money. So our noble health warriors are wrong out of the starting gate.

Anyway, we all know whay the solution to obesity is. Ban central heating.

35 thoughts on “Perhaps we should start by getting the numbers right”

  1. I was a bureaucrat. So I’d just ban fussing about obesity.

    Meanwhile, would you like a slice of chocolate cake??

  2. There’s a hypothesis that the increasing amount of dietary ‘seed oils’ over the last few decades has led to obesity in later life. Unfortunately ‘seed oils’ are found in many tasty processed foods and even meant from animals fattened on grains and soya.

    If the hypothesis is true then reducing obesity will need wholesale changes in how our food is produced. And of course those with fond memories of ‘naughty but nice’ foods will resist.

  3. If the hypothesis is true then reducing obesity will need wholesale changes in how our food is produced.

    That’s probably the attraction for the nannies writing the article, and the bureaucrats micromanaging our daily lives.

    And when their meddling has upended the food production system, made the weekly shop cost 10 times more for everyone, and it turns out that their new centrally-planned production system is far more toxic and likely killed thousands, it won’t be a problem for them because they will have long retired on their gold-plated index-linked taxpayer-backed state pensions.

  4. You could say that the thinking behind banning gas boilers and trying to ban cars was the government fighting obesity, but that would require the government to actually have joined-up thinking.

  5. I’m a doctor – here’s how I would solve Britain’s obesity crisis’

    Cool glasses, wanna see a pyramid?

  6. If porkers were only costing the NHS £6bn it would be a drop in the ocean, especially considering how many there are. Of course, as Tim says, they are a bargain compared with all those lingering on benefits for decades.

    This is just the public sector looking for someone else to blame for its own uselessness. See also: government spunks trillions in borrowed money for a decade but rising prices are the fault greedy supermarkets.

  7. ” even meant from animals fattened on grains and soya.
    If the hypothesis is true then reducing obesity will need wholesale changes in how our food is produced. And of course those with fond memories of ‘naughty but nice’ foods will resist.”

    No you’d just need to go back to traditional farming. Grass fed meat, and grass based dairying as well. Instead of vegetable oils use all the animal based fats instead.

  8. The government poking its nose into stuff that it knows nothing about is what caused the problem in the first place. If you are fat there’s a good chance that it’s because you followed government advice that stated that fat is bad and carbohydrates are good. Carbohydrates make you fat because your body metabolises them quickly and easily. Great if you need lots of energy but if you do a desk job and no exercise you’ll get fat.

  9. “Fat people dying young saves the NHS money. So our noble health warriors are wrong out of the starting gate.”

    Well yes and no. A person dying young because of obesity is a cost (A) in the here and now (NHS expenditure), and a saving (B) in the future (no pension or late life NHS/social care costs). However in politician world, a saving now is worth a lot more that a cost in the future, even if B is larger than A. The cost saving now is quantifiable, and a cash amount which can possibly directed to other use (which make the politician look good), whereas the future saving may not be a cash amount, instead a low rate of increase in costs in an otherwise ageing society, and happens when the politician is long retired or (hopefully from our perspective) dead.

  10. “obesity now affects two thirds of UK adults”

    66% of Brits are obese? It’s actually ~26%. 66% are above the arbitrary BMI of 25 which is used to define overweight, in spite of evidence that the optimal BMI for those over 50 is 26-27.

  11. ““I’m a doctor…” /tunes out.”

    Is it just me, or has anyone else decided that doctors are largely charlatans since the whole covid fiasco (with a few honourable exceptions)? That they obviously know very little about actual medicine and are just mouthpieces for what a combination of Big State and Big Pharma want the public to be told? And have no intellectual curiosity or ethical standards whatsoever, just thinking about their bank balance instead?

  12. The Meissen Bison

    Is it just me…

    Er, clearly not. Not only do medics not know nearly as much as they would like one to think they do, they appear to take every conceivable opportunity to avoid seeing ill people while receiving a very decent wedge for playing golf. Their appeals to authority are especially nauseating. “Primum non nocere?” – not so much.

  13. “Obesity” is like drunk driving. Reduce the blood alcohol limit and drunk driving increases.

    Set the ‘test’ for obesity low enough and soon 100% of the population will be obese.

    PCR testing: repeatedly replicating target viral material in the sample to the point that it becomes detectable. Replicate it enough times and just about anything will give a positive result, and we have a pandemic.

    The Body Mass Index is a calculation comparing height and weight. Like ‘climate sensitivity factor’ it is algorithm x computer model x best guess x what result do we want = work of fiction like ‘pre-diabetes’ and, safe & effective Covid vaccines and any other tosh that the Medical Pharmaceutical Industry complex bureaucratic busybodies come up with to boost profits, make work in non-jobs.

    There is seemingly no limit to how many times the grand public are fooled before they feel any shame for being so daft and believing any of this nonsense.

  14. Theophrastus (2066)

    “Fat people dying young saves the NHS money.”

