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Great Britain and the shame of a nation

This topic has been archived, and won't accept reply postings.
 LeeWood 14 May 2020

Our own PM has hit the news in France - analysed for his obesity. He is pictured in this article looking sad and tired. 

https://liguecontrelobesite.org/actualite/covid-19-le-surpoids-sans-doute-a-lorigine-de-la-degradation-de-la-sante-de-boris-johnson-le-premier-ministre-anglais/

But that is not the worst. The shame of Britain - and many other nations - is inaction on the knowledge of obesity, in face of evidence to the link with increased mortality due to covid-19

Dr Aseem Malhotra is an NHS Cardiologist and Professor of Evidence Based Medicine.

// Asked by host Stephen Nolan how much of a risk is conferred by obesity, Malhotra called it a “huge risk” for COVID-19 and urged the National Health Service (NHS) to do more to promote healthy eating in the midst of the pandemic. “And in fact if they don’t do this,” Malhotra told Nolan, “I actually consider it an act of negligence and ignorance.” //

// “I think that message needs to be loud and clear, and I call for this in my article, that actually to reduce morbidity and mortality from COVID-19 people need to be getting the message right now to be cutting out the ultraprocessed junk food,” Malhotra told TCTMD. “Eat real food, protect the NHS, and save lives.” //

https://www.tctmd.com/news/obesity-and-covid-19-theories-and-blame-fill-scientific-void

More shame in a UK hospital over a delivery of Krispy Keme donuts. The author - // As an obese clinician myself, I have personal insight into this. //

// a Twitter storm (on one hand, Dr. Aseem Malhotra, Cardiologist and outspoken advocate of a particular mode of eating, on the other hand, multiple members of the medical/nursing profession, with esteemed members of the public piling in on both sides) erupted after a large consignment of Krispy Kreme donuts was delivered to a hospital for the staff to enjoy //

// We have already lost 119 healthcare professionals to Covid-19  and front line staff are at highest risk of infection. Surely the priority should be to minimise their risk as much as possible? //

// Why is no one demanding that Trusts ensure the highest quality food be made available for those at the front line? //

https://life.spectator.co.uk/articles/its-time-we-were-honest-about-obesity-and-covid-19/

Aseem Malhotra's commentary also available in these other sources:

https://www.telegraph.co.uk/health-fitness/body/time-honest-conversation-risks-excess-weight/

https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/

https://www.dailymail.co.uk/news/article-8281831/Being-fat-triggers-troublesome-immune-response-Covid-19-scientists-fear-SAGE-investigates.html

http://www.royalgazette.com/opinion/article/20200425/obesity-in-age-of-covid-19

https://www.thesun.co.uk/news/11497211/overweight-brits-ten-times-more-likely-die-coronavirus/

25
 profitofdoom 14 May 2020
In reply to LeeWood:

What's wrong with Krispy Keme donuts as part of a balanced diet, e.g. breakfast=porridge and fruit, lunch=salmon salad, tea=2 Krispy Keme donuts and black tea, dinner=sardine curry with rice?????

It's a witch hunt!!!

3
 Lankyman 14 May 2020
In reply to LeeWood:

Wish I hadn't eaten that sausage and egg sandwich just now .....

 Ridge 14 May 2020
In reply to LeeWood:

> As an obese clinician myself, I have personal insight into this.

Not sure who you're quoting there, but when a grossly obese nurse who was wheezing getting out of the chair suggested that, with a BMI of 27, I could do with losing some weight I found it hard to take it seriously.

Edit: I'm hovering around 25 now, noting that BMI is largely bollocks.

Post edited at 09:30
4
In reply to LeeWood:

You're quite correct - if you die from CV it's your fault because you're fat. Instead of just sitting in your chair in your care home, why didn't you do a few press ups before taking over the kitchen and preparing a nut cutlet and salad.

Look at the sources that man gets his articles published by - see a pattern there? 

FWIW - of course we have an obesity problem, it's world wide. Do you know why? I will tell you: because for the first 2 million years of our existence we evolved to relish a high fat, high protein diet.  The bad effects of this were mitigated because these things were in short supply but gave us enough energy and musculature sufficient for us to breed. Then b*gger me, in not much more than my own lifetime these things suddenly became abundant beyond imagining. (When I was born sugar was still rationed; when I went to school 'a Mars a day' was a luxury I certainly didn't have. And crisps had only just started becoming available.) So; for 2 million years we ate as much fat, protein and sugar as we could lay our hands on, which wasn't much; now we have slam that into reverse. That's OK, we're doing it; but if you think our entire evolutionary history can be overturned in days and weeks, (or even that it will make a difference to people in care homes today) you're bonkers.

Which of course, as a paid up anti-Vaccine, anti-science, Icke supporting, Jewish conspiracy theorist you are, so I don't know why I bother.

9
In reply to Ridge:

There's definitely an elephant in the room about obesity among NHS staff - I'm not sure that it would be very popular to point it out at the moment though. Maybe later?

L KriszLukash 14 May 2020
In reply to Rob Exile Ward:

> There's definitely an elephant in the room about obesity among NHS staff

I see what you did there.

1

In reply to fakelx:

Absolutely. Couldn't be clearer.

 Lankyman 14 May 2020

In reply to fakelx:

I've just worked out that your name is an anagram for 'I'm talking tripe'.

Edit: sorry got it wrong. I'm not very good at agranams.

Post edited at 10:32
 snowmore 14 May 2020
In reply to Rob Exile Ward:

> Look at the sources that man gets his articles published by - see a pattern there?

Yup. Worth looking up the man himself. https://en.wikipedia.org/wiki/Aseem_Malhotra
He's been publicly criticised by both the British Heart Foundation and the British Dietetic Association.

> Which of course, as a paid up anti-Vaccine, anti-science, Icke supporting, Jewish conspiracy theorist you are, so I don't know why I bother.

We can only conclude that the BHF and the BDA are under the control of Bill gates and the illuminati.

 Oceanrower 14 May 2020

In reply to fakelx:

Bit early for the gin, isn't it?

In reply to snowmore:

I'm often reminded of Bob Dylan's 'John Birch Blues':

'I was lookin' high an' low for them Reds everywhere
I was lookin' in the sink an' underneath the chair
I looked way up my chimney hole
I even looked deep inside my toilet bowl
They got a way...'

2
 neilh 14 May 2020
In reply to Rob Exile Ward:

I have noticed that those in the high pressure environments of the NHS- ICU and so on look remarkably fit and healthy( I suspect they have to be).It is in shall we say the commumity side where this appears to be a shall we say a real messaging issue on this subject.. I am sure the free cakes , sweets etc from the grateful public do not help.

If ever there was a time to ram home the message then it is now.Especially the older you get, the stats at the moment should be making people sit up.

I have also noticed that over the past few weeks there are more people attempting jogging who look a bit shall we say paunchy. That is excellent, well done them.

 DaveHK 14 May 2020
In reply to LeeWood:

Why do your posts contain all these // ?

It makes them very difficult to read and understand.

Post edited at 11:07
1
 LeeWood 14 May 2020
In reply to Rob Exile Ward:

> if you die from CV it's your fault because you're fat

Let's be clear - we're talking collective, democratic voted government responsibility for poor health in all its guise - but esp Non Communicable Disease - NCDs

Tell me where this reasoning goes wrong:

Inaction over un-constrained food industry leads to ill health

Inaction over ill health leads to obesity and diabetes

Inaction over obesity and diabetes leads to increased risk of death during pandemic

Inaction over ill health puts medical workers under increased risk, while working under high viral loads

Inaction over medical workers already ill of health, leads to even greater risk if supplied with incorrect foodstuffs, while working in hi-risk environment 

5
 LeeWood 14 May 2020
In reply to DaveHK:

> Why do your posts contain all these // ?

> It makes them very difficult to read and understand.

To distinguish who said what

// material copied from a stated source //

8
 DaveHK 14 May 2020
In reply to LeeWood:

>  Tell me where this reasoning goes wrong:

Right at the start by omitting any reference to personal responsibility for health and instead laying it all at the governments door.

The govt has a part to play but it's not the whole story.

 DaveHK 14 May 2020
In reply to LeeWood:

> To distinguish who said what

> // material copied from a stated source //

Is that a widely used thing?  Inverted commas would be more usual I think.

 Wainers44 14 May 2020
In reply to Ridge:

> Edit: I'm hovering around 25 now, noting that BMI is largely bollocks.

Your BMI at 25 is largely your bollocks?

Wow, they must be enormous?

 Lemony 14 May 2020
In reply to neilh:

> I have noticed that those in the high pressure environments of the NHS- ICU and so on look remarkably fit and healthy

Anaesthetists, init. They're mostly either fitness freak, adrenaline junkies or a bit potty - often all three tbh. My working theory is that it's because you can only try to put a spinal in an even mildly overweight person so many times before you start cutting the carbs - well that and constant exposure to high stakes risk management leading to excellent high pressure decision making.

p.s. my OH is an anaesthetist and she's not a fitness freak or an adrenaline junky so...

