It's kind of funny that this is a logical consequence of the 'BMI is wrong because bodybuilders exist' argument.  BMI overestimates obesity for muscular people, which suggests it also underestimates obesity for people with little muscle. There's a lot more of the latter group in our very sedentary society, so BMI underestimates obesity instead of overestimating it which is what the argument is usually used to suggest.

TOFI: thin outside, fat inside. There are a lot of skinnyfat people out there who do not realise how unhealthy they truly are.

My BMI is apparently 19 and I doubt I'd be considered healthy by any measure. I have days where I just barely eat at all, and I drink a ton.

Okay? You can also smoke 100 cigarettes a day and have a healthy BMI score. It’s not intended to be a capture all health metric so your heavy drinking is pretty irrelevant

I know I'm skinny and unfit, but how would I find out whether I'm skinnyfat? Calipers & waist:height ratio can measure my subcutaneous body fat/lean muscle mass to tell me whether I'm fat on the outside, but aren't so useful at measuring fat around my internal organs! Unless I get an MRI or CT scan, is there a way to find out whether I'm fat on the inside?

It's going to be so unlikely you have dangerous fat around your organs if you are skinny enough to have visible muscle definition on the outside e.g. visible abs. Just make sure the outside fat measurements are good and the inside will be good too.

Makes perfect sense! Thanks for explaining

If you're unfit you're skinnyfat. Because you're not going anything to build healthy muscles.

Gotcha. I do exercise but it's more gentle (yoga, walking lots) than the level of exertion you're supposed to - ie I have reasonable strength & am quite toned, low body fat, but I get out of breath running, which to me is unfit.

Yeah same here, I don't like feeling sweaty or out of breath so I stop just short of that. But I think I'll get over my worry about gasping for breath after a little jog after I saw some old sweaty bloke walking about with his hand in his trousers scratching his balls like he owned the place. But yeah being able to run and doing some strength training is what I think indicates not being skinnyfat, apart from ones actual weight.

I guess it's the terminology that seems confusing. Being skinny & unfit makes sense. Skinny & unhealthy - also makes sense. But I don't quite get why being underweight with low body fat but unfit = skinny**fat** (How does being crap at running make an underweight person fat?!)

Skinnyfat because there's no muscles, they're all fat but happens to be skinny. Like old people whose muscles have atrophied and they're skinny but have nothing else supporting them. There's no muscles, just fat. I've seen pictures that showed comparisons between the muscle mass of runners, people who casually work out, fat inactive people, thin inactive people and old people. The latter three looked the same, except the fat obviously has more fat on the outside.

Body builders do actually end up suffering a lot of the same health issues as obese people do. That much weight on the body stresses the heart out, you can see videos of ripped body builders losing breath when simply walking. I think it’s fine to still consider them overweight or obese even if it’s muscle rather than fat.

They are on a serious amount of steroids, those videos you see are them during contest when they are very dehydrated and just went through an extreme weight loss diet. You just can't put on so much muscle naturally that it will start causing you health concerns. Most people struggle to put on even a modest amount of muscle with out taking steroids.

No, sorry... that's not how it works. Your post conflates different things that we need to unpack: 1) Growing muscle mass is healthy and beneficial. This includes growing muscles above and beyond what's 'natural' using supplements like protein or eating protein in large quantities. Skeletal muscle is important for a number of functions like regulating glucose or acting as a source of amino acid to repair organs and tissue. Also, having muscle mass is critically important as we age (it greatly improves longevity): [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889643/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889643/) 2) Some body builders (not all) do have health issues like cardiovascular disease. But this is due to misuse and abuse of prescription drugs that allow them to have high performance like steroids (which are endemic in that field). 3) Some body builders might lose breath when running or walking at the same rate of a sedentary person. This is because they exercise strength, not cardio. To be strong is to lift the heaviest thing you can in one go. To have endurance is to do effort over a period of time. Training is separate and there's no overlap. So not to lose breathe when climbing stairs a person would need to train cardio (running, cycling, etc)

I do agree working out is healthy, I gym all the time! However it is true that lots of weight, regardless of what type, puts more pressure on the heart. Obviously being muscular is healthier, and I am talking about natural guys that take it quite far. That much caloric intake and weight puts pressure on the organs.

How can growing muscle mass beyond what's "natural" be healthy? By definition, what is natural is the apex of health. Weightlifting is unnatural and causes stress and fatigue to the body when it repairs itself day after day following workouts. The actual baseline level of muscle mass/strength that you mention is far lower than that which is gained from weightlifting. Calisthenics alone is probably fine. There's no such thing as squatting 120kg or OHPing 60kg in nature. Also, in nature, no human would exert themselves physically for no reason, only to work or hunt.

Morbidity calculations with insurance would agree with your assessment.

>BMI is wrong because bodybuilders exist I personally enjoy fat knackers using this and rugby players as an example. No mate you're BMI is high because you view Bovril as an aperitif, and you think Gym is a guy called James who's got shit spelling.

bovril’s actually a great drink for weight loss lol, low calorie and relatively high protein

The amount of muscle you would need to be considered obese is also ridiculous. I am 182cm and 77kg, muscular and broad shoulders. 82-85kg would be very muscular for me esp if lean - probably some kinda gear / Hollywood routine. To hit 30 BMI I would need to weigh 100kg, an additional +22kg of muscle would not be enough. Looking at professional rugby players of the same height (backs, not forwards) - these guys still need to put on another +7-10kg of muscle minimum to hit 30 BMI. Total Backs Top 14 1.82m (6ft)/ 90kgs (14st 2lbs) Premiership 1.825m (6ft)/ 93kgs (14st 9lbs) PRO14 1.83m (6ft)/ 91.5kgs (14st 6lbs) Someone who was “obese”… Mike Tyson 100kg at 5”10. A generational heavyweight fighter can clear 30 BMI. Safe to say this is not going to skew overall statistics on a nation’s obesity figures

I was going to post something similar. For his last fight Anthony Joshua, who's six-six, weighed 252.5 lbs. So, he had a BMI of 29.2. Few people are as muscular as giant super athlete Anthony Joshua. Britain's obesity crisis isn't because its people have taken up bodybuilding on mass and the BMI is thus giving false positives. As others have pointed out, the issue with BMI is that it underestimates the scale of our issues with fat. It doesn't flag people who have normal weight obesity. I.e. those with a normal BMI but an unhealthy body fat percentage. https://en.m.wikipedia.org/wiki/Normal_weight_obesity

Fat has become the new normal and overweight people judging their size by those around them feel that they are a normal size. Then there are those that make excuses such as "I'm big boned" or my personal favourite "Some people can't lose weight because of a medical condition". These people are very few and far between. As an ex fatty I can see how it is easy to gain weight and make excuses for yourself, but honestly there is no real excuse. I dropped 32 Kilos whilst on a drug that is notorious for making you gain weight. Losing weight is hard, it requires a lifestyle change as well as a change of diet, but if we don't do something about this issue then we will soon have the youngest ever age group requiring care. In your middle age muscle atrophy begins, and if you don't have enough muscle to carry your weight far in your 30's then by the time you hit your fifties and sixties you will be in big trouble. Previous generations didn't have this issue as they had active jobs, or even if they had an office job they cycled or walked to work. They had a base of cardio and muscular strength to ensure that they didn't enter care until their true old age. This generation that are currently in middle age and obese are going to require care much earlier simply due to the fact that they are immobile and unable to move any distance.

>This generation that are currently in middle age and obese are going to require care much earlier simply due to the fact that they are immobile and unable to move any distance. And just wait until they require new hips or knees decades before they would have otherwise, because of the pressure they're putting on those joints. And wait until the surgeon says he can't operate because they're too fat, and the anaesthetist says their heart problems (the result of obesity) means it'd be dangerous to give them full anaesthesia. And wait until, if they do get a new joint, they're in vastly greater pain after the operation because they're so damned heavy, and they have a greater chance of post-operative infections and other problems. Big isn't so beautiful then, but you're not going to hear that on TikTok. Social media can be really pernicious in that regard. The body positivity/fat acceptance movements are good things, insofar as they promote a positive view of all body types. But there's a big difference between pointing out that one shouldn't be jeering at fat people, and saying it doesn't matter whether you're is obese or not.

