Saturday, 26 February 2011

Heavy people

This was entirely predictable.

I wrote my degree dissertation on the subject of childhood obesity and I proposed at the time that we’d see a growing number of huge teenagers and, likewise, a growing number of weight-related problems facing the ambulance services in the UK. Today, we are introducing ambulances that are extra-wide and have the capacity to bear the weight of a small elephant. The teenager in the recent news story weighs about a third of a ton and she can expect some really painful physical complications; joint problems, spinal problems, muscular aches and pains. Then there’s the added stress on her heart and lungs, diabetes, high blood pressure and a very unfavourable outlook generally.

But she was born heavy it seems and the trend for weight-gain has never left her, except for one USA fat-camp stint that helped her shed an amazing 15 stones in 9 months. So, physically, if she stops eating so much, she can lose weight. It’s not all genetic. Even she admits that when she gets depressed about her weight, she eats to feel better!

I have been writing about this subject for years and I am not unsympathetic but we are reaching a point where, once again, instead of dealing with the problem head-on, we are simply pandering to it by ‘accommodating’ the needs of those who don't help themselves, such as extra weight and space humans.

A recent study has revealed that we will soon run out of available land for growing food. The world population is increasing faster than we can recover arable land. Obese people, who will increase in number hugely over the next few decades, will be responsible for the consumption of a lot more of the available food than those who are not fat.

The cost to tax payers increases with this trend too; we have to help foot the bill for an ever-growing demand on the NHS for long-term care of the illnesses and injuries that accompany obesity. Ambulance services, like mine have to use (at great cost) specialist vehicles, called bariatric ambulances, to carry these patients to hospital and then they have to be put into special beds so that they can be treated. My colleagues and I suffer back problems and often injure ourselves lifting and carrying obese people because, without us, they simply would not be able to get up when they fall down. Nobody else will do it; nursing and care home staff call us because, apparently, their backs are more valuable than ours.

Without sounding insulting because I really don’t want to be, it’s worth remembering that over-feeding starts in childhood and it’s generally the parent (mum in most cases, according to sound research) that entices and encourages eating when the child isn’t even hungry. It’s habitual. It’s also worth remembering that stress doesn’t make you fat – FOOD does!

My eldest son thought I would like this – it’s a follow up to my rant on equality and racism and freedom of speech. I’m sure nobody will mind giving the Avenue Q cast a pat on the back for being frank with their point of view.

Be safe.


Anonymous said...

Obesity's certainly a major public health problem.

Can you tell whether an obese person is trying to help him/herself, or do you just assume that if they're fat, they obviously don't care?

Fat people may consume disproportionately large amounts of our increasingly scarce food resources (or they may not), but only if they can afford it. Unless food prices are massively subsidized, the costs will go up, which may help solve the obesity problem by making it difficult for people to purchase large amounts of food. Taxing fast food and junk foods, helping people learn how to cook again, and encouraging people to grow their own food could also help manage food consumption trends at the societal level.

Xf said...


No, I can't tell but, without making sweeping generalisations, if someone says 'I get depressed, so I eat' then by that admission, they don't care enough to try something else for their depression - like looking and feeling better about themselves.

Taxing food will not change things. Cheap food will always be around. What will change things is the end of our dependency on food to appease children and an increase in exercise.

Anonymous said...

Reading her story is somewhat similar to me own, whilst I am not 40 stone I am overweight and I have a Compulsive Eating Disorder along with BPD. I look back at my past and the trigger to my problems began when I was about 6, although it was never food related then, my mum was normal weight although my dad is overweight as is his family... however my mum was the cooking person in the family and we only ever got ‘healthy food’. I was an active child swimming several times a week till I gave this up when I reached 12 in order to ‘hang around more with my friends’ that is when the weight gain and my secret eating binges began...

I was a long time carer for my mum who had renal failure in my teens she passed away almost two years ago now, and whilst I am ‘over her death’ my eating still continues to cause problems. I have recently lost 5 stone, but gained back 3 thanks to anti-psychotic medications which I have now come off.

I was hoping to gain a place in a therapy group to deal with my eating disorder, in fact I was promised a place in this group, but it’s a farce and it does not look like I am going to get a place anymore... people with eating disorders of any kind need psychological therapies to deal with why they have such disordered eating, until the government fund this the obesity crisis and people like me and 17 year old Georgia are not going to go away and the problem will get worse.

Incidentally I ate my feelings because I had been a victim of abuse at the age of 6, and because I was scared my mother was ill and dying as a child, it was not until I was 13 / 14 I found out about the Renal Failure. There more I care for her throughout my life the more I hated myself and the more I ate... it was a circle that became hard to break.

