Wednesday, 28 July 2010

Fat, not Obese

The FM used to work at a care home, where various members of staff wanted to lose weight. Or more accurately they wanted to talk about losing weight. This is easier then actually getting off your backside and going for a run/swim/cycle/walk.

It would be quite common for the FM join the rest of the staff when they had a fag break. The FM was amused at one time to see the Deputy Manager marching up and down on the spot. This was the latest craze to get fit and into shape. This is unlikely to constitute a sufficient enough lifestyle change needed to lose weight.

People were often annoyed at the FMs response to “How to avoid getting fat, you always eat more than us!” The response usually involved a list that included three hours of doing karate a week, going for a jog, family walks and going to the gym and playing tennis when people were free.

Perhaps the FM is being too harsh, but at the end of the day fat people get fat because they eat too much. Maybe if the FM was not blessed with her particular genetic makeup she would think differently.

NHS should use term fat instead of obese, says minister, but then should HCPs be worried about causing offense to people? Certainly medical students have had to walk a fine line when presenting a patient to a consultant (in front of the patient) who is seriously overweight. Being asked what are the risk factors for having an MI by a consultant is not nice , especially when you then go and state diet and obesity in front of a seriously overweight patient.

Perhaps we are too nice as a society? With regards to the earlier situation presented in this blog it took some self-discipline for the FM to remain quiet and not say something along the lines of “Stop bloody talking about it, replace that Mars Bar you have with an apple and instead of spending all evening watching neighbours, home and away, emmerdale, coronation street and eastenders go for a fucking run.”


  1. I suppose you have the misguided view that;
    Fat makes you fat.
    We all need 'five-a-day'.
    The diet-heart-hypothesis.
    And all such other twaddle. Exercise does not make you thin, it helps to make you fit. Read the Plymouth Study, inject some science into your prejudices and then do a retake.

  2. Obesity arises when calories in is more than calories out.
    If you do lots of exercise then calories out is higher.
    It is true that diet has a major role, with regards to calories in.
    With regards to the study it was very small, but did point out other factors that obese children may feel unable to exercise. To overcome the notion that being a couch potatoe does not contribute toward being obese I would need far more and far bigger studies.
    Plus this was only in children

  3. "Perhaps we are too nice as a society"

    I'm not!

  4. At last a debate! Calories in more than calories out is a fine model for.. er a steam engine, or an electric motor. We can calculate the losses for these quite easily. Human metabolism and diet choice is somewhat more complex. Remember the 2nd Law of Thermodynamics as well as the 1st. Dissipation is the key. We do not metabolise some nutrients in the same way as others. Carbs differ, in the way that they require insulin to metabolise them into glucose, fats do not. Modern diets based on 2/3 carbs are producing obese people by Medical sanction. To believe that a Mars Bar is much different from a bowl of pasta, rice or mashed potatoe is a delusion. Starch plus H2O equals glucose whatever the the time scale involved.
    The Plymouth study was quoted because it's topical. I was in fact quite surprised you knew of it and for that I apologise. I should not stereotype people. There are many others (studies that is) that support the view that obesity is diet provoked, not the converse and you surely realise that exercise, unless you are regularly running marathons is a futile route to any serious weight loss. I do support it for health and diabetic control, and indeed employ it myself and advocate it generally.
    We need to stop this condemnation, however, of humans who have become obese by consuming precisely the diet we have advocated they should for the last twenty years or more. Look who sponsors some of the protocols for diets and then see where blame should lie. High Fructose Corn Syrup in cereals and soft drinks, concentrated fructose in smoothies, high concentrates of sucrose/fructose in low fat yoghurts, simply to make them paleatable together with additional starches to give body, which in turn, rapidly turn to fat by insulin reaction. These are so called healthy, even weight loss products! As I have said before, we surely cannot keep doing the same thing, over and over again,in the blind hope that the result will be different. It hasn't thus far and it won't.

  5. Exercise doesn't burn a lot of calories by itself unless you do an awful lot of very intense exercise. However, the metabolic-rate raising effect of it lasts after the exercise is completed, and, more importantly, if you increase your muscle, you'll use more calories all the time. Exercise can also regulate the appetite.

    So if you want people to lose weight with exercise, don't just say get some exercise, tell them what exercise to get - get nearly out of puff for a while then build up some muscle for a while. Mowing the lawn followed by digging the veg patch does nicely.

  6. ...but at the end of the day fat people get fat because they eat too much.

    Sadly this is not always the case. Did you fall asleep during your endocrinology lectures or were you off that day?