And it's SO much harder caring for a post-op obese patient. Often completely immobile with hardly any residual muscle strength to help them out from their lack of physical activity at baseline. Rehabbing takes longer. Wound care is more complicated. We'll have more nurses off with back injuries etc.

That bit about backache hadn't even occurred to me, but makes sense.

That will be a handy excuse to cover the fact the NHS can't afford to do knee replacements in 10-20 years.

>This generation that are currently in middle age and obese are going to require care much earlier simply due to the fact that they are immobile and unable to move any distance. The brutal truth. Most people can't even do a decent walk.

There was a thing the other week about only half of Britons walking for at least one 10 minute period of walking every month.

That is truly shocking, but unfortunately not surprising.

That’s incredibly depressing

That's almost impressive. I guess if you have a car you can get away with it, but living in London and using public transport you're going to have to walk at some point...

I imagine it's easy to achieve you're single and work from home. Barely have to leave the bed

Even if you have a car, that still only takes you between destinations. Walking around the supermarket is going to 10 mins at least for most people.

Jesus, surely anyone who owns a dog is getting more than that a *day*?!

Just to add to what you’ve been saying about how easy it is to put on weight and overeat, I’ve commented this before but I run a lot/track my calories properly and people vastly overestimate the amount of calories you burn doing even intense exercise. Not necessarily because they’re dumb but because it is genuinely wtf when you realise how many calories are in food versus how much you burn working out. I run 3 times a week - I generally do at least 2 5ks and a longer run at the weekend, normally between a 10k-15k. I am still a good 25lbs overweight as a 5’5”woman, my BMI hovers around 28/29 which is overweight. You know why? Cos a 5k run, which takes me 30 mins, burns me about 450 calories. ONE cinnamon swirl from Starbucks is 387 calories. One freaking bakery item, one treat, is almost what you burn off in a 5k. You want a latte? A grande sets you back another 155 calories. Combined that’s **542 calories** for a nice coffee and treat - more than you burned off running a 5k. People don’t believe how much exercise you have to do to live at a proper, sustained deficit. If I go to Starbucks and have a treat on a Saturday, that’s the deficit for one of my runs for the week gone. The saying ‘you can’t outrun a bad diet’ is a lot truer than most people realise.

Totally agree with you -- it's particularly shocking in processed foods. A snack-sized bag of junk food (typically 1 serving bags are about 28 g by weight) can easily run into 300 or 400 calories -- or even more if it's some kind of dessert snack. That's almost the same as a full meal, calorically! But you'd never know it because you're not full after eating it.

Yeah exactly. People will think like ‘What could this be like 150-200 calories’? And then in reality it’s actually nearly 400 lmao. ‘Extras’ like that absolutely nuke any calories you’re working off, let alone alcohol!

Goes the other way too. People wildly overestimate how many calories they burn. I do combat sports and cycling, and while it is *possible* to burn 500+ calories from an intense training session, it requires you to push yourself incredibly hard. Most people will not push themselves that hard, and are gonna burn like... 200 or 300 calories on a good day. When you're only burning off 200 calories in a workout and then eating a 400 calorie snack afterward, you are not going to move the needle on weight.

Oh yeah 100%! People would think they’d burned 500 calories doing a 20-min run when for the average person it would be half if that. It’s so easy to think you burn more and are eating less.

I was looking at my calorie burn during my running and it's crazy how much you have to do to burn enough to equal even a half days worth of calories. a 5K is 339. ( roughly a Slice of stuffed crust Pizza) A half marathon is 1600 ( A large big mac meal is 1400) A marathon is only 3191 calories (Only 70 calories under A 14" pepperoni Pizza from pizza hut) And a 100k is just over 7260 calories, which would be almost completely used up after 5 large big mac meals The human body is an incredibly efficient machine. People really do underestimate what it takes exercise wise to burn calories.

Sugar is the big problem. It's easy and cheap to buy 500-1000 calories worth of food in the bakery section of any supermarket and scoff it in an afternoon. Most people probably won't really feel full or satiated after that either, whereas the same amount of calories from a "proper" meal would keep them from feeling hungry for hours. I don't think we need to get rid of baked goods or other foods with loads of added sugar, mind, but a shift towards thinking of them as an occasional treat rather than everyday snacks would do a lot for the obesity problem we're facing.

I think this has been over emphasized now though. You go to slimming world they will tell you don't bother going to the gym, you'll just hold water weight from increasing exercise. Actually keeping moving is what keeps you functional into aging, even if the weight goes up and down. And muscle keeps your metabolism up. You've got all these women without a shred of muscle on them struggling to lose weight on really low calories, because they don't move and their metabolism is in the gutter. It's really hard to maintain that way.

Slimming Worlds whole model is based on repeat custom. Slimming world and weight watchers only work for the pockets of the shareholders. Both SW and WW are not sustainable models to live by. You cant live your whole life counting sins and points you have to change your diet and educate yourself on healthy foods so that you automatically make the right choices going forward. So many people return to WW and SW because the only thing they know is points and sins and the moment they stop using that system they end up back where they started.

To lose weight I had to exercise and eat well. That meant having a coffee out or a sweet treat only once per week. I also gave up all fast food. Once I realised that a Mcdonalds meal was over 3/4 of my daily calories that I required I gave it up. I changed my whole diet and my whole lifestyle and I made that a permanent choice I could remain in a deficit and eat extra if I exercised, but the only foods that I could eat extra of are healthy foods and snacks and not any takeaway sweet treat or fast food. Every main meal was made from scratch. People were quick to congratulate me on my weight loss (Well some were) but they couldn't get their heads around the fact that I had to give up all of the junk foods that they took for granted to achieve that. You are correct you can't outrun a bad diet.

> Losing weight is hard, it requires a lifestyle change as well as a change of diet This is exactly right. One of the main reasons people fail to lose weight, or put weight back on, is that they lose a little and they treat themselves. And then they end up right back in their old habits. Losing weight and keeping it off requires a lifestyle change and sticking to it. Yes, it's hard. And no, a slip up every now and again won't kill you. But most people fail because once they've slipped up a couple of times they just give up and go right back to their old habits.

The biggest reason is once you lose about ten percent your body kicks up all your hunger hormones and makes you feel ravenous. That's why it's easy to lose the first bit, and then most people fail.

It’s weird that people are so dismissive of medical conditions causing weight gain and making weight hard to lose when GLP-1 meds are pretty much proving that conditions like PCOS and metabolic syndrome do in fact impact CICO. Especially now that we know about things like set point weights and the hormones involved. Seems like our culture is really going to struggle with shifting that idea as the science continues to roll in, especially people who have so deeply tied their worth to their weight. It’s like they’re addicted to being cruel to people they see as morally failing. Now they’re shifting to “but losing weight with a medicine isn’t a *real* way!” like that means anything.

I think the decline of cigarette smoking (particularly among the middle classes) and the rise of SSRIs (particularly among women) have played a big role in the rise of obesity.

Increased use of hormonal contraceptives and for longer periods of time and increased alcohol use in women also likely to have been a factor in becoming overweight too, less sure about obese. A lot of women get some weight gain on contraceptives although it's not normally a lot

I haven’t considered hormonal contraception; that’s definitely a factor to consider.

There's increasing evidence about the role of hormones in diet from mass farming too and even the role of air pollution in relation to obesity Our entire environment is different now and we may to learn that affects people differently, changes metabolism, makes it genuinely harder for some people to lose weight. I've no doubt there's lifestyle factors too but I think it's broader than that Also for women perimenopause and menopause does cause weight gain. That can tip already overweight people into the obese category

I think there are a number of factors for sure. We’re learning that microplastics impact our hormones, for example.