Would like to add not all fat people are lazy though, I do have a gym membership and attempt to go twice a week...

Jo said...

I do feel very sorry for the teenager in the article (for a start, she's been conned by the Hate Mail into giving an interview, when it is very apparent that the paper only has a tentative acquaintance with the truth at the best of times).

As you said - parents and their food / exercise knowledge (or lack thereof) are one of the root causes of childhood (and then going into adulthood) obesity; my mother-in-law is a prime example - the whole family has weight issues, and when my husband lost three or four stone in order to get his BMI under 30, she told him that he was 'wasting away'. My sister-in-law still lives at home, and will happily eat a bag of toffee popcorn before supper. She's a size 32 and diabetic. My m-i-l is a post-war baby, and her upbringing through rationing means that if you love someone, you make sure that their plate is always full and they are never hungry.

Education is a main factor - people need to be retaught how to eat healthily, and how to cook meals which cost the same as a takeaway or a ready meal, but are far better for you. If you were never taught this, how can you teach your children? And if the green areas are being taken away to build office blocks, and joining in with an organised sporting activity costs (particularly when you factor in public transport, which often stops before the activity finishes - this is from personal experience of trying to get to my hockey club in the UK when the car had broken down), how do you encourage someone to exercise?

Not that I'm making excuses in any way shape or form, and there is already a scary impact on the economy and society from obesity, but I do wonder whether papers such as the Hate Mail (as probably one of the main ways of reaching people on a low income) do anything on the 'healthy, cheap cooking' (and recipes for tofu or quinoa do *not* count as cheap - it needs to be for food which people on low incomes will recognise!) 'how to exercise safely without spending money' front, or whether they just fill their paper with point and laugh articles?

Anonymous said...

Perhaps they don't. Or perhaps they are or have been treated for depression (or whatnot) but the treatment is ineffective. Although I'm sure you know much more about depression than I do, my understanding is that once someone is in a depressive spiral they often lose interest in helping themselves get better. I do know depressives often lose their sense of perspective. If that's the case, then overeating for short-term relief from depression and the unwillingness/inability to make the long-term changes in habits needed to lose weight would be predictable outcomes from untreated or ineffectively treated depression. Not that that excuses not trying to be healthier, but I'm inclined to see it more as a physiological, rather than a moral, problem.

Of course, there could be people who attribute their behaviors to depression, who aren't actually depressed or suffering from other mental illnesses. That's a different kettle of eels.

I have a female cousin who was treated for depression for years without any real alleviation of her symptoms or long-term decrease in her weight (she topped out at about 20st in her mid-20s, I think). Her family's eating habits weren't super-healthy, but they were okay (and her brother was as skinny as a rail growing up); I think the only real disservice her parents did her in that area was in not ensuring that she attained and maintained a healthy weight as a child. They were unwilling to deal with it, and she's told me that she didn't know what to do about it as a kid. My understanding is that as an adult, she just didn't seem able to study or work AND lose weight, despite putting quite a lot of time, effort, and money into it. Not studying or working wasn't a financially feasible option for more than a few months for her. She finally found a good doctor, got what seems to be the correct diagnosis (ADHD) and what is apparently appropriate treatment, and she's lost a lot of weight (and is still losing) and can actually handle life now. I know she didn't want to be fat, and that she tried to lose weight a number of times, only to gain it back as soon as her very low stress-tolerance level was passed, because she can't handle more than one or two things at a time without medication, and because she seems to find life exceptionally overwhelming. Which is a long precursor to saying that I'm not comfortable making those sorts of judgements about people, because I know for some of them life really is all knotted up, and they haven't found a way to untangle it yet.

If food is scarce, then prices will go up. Unless the government subsidizes production, I don't really see a way around that. It's a commodity like anything else.

I don't know about appeasement of children as a large driver of obesity, but I agree that healthier eating habits and more activity need to be incorporated into many people's lives. Education, practice, and financial or legal incentives for adults to support their own health and raise healthy kids can help accomplish that. Individuals need to make the right choices about food and exercise, but unless they have the knowledge, ability, and incentive to do so, most won't try to change their bad habits as long as junk foods and sedentary activities are available.

Anonymous said...

I agree obesity is a problem but you can't just put higher taxes on food. Same as the binge drinking problem - higher taxes will not stop it. It would be the hard working people that struggle to make ends meet now that would be affected not the intended portion of society.

