Michael Buerk. Is obesity a disease?

Because the healthy ones live longer, Sparklefizz. And the older you are the more health care you need. It's pretty obvious really.

I'm confused by that article as well. Do obese people just die without ever having health issues?

Slim and fit people might live longer but until they need a doctor for whatever reason they haven't been costing the NHS a penny and they probably contribute more through National Insurance.

Why is there a type 2 diabetes epidemic?

Agree with MissAdventure that the people who "eat what they like" dont necessarily over eat.

They may enjoy a big slice of cake at lunch, but not graze between meals.
Or they may graze a lot, but only have light meals
Or they will enjoy 3 courses with gusto on a night out, but they wont have had lunch.

It is well researched that people are terrible at guessing their intake

This explains it quite well.

www.sciencedaily.com/releases/2008/02/080204212858.htm

There is some evidence that some people are genetically pre-disposed to obesity - the most extreme example is some of the Pacific islanders. The theory is that people with a "thrifty" gene stored fat more easily and metabolised it slowly. It gave them an advantage during the long sea voyages when these people were colonising the islands - "survival of the fittest". Nowadays of course it's a big problem there. www.ncbi.nlm.nih.gov/pmc/articles/PMC5069069/

In the rest of the world, people with the "thrifty" gene had an advantage in times of famine, but nowadays with abundant food it's an obvious disadvantage. At a recent wedding I noticed various members of an extended family. Most were more or less normal weight, but a few stood out as obese. One had a mother who was always heavy, but her siblings were not. Another had parents who were both slim, but had 2 very obese uncles. In these cases it would probably not be eating habits of the family, but something genetic.

In my own case, I could eat a lot when younger and not put on weight, but then found I had overactive thyroid. This caused my metabolism to run faster than normal - opposite to underactive. My resting heart-rate was always over 80, so even when sleeping I was burning more energy than a normal person. After eventual removal of thyroid I put on a little weight, but appetite was reduced so it wasn't too bad.

There seem to be multiple reasons for the obesity epidemic, but in my opinion, genetics plays some part.

I think the carbs/insulin/leptin debate is the most compelling for explaining the obesity "epidemic".

Carbs are essentially sugar, which act on the body in such a way as to create a cycle of insatiable hunger.

So diabetes is both the cause and symptom of obesity.

That's a terrible explanation but at least explains why obesity is classed as a "disease".

Carbs are essentially sugar, which act on the body in such a way as to create a cycle of insatiable hunger.

Are you sure? Go back in history and most people's diets were primarily carbohydrate, meat was a luxury and alternatives limited. There is no evidence that the population before the 19th century had an obesity problem.

I have always eaten a lot of carbohydrates without ever suffering from insatiable hunger (except as a child, when I was as skinny as a beanstick). Except in the aftermath of the menopause, I have never been overweight. I always understood that it wasn't the carbohydrates that did the damage but all the sugar and fat that was usually eaten with them (frying potatoes, butter and jam on bread, sugar and fat in cakes and biscuits.)

I always understood that it was not the carbohydrates

I really do not think there is a carbohydrate

As has been said, people seriously underestimate how much they do actually eat so they put their obesity down to genes/medical issues.

100g bar of Cadburys is over 500 calories
100g bar of Green & blacks is over 600 calories

A shortbread finger is about 100 calories! And how many people stop at one?

I follow a low-carb diet in general but to be honest it all depends on how much you eat.

Whatever was eaten in the past, lack of physical labour, new food types available in the past decades haven't changed our metabolism or introduced a new disease, it's simply that people eat too much now that it's relatively cheap and available 24/7.

I think, looking at the wider picture, individuals have been encouraged to lose track of what is normal as far as food is concerned.

Portion sizes have increased dramatically over recent decades. Commercial food production and presentation hides the “bad” stuff. Cereals promoted as healthy because they do not have added sugar contain sugars none the less and the portion size recommended is tiny in today's expectations. In articles about changing portion sizes over the years we have become accustomed to much larger portions than the 50's or 60's to the extent that its hard for people to recognize that what is on their plate is probably double what their parents and grandparent ate.