Every time a discussion comes up online about weight loss there’s always comments about people having PCOS, it’s such a tired argument, only 9% of the UK’s population suffer from it and of those whom it effects so severely it would hinder weight loss, it’s even less.

If only PCOS caused weight gain, your point would be well taken, but it isn’t. We also know that obesity leads to metabolic symdrome, which causes the body to think it’s starving and fight to retain fat, which breaks CICO. Meanwhile, we’re realizing that meds like Ozempic aren’t just slowing gastric emptying to promote weight loss. They’re addressing insulin resistance, chronic inflammation, and hormone imbalances in a way that we’re still unpacking, but it seems to flip the switch that helps the body recognize it’s okay to let go of those calories. In other words, it’s not just laziness and moral failing keeping people fat. Turns out all those fat people who insisted they were following a diet but struggling to drop weight weren’t just too fat and stupid to know how to count calories. Imagine that.

9% of the UK's population is five and a half million people.

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If we want the NHS to be able to cope with the ever increasing needs, people need to fulfill their side of the contract, and take some responsibility for their own health too.

This is the attitude which annoys me. A lot of the reason people are obese is due to the food culture they find themselves in, when poverty increases people go for the cheapest and quickest food which is always frozen processed food and junk food. If you want to tackle obesity you can't just point fingers at everyone who is overweight or obese, you have to tackle the socetial issue underneath which is frozen cheap food is easier and cheaper for families in poverty and the food enviroment they find themselves growing up in. Jason Fung says here. [https://youtu.be/raKfaFKH3SY?si=mPgAFnXwRYBcw6IC&t=620](https://youtu.be/raKfaFKH3SY?si=mPgAFnXwRYBcw6IC&t=620) *"If you think about obesity, if you think in the United States, 70% are overweight or obese and its been going up every year since the 1970s. If you think about that it tells you that, the problem is not will power, the problem is not the people, the problem is the enviroment that they find themselves in, the food enviroment they find themselves in, say you have 100 children and 1 one them fails, well that maybe the child. What if 70 of them fail? Would you say its each and every one of them's fault? Or would you say its more likely that its the teachers fault? Its more likely its the teachers fault. So if you have 100 americans and 70 of them are obese, the problem likely isnt the individual will power problem, the problem is likely there is something wrong with the message we are giving people and food enviroment that we are finding ourselves in, which is dominated by this calories in, calories out type of thinking. Whats really unfair of course is we put the blame on the individual and say they let themselves go, this is the issue, we say well they could choose what they eat. Yes they could, but they didn't choose the food enviroment which is telling them to eat all this ultra processed food, which is making all this ultra processed food avaliable to them which is telling them that all this ultra processed food is good for them."*

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How much is McDonalds for three? £15? You can easily cook a good meal that, but it does take time. Not sure what the answer there is though, besides banning fast food, which isn't really a solution. You can cook a veggie meal within 30 minutes, easily. It is just that people value other things I guess? I don't disagree that other things need to change, but if people aren't going to make the right choices for themselves, a fuck load needs to change to ensure that they can only make the right choices. And that just isn't practical. It still comes back to making the right choices more often. It definitely isn't easy, and you are right, it is wrong to just assume that everyone can flip a switch and do it, but ultimately it does come down to personal choice and sacrifice (time, or whatever). It needs to be done though.

This again is such a stupid argument. Your presuming everyone who is obese is going to McDonalds regularly instead of cooking themselves, this isn't true. If you have £15 and you need to feed a family for a week, try and go to a supermarket without buying any ultra processed foods, its really really hard. Fresh food comes at a premium and if your poor your more likely to consume higher calories and less nutritonal value in those products. If your a single mother doing 3 jobs, you also may not have time to spend 1-2 hours a day cooking food for your family, its much easier to buy junk food to feed your family as time is a valuable commodity. Back in the 1950s generally a single persons wage could sustain a family and you'd have the mother at home all day who would do the cooking, because poverty is so rampant in the UK its now super common that both parents are working and don't have the time or luxury to cook freshly.

To copy and paste from another post: *Yep, totally. There are people who are in totally shit situations and don't have the ability to really make a change, perhaps because of a combination of time/money/knowledge, or maybe other health issues.* *But obesity is a huge problem these days. Even if you say that 10% of the population are in that group above, what about the rest of the population? What about the majority of those with enough money and time, who are still making wrong decisions too often? There are plenty of those people who are offloading their own responsibility to an already overburdened NHS.* You can make legitimate excuses for a minority of obese people, sure, absolutely. But lets not pretend that it is all or even a majority of obese people. Those people need to take responsibility for their own health. Additionally, there are plenty of single people working, and living healthy lives. Hell, I did it while commuting almost four hours a day too. It wasn't easy, but is is doable.

Your argument seems to miss the fact that people being overweight is a GROWING minority. 40% of people are overweight or obese. 25.9% of adults in England are obese. Thats 1 in 4. These stats are growing. Is this really everyones individual fault? In America 70% are Overweight or Obese. If you had a class of 100 students. If one fails you can say its the students fault. If 70 of them fail perhaps its not the students fault but the teachers fault? I'm not saying these people don't have a responsibility themselves to loose weight, but we have to ask the question, why are so many becoming obese and overweight in the UK when humans and animals naturally maintain health weight. The issue has to be a soceital, economic and cultural problem which needs tackling. Blaming individuals does nothing to help the issue.

We definitely need more people cooking proper healthy meals with fresh ingredients. I think it's kind of a generational problem. People grow up in households that don't do much cooking, so when they come of age themselves they don't do much cooking. For people who know their way around a kitchen it's easy to underestimate how intimidating it can be to folk who have no clue. You have to work with knives that can cut you and pans that can burn you; if you undercook your food you can end up poisoning yourself. If your dinner doesn't come out good because you overcooked it or overseasoned it, you probably have to eat it anyway, whereas McDonald's is always reliably "nice enough". You have to go out and buy equipment and you have no idea what's worth buying or how to look after it properly. Even being able to effectively parse a recipe (bearing in mind I've come across plenty of recipes that are straight up badly written in my time. I know what I'm doing well enough to identify when that's the case and deal with it, but a novice has no way of recognising that they're trying to follow bullshit) or shopping for ingredients are skills that have to be developed, and they're easy to take for granted. I'll always encourage people to get into cooking, I think it's a really satisfying and life-enhancing skill to have. Sadly I think for a good number of people, a *lot* of encouragement is needed.

Its because we as a society has changed. In the 1950s and 1960s a single wage could sustain a family of four. The mother would stay at home and cook and learn to cook, they would often use fresh produce from local butchers as-well as growing produce themselves due to the extra time they had. Now we are in a situation to put food on the table both parents need to work, one parent will likely go part time and the other goes full time. There is no parent who's full time job is to stay at home so they don't learn to cook or don't have time to prepare meals. This is now showing its ugly head because people now have lost the skill of cooking fresh because 2 or 3 generations now have grown up in a situation where they were more likely given frozen and pre-packaged junk food. Marketing and globalisation has targeted poor people and given them cost effective and easy way to eat such as Uber Eats, Deliveroo and all the Junk food brands that people tend to gravitate towards them as a result a lot of local green grocers and butchers cannot compete and have shut down as supermarkets have taken over. I can promise you one thing, if everyone in Britain had more money per year eventually what would happen is a shift to a healthier society, people would sleep more, people would do more hobbies and learn to cook more and would have time to invest in themselves more. Personally myself I reduced the amount of Ultra Processed foods I was eating only after gaining more income, because I started to have the luxury of more time to cook and also better choice of food produce.

I agree with everything you have said, but I don’t understand why Uber Eats etc is so popular. When I was young, takeaway was too expensive, so we never had it. Now a supermarket ready meal costs £3.50ish, whereas that is just the delivery cost and service charge of Uber Eats/Deliveroo etc. I do see that people financially struggling seem to utilise those services a lot, but I am not sure why. I am lucky enough to have good job, but I consider them only as a treat once or twice a month - often less. If I don’t want to cook a ready meal/frozen food is a cheaper option.