We need to look at the root causes of such problems and help people before they get into such a state. Of course they don't want to be like that - they just don't know what to do about it, or where to get help once it gets hold of them - I'm guessing the same as alcoholics. I am neither obese or an alcoholic but I never assume anything as until you have been in that position you cannot pass a judgement on someone.

I'm not sure what the answer is and nowadays we are aware of the values of a balanced, nutritional diet and the consequences of not having one! So where are we going wrong?

Student in Scotland said...

A really horrible notion occured to me that if we went back to rationing, people would only be allowed a certain number of calories per week and noone could get to 40 stone. Wonder if the Con-Dems have thought of it already.

On a more serious note, I have had patients in hospital toss plates of food on the floor because the food is a salad or fish. Then wait for their friends and relatives to bring them in McDonalds or fish and chips. I have patients who point blank refuse excercises the physios give them and will buzz to have their water jug moved slightly to the left.

I know that not all overweight people are lazy. But alot of them are. And they are comming into our hospitals with horrible sores from being unable to move or wash themselves properly, and their families just continue with the mammoth meals and junk. It makes you want to tear your hair out sometimes.

Bex said...

Competely agree with xf.

After recently starting working in a secondary school, it is pretty shocking to see how many pupils are overweight, with a pretty poor attitude toward sport and exercise. And this is in a pretty affluent area, I can only assume that it will be worse in poorer areas.

Thankfully the schools are starting to get the message of healthy eating across. The real problem lies with parents who are either ignorant, lazy or lack discipline. Sowing the seed of healthy eating and exercise early in childhood is the only way our obesity problem can be solved. Once the 'let's stuff my face with chocolate and burgers' habit is formed it's game over unfortunately, 9 times out of 10!

Kath said...

I'm two years older than her, and she is near enough 5 times my weight. Wow. Just wow. I just actually do not see how someone can get that big without their heart/lungs giving out, especially because it says she is a smoker, as is her mum.

I think it definitely does start in childhood too, I have a few friends who are on the larger side, and they always say that when they were little their parents used to say "You have to empty your plate because there are kids starving in Africa." which is just ridiculous. Kids should stop eating when they are full, not when the plate that somebody else has (over)filled for them is empty.

Anonymous said...

I think that it is easy for people to get obsessed by obesity. I eat a lot of sugar, cakes, chocolate, fried food - you name it. I am also as thin as a rake because I work hard and do lots of exercise. It is absolutely disgusting that people can talk about taxing food (the stuff of life) just because some fat sod can't be bothered to do some exercise. The penalty falls on them through shortened life and illness.

Anonymous said...

....but the penalty also falls on the NHS due to an increase in workload and costs due to obesity related health issues. It's only going to get worse, and the strain on our taxes will grow. All while schools, armed forces and police are being stripped bare to save the pennies. And while I'm ranting about mis-spent taxes, we should be charging anyone and everyone who abuses the ambulance service through time-wasting or too much booze. It's only since reading Stuart's book (a very good read mighten I add!) I've realised how serious the problem has got. It's about time this goverment grows a spine, stops fannying about and starts using some common sense. Chavs and criminals have never had it so easy. Rant over!

Anonymous said...

I work for the north west of the ambulance service and there are more and more obese people that i come into contact reading a lot of the comments on here that fat people are not lazy may be not but the wrong foods are being consumed in mass quantaties there are a number of our regulars that call us because even at the meagre age of 25 they have more stoneage than years on this planet I WILL go to the house to pick them off the floor (which is no easy task) only to watch them breath really hard then tuck into a packet of crisps a deep fried substance (apparently food) etc I do this job as I want to help people but people sometimes YOU NEED TO HELP YOUR SELF ....

Anonymous said...

hi stuart,
I'm at university at the moment and were just doing some research into obesity, I was wondering if I could perhaps read your dissertation if you didnt mind?
my email address is if you could contact me that would be great. Thank you

jess said...

I see that obesity is a large problem, but coming from the opposite side (i have been in and out of IP for anorexia in the past) i see the problems that all this healthy school lunches and fear of obesity is doing to some. At my school there were 3 of us who had been Inpatient at ED units and more suspected of bulimia and anorexia. Obesity at least in our year was not very common. Although obesity and its awareness does not cause eating disorders such things as looking down on bigger people and idolising tiny celebs etc is sort of like they say " genetics load the gun, environment pulls the trigger" I think the problem is that theres all this obesity awareness but its not getting to the right people, there needs to be more focus on getting the help and info to the people with the problem in a way that is usefull for them. Anyway thats just my small thoughts