Finally a sensible appraisal of the whole obesity issue. I have no doubt many will disagree with you - because those who have never struggled with their weight really do not get - or want to get - the idea it might be a tough challenge. Yes they get if you're a drug addict yes if you are an alcoholic quitting may be very very hard to do and to sustain - but over eating - no that's just laziness & poor mental attitude.
And a large part of all stems from the point you make - the correlation with poverty. Oh dear - not good news at all - that means rather than just exhorting people, as you say, to eat less and move more, we as a society need to get up off our collective backsides and spend money and time changing things. It is down to all of us, not just those of us who are overweight.
And don't get me started on BMI - an underweight (seriously - multiple reasons) elderly friend was told her BMI was fine when they themselves had worked out it was not. Why? Because curvature of the spine meant she measured 5 cms shorter than when she was in middle age. What on earth sense does that make!!!
And yet, you have chosen to ignore another, very important, cause of weight gain that does not involve either food or exercise and that is hormonal, with special emphasis on hypothyroidism. This condition, which happens to affect me personally, manifested itself with unexplained weight gain a full 7 years before I finally got a diagnosis in spite of having had blood tests specifically to look for it. 7 years of constant weight gain before I finally hit the “magic” TSH score of 10, by which time I was carrying an extra 3 stones in weight! Then came another 7 unsuccessful years taking Levothyroxine (T4) which, I was assured would solve all my problems but didn’t, before my old (sadly now retired) endocrinologist decided to trial me on Liothyronine (T3). This finally gave me something resembling my former life back. The brain fog disappeared and I got some measure of energy back. Then the pharmaceutical company decided to hike the price of Liothyronine by 6000% and we were suddenly having to fight for our life saving meds. Thankfully I lived in Wales where the English endo had no jurisdiction so I was able to keep it. The one thing I have never been able to shift, however, is the weight. I’ve managed to bring it down from 93kg to 73kg but the last 10kg I would like to get rid of just won’t shift. That has also had other consequences, the biggest one being the need for a hip replacement which I have been waiting 14months for so far and will be waiting until at least February next year for! Nutrition has nothing to do with this weight, nor a lack of exercise… so please, get off this bloody merry-go-round that still blames the patient for eating too many pies whilst sitting around watching daytime tv! Some of use really DO have a hormonal problem!
Thank you for sharing your story - it really brings home just how complex and frustrating weight issues can be when compounded by medical conditions like hypothyroidism. You’re absolutely right: there are significant physiological factors, like hormonal imbalances, that don’t fit neatly into the “just eat less and move more” narrative, and I completely sympathise with how dismissive that approach can feel.
I left physiological causes like thyroid issues and other medical conditions out of this particular post because I wanted to address the most common - and often superficial - arguments around weight loss that focus purely on lifestyle factors. The aim was to debunk the idea that weight issues are purely down to willpower, ignoring the far larger societal and structural issues. However, I completely agree that it’s crucial to recognise that many people, like yourself, face hormonal or medical challenges that make weight loss (and even proper diagnosis and treatment) a whole other battle.
Thanks again for your input - it's a powerful reminder of the importance of a more nuanced and compassionate discussion around weight. I’ll definitely address these types of conditions in future posts, as they’re an essential part of the conversation.