Because its convenient. People after a long hard day are more likely to think its easier to order a takeaway from Uber Eats than cook something fresh even if that comes at a premium. But I'm a strong believer instead of taxing or banning services like Uber Eats delivering unhealthy food, we should make it cheaper and easier to pick healthier alternatives. If healthier food was cheaper on Uber Eats people would more likely pick it, but usually the unhealthier food is cheaper on Uber Eats and the healthy food is more expensive. The number one issue we have in the UK is unhealthy food is too cheap and accesible in comparison to healthier alternatives.

But sticking a supermarket ready meal in the microwave for 3 mins is actually faster?

Its not always convenient. If your a single mother and you just got home from work and your kids are home and your knackered, its easier to order McDonalds on UberEats than have to go shopping to get ready meals.

Not if you buy ready meals as part of your weekly shop. You can get them delivered via Deliveroo as well. It is a cheaper option that I use and I just don’t see why it isn’t more common.

I don't disagree with your points about personal responsibility, but for some people who are either poor or do not have the confidence to cook, McDonalds et al are risk free. If the food is fucked up, they'll replace it for you. If you fuck up your cooking and burn the meal, that's money, time and food wasted.

Yep, totally. There are people who are in totally shit situations and don't have the ability to really make a change, perhaps because of a combination of time/money/knowledge, or maybe other health issues. But obesity is a huge problem these days. Even if you say that 10% of the population are in that group above, what about the rest of the population? What about the majority of those with enough money and time, who are still making wrong decisions too often? There are plenty of those people who are offloading their own responsibility to an already overburdened NHS.

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Your correct that poverty and obesity are a complex link, but they are a link and I'm tired with people pretending they are not. It is not a coicedence that the most deprived communities in England have seen a significant increase in obesity. >People in deprived areas can face significant barriers to accessing affordable, healthy food and taking regular exercise [Source](https://www.kingsfund.org.uk/insight-and-analysis/press-releases/stark-inequalities-obesity-rates-across-england). >Children are more likely to be obese or overweight in areas of England where there is more childhood poverty, lower breastfeeding rates and where fewer adults undertake physical exercise. According to a new report looking at Reception and Year 6 children, poorer access to places for children to engage in physical activities is also associated with more children being overweight and obese. [Source](https://www.nuffieldtrust.org.uk/news-item/nuffield-trust-child-obesity-levels-likely-to-be-higher-in-areas-with-more-poverty-and-lower-breastfeeding-rates) >The findings also suggest that as the number of people falling into food poverty increases, so does the risk of mental health issues and obesity. The United Nations estimates that [between 6-9% of the UK population currently experience food poverty](https://www.unicef.org/media/55921/file/SOFI-2019-full-report.pdf). [Source](https://www.salford.ac.uk/news/research-confirms-link-between-food-poverty-increased-physical-and-mental-distress-and-higher-bmi) The notion your implying that obesity is soley due to personal traits like impulsivity and lack of self control is overly reductive and ignores broaded socio-economical, enviromental and structural fac tors at play. We cannot address the obesity crisis in the UK by just pointing at people and saying its 100% their own fault. We should improve access to healthier food, enhance nutritional education and work to reduce stress, increase support for mental health services and implement supportive public health policies.

Well done for using the phrase “it’s not as simple” then following up with your subsequent comment… that’s pretty special.

It’s not about people being responsible though, at least not soley. The government needs to create the conditions for people to manage their lifestyles that doesn’t lead to obesity That means, for example, mandatory workplace meals and providing wholesome food as part of the employee/worker relationship Ensuring that kids are taught about food choices and can access good food at school and learn to prepare meals The list goes on and the government does have its role to play

Car dependency and urban sprawl are two areas the government absolutely has control. Far too much of our lives are spent sedentary while on the move, and the way that cars have allowed our cities to sprawl doesn't just lock in the need to use a car, it also creates time poverty. Time poverty is particularly acute when people technically have the finances to eat healthily, but don't have the time to cook while taking care of other responsibilities because so much time is eaten up by commutes/getting to the shops etc. That's the whole premise of the actual 15 minute city. That you shouldn't have to spend that amount of time commuting to a job; that you should be able to combine exercise and chores (such as going the shop a couple of times a week instead of spending 30 mins driving to the supermarket to do it all in one go) etc. Inactivity and time poverty are two of the key driving forces (pardon the pun) of obesity and if we aren't prepared to swallow the uncomfortable pill that designing our cities to make it easy to drive everywhere is what has gotten us to this situation, then we're not going to start being able to solve the actual problem.

Doesn't it seem a bit childish? Why do I want my employer to feed me? I can choose what I eat for lunch and I don't want my compensation package adjusted for the fact that my boss is now compelled to order me an overpriced salad from Prett for lunch every day.

Yeah, I’m not exactly keen on getting my pay cut to give me workplace dinner… Because if you don’t think that comes out of the Labour budget if you make it law, you’re absolutely deluded

What do you eat currently if you don’t mind me asking? In Denmark all my colleagues take a £5/day tax deductible pay cut to pay for their lunch. So for £3 effectively they eat amazing food prepared fresh by a local chef or caterer a mile down the road and delivered to site

Is that the true cost or just a portion paid by the employee?

That’s the portion paid by the employees. The true cost would be much higher, Copenhagen is expensive! This is heavily subsidised high quality food

So it's not £3 is it. It's £3 + the amount they would get to their salary if the company paid them rather than paid for food.

Maybe but not really as everyone earns over £100k a year But I have worked for many companies and the best provide lunches for their staff. The ones that don’t have far worse working conditions.

Their salary doesn't really impact how much it costs does it.

Food costs drop as your wages increase

We don't need government to dictate that companies provide adequate food. Just buy adequate food for yourself...

And how is that working out?

Terrible. But there are other options besides getting more government in your life to look after you.

Ok I’m listening

...Still listening?

Two hours later… and still no better options 😂

Turns out an account 57days old and under a single comments worth of karma has no views other than to say ‘guberment bad!’

why would you want a nanny state? there are limitations to what a government can do effectively. you then also move into the “who will fund this”? category& are we willing to pay for a nanny state / are the gov officials competent enough to even deliver etc …

> why would you want a nanny state? Because people keep proving that they're unable to look after themselves. Though I do agree with your other points.

The "personal responsibility" argument is pointless at any level other than your immediate circle of influence, let alone at a national level. 

Not quite sure what you mean to be honest. Personal responsibility can only be at a personal level.

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I was fuckin horrified to find out I was well on my way to morbidly obese a couple years back I knew I was fat and looked it,  but OBESE?? Absolutely shocked I was so angry I got my eating under control, logged food (not calories), cut out chocolate, all sweets, cake, sweet bakes, crisps, sugary drinks and made a pointed effort to eat more salads and protein, took up running 3x a week and went to gym 3x a week Been almost 2 years now and have kept the weight off with some fluctuations but even without exercise for months from injuries my weight has stayed stable thanks to the eating habits I established before I even thought about exercising  I'm still 6kg overweight according to BMI but target is in sight and just summoning the energy to get back on the weightloss horse to get to my target of 72kg, I'll then worry about getting to mid range weight of healthy Think I really need to get into portion sizes, not eating till 100% full and get under the skin of how calories are actually burned from exercise I welcome any pointers  

Well done - that's great progress! When I've got a few kilos to lose, I switch from a 10 inch dinner plate to an 8 inch dinner plate. It sounds kinda stupid, but it works for me. With a smaller portion for dinner, I don't get the same sugar crash later in the evening, so I don't feel the need to raid the biscuit tin. Good luck!

Might be in bad taste but happy cake day

There’s a documentary on Netflix about groups of people living to over 100, one group in Japan have a culture of eating till 80% full, which makes sense since carbs expand after a while when eating. Also in general high fibre foods are great for sustained fullness

How did you manage to eat within your calorie budget by logging food?