In reply to Wainers44:

I once had a rather unfortunate climbing accident in Norway, and one of my bollocks nearly doubled my BMI.

 Wainers44 14 May 2020
In reply to mick taylor:

> I once had a rather unfortunate climbing accident in Norway, and one of my bollocks nearly doubled my BMI.

Ouch. What did you do for that? Raise them above your head, put it in a sling, massage??

 balmybaldwin 14 May 2020
In reply to Rob Exile Ward:

> There's definitely an elephant in the room about obesity among NHS staff - I'm not sure that it would be very popular to point it out at the moment though. Maybe later?


Is there tho?

Are NHS staff any more or less likely to be obese than the general population?

In reply to Wainers44:

Hospital - haemorrhaged and infected - tonnes of pills and rest and piss taking seemed to cure it.  When plane arrived at Prestwick, the west coast line was shut so my wife drove from Wigan to get me.  Went straight to A & E and decided I needed urgent treatment so announced at the front desk:  i've had a climbing accident in Norway, I'm pissing blood, feel sick and about to feint.  That seemed to do the trick and got pushed in front of everyone else.

 Ciro 14 May 2020
In reply to profitofdoom:

> What's wrong with Krispy Keme donuts as part of a balanced diet, e.g. breakfast=porridge and fruit, lunch=salmon salad, tea=2 Krispy Keme donuts and black tea, dinner=sardine curry with rice?????

Your tea causes a massive spike in blood sugar which, if repeated too regularly will cause inflammation in your arteries.

The inflammation roughens the inner wall of the artery, meaning that blood cholesterol which would otherwise have sailed on by gets trapped, leading to narrowing and hardening of the arteries. 

The narrowed and hardened arteries put a heavy load on your heart, which can cause it to fail before it otherwise would have.

But aside from premature ill health and death, there's nothing wrong with such foods as a regular part of your diet.

As an occasional treat, there's nothing wrong with them at all. The problem lies with the regularity in which these foods are consumed in the modern Western diet, even for many whose diet and exercise is otherwise pretty well balanced.

2
 lorentz 14 May 2020
In reply to Wainers44:

> Ouch. What did you do for that? Raise them above your head, put it in a sling, massage??

Wheelbarrow... a la Viz's own Buster Gonad?

 LeeWood 14 May 2020
In reply to DaveHK:

> Is that a widely used thing?  Inverted commas would be more usual I think.

Look carefully at some of the quotes - which comprise the remarks from interview-ees:

// when asked his opinion the respondant said "these are my comments" //

4
 SouthernSteve 14 May 2020
In reply to LeeWood:

In many hospitals the nutritionists have been very upset by campaigns to close Macdonalds, only allow healthy foods, or be very prescriptive about foods in general as often when you are ill you just need to eat. As a busy harassed clinician a doughnut is a great pick-me up. I doubt whether severe dieting and COVID19 together is a happy combination. You do not want to be in energy deficit fighting disease. 

You seem to be trying to frequently push an agenda (albeit a little unclear, Bill Gates Foundation, obesity, antiVAX) here on the forums here and I am not sure it either constructive for UKC or even for you. 

Post edited at 12:32
5
 DaveHK 14 May 2020
In reply to LeeWood:

> Look carefully at some of the quotes - which comprise the remarks from interview-ees:

> // when asked his opinion the respondant said "these are my comments" //

That doesn't really answer my question, is this common usage somewhere or is it just some notation of your own?

1
 neilh 14 May 2020
In reply to balmybaldwin:

Its context. If you are sat opposite a community nurse who is checking out your health condition ( common practise for the over 50's) and you are talking about alcohol, eating, BMI etc. Then maybe its a good idea for that person not to be clearly overweight.

It really defeats the object of the health message and considerably weakens any discussion with patients.

It annoys the hell out of me.

Post edited at 12:19
1
 fred99 14 May 2020
In reply to Ridge:

> > As an obese clinician myself, I have personal insight into this.

> Not sure who you're quoting there, but when a grossly obese nurse who was wheezing getting out of the chair suggested that, with a BMI of 27, I could do with losing some weight I found it hard to take it seriously.

> Edit: I'm hovering around 25 now, noting that BMI is largely bollocks.


I seem to remember that the England Rugby Union team at one of the World Cups was found to have every single player technically clinically overweight (or maybe even obese) - including the fly and scrum halves. Maybe that was why they only came second in the Final !

Just how do they make these assessments, doesn't seem to take into account muscles required for a job.

 Eric9Points 14 May 2020
In reply to Rob Exile Ward:

> You're quite correct - if you die from CV it's your fault because you're fat. Instead of just sitting in your chair in your care home, why didn't you do a few press ups before taking over the kitchen and preparing a nut cutlet and salad.

> FWIW - of course we have an obesity problem, it's world wide. Do you know why? I will tell you: because for the first 2 million years of our existence we evolved to relish a high fat, high protein diet.  The bad effects of this were mitigated because these things were in short supply but gave us enough energy and musculature sufficient for us to breed. Then b*gger me, in not much more than my own lifetime these things suddenly became abundant beyond imagining. (When I was born sugar was still rationed; when I went to school 'a Mars a day' was a luxury I certainly didn't have. And crisps had only just started becoming available.) So; for 2 million years we ate as much fat, protein and sugar as we could lay our hands on, which wasn't much; now we have slam that into reverse. That's OK, we're doing it; but if you think our entire evolutionary history can be overturned in days and weeks, (or even that it will make a difference to people in care homes today) you're bonkers.

I should point out that if you go into a hospital you see fat people and old people but no fat old people. If you go into a care home you see very few fat people. Other than the nurses obviously.

Yes, you have a point about genetics. The world's biggest fatso's can be found in Polynesia. There is a theory that the descendants of the islanders were the ones who survived voyages of many months because they were the fat ones on the boat. The thin ones used up their small reserves of fat and died of starvation before they reached land.

Finally, I think it is important to point out that while advice on over consumption is welcome, it is ultimately a matter of personal liberty as to how many pies you shove in your mouth. 

2
 abr1966 14 May 2020
In reply to neilh:

It wouldn't affect my opinion of health advice if the clinician was overweight....my mechanic drives a car that looks like its held together with tape....it doesn't make him a bad mechanic...

I once had a really great GP....always looked a sight but he listened very carefully to his punters and was a good medic. He was the mental health lead for the practice and was very well respected....he drank a fair bit and didn't look after himself too well.....how he looked didn't affect my opinion of his practice though, quite the opposite if anything.

2
 SouthernSteve 14 May 2020
In reply to Lemony:

That is so true. I can only think of one exception.  99% boredom + 1% life-saving crises; they are a breed apart. 

 neilh 14 May 2020
In reply to abr1966:

Out of interest have you ever been to one of these well person clinics or attended a surgery to look at these issues?

In reply to abr1966:

I think you're in a minority there. I wouldn't knowingly employ a mechanic whose own car was a wreck, or take advice on diet from someone who was overweight. (In fact a local NHS employed nutritionist I know is overweight, but sadly so is her daughter. How she sleeps at night I have no idea.)

1
In reply to fred99:

The average obese joe public doesn't have a high because of muscle, it's fat. Of course they'll blame being big boned, genetics etc. But in reality 99% of obese people eat too much, do too little. 

In reply to fred99:

The average obese joe public doesn't have a high because of muscle, it's fat. Of course they'll blame being big boned, genetics etc. But in reality 99% of obese people eat too much, do too little. 

 abr1966 14 May 2020
In reply to neilh:

I haven't no.....I do work in the nhs though. I agree in part with your sentiment and as an nhs employee I do feel a sense of representing the service and regard overall appearance as part of a professional image.

My personal gripe is seeing staff in uniforms smoking....very poor image.

Ultimately though I think that clinical skills, knowledge, relationship with clients are the fundamental themes much more than appearance.

 abr1966 14 May 2020
In reply to Rob Exile Ward:

Just out of interest....would you think of it in the same way if they were grossly underweight?

In reply to abr1966:

If they were stick thin, yes. 

 abr1966 14 May 2020
In reply to Rob Exile Ward:

Its interesting that the whole issue of obesity often draws quite polarised views....I have a belly and see this as solely my own making....although lifestyle, stress and long days at work and commuting play a part in my often poor choices of what to  consume....my Achilles heel is alcohol rather than food.

There also seems a lot of anxiety about talking about it....I posted on here a while ago about helping out at a program for overweight kids (I was asking about an app) and a lot of replies were advising caution and saying do you know what you're doing etc.....as in I may make things much worse for kids and cause more problems than help.

There is a lot of shame in the mix too....not helped by ridicule and negative language as evidenced on UKC.