I agree wholeheartedly with you dear Bear 🐻. Four and a half years ago I lost my darling mum to Alzheimer's in February 2020. I'm an only child and was totally devastated. In the May of 2020 I tripped in my kitchen, sustaining 4 breaks in my left leg , with what my consultant called a twisting break as if I was a skier. I had 2 breaks in my ankle and 2 in my tibial plateau, resulting in surgery to try and put my leg back together. My mobility is severely restricted because of the pain from the metal plates pressing on my leg. I can't walk any distance, can't garden because I'm unable to kneel, can only do housework in small chunks having to rest in-between. In the meanwhile, my husband was made redundant overnight and lost his company pension of 20 years due to the incompetence of the company. In October 2020 we lost my mum in law, and in November 2021 we lost my darling daughter aged 47. I lost my son in 2001, so we're now doubly bereaved parents. The stress, sadness, pain, fear, inability to move like I used to have all meant I have piled weight on. It's not about being lazy, it's about life throwing curved balls, and having to try to keep going best as you can. I love you so much dear Bear 🐻, thank you for your wonderful, truthful, kind, inciteful article. Sending you mahoosive Bear hugs 🫂 xxxxxxxxx ❤️
Thank you, Bear. Saw the heart consultant today. We agreed it would be kinder to my tired, old heart if I lost weight. There was no shaming. He acknowledged how hard it is. Here's the thing. I'm the same weight I was when I saw him four years ago. (Heavier than is advisable.) What I forgot to tell him is that between then and now, my weight increased. Lockdowns, illness, worry, pain, drop in income. Getting back to where I was four years ago has been really tough. I'll tell him next time I see him. In the meanwhile, I'm telling you! xx
Hi Bear - great article, as usual. I've a couple of thoughts on it I'd like to share:
Firstly, the rise of fast food outlets, as far as I can see, is the major culprit in the rise of obesity. I was born in the 1930s, and grew up in the 40s and 50s. Poverty is no worse now than it was then - but, there were very few 'fatties'! The only takeaway was fish and chips - a weekly treat, in the main. (Not quite true, I remember in the 40s and early 50s, for a few pence, you could buy a cone of boiled, salted potatoes, from a horse-drawn cart on Blackburn boulevard.) Now, however, fast food is ubiquitous! And I'm pretty sure that a graph of the rise in fast food outlets, and the rise in obesity would mirror each other.
Along with the availability of fast food came the rise in working women. It used to be that a man's wage would support a family - now a family needs two incomes. So there's no-one at home to prepare healthy home-cooked food - very convenient to pick up unhealthy food from McDonald's, et al. This was made worse by the introduction of Sunday working. Now, one partner is often away from home on that 'day of rest', and families meet and, perforce, eat in shifts.
There's another factor to consider. Processed meats are a Class 1 carcinogen - alongside cigarettes and asbestos. Red meat is class 2, meaning that consuming red mean will 'probably' lead to cancer. 'Probably' in the sense that, if an aircraft told you that an aircraft will 'probably' crash, you wouldn't climb aboard! Chicken, the so-called healthy meat, is also not good for us.
With reference to BMI, I learned to disregard it long ago, and instead a more accurate measurement was the ratio of waist to height - your waist should measure half your height or less. About losing weight, I followed the late, great, Michael Mosley's advice on intermittent fasting. I did the 5:2 variation of IF for several months and lost 24lbs of middle-age spread I didn't know I had to lose. I thought middle-age spread was normal.
I'm a vegan, so I eschew all animal products. I try and follow whole-food, plant-based nutrition - because, well we're herbivores, the same as the great apes. I tell people, I'm 87, on no meds, living my best life. I'm also the happiest I think I've ever been! And I want to share that! (Just realised I'm repeating myself - I told you all this on a DM on Twitter , but others reading this may no be aware)
Anyway, good luck with the new book, and look after yourself - self care is important, especially for NHS staff! xx
As you allude, the food industry bears a large responsibility, in fact I consider it has prime responsibility. Consider how the industry operates in a capitalist system - the mantra for business is growth, i.e. you have to increase sales. But unlike selling most things, the food market is saturated, because we are all eating already. So the only way to increase sales is to persuade people to eat more. And as it's processed food that makes most profit, you need people to choose your processed products over healthy fresh food. Advertising works. We hear of govt initiatives to block advertising of unhealthy food to children, but it would be better to ban all advertising of unhealthy food. Even better, how about banning the SALE of unhealthy foods? Nanny state? True, but maybe that's what we need.
Exactly, the Nanny State isn't regarded as a bad thing when it bans so called dangerous drugs, so why should the banning of dangerous foods be considered an issue?
Thank you, thank you. 🙏🏽 I’ve been an “obese” size 12 since peri-menopause, currently an “overweight” size 10. At my lowest weight I was an “overweight” size 8. Worse, being a person of colour, a BMI over 23 is classified as overweight. I can’t have been that since my early teens. You’re right that it’s stacked against us from the start.