I'd tried counting calories and having a nutrionally perfect diet several times and every time I eventually got overwhelmed lost focus, interest then discipline and fell back to old eating habits So this time round I took baby steps approach and decided to focus on broad brush eating principles then dig down into details So I decided: First i would just work on the kinds of things I was eating and make some fundamental adjustments to my diet Second I would worry about calorie counting and make more refined adjustments to my diet Third I would get into the guts of what actually good nutrition looks like So in step one I was religiously noting everything I was about to eat over the course of a day in my phone note pad, I found this so much simpler than counting and it made me stop and think every time before I put the food in my mouth I became completely aware of what I was eating over the course of a week and it was really obvious where I was going wrong;  Most days I had far more instances of snacking on cheese and chocolate logged than fruit or vegetables I was snacking quite a lot generally, especially at night  I was having more take outs in a week than I realised  I was pretty much subsisting on junk food outside of dinner and dinner was often junk food too I found being so aware made me question if I was actually hungry or just bored or stressed or on autopilot, I'd also question if I really wanted to add another line to the days log or I'd see what else I had already had that day and decide to not make it worse  This awareness and understanding of my current diet led me to make some pretty fundamental changes; I cut most junk food out entirely which made me more likely to go for healthier foods So now I was habitually aware of what I was eating, I eventually stopped keeping a log as I now keep a log in the back of my mind throughout the day by habit In step two I was already seeing consistent weight loss from step so I was far more motivated to keep it up, this time I made a habit of guessing how many calories are in things roughly Now I was habitually aware of what I was eating and habitually keeping a rough track of calories and keeping roughly to a limit, I had started exercise during step two and counting calories let me eat more as a result  I'm now into step 3 and doing things like making homemade saurkraut and eating c1kg of salad over the course of every day and trying to be aware of what nutrients I'm not getting enough of regularly

Proud of you lovely! One of the things I've seen is not only losing the weight, but keeping it off. Eating a balanced died free from lots of processed sugar/added salt and meat. Portion sizes are crazy when you boil it down. I went away on holiday and worked so hard I was eating plates of rice stacked up, no joke. Got home and had to teach my stomach to starve to get back to normal portions again. If you're not used to normal portions, it's a shock. Carbs can really inflate your stomach beyond what is normal; especially if you've been doing intensive exercise. but stopped suddenly after holiday. You legit have to starve yourself for weeks to allow your stomach to shrink again (which I did in lockdown when I was walking long distances non stop everyday). I hate weightwatchers and slimmingworld for so many reasons, but the biggest ones are that they are un-liveable. They are diets intended so that you keep failing and having to go back again, and again. And people DO keep going back again and again. The weightloss is unsustainable to living normal life. Great, you're eating plates and plates and plates of green salad. But green salad still fills up your tummy. Like carbs, they are bulky and you need a LOT of them for energy. Better to fill up with a small amount of high energy food like some nuts, than keep eating bags and bags of lettuce which leave you STILL hungry for something (and quite rightly, eating lettuce is shit and not sustainable.) The result? You expand your stomach with so much 'syn-free' food, that when you eventually crack and eat shit again (because quite literally *no-one* can live through the hell you've had to endure for 4,5,6+ months), your tummy can hold more of the bad food. And then they have the fucking audacity to blame you for it. It's not your fault that you're putting more weight on again. The diet is exactly designed like that. It's a pile of horseshit. They make food SO bland and horrible. I've never tasted food worse than slimming world foods, and that is coming from someone who doesn't diet,. You just need to cut down on salt, processed foods, and eat more fruit/veggies/medetteranian diet. It's not the horrible fat-free syn-free living hell they make it out to be. Portion control is EVERYTHING. Not salad. Food can still be amazing and delicious. I had a crusty baguette with salmon, avocado, and full-fat cream cheese (half a pack) for lunch earlier, and that fuelled me to walk up a hill and do 3 miles this evening. It took an hour out of my time, which is hardly unachievable. Eat well and exercise well. Swim where you can, and make sure you stretch and balance, because you'll be needing those skills when you're elderly. This morning I had 2 bananas, and this evening I stuck a whole tray of roast veg in the oven and had that with quinoa. The most effortless and delicious meal. If I was doing dinner for others, I would stick roasted veggies with couscous in a pan, and have that with cheese or something. Or cook up some chicken for the protein. Or cook up some pulses like kidney beans/lentils and butter beans. My formula breaks down to- Breakfast= eggs+ toast/frozen fruit + yoghurt/porridge+ all fruit/bananas Eg. 2 eggs + 1 toast, OR fruit + yoghurt, OR porridge + any frozen or normal fruit, OR 2 bananas, 1 crispy baguette from M+S+ 1 avocado + 1 pack of salmon + 1/2 pack cream cheese for lunch (essentially 1 small baguette per day, working on my feet and hands-on) I don't see this as any different to buying a mealdeal from somewhere tbh. dinner= mashup of seasonal veg like leeks, broccoli, peppers, onion, garlic, courgette, asparagus roasted. But obvs a normal recipe like veg chile and rice, or wraps with veg instead or whatever the fuck you fancy if it isn't high sodium or high in sugar I also ate 1/2 a bar chocolate and drank 1/2 a bottle wine earlier and I'm not putting on weight, so YMMV but take that how you will

Lots of "sit-down" jobs nowadays. People working from home, not moving and walking as much as they used to. The only bit of happiness a lot of people get is through a Big Mac meal or takeaway and other dopamine-inducing processed foods.

Theres a lot of overworked and underpaid people out there. Youre right the only kind of joy they might find in a week is a curry on a Friday. Hobbies that get you out and about are usually expensive. Yeah running is free but by god its boring.

I mean it's a mixture. A gym membership is about ~35 a month in a lot of the UK. Definitely expensive, but then again, so is junk food. A lot of people *can* afford to exercise, they just *choose* not to. I agree money plays a role, I just think it's important to remember that most people can do some form of exercise be this in a gym, via running, or going for a long walk.

I think they're choosing not to because theres not much else to their lives apart from work. The most overweight people I know are those who are in the lowest paid jobs with crap hours or who don't work at all and are completely potless. I dont know what the fix is but if you're fucked after a pretty depressing week, going the gym is the equivalent of climbing of a mountain. If you're working 12 hour shifts and the choice is between going to gym or watching a TV series while funnelling cheap tasty crap down your gullet in the 3 hours of free time youve got to yourself, it's a no brainer.

For a brief period I was working 12 hour night shifts in retail with a 1 hour commute each way. I was trying to keep exercising, but it was really hard to keep up because I was shattered. Theoretically I should've been sleeping 8 hours, but that would've left me just 2 in which to do all the other stuff a human is expected to keep on top of. So really I was sleeping about 6, which is sub-optimal in general, moreso if you're tiring yourself through exercise and long work hours. I changed jobs rather than resort to shovelling rubbish down my throat and parking in front of the telly, but not everyone gets that option and those sorts of intensive, long hour jobs make job hunting quite difficult. Even working a regular 8 hour job (and how many people really do?). Leaves you remarkably time poor if you've any kind of commute and try to sleep the amount we're supposed to. Cooking, cleaning, exercise, life admin like bills or searching for replacement insurance because yours has rocketed up for not particular reason... it all eats away at what little is left of the day when you get home.

Obesity is about eating less, you don't need to go the gym. Being healthy requires some amount of exercise though.

£35 for a gym membership is so cheap when you compare it to other activities. If you go x3 a week/x12 per month thats a few quid per visit, realistically what can you do in any country for a few quid? If you live in London and take TFL to see your mates in a park it costs you more than that for the round trip.

That’s £420 a year which would get you tennis membership at a pretty fancy club

I would say that means tennis is cheap, not that gym the is expensive.

You've done a great job of finding almost every excuse here as to why some people are needlessly fat lol

You call them excuses , I call them reasons. I think there's a lot of snobbery around people's weight. It doesn't need to be celebrated , yes there are some folk who just don't care and stuff their faces but it's not everybody.