I always find myself respecting overweight people in the gym etc....must take a lot of confidence and volition.

 EdS 14 May 2020
In reply to LeeWood:

as a 50 year old public sector employee - it is my opinion that anyone paid via the public purse from MPs down to the "lowliest" should meet a minimum fitness standard to do the job / set example.

Yes it can be tweaked for age, medical conditions etc.. It doesn't require everyone to meet Fire Service levels of fitness but

Looking around at some of the folk in our office on a normal day - I'd not employ them - either they are not fit (as in fat & unhealthy / lifestyle induced) to do the job or are due long term sickness absence due to lifestyle.

As I say - my opinion based on observation and the impact on the public purse

5
 neilh 14 May 2020
In reply to abr1966:

I recommend getting well person advice from the NHS when you hit 50/55.I encourage everyone, too many do not want to face what they know is a reality and bury their heads in the sand.

Its like Boris at the start of Covid not social distancing in the press briefings.

Practise what you preach. No wonder people ignore  the message.

 Andy Gamisou 14 May 2020
In reply to Wainers44:

> Your BMI at 25 is largely your bollocks?

> Wow, they must be enormous?

Or very fat.

 Toerag 14 May 2020
In reply to Ridge:

>  Edit: I'm hovering around 25 now, noting that BMI is largely bollocks.

...except it isn't when you look at the load on the body - the load on the heart, the load on the joints, the load on the kidneys & liver.  Yes, muscly people like rugby players may be 'overweight' without being fat, but weight is weight, no matter what it's made from. Heavy people's bodies are going to wear out quicker than lighter people's.

1
 SouthernSteve 14 May 2020
In reply to neilh:

> I recommend getting well person advice from the NHS when you hit 50/55.I encourage everyone, too many do not want to face what they know is a reality and bury their heads in the sand.

Definitely and do go for bowel screening as well, despite the slight indignity of the procedure.

 LeeWood 14 May 2020
In reply to summo:

> The average obese joe public doesn't have a high because of muscle, it's fat. Of course they'll blame being big boned, genetics etc. But in reality 99% of obese people eat too much, do too little. 

Attention! The message from the doctor is not just too much food - but the wrong food. This is where the government should be playing a much bigger part. Certain foodtuffs should never appear in the shops.

A rough judge is to consider the proportions of calories : fibre; ribre moves the food mass more quickly through the intestines and slows down the sugar-rush causing insulin-swing. The nearer a foodstuff is to it's naturaly occuring origins, the less likely it is to force calorific deposition.

Think unfried potatoes, wholemeal bread, semi/wholewheat pasta & rice etc

4
 nikoid 14 May 2020
In reply to Rob Exile Ward:

I've never known a mechanic who's car wasn't a wreck. Busman's holiday innit.😁

 Skip 14 May 2020
In reply to LeeWood:

>  Certain foodtuffs should never appear in the shops.

Correct

 Stuart William 14 May 2020
In reply to LeeWood:

I thought you wanted the government to step back and stop trying to control every aspect of our lives? But now they should be dictating our food choices? I’m confused.

There have been plenty of public health interventions aimed at obesity. The links between obesity and health are hardly a big secret. Before covid it was on the news on a fairly regular basis. However, by and large the interventions have respected people’s personal responsibility and allowed them to make their own choices. Which I seem to think was exactly what you wanted the government to do with regards to current covid interventions.

In reply to LeeWood:

You can't change calorific value of food. Unless you have the trots then the human body is very efficient in extracting all nutrients regardless of food type*. Poor diets do usually correlate with people who aren't very active. 

I think what you are referring to is the glycemic index, which is speed of absorption, but doesn't change energy content. 

* except sweet corn!! 

Post edited at 15:33
 krikoman 14 May 2020
In reply to neilh:

> Its context. If you are sat opposite a community nurse who is checking out your health condition ( common practise for the over 50's) and you are talking about alcohol, eating, BMI etc. Then maybe its a good idea for that person not to be clearly overweight.

Aren't they allowed to be normal people, we're short of 30,000 nurses and you only want skinny ones.

How about only blonde ones with big tits?

3
 krikoman 14 May 2020
In reply to summo:

> * except sweet corn!! 

You need a trip to a sewage treatment plant, carrots and peas often survive unscathed.

Post edited at 15:53
In reply to krikoman:

> You need a trip to a sewage treatment plant, carrots and peas often survive unscathed.

 neilh 14 May 2020
In reply to krikoman:

Where did I say skinny ones? . And the last one I saw was a bloke......your implication not mine

Post edited at 15:55
 Ian W 14 May 2020
In reply to nikoid:

> I've never known a mechanic who's car wasn't a wreck. Busman's holiday innit.😁

The guy in charge of our workshop has a car which is mechanically superb, despite high mileage. Absolutely superb. The bodywork and interior maybe not the same standard......

 krikoman 14 May 2020
In reply to EdS:

> as a 50 year old public sector employee - it is my opinion that anyone paid via the public purse from MPs down to the "lowliest" should meet a minimum fitness standard to do the job / set example.

So that wipes out any disabled people then?

Do you not think being able to do you job is paramount?

1
 SouthernSteve 14 May 2020
In reply to krikoman:

That's why nuts are healthy and less fattening - much of them is just defaecated unless you have chewed for 20 minutes! The calories of a Brazil nut are amazingly high, but how much we get is another matter.

2
 krikoman 14 May 2020
In reply to neilh:

> Where did I say skinny ones? . And the last one I saw was a bloke......your implication not mine


you know what I mean, but deflect the question if you like.

1
 neilh 14 May 2020
In reply to krikoman:

I really resent the implication for what it is worth. You make a crass and infantile post imho which detracted form your excellent point on the shortage.

1
 LeeWood 14 May 2020
In reply to Stuart William:

> I thought you wanted the government to step back and stop trying to control every aspect of our lives? But now they should be dictating our food choices? I’m confused.

Admitted - it"s not quite so simple. I can make intelligent choices for my own personal health but I can't escape epidemic constraints - lockdown - alone. Thats my motivation to identify the truth. In times of peace 'free' choice to ruin one's own health could be excusable - in full knowledge (cigarettes carry gov health warnings) - but not during a pandemic. If your behaviour holds me in lockdown then it becomes my concern. 

The people can only do it when correctly educated - and given healthy choice. We all give in to unhealthy choice at times - knowingly, self included. My cut-off has to be in the shops, once things tempt me at home I'm a gonner - !

1
 abr1966 14 May 2020
In reply to LeeWood:

I think you've got a fair point....

Not sure you will find 'the' truth though....for the rest of your life even if you keep looking.

This is 'peace' time though....you do realise currency in war is cigarettes...!

 krikoman 14 May 2020
In reply to neilh:

> I really resent the implication for what it is worth. You make a crass and infantile post imho which detracted form your excellent point on the shortage.


Ok then, let's try again.

Aren't they allowed to be normal people, we're short of 30,000 nurses?

 krikoman 14 May 2020
In reply to SouthernSteve:

> That's why nuts are healthy and less fattening - much of them is just defaecated unless you have chewed for 20 minutes! The calories of a Brazil nut are amazingly high, but how much we get is another matter.


I'm pretty much convinced, for myself at least, it doesn't really matter how much I eat I stay around the same weight.

Obviously, I could put weight on, or lose it, by extremes of diet, but it would be weird if the only thing the body doesn't "self regulate" is calorie input.

 fred99 14 May 2020
In reply to krikoman:

> So that wipes out any disabled people then?

> Do you not think being able to do you job is paramount?


I believe "fitness" as in ability to complete a sub four minute mile would be unnecessary in all cases except a senior male running the mile for their country.

"Fitness" as in capability and suitability to do a job is a different matter. For example; a medical practitioner giving advice on cutting down on weight and smoking is hardly going to be able to convince a patient if said practitioner is so fat that they are jammed in their chair and have nicotine coated fingers and a smokers cough. (Or for that matter a government health advisor who tells people to stay home and not associate with anyone outside of their household who then either trots off to their second home - twice - or another who invites their married lover in for a night of not-so-social distancing rumpy-pumpy - also twice).

1
 fred99 14 May 2020
In reply to krikoman:

> Ok then, let's try again.

> Aren't they allowed to be normal people, we're short of 30,000 nurses?


Normal is one thing. However being in the National HEALTH Service, it always helps if those working there are themselves at least reasonably HEALTHY, and not appearing to be liable at any moment to become customers of said service.

1
 LeeWood 14 May 2020
In reply to Ridge:

> >  As an obese clinician myself, I have personal insight into this

> Not sure who you're quoting there,

Sorry this was not clear, the author of the article at spectator.co.uk

 Stuart William 14 May 2020
In reply to LeeWood:

I see where you’re coming from, but I think it’s tricky. Firstly we aren’t gonna solve the obesity crisis quickly, so while it’s part of the puzzle it’s not really a viable intervention to the current situation. Nothing is going to happen there that will speed up lockdown being lifted. It might make us healthier over the coming years which is great. But just restrictions on food during the coming weeks will do absolutely nothing noticeable  

Secondly, alongside your other posts this reads a little as though you are well in favour of the government restricting everyone else’s freedoms, as long as it doesn’t impact you. That’s a tricky position to take since it doesn’t really scale up well to the rest of the population.