    Except they generally don’t. Yes, excess weight shortens human lifespan. But weighing a third more than the optimum (ie 20-30kg) shortens lifespan by only about 3 years. Morbidity is higher for fatties but mortality not so much. And conditions like diabetes are expensive to treat.

  15. “Fat people dying young”

    The ‘overweight’ outlive the ‘normal’. The slightly ‘obese’ outlive the normal. The things not to be are (i) grossly obese, or (ii) underweight. So why are the ‘underweight’ not the subject of equal amounts of interference and bullying?

    (OK; that’s based on mere observational data but that’s all we’ll ever have.)

    And anway, an apt response to “I’m a doctor” is “Then fuck off.”

    During The Pandemic plenty showed themselves to be all or any of dishonest, lazy, stupid, ignorant, and cowardly. And now they’re strike-prone pieces of shit too. We need machine-gunners.

  16. Yet Another Chris

    Arthur the Cat gets it. It’s not so much that there are large numbers of large people around, but the simplistic measurement of BMI is simplistic. Yes, compared to when I grew up in the 50s, there are many more people waddling around my local supermarket. But the 50s was rationing and austerity! The problem with BMI is it takes no account of all sorts of physiques. In the case of one of my son in laws, he is skinny but muscular, and his BMI is 32. Obese? No way. Simples. Muscle weighs more than fat. Even at my age I still have muscles left, look skinny, but my BMI is 30.

  17. Er, clearly not. Not only do medics not know nearly as much as they would like one to think they do,

    Doctors are complete morons, only given social standing by the fact that they insist on being the only ones that can access medicine to prevent you treating yourself without paying homage to the great high priest class.
    Their arrogance knows no limits.
    Despite the fact that, of the few times I’ve been to actually see a doctor in this country, twice they’ve actually been fucking googling the symptoms, several times they’ve been flat wrong and the rest has basically been trying to fob me off.

    Watch their reaction if you say you want a general referral so you can go private.

    Try telling them they’re wrong or that you disagree with them. How dare you question the great high priest!?!
    Had an argument with one because he wouldn’t give me a general referral without a test (results would take weeks). I civilly explained to the cnut why the results wouldn’t show anything and would come back normal but still required a specialist to look at. He insisted.
    After much to-ing and fro-ing. I did the test. Results came back normal. Then I didn’t hear anything because the results were normal and they decided it didn’t need investigation because the results were normal. Twats.

    Lions. Flamethrowers. Squirrels.
    All are needed. Burn the NHS to the ground. Salt the earth. Then rebuild the buildings and burn them down again for good measure.

  18. “… conditions like diabetes are expensive to treat.”

    Not necessarily, type two diabetes, the one that is triggered by excess fat around the liver and pancreas, can be effectively treated with diet and exercise. It does take a certain amount of self discipline but is relatively cheap.

  19. Oh, for Pete’s sake!
    The BMI is rubbish, dimensionally unsound so that any good Rugger forward (possibly excluding the hooker) gets labelled obese.
    I could say that the average height of the adult male in the UK is 3″ higher than in my father’s day so all BMI threshholds should be raised by 5%, but my preferred example is that when I was young and fit the fittest guy I ever knew was 1″ shorter and sweated down to 34% heavier than me because he was broader and more muscular.

  20. “Had an argument with one because he wouldn’t give me a general referral without a test”

    Just ring your local private hospital/clinic and ask for an appointment with the appropriate specialist. Or their private GP service if they want to be pedantic, so he or she can refer you. I think the private hospitals have largely given up on requiring referrals from the NHS, they know its impossible to get to see a GP anyway. I’ve seen specialists at my local private hospital several times over the last 3 years and I’ve never gone near an NHS GP in order to get an referral.

  21. @Jim

    This was about 6 years ago, maybe 7.
    Now it seems that health insurers have their own GPs for consultations on the phone to give referrals. Had been for a few years, probably for the reasons you state.

    Personally I try to go abroad unless it’s urgent.
    Just had so many bad experiences with the NHS. I can’t understand why people think it’s so amazing. In the foreigns I go to, referrals aren’t a thing. Want to see a surgeon? Make an appointment? I went to see a dermatologist to make an appointment, he had an opening and had a minor procedure there and then. Soooooo much better than our sainted system.

  22. They’re looking at the problem from the wrong direction. The simplest way of preventing any drain on state healthcare budgets because of obesity is to get rid of state healthcare budgets.

  23. “I’m a doctor…” /tunes out.

    Behavioural nudge unit – tunes out. He can stick his behavioural nudge unit where the sun don’t shine.

  24. Theophrastus (2066)

    “Not necessarily, type two diabetes.”
    Diabetes costs the NHS 10% of its annual budget, and 90% of all diabetics are type 2. The drugs, check-ups, blood sugar monitors, chiropody, etc add up.