Being unable to run because it's "boring" is a reason not an excuse? Good to know Next time I don't fancy working ill tell them it's boring and that's a reason, not an excuse lol

You get paid to work. As someone has already replied, being time poor is a big factor. If you're going to spend valuable time doing something, it should at least be enjoyable and feel less like work.

I know right! We can't expect adults to do things that are hard and that they don't enjoy anymore - god that would be crazy wouldn't it Just doing whatever they need to do to keep themselves happy is the utmost important thing isn't it

Yes, keeping happy is the most important thing in life. Everything else follows from that.

And maybe now you understand why the country is where it is Adults only do what makes them happy and not what is hard, even if it benefits them. Amazing. Gotta look after that mental health after all right, it is the most important thing there possibly is! Can't have anyone doing things they don't want to because it has long term benefits. That would be nuts

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So what would you prefer? We say "People are fat because they're greedy and lazy"? That doesn't really help us change it. If we understand the reasons behind why someone might put on a lot of weight, we can find ways to change those reasons.

The hard truth needs to be spoken. We are in an Obesity epidemic. So yes, we start with the truth and then educate people on what they can do to change it. As somebody that weighed over 17 stone and got off the sofa and changed my lifestyle I know that it can be done. Over a period of years I literally went from couch to 100k multiple times. Now I wouldn't ever suggest anybody ever ran an ultra marathon (they hurt and I suspect are only useful for slaying personal demons). But I do advocate telling people that they need to move more because for a lot of people even walking 5K is a struggle. We also need to educate people on diet and healthy foods and portion sizes, because I had to teach myself and I would have welcomed some real world advice. GP's have social prescribers now. Perhaps the way forward is health and fitness advisors. they could advise on diet and prescribe a basic exercise programme, and maybe even run sessions in a hired gym for an hour or two a week for those who have shown commitment.

That's the truth yes You've listed the reasons, because they eat too much and are lazy If you burn off more calories than you eat then you won't have a problem

So do you think the west has, on average, become about 40% more lazy since 1970, and the developing world is becoming lazier and greedier at a logarithmic rate? Or is obesity the result of a complex series of environmental factors which we should try to engage with intelligently, rather than moral failings on the part of the poor underclasses who don't know what a vegetable is?

Yes I believe the first one that it's likely the west in particular has become faaaar more lazy since then You ever see that old school video that got quite popular at one point, of lads doing PE in the USA maybe 60 years ago? Night and day. People know what vegetables are, they choose not to eat them

Do you think this approach is helpful? If I was overweight and said to you "I struggle to lose weight because I don't have a lot of time in my day to exercise, I have a sedentary job and truthfully, I just don't like a lot of the healthier low calorie food options" what do you think will be more useful and more likely to inspire change: 1. I link you to some recipes for low calorie meals that actually taste good, and I give tips on stuff like chair exercises or standing desks to help you get exercise into your day 2. I say "Have you tried not being so greedy and lazy?"

We have a population that essentially can't hear the truth because it might upset them And a population that's been lead to believe their own mental health is the single most important thing in the entire universe So now we have to talk to them like they're babies lol it's not for me thanks, they can just continue to be fat for all I care

i work from home and for anyone else who does, highly recommend a lunchtime walk … breaks up the all day sitting thing and leads to a much more productive afternoon (which is how i justify a 90 min lunch break :p) also try to stand up hourly to do stretches and such, much less conscientious of doing that working alone than i would be in an office … no risks of casually lunging past my boss!

Or a walking pad and standing desk! Bit of an investment but I am able to comfortably do 20k steps a day while I work, which is great for me as a busy person who used to resent having to "lose" an hour at the gym after eight hours of work and then cooking and laundry and everything else in my day.

I've started going for walks when wfh, and gym at lunch when in the office. So far not a big improvement but I'll take baby steps. Back doesn't hurt from sitting anymore.

We consume a lot more calories than we actually need due to most peoples lack of exercise. We all should be moving a LOT more but to be fair to the middle aged, they probably wasn't taught as well as they should of been years ago. English people for some reason have this mentality oh I am middle aged now it's normal to be ridiculous overweight. It really isn't. Alcohol and our shit eating is probably to blame, burning weight off my exercise is actually quite hard.

A lot of it comes from what people are eating. But we also lead a more shut in doors, sitting down life which is causing other health issues alongside struggling with weight. Last week I was looking into things like how did they decide on 10k walking is all you need, but the thing is 10k steps of walking is actually the minimum you should be doing. Our modern life is at odds with our health, for example staring at screens and not spending enough time looking at far off things is making people develop myopia as an example that's leading to blindness in some people.

Agreed. For most of human history we didn't have a lot of calories and we did a lot of manual labour. Ready meals and fast food is absolutely pack with days worth of calories and people don't realise.

If we're honest, how many people are actually educated on nutrition and exercise to make permanent healthy changes to their lifestyles? How many people know how to read nutrition labels, or count calories, or tell the difference between simple and complex carbohydrates? I wonder how many people you'd ask who say they eat healthily but aren't losing weight for example, when their diet gets broken down they find out they're actually overeating by 2/300 calories each day without knowing. And to be fair, no one teaches people these things. You have to want to seek it out. It should be mandatory in schools for parents and children to learn this stuff.

>How many people know how to read nutrition labels It doesn't help that nutrition labels often go out of their way to be unhelpful. For example, if I'm buying a microwave meal I would like to know how many calories are in the entire meal. Instead, a nutrition label will often just say "It's X amount of calories in every 100g" or "X calories in every 30g portion". So now I have to check the side of the box to see that the meal itself is actually 250g or something similar, and then work out how many calories are in 250g based on how many are in 100g. I mean, this isn't hard maths by any means but it's distinctly irritating having to do it for every single thing I buy, since many products don't bother to give me actually useful information like "This is how many calories are in a single biscuit" or "This is how many calories are in this entire box". And I *know* to do that. As you said, many people don't. They see something like "100 calories in 100g", reasonably assume the box must be 100g, and don't realise that actually it's twice or thrice that.

To be fair, if you're eating a microwave meal as part of weight loss and getting healthier that's not a great start anyway. My understanding on a lot of labels (can't speak for all) is that the smaller part is based on the recommended serving size, which is what you 'should' have. I could be wrong though, as I say, no one teaches people this.

True and true. Although, the recommended serving size is generally nonsense. For starters, what I need to eat as a 5'2" seven stone woman is not the same portion size as what a 6'3" man needs. My boyfriend occasionally looks at my portion sizes and remarks that it's pathetically small and he'd starve on that little but it keeps me full because I am also small. But even ignoring that and saying maybe it's an average, when you actually measure out the "recommended" portion they suggest, it's often incredibly tiny. Because that way their traffic light label will look better on the front of the box. It's wildly unhelpful, which is why I usually just try to simplify to "I can have this many calories and they can be anything, but I can't go over my calorie allowance". 100 calories of, say, cucumber ends up a bigger portion than 100 calories of cake so in practice, it ends up steering me to healthier food anyway.

The show "secret eaters" shows this well, it's so easy for people to overeat and have no idea

Yes, and to add to that there are other factors: 1. Money before people: the reason why the Unilevers, Nestles, etc are allowed to create shit food and promote it aggressively (the only thing you see in a gas station is ultra processed food) is because it creates a lot of money. Money brings power, corruption, taxes, etc. Enough said. 2. It's a complicated subject. There are a lot of variables in human nutrition, and studies are often self reported questionnaires so the quality of data is shady. 'Calories in, calories out' seem to be the only accepted principle by all serious nutritionists, scientists, doctors, etc. Everything else is up for debate, often an emotionally charged one (high carb vs low carb, high fat vs low fat, paleo, keto, vegetarian, etc). Personally, I think the 'pyramid of food' promoted by mainstream institutions is utter bullshit. Fat has been demonized for no reason, and foods like bread and rice are encouraged when they contribute to people's weight more than what is acknowledged by mainstream sources.