Finally a sensible appraisal of the whole obesity issue. I have no doubt many will disagree with you - because those who have never struggled with their weight really do not get - or want to get - the idea it might be a tough challenge. Yes they get if you're a drug addict yes if you are an alcoholic quitting may be very very hard to do and to sustain - but over eating - no that's just laziness & poor mental attitude.
And a large part of all stems from the point you make - the correlation with poverty. Oh dear - not good news at all - that means rather than just exhorting people, as you say, to eat less and move more, we as a society need to get up off our collective backsides and spend money and time changing things. It is down to all of us, not just those of us who are overweight.
And don't get me started on BMI - an underweight (seriously - multiple reasons) elderly friend was told her BMI was fine when they themselves had worked out it was not. Why? Because curvature of the spine meant she measured 5 cms shorter than when she was in middle age. What on earth sense does that make!!!
Thank you so much for this post.
And yet, you have chosen to ignore another, very important, cause of weight gain that does not involve either food or exercise and that is hormonal, with special emphasis on hypothyroidism. This condition, which happens to affect me personally, manifested itself with unexplained weight gain a full 7 years before I finally got a diagnosis in spite of having had blood tests specifically to look for it. 7 years of constant weight gain before I finally hit the “magic” TSH score of 10, by which time I was carrying an extra 3 stones in weight! Then came another 7 unsuccessful years taking Levothyroxine (T4) which, I was assured would solve all my problems but didn’t, before my old (sadly now retired) endocrinologist decided to trial me on Liothyronine (T3). This finally gave me something resembling my former life back. The brain fog disappeared and I got some measure of energy back. Then the pharmaceutical company decided to hike the price of Liothyronine by 6000% and we were suddenly having to fight for our life saving meds. Thankfully I lived in Wales where the English endo had no jurisdiction so I was able to keep it. The one thing I have never been able to shift, however, is the weight. I’ve managed to bring it down from 93kg to 73kg but the last 10kg I would like to get rid of just won’t shift. That has also had other consequences, the biggest one being the need for a hip replacement which I have been waiting 14months for so far and will be waiting until at least February next year for! Nutrition has nothing to do with this weight, nor a lack of exercise… so please, get off this bloody merry-go-round that still blames the patient for eating too many pies whilst sitting around watching daytime tv! Some of use really DO have a hormonal problem!
Hi Mary,
Thank you for sharing your story - it really brings home just how complex and frustrating weight issues can be when compounded by medical conditions like hypothyroidism. You’re absolutely right: there are significant physiological factors, like hormonal imbalances, that don’t fit neatly into the “just eat less and move more” narrative, and I completely sympathise with how dismissive that approach can feel.
I left physiological causes like thyroid issues and other medical conditions out of this particular post because I wanted to address the most common - and often superficial - arguments around weight loss that focus purely on lifestyle factors. The aim was to debunk the idea that weight issues are purely down to willpower, ignoring the far larger societal and structural issues. However, I completely agree that it’s crucial to recognise that many people, like yourself, face hormonal or medical challenges that make weight loss (and even proper diagnosis and treatment) a whole other battle.
Thanks again for your input - it's a powerful reminder of the importance of a more nuanced and compassionate discussion around weight. I’ll definitely address these types of conditions in future posts, as they’re an essential part of the conversation.
I agree wholeheartedly with you dear Bear 🐻. Four and a half years ago I lost my darling mum to Alzheimer's in February 2020. I'm an only child and was totally devastated. In the May of 2020 I tripped in my kitchen, sustaining 4 breaks in my left leg , with what my consultant called a twisting break as if I was a skier. I had 2 breaks in my ankle and 2 in my tibial plateau, resulting in surgery to try and put my leg back together. My mobility is severely restricted because of the pain from the metal plates pressing on my leg. I can't walk any distance, can't garden because I'm unable to kneel, can only do housework in small chunks having to rest in-between. In the meanwhile, my husband was made redundant overnight and lost his company pension of 20 years due to the incompetence of the company. In October 2020 we lost my mum in law, and in November 2021 we lost my darling daughter aged 47. I lost my son in 2001, so we're now doubly bereaved parents. The stress, sadness, pain, fear, inability to move like I used to have all meant I have piled weight on. It's not about being lazy, it's about life throwing curved balls, and having to try to keep going best as you can. I love you so much dear Bear 🐻, thank you for your wonderful, truthful, kind, inciteful article. Sending you mahoosive Bear hugs 🫂 xxxxxxxxx ❤️
My heart goes out to you Helen ❤️. Too much for anyone to bear.... you just have to find ways to keep going....