  25. @ Charles
    The Grauniad is, as usual, talking bollocks. Of course being told you’re fat in childhood is correlated with being fat when you are grown-up, just as is being fat in childhood and not being told that you are fat!
    As a child I was told that I was “one of Joseph’s lean kine” (no, I did not eat up all the fat kine around me) but that did not cause major psychological damage and major weight problems in adult life.
    Yes, there is nonsense and there is also simplistic comment which is only true for some people; there is a lot of research, some of which is biased and some is not.
    What I really dislike about the Grauniad and Ms Sole-Smith is that they want to deny simple arithmetic because it doesn’t fit in with their agenda.

  26. If you’re doing an Intention To Treat analysis (as you should) then the idea Type 2 diabetes is cheap to treat because patients should just take proper care of themselves falls apart – if compliance to a particular course of treatment (eg “diet and exercise”) is low then it isn’t going to be a very effective treatment. And if it’s type 2 diabetes as a result of obesity, you already have a warning sign the patient may well not have been looking after themselves for some time. No guarantee they’d start now. I’ve known people with type 2 diabetes totally fail at diet and exercise even when they knew full well the stuff they were putting in themselves was killing them.

    It makes about as much sense as the policy prescription “We the people of the UK heretofore declare that we will make obesity a thing of the past by a grand national agreement that each one of us will eat carefully and exercise properly.” I mean that would cure obesity within a generation, would it not? Clearly bound to work…

  27. Serious question for Jim.
    What % of UK beef and milk production is grass fed?
    I assume 99%+ of lamb is.
    I’m assuming UK does not follow the worst examples of US style feed lots for cattle?
    The seed oils being harmful argument is amusing to me as it means we go back to using beef dripping, lard and teal butter as healthier options.
    Suits my taste buds.

  28. “What % of UK beef and milk production is grass fed?”

    Difficult to say.

    All lamb is grass fed pretty much, as you say. Sometimes some concentrates are given in winter when the grass doesn’t have much nutritional value, and/or when ewes are in lamb so need plenty of food, but in both cases thats for the ewes not the lambs. So lamb is about as grass fed as you can get. If you’re eating mutton (or what they call ‘lamb’ in a curry house) then that could have been fed grains at various points in its life. But even that will have eaten grass along with any concentrates all its life. No sheep are kept 100% on concentrates.

    Cattle on dairy farms will graze grass when available but they will also be fed a mix of concentrates and silage every day to keep milk yields up. The silage is made from either grass or maize, maize being very common, so a large proportion of milk (and thus butter and cheese) will come from animals fed on concentrates and grains.

    Beef is a bit of a mixed bag – most animals that end up as meat will have predominantly been fed on grass over their lifespan. However feeding barley (and other non-grass feedstuffs) to ‘finish’ an animal is quite common, especially for beasts approaching selling age in winter. Then a bit of barley will just add the final ‘condition’ to an animal that gets them to a good selling weight. Only a quite small proportion of UK beef would be fed barley and concentrates all its life, and even they would get hay and silage along side, as too much barley is bad for the animals gut. Feed lots are not a feature of Uk farming, thats not to say there aren’t beef producers who keep cattle in sheds all their lives and who never graze grass, but its pretty unusual here.

    If you want to eat 100% grass fed meat, then lamb is the best bet, even the stuff from the supermarkets. Beef would require you to know the provenance, which would probably mean buying it from a farm shop or local butcher who you could quiz about where their meat comes from and what its been fed on. But beef from a supermarket is more likely to be grass fed than pork or chicken, as both of those are almost entirely raised on non-grass feeds. Even outdoor pork will have been fed concentrates, I don’t think any pigs are raised 100% on grass. They aren’t ruminants, they need protein and carbs like we do.

  29. Jim,

    That’s interesting, thanks.

    Simply re seed oils (DJ & N), presumably relevant when eating fattier parts of the animal? For example, chicken breast is predominantly protein, so guessing that whatever the chicken ate is not going to affect that too much? And wouldn’t this also be relevant to the type of fat in the food? Butter is mostly saturated (or monounsaturated) with very little polyunsaturated omega 6?

  30. Jim, thanks.
    I’ve heard there is a very niche market for Highland cow beef.
    Presumably those wanting to avoid grain fed should go for venison first then lamb.
    I thought mutton was almost impossible to get? as no one keeps lambs for 2+ years – more commercially viable to put them to market at 11 months?

  31. “I thought mutton was almost impossible to get? as no one keeps lambs for 2+ years – more commercially viable to put them to market at 11 months?”

    Well yes, no-one keeps fat lambs over 2 years and sells them as mutton, as mutton is worth less than lamb. But something happens to all the cull ewes that end up in the abattoirs, I suspect a lot of them end up being sold as ‘lamb’ in places like curry houses. I’ve never had a lamb curry where the meat tasted or had a texture anything like actual lamb. Tough as old boots normally, which would tally with it coming from ewes could be up to 7 years old.

  32. They are effectively banning central heating by insisting on everyone having air source heat pumps. So we can all look forward to a slimmer future, so kind and thoughtful of them.

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