Fruit juices and smoothies are promoted but contain tons of sugar. Snacking on sweet fruits is seen as a good choice.

Manufactures play to our busy lifestyle and promote high fat, high sugar ready meals and convenience food. Maybe we should say no, but it takes a strong will to study every tin or package for the content when we shop.

Ultimately we are all responsible for what goes into our mouths. But lets look at the bigger picture here as well. If advertising of food products wasn't effective, manufactures wouldn't do it

My dear sister has always said you don’t go to bed weighing 10 stones and wake up weighing 20! It creeps which is easily felt in clothes so when the waistband feels tight, cut down immediately. I’ve had UAT for years and I have such a sweet tooth too so I have to exercise self control and-guess what!-it works! ?

riverwalk, you are assuming that everybody eats a diet full of sugar and fat and cannot resist eating more.

Offered a short bread finger, I will usually stop at 0, because I will say 'Thanks, but no thanks' and I cannot remember when I last ate any chocolate, or any other sweets, Easter? I am not exceptional in this. A lot of people have similar diets.

I am so fed up with this lazy simplistic thinking: That if you are fat it is because you deceive yourself about how much you really eat and are always eating sweets and biscuits - and are probably bone idle as well.

I am sure that there may be people this does apply to, but this lazy labelling of every overweight person in this way, does not help those whose problems do not have those causes. As I have said before, obesity is a multi-factorial problem. There have always been obese people, even when most people were slimmer than now.

There is more to obesity than what you eat.

riverwalk, you are assuming that everybody eats a diet full of sugar and fat and cannot resist eating more.

I'm not assuming any such thing.

we seem to have deviated from the thread and started to get into fat blaming.

I found the article interesting in that far from being a drain on resources the people who in societies eyes are bringing the system down are, in fact, doing the opposite.

The logical conclusion is that if we want to save the NHS and our social system we need to encourage our population to get fat or smoke themselves to an early grave.

The thin, fit folk will have to fall on their swords when they get to 90??

As one dangerously over weight person said to me " An alcoholic can stop drinking, a drug addict can stop taking the drugs, a gambler can cease gambling but an obese person cannot stop eating". Its a hard problem to solve and as someone who needs to lose a few pounds I can understand their dilemma.

Some people are over weight through choice , but some people are over weight because of health problems . Who are we to fat shame , this just make people with weight problems feel even worst about themselves . Try having a little compassion .

I agree with Pinkquartz..we are far too judgmental nowadays, and label everyone, and everything

many overweight people have mental problems, mind you I think we all have mental problems

@monica in my defence that carbs/leptin/insulin/sugar/diabetes explanation was terrible!

Edit: I DO believe that there is a link between carbs, sugar, leptin, insulin, diabetes and obesity. It's been medically proven, pretty much.

It does not mean that an otherwise healthy person who eats carbs as part of a healthy diet will become diabetic or obese. All of us will have been brought up on a diet of carbs in the form of potatoes, bread etc and not necessarily become obese. Thing is, we would have eaten everything in moderation.

The obesity - as - a - disease argument hinges on a way of eating carbs that is most definitely NOT in moderation. The cycle kicks in when people overconsume carbs - particularly the refined carbs. Their systems become overloaded and can't cope, setting up the insulin response (insert science-y bit here). Hunger becomes insatiable, resulting in - yes - yet more overeating!

It explains why people who are already obese can eat loads more, becoming even more obese. The eating is said to be uncontrollable due to the changes in the body. (This is the bit I could never understand).

So - on that basis - obesity CAN be classed as a disease, either in its own right or as a consequence of the insulin/ carb response in the body (it has a name which I can't remember off the top of my head).

Hmm! I think obesity is a symptom of many things. We have the combination of a sedentary lifestyle, processed foods which we are preprogrammed usually to like, we don’t have to hunt and gather anymore....we can drive to the shop for our chocolate bar (or whatever).