 LeeWood 14 May 2020
In reply to Stuart William:

> But just restrictions on food during the coming weeks will do absolutely nothing noticeable  

malhotra"s opinion at tctmd.com:

// "I think we're going to be locked down for a few more weeks, and I think if people do change their diet tomorrow, my view is that not only will it have an impact on their health, but it will significantly reduce the risk of complications of COVID-19 within a short space of time.” //

> Secondly, alongside your other posts this reads a little as though you are well in favour of the government restricting everyone else’s freedoms, as long as it doesn’t impact you.

Restriction of freedom is all relative. Each country has rules - some of which are regarded as reasonable - others not. Right now, the worldview is 'the only thing which will save us is vaccination for all' - along with surveillance.

These are both unacceptable to me - greater breaches of freedom. In any case - inaction on matters of basic health means greater mortality - until the vaccine arrives - so it is quite unreasonable. As Malhotra says 'negligence and ignorance'

I have no objection to a vaccine - for those who accept it voluntarily, in full lnowledge of any consequences. But it should not become the focus of liberation.

3
 off-duty 14 May 2020
In reply to LeeWood:

> Admitted - it"s not quite so simple. I can make intelligent choices for my own personal health but I can't escape epidemic constraints - lockdown - alone. Thats my motivation to identify the truth. In times of peace 'free' choice to ruin one's own health could be excusable - in full knowledge (cigarettes carry gov health warnings) - but not during a pandemic. If your behaviour holds me in lockdown then it becomes my concern. 

> The people can only do it when correctly educated - and given healthy choice. We all give in to unhealthy choice at times - knowingly, self included. My cut-off has to be in the shops, once things tempt me at home I'm a gonner - !

I'm not clear how obese people "hold you in lockdown".  There is no evidence whatsoever to indicate they are more likely to catch the disease.  They may well be more severely affected by it.

You appear to believe obesity is simply about eating "the right food", which is far from clear on the evidence. 

Obesity is a pretty complex issue, and despite the opinion of both you and Katie Hopkins, simply suggesting obese people eat less is like telling an anorexic to just eat more.

I've for some sympathy for frontline NHS (and other occupations) working gruelling shifts, which screw up body clocks. Struggling to manage regular meals, as well as take the healthy option at every occasion. Too tired or unmotivated to take exercise when they should. Often with temptation in the form of cakes or sweets easily accessible. 

Yeah sure, you can just point and laugh - but tell me the last time you worked all night without a refreshment break. 

 off-duty 14 May 2020
In reply to LeeWood:

> > But just restrictions on food during the coming weeks will do absolutely nothing noticeable  

> malhotra"s opinion at tctmd.com:

> // "I think we're going to be locked down for a few more weeks, and I think if people do change their diet tomorrow, my view is that not only will it have an impact on their health, but it will significantly reduce the risk of complications of COVID-19 within a short space of time.” //

> > Secondly, alongside your other posts this reads a little as though you are well in favour of the government restricting everyone else’s freedoms, as long as it doesn’t impact you.

> Restriction of freedom is all relative. Each country has rules - some of which are regarded as reasonable - others not. Right now, the worldview is 'the only thing which will save us is vaccination for all' - along with surveillance.

> These are both unacceptable to me - greater breaches of freedom. In any case - inaction on matters of basic health means greater mortality - until the vaccine arrives - so it is quite unreasonable. As Malhotra says 'negligence and ignorance'

> I have no objection to a vaccine - for those who accept it voluntarily, in full lnowledge of any consequences. But it should not become the focus of liberation.

A healthy diet will not be a replacement for a vaccine.

A healthy lifestyle will not prevent infection.

Being young, fit,  with no underlying health conditions may prevent YOU from being struck so harshly by COVID 19 if you get it.

"May".

1
 SouthernSteve 14 May 2020
In reply to krikoman:

Lucky you! For me it is stressful times that does it so I feel that cortisol rather than the type of food I eat is important. Having said that we don't eat too much junk so I may not be testing the system.

 LeeWood 14 May 2020
In reply to off-duty:

> Yeah sure, you can just point and laugh, but tell me the last time you worked all night without a refreshment break. 

I'm not laughing at them and neither is the author at spectator.co.uk: the following two exracts express compassion with medical person and the situations they are put into

// I have never, in clinical practise, ever met an obese patient who objected to the facts, provided they were delivered with respect, courtesy and compassion. As an obese clinician myself, I have personal insight into this. //

// It is not choice however, when during a busy shift, you are surrounded by carefully designed, hyperpalatable, addictive, cheap processed foods, that take advantage of brain biochemistry to induce dependence that are injurious to human health. //

3
 krikoman 14 May 2020
In reply to fred99:

> Normal is one thing. However being in the National HEALTH Service, it always helps if those working there are themselves at least reasonably HEALTHY, and not appearing to be liable at any moment to become customers of said service.


So what weight do you suggest is the cut off limit?

 krikoman 14 May 2020
In reply to SouthernSteve:

> Lucky you! For me it is stressful times that does it so I feel that cortisol rather than the type of food I eat is important. Having said that we don't eat too much junk so I may not be testing the system.


ha ha I wasn't showing off, and I could do with losing a couple of stone, but my weight has gone from pretty much stable at 18 yr old at 10st 8lb till about 30 ish, when it went up to about 12st and now I've been about 13 1/2 for the last 10 years or so. There have been periods of "step" increases, and I don't know why.

 krikoman 14 May 2020
In reply to LeeWood:

> I have no objection to a vaccine - for those who accept it voluntarily, in full lnowledge of any consequences. But it should not become the focus of liberation.

What's your focus of liberation? Getting rid of all the fat people?

 Lankyman 14 May 2020
In reply to krikoman:

> You need a trip to a sewage treatment plant, carrots and peas often survive unscathed.


Can these be recycled? Think of the savings in food miles, fertilizers etc.

 EdS 14 May 2020
In reply to krikoman:

No.... As I said medical conditions etc can be tweaked for.

Being lifestyle induced unfit etc.... Doesn't include less abled bodied / mental health 

 LeeWood 15 May 2020
In reply to snowmore:

> Yup. Worth looking up the man himself. https://en.wikipedia.org/wiki/Aseem_Malhotra

> He's been publicly criticised by both the British Heart Foundation and the British Dietetic Association.

Interesting. It's clear that he is at the centre of some controversy and that medical science is itself split in opinion over many issues. While I agree largely with his dietary conclusions I'm not sure to take up his recommended Pioppi regime - or increase fatty food sources.

In respect of statins. We have a friend who retired from a career as educator in the NHS -  training nurses; she is with Malhotra in condemning statin use - says doctors 'hand them out like smarties' willy nilly.

Statin sales are worth a trillion ! - so it's not surprising of a backlash from the BHF, with lobbyists behind the scenes.

// On the contrary the decades long campaign to lower cholesterol through diet and drugs has completely and utterly failed to curb the global pandemic of heart disease. Indeed, heart disease still remains the biggest killer in the western world and the UK has recently seen a rise in death rates from the condition for the first time in 50 years[3].//

// It is still little known or understood amongst the wider medical community that insulin resistance, linked to excess body fat is the most important risk factor for heart attacks[4]. It is also a clear sign of impending type two diabetes. A disease which has become the single largest cost to the NHS, accounting for approximately 10% of the budget. //

Yet the fear of cholesterol is very much imprinted on the minds of doctors and members of the public. A message that has been enthusiastically driven by a multi-billion-dollar low-fat cholesterol lowering industry. Next year it’s predicted that total revenues from sales of cholesterol lowering statin drugs could reach US $1 trillion[8].

https://www.europeanscientist.com/en/features/do-statins-really-work-who-benefits-who-has-the-power-to-cover-up-the-side-effects/

// A key drive for unreliable research he said was “the greater the financial interest in a given field the greater the likelihood the research findings are to be false.” The ‘evidence’ is then incorrectly passed on to patients. No wonder my patient was angry.//

A conclusion we should all be aware of in respect of all health conditions and their proposed pharmaceutical remedies !

3
 jt232 15 May 2020
In reply to Lemony:

> Anaesthetists, init. They're mostly either fitness freak, adrenaline junkies or a bit potty - often all three tbh

Can you even call yourself an anaesthetist if your road bike cost less than £5000? 

 krikoman 15 May 2020
In reply to Lankyman:

> Can these be recycled? Think of the savings in food miles, fertilizers etc.


They make a terrible soup, to be honest.