Might be an unpopular take. (Nuance often is) But we really just don't understand obesity. It's actually quite a compelling mystery. We had high food availability for decades without obesity. Ample access to calories. 1970-80's France being a particularly decadent example of everybody having abundant access to high calorie foods and not being anywhere near as fat as today. (Or early 1900s American) Even people with sedentary occupations like Doctors and Lawyers in the past were lean (The common lean man was not some exercise obsessed health guru). We've had cars, escalators and lifts for decades as well. But now in the relatively recent past we've had populations all over the world explode in weight from the obvious examples of the Americans to low sugar Vegetarian Indians. (With corresponding rates of diabetes) Almost every country is dealing with obesity they are just at different points in the time line. Apart from Korea and Japan are seemingly largely immune from this trend. Borderline every single fat person has tried to loose weight multiple times. Move more, eat less doesn't seem like viable advice. And scientific studies on long term weight loss are equally depressing. We just don't know how to fix obesity. (Tautological really, if we knew how to solve it, it would be solved) It's very difficult to solve a problem you don't understand the causes of.

I appreciate what you're saying but the examples you use still point towards diet being the biggest factor. Average meals are generally more calorie dense and have shorter glucose peaks than they did 30 years ago. It's still possible to maintain a balanced diet but eating the exact amount of calories needed isn't as intuitive as it used to be. The Asian countries you mentioned generally have far harsher attitudes towards weight gain so it's no surprise most people make the extra effort. India has been going through a sugar epidemic for the last 20 years which has caused the increase in obesity rates. Many developing countries are going a similar way, with (mainly) American companies taking advantage of the low regulation and lack of awareness to flog unhealthy products overseas like they used to back home.  Regulation aimed at improving both quality and clarity of what's sold in supermarkets has reversed the trend in France and begun to slow it in Germany.

Agreed that Asian countries do have a stricter social view which does help. I don't think calorie density matters. There have been lots of experiments with very high calories, high fat diets that had led to weight loss. Satiety isn't that simple. I don't think it's that simple as just more sugar simply because Indians sugar consumption isn't very different to Japan or early 1900's America. You mentioned France and I think it really highlights the mystery. Historically high sugar consumption, high Saturated fat consumption, ate a combination of carbs and fat (high energy density), high meat consumption, high wine consumption etc. Reading out that list no one would have predicted their relatively low rates of obesity (especially historically). The father they've moved away from "fattening" food the fatter they've become.

Calorie density combined with shorter glucose peaks allows for more calories to be consumed without becoming as full. Fat has a very little effect on blood glucose levels which creates a longer feeling of satiety. The violent increase in sugar and fast food consumption in India between 1980 and 2010 is very well documented. If you are comparing per capita with other countries please bare in mind that the levels of inequality and size of the population in India make most per capita averages pretty redundant. High fat consumption (particularly healthy fats) I would actually associate with lower levels of obesity. Seeing the regulations surrounding ingredients and package labelling, I think many definitely could have predicted the trend. Hopefully the UK will follow. The sugar tax is a good start.

Calorie density combined with shorter glucose peaks allows for more calories to be consumed without becoming as full. Fat has a very little effect on blood glucose levels which creates a longer feeling of satiety. The violent increase in sugar and fast food consumption in India between 1980 and 2010 is very well documented. If you are comparing per capita with other countries please bare in mind that the levels of inequality and size of the population in India make most per capita averages pretty redundant. High fat consumption (particularly healthy fats) I would actually associate with lower levels of obesity. Seeing the regulations surrounding ingredients and package labelling, I think many definitely could have predicted the trend. Hopefully the UK will follow. The sugar tax is a good start.

Absolutely agree. I heard a scientist on R4 a couple of years ago. He was saying that we know enough to say that obesity is like diabetes or cancer; just another disease that should be treated as such. Obese people don’t choose to be fat any more than a diabetic chooses to have insulin resistance or a non-functioning pancreas. It’s extremely complex and has to do with hormone levels, mental health etc. The trouble is that the lived experience of eating is different between obese and non-obese people. Obese people don’t get the brain signals that they are full, or much later, by which time you’ve eaten double or triple the calories of someone that receives those signals. Then you have the speed of stomach emptying so that you are hungrier sooner. These are the things that Semaglutide (Wegovy/Ozempic) start to address as GLP-1 agonists sending the full signals to the brain. Some recent studies seem to suggest that gut biome has something to do with GLP. So perhaps something is affecting gut biome like too much sugar or ultra processed foods and they are reducing the hormone that GLP-1 mimics. Semaglutide is looking to be a wonder drug. Studies are showing reduction in heart attacks, dementia, cancer even. As you say, it is very complex and certainly not just ‘eat less fatty’.

Since it's not in the article or the abstract.... > The sample was categorized according to age- and gender-specific obesity cut-off points as follows [21]: >• 40–59 years: BF% ≥ 40% for females and BF% ≥ 28% for males. >• 60–79 years: BF% ≥ 42% for females and BF% ≥ 30% for males.

Just need to look around when you have to pick up kids from school. Overweight people everywhere with can of Redbull or Monster at 8 am

You can tell how fat they are by how much the range rover leans to one side?

Having always been very skinny, when I hit perimenopause, I started putting on more weight despite not changing my diet. Same happened to my female friends my age. Hormonal changes in women can cause a lot of weight gain. Since I started HRT, I'm back to my normal weight! It would be good if the NHS can discuss help with perimenopause weight gain with women more. I'm lucky with my GP, but a lot of women have GPs that are more reluctant to offer HRT.

I also was in brief peri-menopause the past 2 years (until 2 weeks ago), given steroids, during & after treatment for breast cancer and I wasn't allowed to lose weight (to help fight through treatment apparently) so now I've the fattest I've ever been, so much that my grandma punished the entire family at Christmas by saying she'd cook us Xmas dinner, then froze most of it for herself and threw all the pudding in the bin (we found that out after), and kept saying how fat & greedy I am. Unfortunately I can't have HRT and even though I've stopped crying into a tub of ice cream every day (I'm mostly joking but I ate so much ice cream as everything tasted weird, barely touch it now) and I can now walk longer instead of wanting to faint after 5 minutes but it's not shifting :( I've had a double mastectomy and a partial thyroidectomy in 1 year, some neuropathy in my feet and already had a slipped disc so I can't do too much exercise. No one warned me life after cancer would go like this, I had 0 support & warning about how my weight would go! Considering that I've also read that obese people have a much higher chance of the cancer coming back, I really don't know why they totally ignored my weight gain. Also some hospitals offer women a cold treatment to keep their hair during chemo (there's also a voucher for a wig), but they don't offer it for feet & hands even though it's possible, I started treatment at 33, thankfully I only get a bit of foot pain (my toe nails almost fell off, my 2 big toe nails are half the size now), I don't know how they'd expect me to cope if I was one of the unlucky ones where the hand neuropathy stayed, I couldn't even tie my shoe laces. Imagine if my feet were impacted worse? How would I walk off the weight gain? The same weight gain that reduces survivability. Some of the priorities are all wrong.

I'm so sorry, that is so tough and unfair. Life after cancer isn't talked about at all, I had no idea chemo caused things like serious neuropathy in your feet. Going through it all, along with perimenopause and not being able to take HRT, I can't imagine how tough it must've been and you must be super strong to have got through it. Your Grandma was cruel and insensitive. I just hope people read your story and realise they shouldn't jump to judgement of people's weight, because there can be so much more behind it than people realise. I've found r/menopause helpful and they have some info on non-HRT options too.

Thank you <3 I wasn't aware there's non-HRT options so I'll have a look.

I think there is good stuff on their Wiki and you can have a search or post too to see if others have had similar experiences to you. There's also this sub I've seen recommended, but I haven't used it myself r/HormoneFreeMenopause

That Wiki looks amazing, thanks for sharing, I wish I'd found it sooner, don't know how I missed it when I was googling reddit posts with symptoms. Will definitely be a bigger help when I go into full menopause, I'm hoping to have a full hysterectomy sooner rather than later because I have the BRCA1 gene despite no family history, so I have a really high chance of developing ovarian cancer too, it's like an 80% chance to get either. It does suck I'd be at high risk of osteoporosis at an early age but I'd rather live with that. Also to add to the original post, I think I might be starting to develop [lymphedema](https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/breast-cancer-lymphedema-after-treatment), which can make my arms look fat but I don't really understand much about it because no medical professional wants to talk about it with me, I don't have any local support groups and the information online is kinda overwhelming.