For me the answer lies in moving more and having a good understanding of nutrition.m

I am overweight, I am losing weight though and I am doing it on 1900 cals a day, 10000 steps a day and working out three times a week,

I weigh daily so can see normal fluctuations too.

I focus on protein and fibre to the exclusion of the other macros .

As a result I no longer have a desire to binge eat.

I do Parkrun most Saturdays and have seen my times get faster .

I am 53 and the healthiest I’ve ever been.

I am still obese at the moment.

Dementia is a massive issue as we have an aging population.
Diabetes is a big issue and potentially a major public health issue.

But we live in an obesogenic environment which makes it harder.

Plus if you’re feeding a family.....

A pizza, frozen chips, garlic bread and a tub of ice cream is on offer at my local store this week for £6.

Buying fresh fruit, veg and meat and cooking from scratch comes in much higher.

I remember my lovely mum thinking she was overweight at 10 stone. Dad probably weighed about the same. They didn't eat fast food and didn't drink alcohol. Mum walked everywhere as she didn't drive. Dad spent every spare minute working on our huge garden. Their lifestyle was spot on. I'm overweight, drive everywhere, eat takeaways a couple of times a week. My own fault I'm fat.

I too can easily get overweight and have thought a lot about what leads to my eating more than I need. I am now a healthy weight, but it took time to understand enough to get here - I've been a healthy weight now for over 9 years and expect to stay that way. I think it is important to think about the feelings and thoughts and habits which lead to overeating. If it were simple, none of us would be over weight, but food is so basic to our lives, and has so many meanings for us - and nowadays the world around us is full of advertisements, food, drinks, images, all of which promote the kind of eating which leads to being over weight. And if you are overweight or obese, you probably fear others are judging you as greedy, so you feel bad, so you turn to your habitual source of comfort - food. Then the whole cycle begins again - people need support and understanding to get out of this cycle and change. Yes, it is down to ourselves to change, but it is also possible and helpful for people to get appropriate support.

Eating has become a leisure activity.
Food is everywhere you look. They are so many supermarkets, express stores, coffee shops fast food drive throughs. We tag eating onto lots of other things that we do. Eg a swim then go to the cafe. Meeting friends for coffee AND cake .
Taking children to the cinema where eating all the way through the film is the norm. Big bags of pick and mix, huge tubs of popcorn, large bags of sweets not to mention all the fizzy drinks . Then perhaps pizza afterwards.
No wonder we are overweight.
When I was a child I was slim and my mother was always trying to fatten me up. She wanted me to be a little Shirley Temple all chubby cheeks.
When I look at old photos I realise that I was a perfect weight for my height but I grew up with a complex that I was too skinny.
Now I am over weight !
My mother would be proud !

Food can be an addiction - just like booze, fags, drugs. Difference is if you are addicted to the later 3 you get help, support and understanding from NHS / society etc. If it is food - you just get fat shamed and guilt tripped.

I think it is putting too many calories in your body. It is however, a complicated problem. If you look back at our tv shows in the 70's, most people were thin or normal weight. Portion sizes and availability of take out (USA!) no exercise, video games, smart phones, etc. has led to obesity or is a great contributing factor. When we were bored, our mothers would tell us to go play outside. And honestly, the world is not that much more dangerous. We just hear about it twenty four/seven. I had a sandwich, an apple and milk for lunch-in a brown bag! I am not trying to be an old grump because I love delicious treats and fast food. But they are treats! not just an everyday food choice. Moderation is key.

I think obesity is a disease and can be a part of the eating disorder spectrum. You cannot hide being obese while you can hide anorexia and bulimia, so sufferers are obvious. I was so angry when I read Buerk's comments. People don't know why a stranger is obese but they mostly judge them. There are so many factors involved. I am obese and struggle on a daily basis with this and, to be frank, would rather die than carry on with this struggle. I have a DNR on my medical notes. Writing this post has been so hard as I normally try and keep quiet about my struggles. Don't judge until you've walked in someone else's shoes. People need proper help which isn't available, not judgement or being condemned.