They do get recycle, like the poo, most sewage goes through a screening process, the big chunks go through a macerator, think big liquidiser, after that they carry on with the rest of the crap.

After a number of other processes you end up with water and "cake" this is used on the land, after a while spent "resting" to kill anything while might be dangerous.

 krikoman 15 May 2020
In reply to EdS:

> No.... As I said medical conditions etc can be tweaked for.

> Being lifestyle induced unfit etc.... Doesn't include less abled bodied / mental health 


So what about some giant fat bloke, or woman, who does fit your parameters but has a brilliant mind, or is a deft surgeon, or even just a good communicator?

Supposing your oncologist was 25st, but the best in the country, would you tell them to f*ck off!

 Lankyman 15 May 2020
In reply to krikoman:

> They make a terrible soup, to be honest.

Good on you for trying!

 LeeWood 15 May 2020
In reply to krikoman:

> What's your focus of liberation? Getting rid of all the fat people?

Hopefully BJ's action will deal with this - !! Breaking !!

https://www.independent.co.uk/news/uk/politics/boris-johnson-anti-obesity-strategy-coronavirus-overweight-a9516206.html

// “poor diet is now a bigger health threat than smoking”. //

Also in The Times - paywalled

In reply to LeeWood:

Great to see our glorious leader is on the case about something the rest of us have know about and understood the health risks of obesity and type 2 diabetes for at least the last ten years.

I wish I'd voted for him now!  He's an inspiration.

 LeeWood 15 May 2020
In reply to Ultradecrepidarian:

> He's an inspiration.

He already has been ! the french journal Ligue Contre L'Obesité  - 1st reference in the OP - pounced on the news within a few hours. BJ this time pictured on his bike in fine racing style

https://liguecontrelobesite.org/actualite/gueri-du-covid-19-boris-johnson-part-en-guerre-contre-lobesite-et-sapprete-a-lancer-une-campagne-publique-de-sante/

strategie // « beaucoup plus interventionniste » //

How good is your french ?! Start thinking 'sugar tax' ! From shame to pride ?

 jkarran 15 May 2020
In reply to LeeWood:

> Our own PM has hit the news in France - analysed for his obesity. He is pictured in this article looking sad and tired. But that is not the worst. The shame of Britain - and many other nations - is inaction on the knowledge of obesity, in face of evidence to the link with increased mortality due to covid-19

We've had a serious covid problem for what, about two months. Before that we had another couple of months clear warning during which we failed make proper pandemic preparations let alone organising distracting and ineffective national keep fit and diet program. I'm really not sure curing obesity is or should be top of the government's agenda right now, whether or not it's protective against covid (I'm sure it is to a degree). You might have noticed they are quite busy right now and obesity is a very complex slow problem to solve (in the absence of genuine and rationed food shortage).

jk

 jkarran 15 May 2020
In reply to LeeWood:

> Let's be clear - we're talking collective, democratic voted government responsibility for poor health in all its guise - but esp Non Communicable Disease - NCDs

> Tell me where this reasoning goes wrong:

> Inaction over un-constrained food industry leads to ill health...

Action against the processed food industry leads to well funded action against the government de jour and replacement of that government or its leadership with one more compliant. Late stage capitalism.

Still. Moaning about all this makes no sense in the context of covid other than to note that on yet another front we were as a society ill prepared for this particular disease.

jk

 fred99 15 May 2020
In reply to krikoman:

> So what weight do you suggest is the cut off limit?


I said;

"at least reasonably HEALTHY, and not appearing to be liable at any moment to become customers of said service."

I do not feel that I should need to further define my thoughts to any sensible person.

 fred99 15 May 2020
In reply to krikoman:

> So what about some giant fat bloke, or woman, who does fit your parameters but has a brilliant mind, or is a deft surgeon, or even just a good communicator?

> Supposing your oncologist was 25st, but the best in the country, would you tell them to f*ck off!


Neither of these specialisms have anything really to do with weight, so what you have written is a complete "non sequitur".

2
 LeeWood 15 May 2020
In reply to jkarran:

You apparently have no respect for Aseem Malhotra and his position and opinion as NHS Cariologist. Taking action on this issue of national health is of singular importance RIGHT NOW

You'll have to get active on twitter if you want to compete against public opinion

Dr Aseem Malhotra @DrAseemMalhotra

// Dear @BorisJohnson

I’m delighted you’re taking #obesity seriously after falling sick from #COVID19

Real issue is insulin resistance, driven primarily by poor diet.

So message to public must also be eat real food, protect the #NHS & save lives //

Tom MacKeown @TMackeown 9hEn réponse à @DrAseemMalhotra et @BorisJohnson

// Prime Minister, The single & most important thing that you might be remembered best for is your efforts to improve the metabolic health of the population of UK. Your war on fat is to be commended. Please speak to those who have demonstrated the Metabolic Syndrome can be reversed //

Ann Whitfield @craftyanns 10hEn réponse à @DrAseemMalhotra et @BorisJohnson

// He needs you Aseem and I’m sure

@tom_watson

will be hapy to help too. Please listen to the right people

@BorisJohnson

for all our sakes //

For all our sakes

2
 Lankyman 15 May 2020
In reply to EdS:

> as a 50 year old public sector employee - it is my opinion that anyone paid via the public purse from MPs down to the "lowliest" should meet a minimum fitness standard to do the job / set example.

The police are setting a fine example: https://www.youtube.com/watch?v=SQM-OTVUMHs&

In reply to LeeWood:

If you could construct a coherent post it would be easier to engage with you. Your unique '//' convention doesn't work. 

BTW - what's 'Tom MacKeown' doing there? Any relation to THE Thomas McKeown?

 jkarran 15 May 2020
In reply to LeeWood:

> You apparently have no respect for Aseem Malhotra and his position and opinion as NHS Cariologist. Taking action on this issue of national health is of singular importance RIGHT NOW

I don't have much of an opinion either way. He might be a good and clever cardiologist but if he thinks right now in the middle of the crisis phase of an emerging pandemic is the time for a massive, peripherally related public health drive then I do wonder how practical a chap he might be. 

> You'll have to get active on twitter if you want to compete against public opinion

War against public opinion? No thanks.

Jk

 Timmd 15 May 2020
In reply to Ciro:

> Your tea causes a massive spike in blood sugar which, if repeated too regularly will cause inflammation in your arteries.

> The inflammation roughens the inner wall of the artery, meaning that blood cholesterol which would otherwise have sailed on by gets trapped, leading to narrowing and hardening of the arteries. 

> The narrowed and hardened arteries put a heavy load on your heart, which can cause it to fail before it otherwise would have.

> But aside from premature ill health and death, there's nothing wrong with such foods as a regular part of your diet.

> As an occasional treat, there's nothing wrong with them at all. The problem lies with the regularity in which these foods are consumed in the modern Western diet, even for many whose diet and exercise is otherwise pretty well balanced.

I wonder if this means a type 1 diabetic could indulge their sweet tooth if they managed it well enough with insulin to avoid a blood sugar spike, avoid the risk to heart health more than a none diabetic might do?  

Post edited at 19:57
 off-duty 15 May 2020
In reply to LeeWood:

> You apparently have no respect for Aseem Malhotra and his position and opinion as NHS Cariologist. Taking action on this issue of national health is of singular importance RIGHT NOW

> You'll have to get active on twitter if you want to compete against public opinion

> Dr Aseem Malhotra @DrAseemMalhotra

> // Dear @BorisJohnson

> I’m delighted you’re taking #obesity seriously after falling sick from #COVID19

> Real issue is insulin resistance, driven primarily by poor diet.

> So message to public must also be eat real food, protect the #NHS & save lives //

I'm sure that insulin resistance and poor diet is "AN" issue, but if you really really want to prevent getting infected by COVID19, then obese, anorexic, fat or thin - the best thing you can do (as the science says) is - wash your hands.

PS. The suggestion that a reaction to a tweet is  a good gauge of public opinion is laughable. 

 jt232 16 May 2020

In reply to fred99:

> Neither of these specialisms have anything really to do with weight, so what you have written is a complete "non sequitur".

I'm not surgeon but imagine operating on a patient with a BMI of 40 compared to a BMI of 20!

I would struggle to think of a single specialty which has nothing to do with weight. 

Post edited at 05:07
 SouthernSteve 16 May 2020
In reply to Timmd:

> I wonder if this means a type 1 diabetic could indulge their sweet tooth if they managed it well enough with insulin to avoid a blood sugar spike, avoid the risk to heart health more than a none diabetic might do?  

Even with insulin pumps there is a delay in insulin action that is not seen from the pancreas. If you are going to have dinner insulin may be released ready for this in anticipation. There are some ultra fast insulins which may give a better effect. So I think you would have to pretreat to get the response you are considering. I suspect we are some way off being better than the body. Also if you get it wrong and your [blood glucose] drops too low the body 'panics' and you then can get an overswing with higher [blood glucose]. 

