I retired at 55 a couple of years from my job as an NHS surgeon. I trained at Bart’s and I remember as a medical student the student nurses saying that at Bart’s their ‘size’ was a factor that was taken into account even at the interview stage. Being fat (let’s use the word) just simply wasn’t acceptable. This was only going back into the 1980/90s.
As the years went by I just saw being fat amongst the nursing staff become the norm rather than the exception. That picture of Hattie as the ‘Fat Matron’ would be nothing these days.
But, the problem is across the whole of society in the UK. It’s multi factorial, for sure. One of those factors is the acceptance of being fat or ‘fatness’ is absolutely nothing to be ashamed of. Well it should be!
I’ve just returned to the UK after spending 3 months in Germany and the difference is stark. It seemed actually rare to see someone who was obese there, let alone the numbers of clinically morbidly obese (often young people) that one sees here in the UK.
It would be an interesting study, if somewhat crude, just to know what the BMIs on admission to hospital of people who died and compare those with for example, France or Germany.
Is BMI sufficiently good enough to pass judgment. Plenty of fit rugby types would fail a BMI test and I will leave it to you to call them fat hahaha.
Metabolic health on the other hand?
LDL for example is not as simple as bad, large boyant LDL is fine, small dense LDL is not and causes atherosclerosis. But does the NHS regularly test for the difference?
Well, no I’m sure BMI is indeed a pretty crude tool. At the same time, we know pretty much what the body habitus of those generally coming out with high BMI scores…and they don’t look like rugby players for the most part! LOL!
You can probably dig into this data to find out. But how would you unpick the impact of different medical treatments? The UK I think has a fairly high (or maybe even highest EU: death rate per x people hospitalised, and Germany the lowest.
But overall obesity rates in France and Germany are only fractionally lower than UK.
Well, Epidemiology and indeed research plud juggling data were never things I particularly enjoyed or was any good at. So, I wouldn’t really want to do it.
However, I’m truly surprised that there is data that suggests obesity rates in France and Germany are only marginally less than the UK…?
I know it’s only anecdotal but that doesn’t match up with my observations at all!
But, I did live and work as a consultant in the West Midlands which apparently has the highest obesity rates in western Europe. When in the UK, I now live in Lincolnshire which has Boston in it…the UK’s fattest town!
On the flip side another interesting statistic that I recently learnt and really surprised me is that both France and Germany both have more McDonald’s than the UK! (they just don’t have as many of all the other thousands of fast food places that the UK has! )
Interesting. Gov’t stats are usually solid - but such a hard thing to measure reliably I imagine -so maybe there has been a decrease of a few percent. Certainly not round here tho’!
Different population densities might account for more McDos… France has a lot more ground to cover with discarded greasy wrappers than the UK.
I don’t know about France so much but I did a few epic drives from Lot et Garonne to northern Germany via SW Germany last summer and tried to take notice. It seemed like any Autobahn services of any size did indeed have a McDonald’s.
I finished a job on a pool a few years back just in time for a nice drive home via an auberge, no luck all closed so on the A20 there was Pauls, even the flies hadnt touched what was left. Only place open, McD’s so I drove home and although late cooked my dinner.
Fast food works because they are open and the sugary carbohydrates keep people going back for more far too regularly.
Whilst others have been gaining weight during lockdown, I have done the reverse on a low carb diet BMI 19.4 and fat % 12.7 got rid of the visceral fat!
Its easily doable to reverse this modern obesity causing diets but there has to be a will to do it.
Unfortunately John it is not so easy for those who are food addicts. There is an excellent woman in the US, Susan Peirce Thompson who has a lot of neuro-science based information on food addiction and obesity and hers is one of the very few nutrition-based (NOT diet-based) programmes for weight loss that works. She’s an addict herself and so understands what those who are go through.
Not everyone is and they are the people who say “you just need will power”.
Someone can give up smoking or drugs and never go near a cigarette or drugs again.
A food addict cannot give up food. Every day they go into a supermarket it’s like a crack addict going back into a crack den. That is what they face and have to learn how to manage.
Obviously it isn’t “easily doable” or it would have been done considering the cost to national health services. It is a bit arrogant to say it is in my view.
It is a hugely complex issue, and the stranglehold huge food industries have is staggering.
But it’s also just not people who eat fast food who are obese - we have a family in our village who would never dream of eating at McDos, and Mum cooks proper meals daily using vegetables from their vegetable plot, and in between them all going off to do sport. But they waddle around like fat ducks.
I was speaking from a personal point of view, if my personal achievment is arrogant then so be it, I can’t change that.
It could be changed by public opinion, if more awarenes of how effective certain measures like low carbohydrate is then it will gow by adoption free of outside ££££ influence. Then despite what some doctors (those that haven’t tried it) think we could get back to a time before Ancel Keys interfered when obesity was a rarer event.
That would require a government who didn’t have their fingers in the pies or donations from food companies to support their party to actually have the will to change. These governments can force me to buy an electric car for the benefit of the environment or not be allowed anywhere near a town but yet they still haven’t banned transfats.
Regarding your fat ducks, they may have poor gut biome so have lost the ability to stay slim, for them a fecal transplant maybe an option. Still early days for this kind of treatment but again it’s having sucess in the sickest nation on the planet.
The family intrigues me. They don’t drink, and mother and daughter play judo at a reasonable level so aren’t slouches, and eat things like unpasteurised cheese which is great for your gut. But they all wobble… so it must be quantity and underlying genetics.
(Your “easily doable” wasn‘t phrased as being solely personal)
Can also be food intolerance. So for example not everybody can digest milk products properly - I note you mention unpasteurised cheese. Not great for everyone’s gut. Raw chou croute is much better.
We in the west have been digesting milk for a couple of thousand years, these recent intolerances could well be damaged gut biome as well. Unpasteurized cheese is good for gut bacteria except maybe pregnant women.
Yes sauerkraut and kefir seem to be popular at the moment.
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