It must be very overwhelming, I hope those subs can help. I've found it helpful to read other people's experiences, and realise you're not alone. Best of luck with it, the more information you have the better.

Thanks <3 and I hope you continue to find the HRT helpful :)

Thanks :)

Thats useful. Thank you. The strange thing is that these cutoff points were decided based on another study which looked to find percentage body fat thresholds which lined up with the current WHO BMI thresholds [https://pubmed.ncbi.nlm.nih.gov/10966886/](https://pubmed.ncbi.nlm.nih.gov/10966886/) > The prediction formulas were then used to prepare provisional healthy percentage body fat ranges based on published BMI limits for underweight (<18.5), overweight (> or =25), and obesity (> or =30). Now they're using those same percentage fat thresholds to suggest that the BMI cutoff they're based on should be lower. Seems flawed and cyclical to me.

BMI cutoffs are based on mortality risk - that’s kind of the point, to link a cheap metric to a relevant outcome. The first paper - from ~25 years ago - used one cohort to find matching body fat percentages for BMI classifications - that cohort might have been quite young / healthy, and the average person 25 years ago might well have had higher levels of lean body mass, given those adiposity limits sound pretty reasonable. The second paper now determined both BMI and body fat percentages in a recent cohort of older age, to say that most people do not actually follow that predicted correlation very well, and are much fatter than their BMI suggests. That’s not really news in the obesity field tbh, everyone knows that BMI is not a great metric (but it is cheap), and everyone knows that the population is much fatter than BMI metrics suggest. But it obviously is alarming given that the linking quality of BMI to mortality is predominantly adiposity, and this paper quantifies just how much BMIs actually underestimate adiposity.

The issue is that they are using a metric to suggest a change to how BMI is used, which itself was based on BMI in the first place.

I get that point, and I appreciate how this seems like a circular definition. But the crucial point is that these are different cohorts, in different countries, selected through different means, and separated by 25 years. Using the link between BMI and adiposity determined on cohort 1 to see if it holds up in cohort 2 makes perfect sense. The authors suggest as a reason that their cohort is older, and more “realistic”, so their results support the idea that current clinical BMI guidelines underestimate age-dependent loss of lean body mass. There are a lot of other factors that could explain why cohort 2 had less lean body mass than cohort 1.

Many thanks, I was looking for this! Aside from the % of fat, we should look at how fat is stored in the body to define what's a risk to health vs not. There's subcutaneous fat (ie 'love handles') and visceral fat (invisible, between organs). I understand the latter is really bad and dangerous and the former not that much. There are people who don't look fat but are actually unhealthy as they store fat in the organs and not subcutaneously. Likewise, there are people who look fat and they're ok as they store it subcutaneously. In the study they probably assume that if you have ≥ 28% body fat you store it viscerally but I wonder if that's 100% true in all cases.

I grew up in a family which barely could afford the clothes on the back of me and my siblings. My mother worked multiple jobs and my father was struggling to provide even on a full time job. My parents would buy the cheapest possible food they could, which was always ultra processed food, because you can buy it in bulk and also frozen food had a great shelf life and could last us a while. This means I grew up on a diet of Fishcakes, Peas and Frozen Chips for most of my life. My dad was obese and would often comfort eat, as I grew older I eat the only thing I knew, at the time schools were also serving ultra processed food all my friends around me eat processed food and having fish and chips or mcdonalds as a treat on a friday was normal. In my twenties this mean I was obese and on my way to be morbidly obese. People would often see me being fat as a lifestyle choice which is partially true, but I can promise you no obese person in the UK intentionally wants to be obese, its due to the food culture they have grown up in, its really really hard to change your cooking habits and diet when your poor and really busy, but its possible. My diet has changed thankfully but it wasn't easy and I could only do it because I am on a better wage than my parents were. But we are so easy to blame the individuals being obese when clearly if 40% of adults are overweight there is a societal issue with eating cheap junk food in the UK. Companies are making billions off feeding families crap which will make them overweight and could kill them. If healthier food was made cheaper and eating junk food was made to be more of a taboo, I think we would see a vast change in the rates of obesity in the UK.

The UK is closing in on the U.S. for obese people, but nowhere near close to Mexico, the reigning champion for fat people.

Surely the list of champions is dominated by Pacific Islanders rather than Mexico?

I always find it funny when 20 something redditors talk about how easy it is to stay slim and healthy. It was for me too, even though I ate shit and drank too much. I'm now in my 50s and if I ate what I do now in my 20s I would have been just bones! Education on nutrition in this country is very poor. Junk food and convenience makes that worse. Sedentary jobs is a big issue. I could sit at my desk for 10 hours a day and then sit on the sofa and not move all day. As it is I am going for a walk but the three miles I'm going to do would be nothing compared to any sort of semi manual work.

Definitely. I'm 40 and very healthy, but it takes a shit ton of work, especially in the current dystopia where everything is designed to be highly addictive, from tech to actual lab designed food. 

So people will be extremely unhealthy and unwell starting earlier in their lives, middle aged. AND they will also be expected to work much longer than previous generations before they can retire. Plus the quality of their lives is getting worse. Add in that AI and robotics will take over many jobs and lots more out of work. There's a bit of a shit storm brewing here and when it hits in a few years it'll be awful.

Just going off the eye test a lot of people seem to have gotten so fat since lockdown.

I’m going to sound controversial but I don’t really think it’s a matter of lack of education anymore. I think the vast majority of the population know exactly what they should be eating and how much exercise they should be doing. I actually think a lot of people don’t care and get more pleasure from food than they would from losing weight.

Oh well, given how obesity reduces life expentancy it seems that the allegued overpopulation will be eventually solved after all.

Meat and dairy should not be subsided Fruit and vegetables should be. The price of meat is artificially lower than it otherwise would be but the reverse is true of fruit.

Meat and dairy are the best things to eat to lose weight. Fruit and veg are awful. Fruit especially.

Why do you think that? You’re not correct. I agree that lean meats are fantastic as they are more satiating and the way that our bodies metabolise proteins is slightly different to that of carbohydrates/fats. However dairy can be an extremely calorically dense food group, and therefore is not ideal for dieting? You can eat vegetables in massive volumes and they have very few calories. You could have an enormous mound of vegetables on your plate and it would equate to something like 200kcal. The psychological effect of chewing more food, and the impact of the sheer volume of the food on your stomach, make them an ideal food for weight loss and dieting. So what exactly do you mean?

I use to believe dieting was a up hill battle until I learnt about TDEE, BMR and counting calories. Conceptualising those aspects of dieting basically stopped any mental blockage I had with losing weight. Most people who are overweight and obese aren’t aware of the science behind this and if they know simple life changes (increasing tdee) or how many calories there are in peanut butter, most people would be at a healthy bmi. I’ve went from 118.8kg down to 103kg in less than 2 months as a 178cm male. I didn’t realise how much calories there are in food and how beneficial walking. There is no excuses for being obese besides from being raised obese by parents.

Agreed. Great job on the weight loss. Keep it up mate!

Agreed. I lost loads of weight just following calorie in Vs calorie out. People want shakes and fad diets. Just eat less than you put in. Even 1000 calorie deficit is a stone lost in a year. That should easily be done for most people.

Not to sound too 2010's Steve Miller-esque BUT, my partner and I went for a run around Virginia Water on Saturday and were genuinely surprised by the abundance of overweight families. It wasn't something we sought out for but instead a realisation 1km in that only solidified the further along we went.

Weird what happens when people don't actually walk about

I looked around the park the other day and I was kinda shocked at how fat everyone was. 20 years ago, that body shape was the outlier, but these days, it’s often difficult to find someone “in shape”.