 LeeWood 16 May 2020
In reply to off-duty:

> I'm sure that insulin resistance and poor diet is "AN" issue, but if you really really want to prevent getting infected by COVID19, then obese, anorexic, fat or thin - the best thing you can do (as the science says) is - wash your hands.

Yes, there's more to it than fat and thin. In another article Malhotra refers to BMI as outdated:

// they have to be extra careful with their diet and what they are consuming and they should also not have the illusion of protection just because they are given a normal body mass index (BMI). Extra body fat, particularly around the waist, is much more detrimental to health than using outdated indices such as BMI to define health risk, //

In relation to covid-19, the key phrases coming out now are 'chronic metabolic disease' and 'chronic inflammation' which is directly linked to the cytokine storm. These are often present with high BMI but are more widely linked to crap food intake.

2
 off-duty 16 May 2020
In reply to LeeWood:

> Yes, there's more to it than fat and thin. In another article Malhotra refers to BMI as outdated:

> // they have to be extra careful with their diet and what they are consuming and they should also not have the illusion of protection just because they are given a normal body mass index (BMI). Extra body fat, particularly around the waist, is much more detrimental to health than using outdated indices such as BMI to define health risk, //

> In relation to covid-19, the key phrases coming out now are 'chronic metabolic disease' and 'chronic inflammation' which is directly linked to the cytokine storm. These are often present with high BMI but are more widely linked to crap food intake.

And, let's face it, this thread was about COVID19 rather than just a diatribe about obesity. 

I think it's pretty clear that obesity plays no role in infection by COVID19. 

There's a suggestion that obesity may be linked to severity of impact of disease. The clearest link is related to being able to be face down prone for ease of respiration.

The cytokine storm and other non-respiratory impacts of COVID19 are not linked to anything clearly yet.

I just wish you'd stop pushing this anti-obesity agenda. It's simplistic, correcting it might assist individuals but is an extremely long term target. 

If you were really interested in preventing COVID19 infection you should be pushing hand washing, good hygiene around face touching and potentially mask wearing.

Droning on about a discredited heart surgeon who was pushing his own diet plan with an unclear link between food types and obesity and trying to drag COVID19 into the debate is verging on conspiracy theory.

 LeeWood 16 May 2020
In reply to off-duty:

> verging on conspiracy theory

classic deflection tactic

There is still heated debate over diet and covid-19, but clearly emerging support for one or more of obesity, waistline measurement, basic health and the connection with diet - more research needed ...

however the food industry has in  the last few decades has been taking the piss - profits prioritised over public health; in an equation of extreme irony the gov spends millions (220 !) on public education, while the food industry spends several times more on advertising to defeat that !  And thats the cashflow before the cost of healthcare to the NHS

Where are your tax contributions going ? are you concerned ?

I propose it slighlty more logical that the gov stop the food industry and save money on their own advertising; what do you think ?

3
 off-duty 16 May 2020
In reply to LeeWood:

> > verging on conspiracy theory

> classic deflection tactic

Given your other threads on vaccine technology, the Gates foundation, I'm not entirely convinced of your motives for trying to tie obesity to COVID19.

> There is still heated debate over diet and covid-19, but clearly emerging support for one or more of obesity, waistline measurement, basic health and the connection with diet - more research needed ...

Finally. An almost agreement. The link is far from proven.  There are many impact facts for severity, the strongest of which is age. 

> however the food industry has in  the last few decades has been taking the piss - profits prioritised over public health; in an equation of extreme irony the gov spends millions (220 !) on public education, while the food industry spends several times more on advertising to defeat that !  And thats the cashflow before the cost of healthcare to the NHS

> Where are your tax contributions going ? are you concerned ?

> I propose it slighlty more logical that the gov stop the food industry and save money on their own advertising; what do you think ?

I think that if you want to discuss obesity and the food industry, crack on. I'm not sure I necessarily agree with the links between food types and obesity but that's a different argument.  

I'm not entirely convinced that in the middle of a public health crisis around a fatal infectious disease we should be prioritizing obesity as a focus, as it is not going to have any real impact over the next 18months- 2 years, which is where we should be looking. 

 DancingOnRock 16 May 2020
In reply to off-duty:

I don’t think anyone is talking about prioritising it. There’s a separate group in the NHS dealing with reduction of Obesity and the whole of the government are not working on COVID-19. 
 

You don’t need any surveys or double blind tests to determine whether obesity is a factor in the outcome, or why it’s a factor in the outcome. It’s stating the bleeding obvious. The NHS will not operate on patients with high BMI. There’s a reason for it. Doesn’t matter whether it’s COVID or any other issue. The risks are great. The heart is already under huge strain and breathing is already a struggle. They see high morbidity rates with high BMI in normal conditions. 
 

I don’t know the OP’s history or agenda but many people I know who are overweight have mysteriously started exercising and cutting down on beer and cake consumption after years of taking the mickey out of people who have been exercising. 
 

I don’t think we need any extra messages from the government at the moment. The time for the pressure will be when a vaccine becomes available and they all go back to their old ways. 

1
 LeeWood 16 May 2020
In reply to off-duty:

> I'm not entirely convinced that in the middle of a public health crisis around a fatal infectious disease we should be prioritizing obesity as a focus, as it is not going to have any real impact over the next 18months- 2 years, which is where we should be looking

Maybe you missed the news - our PM was in intensive care, and now recognises the link between basic health and covid-19 risk factors. Its understandable that he sees this as a priority - he nearly died !

You presume greater wisdom ? than a qualified hands-on cardiologist - who clearly defines an immediate and remediable link between health conditions and cv19 susceptibility ?

1
 off-duty 16 May 2020
In reply to LeeWood:

> > I'm not entirely convinced that in the middle of a public health crisis around a fatal infectious disease we should be prioritizing obesity as a focus, as it is not going to have any real impact over the next 18months- 2 years, which is where we should be looking

> Maybe you missed the news - our PM was in intensive care, and now recognises the link between basic health and covid-19 risk factors. Its understandable that he sees this as a priority - he nearly died !

> You presume greater wisdom ? than a qualified hands-on cardiologist - who clearly defines an immediate and remediable link between health conditions and cv19 susceptibility ?

LOL. You've already said you don't believe in his Pioppi diet: You presume greater wisdom ? than a qualified hands-on cardiologist

 LeeWood 16 May 2020
In reply to DancingOnRock:

> The time for the pressure will be when a vaccine becomes available and they all go back to their old ways. 

Without attempting to twist the meaning in this remark - we should recognise the depth of truth in it. This is a fundamental problem with the medical system. Medications let you off the hook for personal responsibility - and that is why they are so favored.

Eat what you like, drink what you like and do what you like. Don't worry, there's a drug that will fix any problems later. Is this logical, moral, ethical ?

1
 DancingOnRock 16 May 2020
In reply to LeeWood:

It’s a very deep question because obesity is a psychological disease not a physical one. 
 

Mostly we treat the symptoms and not the cause. We put people on exercise regimes and diets but don’t treat the underlying cause. 

In reply to DancingOnRock:

'but don’t treat the underlying cause. '

Which is?

 DancingOnRock 16 May 2020
In reply to Rob Exile Ward:

Whatever Psychological problem the person is suffering from. 

 off-duty 16 May 2020
In reply to LeeWood:

> > The time for the pressure will be when a vaccine becomes available and they all go back to their old ways. 

> Without attempting to twist the meaning in this remark - we should recognise the depth of truth in it. This is a fundamental problem with the medical system. Medications let you off the hook for personal responsibility - and that is why they are so favored.

> Eat what you like, drink what you like and do what you like. Don't worry, there's a drug that will fix any problems later. Is this logical, moral, ethical ?

Interesting suggestion, though important to highlight the fact that in this specific case vaccination or immunity remains the key way to solve the current COVID19 pandemic. It isn't something that can be solved or blamed on lifestyle choices.

 DancingOnRock 16 May 2020
In reply to off-duty:

I think the thread is about obesity and COVID-19 is another good reason to avoid becoming obese. 
 

If you remove reasons not to become obese then people will not seek to cure themselves of obesity. 
 

Obesity is a disease that creeps up on people over time. It kills you slowly. It’s something you will do something about tomorrow and every time a fix comes along that gives you an excuse not to cure yourself, tomorrow becomes less urgent.  

 fred99 16 May 2020
In reply to jt232:

> I'm not surgeon but imagine operating on a patient with a BMI of 40 compared to a BMI of 20!

> I would struggle to think of a single specialty which has nothing to do with weight. 


Precisely. In fact many surgeons have, in the past, refused to operate on patients who have been overweight, smokers, etc. until (and unless) they reduce their weight/stop smoking/whatever. This has been done on medical grounds, so I see no reason not to agree with these surgeons. It's scarcely a giant leap to suggest "physician, first heal thyself".

 krikoman 16 May 2020
In reply to fred99:

> I said;

> "at least reasonably HEALTHY, and not appearing to be liable at any moment to become customers of said service."