Thank you xxxx
Thank you, Bear. Saw the heart consultant today. We agreed it would be kinder to my tired, old heart if I lost weight. There was no shaming. He acknowledged how hard it is. Here's the thing. I'm the same weight I was when I saw him four years ago. (Heavier than is advisable.) What I forgot to tell him is that between then and now, my weight increased. Lockdowns, illness, worry, pain, drop in income. Getting back to where I was four years ago has been really tough. I'll tell him next time I see him. In the meanwhile, I'm telling you! xx
Hi Bear - great article, as usual. I've a couple of thoughts on it I'd like to share:
Firstly, the rise of fast food outlets, as far as I can see, is the major culprit in the rise of obesity. I was born in the 1930s, and grew up in the 40s and 50s. Poverty is no worse now than it was then - but, there were very few 'fatties'! The only takeaway was fish and chips - a weekly treat, in the main. (Not quite true, I remember in the 40s and early 50s, for a few pence, you could buy a cone of boiled, salted potatoes, from a horse-drawn cart on Blackburn boulevard.) Now, however, fast food is ubiquitous! And I'm pretty sure that a graph of the rise in fast food outlets, and the rise in obesity would mirror each other.
Along with the availability of fast food came the rise in working women. It used to be that a man's wage would support a family - now a family needs two incomes. So there's no-one at home to prepare healthy home-cooked food - very convenient to pick up unhealthy food from McDonald's, et al. This was made worse by the introduction of Sunday working. Now, one partner is often away from home on that 'day of rest', and families meet and, perforce, eat in shifts.
There's another factor to consider. Processed meats are a Class 1 carcinogen - alongside cigarettes and asbestos. Red meat is class 2, meaning that consuming red mean will 'probably' lead to cancer. 'Probably' in the sense that, if an aircraft told you that an aircraft will 'probably' crash, you wouldn't climb aboard! Chicken, the so-called healthy meat, is also not good for us.
With reference to BMI, I learned to disregard it long ago, and instead a more accurate measurement was the ratio of waist to height - your waist should measure half your height or less. About losing weight, I followed the late, great, Michael Mosley's advice on intermittent fasting. I did the 5:2 variation of IF for several months and lost 24lbs of middle-age spread I didn't know I had to lose. I thought middle-age spread was normal.
I'm a vegan, so I eschew all animal products. I try and follow whole-food, plant-based nutrition - because, well we're herbivores, the same as the great apes. I tell people, I'm 87, on no meds, living my best life. I'm also the happiest I think I've ever been! And I want to share that! (Just realised I'm repeating myself - I told you all this on a DM on Twitter , but others reading this may no be aware)
Anyway, good luck with the new book, and look after yourself - self care is important, especially for NHS staff! xx
Absolutely excellent, but your writing is always brilliant.
As you allude, the food industry bears a large responsibility, in fact I consider it has prime responsibility. Consider how the industry operates in a capitalist system - the mantra for business is growth, i.e. you have to increase sales. But unlike selling most things, the food market is saturated, because we are all eating already. So the only way to increase sales is to persuade people to eat more. And as it's processed food that makes most profit, you need people to choose your processed products over healthy fresh food. Advertising works. We hear of govt initiatives to block advertising of unhealthy food to children, but it would be better to ban all advertising of unhealthy food. Even better, how about banning the SALE of unhealthy foods? Nanny state? True, but maybe that's what we need.
Exactly, the Nanny State isn't regarded as a bad thing when it bans so called dangerous drugs, so why should the banning of dangerous foods be considered an issue?
Thank you, thank you. 🙏🏽 I’ve been an “obese” size 12 since peri-menopause, currently an “overweight” size 10. At my lowest weight I was an “overweight” size 8. Worse, being a person of colour, a BMI over 23 is classified as overweight. I can’t have been that since my early teens. You’re right that it’s stacked against us from the start.
Thank you so much for writing this.