> I do not feel that I should need to further define my thoughts to any sensible person.


So  you just want them to look fit enough? No matter how good they are at their job?

What do you intend to do with all the "fatties"?

 krikoman 16 May 2020
In reply to LeeWood:

> Hopefully BJ's action will deal with this - !! Breaking !!

> // “poor diet is now a bigger health threat than smoking”. //

> Also in The Times - paywalled


Are you not worried this is some massive smokescreen to cover up the shit job they've done?

It's a bit of an ask for everyone to slim down now!

OF course it's a good idea, but we're in Covidland now, so how does this help?

 Stuart William 16 May 2020
In reply to DancingOnRock:

I'm not sure it is fair, helpful, or accurate to suggest that anyone who is overweight is suffering from psychological problems.

There are indeed links between e.g. childhood trauma and obesity, and obviously there are other potential psychological factors. But there are also lots of other factors at play. There are demonstrated genetic factors to obesity. There are physical health and hormonal disorders that lead to increased weight. There are medications that have weight gain as a side effect. There are people who have disabilities or suffer chronic pain who may struggle to exercise. There are socio-cultural factors in terms of the norms and assumptions baked into different societies. And then there are multi-billion pound industries heavily promoting sweet fizzy drinks, sweets, convenience foods, telly programmes etc with decades of expertise and research into how to manipulate consumers.

There's been some interesting observations on the socio-cultural side of things over the years. For example, that the relatively high incidence of obesity in South Asian cultures may be due to a very high value being placed on responsibility to family - to be spending time out running, for example, is reported by many as selfish since you should be using that time to support your family or spend time with them. Low income is also often associated with increased obesity; often the reasons reported are that people can't afford club or gym memberships, don't feel safe e.g. running locally due to high crime rates in deprived areas, or are working multiple jobs and after working a 16 hour day would rather collapse on the sofa and talk to their family than go out exercising. Equally, even among higher income groups we have a society of increasingly sedentary jobs and, again, after a long day in the office and the choice between family or exercise many will might choose family or a sit down with a cold drink. Many no longer have lifestyles where exercise is just built in to our essential daily activities, it has to be a conscious choice. I don't think it's at all fair to label any of these people as having "psychological problems"

Post edited at 16:14
 DancingOnRock 16 May 2020
In reply to Stuart William:

>I'm not sure it is fair, helpful, or accurate to suggest that anyone who is overweight is suffering from psychological problems.

It is dealt with by addressing the psychology behind the reasons why the obesity has been allowed to happen. 

You don’t put on weight if you don’t keep fuelling your body while doing no exercise. 

There are very few physical problems that create obesity. 

If you work long hours then you should be active. You shouldn’t need to be doing additional exercise. Your employer should also be insisting that you take a lunch break so you are not snacking at your desk for 14 hours a day and making bad food choices. 

It is a decision to know you are overweight and not do anything about it until it is too late. Whether that is conscious or unconscious, and whether it’s under your direct control is another discussion. It’s still a mental issue. 

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 LeeWood 16 May 2020
In reply to Stuart William:

Thats a v intelligent roundup of factors.

But in what sense exactly did DOR use the phrase 'psychological problems' ?

If it was the 'clinical' sense then you're right - people collectively should not be labelled like that for eating junk food. Though of course their will be a smaller number who have real psychological problems. Ultimately it's a spectrum of problem - range. I believe clinical definition would make reference to 'disruption of normal behaviour' - and there's another minefield - normal !

In a looser sense, some of the things you name qualify as psychological problems, or more correctly - factors. More generally stress leads to comfort eating - and what at a given moment you reach for in those circumstances, depends on your susceptibility to advertising, based on education.

 LeeWood 16 May 2020
In reply to krikoman:

> Are you not worried this is some massive smokescreen to cover up the shit job they've done?

Possibly. But if we try to see the best possible motives - we might consider that Real Threat to his life has forced him out into the open ie. honesty. What he proposes tackling has been stuck on lobbied agendas for years now - stifled by the pressure of  invasive and powerful food industry - it will need courage and patience to work through. And all along the way there will be more lobbying to stop or weaken it.

I note already, that yesterday, in the same day that BJ released news of his outline intentions, that The Spectator published a disparaging  article, and contradictory to the one I first posted in the OP.

https://www.spectator.co.uk/article/boris-s-war-on-obesity-is-a-mistake

On a more encouraging note - Labour has commended BJ for the proposal

https://www.theguardian.com/politics/2020/may/15/labour-welcomes-pms-conversion-on-obesity-after-coronavirus-scare

Lets hope Real Change doesn't get drowned in politics. 

 Stuart William 16 May 2020
In reply to DancingOnRock:

> It is dealt with by addressing the psychology behind the reasons why the obesity has been allowed to happen. 

Agreed, since ultimately its behavioural change that is needed as a solution. But we also need to address external socio-cultural barriers people face. For me this is different to it being a “psychological problem” but I may have been interpreting that phrase differently to how you meant it.

> There are very few physical problems that create obesity. 

But many which present significant challenges to doing anything about it, or make it easier to become obese in the first place.

> If you work long hours then you should be active. You shouldn’t need to be doing additional exercise. Your employer should also be insisting that you take a lunch break so you are not snacking at your desk for 14 hours a day and making bad food choices. 

I don’t know how well that’s borne out in reality. Certainly I don’t think that working long hours means you are necessarily active.

I agree that the solution is at its core psychological/behavioural. I’m not keen on the idea that it is just a “psychological problem” though, which I interpret as meaning it’s either a mental health problem or people just can’t make good decisions and look after themselves. I apologise if that’s not what you meant. But if it was, then I think the reality is much more complex and to just label it as bad decision making on the part of the individual belies the different factors and challenges at play in people’s lives.

Ultimately any successful large scale obesity intervention needs to take into account the environment people are in as well as their motivations and individual psychology. 

 fred99 16 May 2020
In reply to krikoman:

> So  you just want them to look fit enough? No matter how good they are at their job?

> What do you intend to do with all the "fatties"?


No, please stop twisting things.

I want NHS staff (and indeed anyone for that matter) to be capable to do their job, both technically and health-wise.

How many smokers are going to take an instruction to stop from a smoker ?

How many obese people are going to take an instruction to lose weight from a similarly obese person ?

How many people who huff and puff walking into a surgery are going to take instructions on getting fit from someone similarly wheezing when they walk in ?

The answer to all four above is NO-ONE !

I wouldn't take advice on how to place runners in a crack from someone who I had just seen place half a dozen in a route which all fell out - who would ?

Why would I take health advice from someone who looked as though the crash cart might be needed imminently ?

 fred99 16 May 2020
In reply to LeeWood:

> Possibly. But if we try to see the best possible motives - we might consider that Real Threat to his life has forced him out into the open ie. honesty. 

Bojo - HONESTY ????

I think you need to sit down and have a long rest - you've obviously been overdoing things

 DancingOnRock 16 May 2020
In reply to Stuart William:

It is what I meant in part. I understand fully how environment shapes us and makes it very easy for us to make the wrong decisions. I don’t accept that we can blame it on environment though. It’s certainly a factor, but the main problem is, and I hear it over and over again, “I’m going to start a diet next week.” 
 

Coronavirus comes along and all of a sudden people realise that it’s a bit late and “next week” may not be coming for some. And hey presto, they start to change. 
 

There’s only so long you can keep making excuses. That’s not a ‘psychological problem’ it’s a ‘problem caused by our psychology‘ if you like. 

Post edited at 19:55
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 off-duty 16 May 2020
In reply to DancingOnRock:

> There are very few physical problems that create obesity. 

> If you work long hours then you should be active. You shouldn’t need to be doing additional exercise. Your employer should also be insisting that you take a lunch break so you are not snacking at your desk for 14 hours a day and making bad food choices. 

Hahahahahaha. Try being a frontline 999 worker. 

> It is a decision to know you are overweight and not do anything about it until it is too late. Whether that is conscious or unconscious, and whether it’s under your direct control is another discussion. It’s still a mental issue. 

Fairly judgemental.  

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 DancingOnRock 16 May 2020
In reply to off-duty:

If frontline 999 workers are not getting breaks every day then there is something seriously wrong and it needs to be addressed. How can you function properly if you are not eating properly? As far as I am aware you generally work shifts so how often in a week do you miss a proper meal? 

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 Tom V 16 May 2020
In reply to fred99:

While I'm not with the general drift of your argument( being overweight myself) I understand the examples you've given - straight away it put me in mind of Attenborough saying we should all cut down on our flying.

 off-duty 16 May 2020
In reply to DancingOnRock:

> If frontline 999 workers are not getting breaks every day then there is something seriously wrong and it needs to be addressed. How can you function properly if you are not eating properly? As far as I am aware you generally work shifts so how often in a week do you miss a proper meal? 

Only once a shift, so it's not too bad...

1
 Stuart William 16 May 2020
In reply to DancingOnRock:

> It’s certainly a factor, but the main problem is, and I hear it over and over again, “I’m going to start a diet next week.” 

The problem there is it tells us absolutely nothing about the reasons why people might say that. You initially were saying that we should be treating the cause, not the symptom. But this is absolutely a symptom because something is driving people to delay making changes despite knowing they should. That statement is the end result of all the other factors coming together, not the root cause.

I’m not trying to make excuses, nor deny people’s own responsibility for their health. But if we want to see change we need to look at what barriers people face or perceive. Because just saying “eat less, move more - your health depends on it” has proven pretty ineffective.

A fear of imminent death from a pandemic might indeed prompt some changes for some. But once that threat becomes less imminent I’m sceptical about those changes lasting since none of the other reasons they became obese have gone away. And CoVid19 is not really a public health intervention that we want to voluntarily maintain long term.

In reply to Stuart William:

Over the last 50 years and certainly the last 30 the cost of food as a proportion of income has shrunk massively. Everyone can afford to over eat. Plus access to food, we are so busy sitting in cars not doing anything, that you can drive through and get 1000 calories of crap in seconds. Take away to your door to save you walking for 5 mins not a problem. Can't be bothered to cook because you are too busy watching Masterchef not a problem, 3 mins blasting some food in a plastic container job done. 

We've made it incredibly easy for folk to get fat from a very young age. Little angels can't possibly walk 10mins to school I'll drive them etc..  

Post edited at 06:48
 krikoman 17 May 2020
In reply to fred99:

> Why would I take health advice from someone who looked as though the crash cart might be needed imminently ?

Because knowledge doesn't change on who's giving it, it's your own prejudices that will stop that.

Are you seriously suggesting you wouldn't take any notice if a fat person explained why you should change your diet, because you have heart disease and if you don't change you'll die?

And I wasn't twisting things, simple reading what you'd written, are you really convinced a fat person can't know about nutrition and diet?

Post edited at 12:45
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In reply to DancingOnRock:

Teachers see very over weight kids, I don't think it's their fault. Do you think social services should be able to remove obese children from their families if their parents "keep making excuses" for not feeding their children more responsibly?

In reply to TobyA:

I don't see obesity as very different to smoking; over-eating, like smoking, were encouraged and huge industries developed to propagate and and profit from them. Even when it became clear that smoking actually was a huge health hazard, inertia, habits and above all the tobacco lobby mean that it has taken us 50 years to get where we are, and where we are is STILL 15% of the population smoking. And efforts to achieve even this have been controversial at every stage.

Tackling obesity is going to be long haul, it doesn't help that successive Tory governments have resisted public health measures at every turn under the influence of food lobbyists. Fatty Johnson came to power promising to  review sin taxes:

https://www.independent.co.uk/news/uk/politics/boris-johnson-freeze-sin-tax-alcohol-tobacco-sugar-matt-hancock-a8984981.html

There's evidence that he may have had second thoughts since his obesity related brush with death, but I imagine that Cummings will whip him back into line soon enough.

 Timmd 17 May 2020
In reply to Ridge:

> > As an obese clinician myself, I have personal insight into this.

> Not sure who you're quoting there, but when a grossly obese nurse who was wheezing getting out of the chair suggested that, with a BMI of 27, I could do with losing some weight I found it hard to take it seriously.

> Edit: I'm hovering around 25 now, noting that BMI is largely bollocks.

It probably is largely bollocks - a brother's friend who used to play rugby and work out for that would have had a high BMI and still been healthy, I reckon it's the message which important rather than the messenger though. 

 krikoman 17 May 2020
In reply to Rob Exile Ward:

> I don't see obesity as very different to smoking; over-eating, like smoking, were encouraged and huge industries developed to propagate and and profit from them.

There was a recent video of a comparison of McDonalds food in the UK and in the US, mainly portions sizes, but also ingredients.

It's amazing, but if you get used to a portion size of 1.5x them I suppose that's what you become to expect.

 krikoman 17 May 2020
In reply to DancingOnRock:

> If frontline 999 workers are not getting breaks every day then there is something seriously wrong and it needs to be addressed. How can you function properly if you are not eating properly? As far as I am aware you generally work shifts so how often in a week do you miss a proper meal? 


Come off it, it rife in the NHS that you get busy, you miss you lunch/dinner/ breakfast. That was "normal" even before the pandemic. It might not be every day, but it's quite regular and often.

 Timmd 17 May 2020
In reply to DancingOnRock:

> >I'm not sure it is fair, helpful, or accurate to suggest that anyone who is overweight is suffering from psychological problems.

> It is dealt with by addressing the psychology behind the reasons why the obesity has been allowed to happen. 

> You don’t put on weight if you don’t keep fuelling your body while doing no exercise. 

> There are very few physical problems that create obesity. 

> If you work long hours then you should be active. You shouldn’t need to be doing additional exercise. Your employer should also be insisting that you take a lunch break so you are not snacking at your desk for 14 hours a day and making bad food choices. 

> It is a decision to know you are overweight and not do anything about it until it is too late. Whether that is conscious or unconscious, and whether it’s under your direct control is another discussion. It’s still a mental issue. 

Except for how eating late after a long shift can mean one puts on weight more easily, and being 'on a treadmill' work wise can mean it can be a struggle to find the time to exercise, and being tired the following day after working a long shift can make it harder to exercise can do too, they're not mental issues or decisions taken particularly,

I'm not having a go, but your post seems to speak a little bit of a lack of knowledge about how unrelenting it can be to work in care work, or the NHS, and of how people might end up overweight in modern working life. 

Post edited at 20:20
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L KriszLukash 17 May 2020
In reply to summo:

> The average obese joe public doesn't have a high because of muscle, it's fat. Of course they'll blame being big boned, genetics etc. But in reality 99% of obese people eat too much, do too little. 

Of course, but if you are severely obese, your chance of going back to a normal weight is about 1 in a 1000.  It’s much harder than quitting smoking.


There is a big difference between losing some love handles in your 40s and reversing obesity. People who have not experienced obesity themselves often don’t understand that.

Post edited at 22:34
 DancingOnRock 17 May 2020
In reply to Timmd:

Except this is a known issue and any employer who isn’t aware and taking steps to prevent those working conditions is basically negligent in their responsibilities. It’s counterproductive to have your employees working in those conditions and long term it leads to increased costs due to absenteeism and short term a lack of productivity. 
 

As I said in a previous post. You need to break the cycle somewhere. And it’s not a physical issue it’s a behavioural issue due to psychology. Be that the employee who imagines that they’re under pressure, or the employer who thinks they can keep drivIng people to breaking point. 

Post edited at 23:20
4
In reply to KriszLukash:

> Of course, but if you are severely obese, your chance of going back to a normal weight is about 1 in a 1000.  It’s much harder than quitting smoking.

> There is a big difference between losing some love handles in your 40s and reversing obesity. People who have not experienced obesity themselves often don’t understand that.

Of course it's an entire change of lifestyle. Companies like weight watchers make a fortune from such individuals who are customers for life with yo yo dieting. 

L KriszLukash 18 May 2020
In reply to summo:

> Of course it's an entire change of lifestyle. Companies like weight watchers make a fortune from such individuals who are customers for life with yo yo dieting. 

The problem is that is practically unachievable for a severely obese person to return to normal weight. The exception to the rule are very, very rare indeed.

The only thing we know works is bariatric surgery, but it comes with its own complications.

Post edited at 06:37
 LeeWood 18 May 2020
In reply to summo:

> Of course it's an entire change of lifestyle. Companies like weight watchers make a fortune from such individuals who are customers for life with yo yo dieting. 

Yep, needs a proper campaign. Here's another journal reporting on what's to be done:

https://www.foodnavigator.com/Article/2020/05/15/Campaigners-call-for-junk-food-advertising-ban-as-British-PM-hints-at-interventionism-to-tackle-obesity

Professor Graham MacGregor from Queen Mary University and Chair of Action on Sugar and Action on Salt.

He is the source of the statistic that - being obese doubles the risk of needing treatment from coronavirus. He called on the government to 'get on its bike' , and proposed the following reform measures:

//

  • Ensure the food industry only discounts, promotes and advertises healthy food and drink 

  • Force the food industry to reformulate food and drink with less salt, sugar and calories

  • Ensure the NHS trusts provide key workers with the highest nutritional quality food

  • Give direct advice to a very concerned public about how to identify their risk, exercise and lose weight safely

"Now that Mr Johnson has direct experience of this vicious virus, we ask him to protect the most vulnerable people in our society and create a more resilient Great Britain, both now and in the future. The responsibility is his."

//

Post edited at 08:35
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