Experts calling for Operation Transformation to be taken off the air

The Black Oil

https://www.boards.ie/discussion/comment/122151455#Comment_122151455

In other words, an organisation with no international standing. I'll take the WHO, World Obesity Federation and research over WebMD. On a more local level, the HSE has its Model of Care for obesity, which Prof O'Shea said on the HSE podcast that the WHO praised. https://www.hse.ie/eng/about/who/cspd/ncps/obesity/model-of-care/

You used your OP to complain about the lack of emphasis on personal responsibility. That same HSE website, informed by NHS information, also gives tips, in its treatment section, for people to make changes to their own situation.

drury..

https://www.boards.ie/discussion/comment/122156292#Comment_122156292

I think he forgot that part

I'm guilty of it myself, but it's so easy to say eat less exercise more

JayRoc

https://www.boards.ie/discussion/comment/122156292#Comment_122156292

Interesting question.

Yes, to a certain extent. It's generally obvious which people are having difficulty in making changes to their life, and you want them to succeed and get the results they're after.

But at the same time, a personal trainer is not a psychologist. My brief was to give these people the information they needed to get what they wanted, and after that it was pretty much up to them.

And I don't really believe most people who are overweight are mentally ill or need therapy. It is incredibly simple to lose weight but that doesn't necessarily make it easy. Food that makes you fat is generally nice to eat so you don't want to stop eating it.

Just exercise a little self-control, make small long-term changes, establish a routine and be consistent. I don't think that requires therapy.

The Black Oil

https://www.boards.ie/discussion/comment/122156821#Comment_122156821

Thanks for that. I wasn't talking about therapy or that form of intervention. Since lifestyle is somewhat of the drumbeat we're hearing in this thread and it sounds like was in your wheelhouse, were you able to support people around good routines? Without a full sense of someone's life picture (job, sleep, family, stress, etc) we can talk about self-control (standard issue buzzword, no different to 'buy a pair of runners') all day long and it probably won't change anything.

JayRoc

https://www.boards.ie/discussion/comment/122156866#Comment_122156866

I get you. Yeah it would have been standard practice to check in at every session regarding just those factors (these were typically high-paid professionals who worked silly hours, slept too little and often ate shite as a result) . More than once I recall taking people into an office for a chat rather than the gym session they had paid for because I knew it might do more good.

Though if I'm being honest, it was the element of the job that interested me the least.

At the time I just wanted to train people and became frustrated at what I saw as people paying me good money for my expertise and then ignoring it. Perhaps a little callow but I was but a pup in my twenties.

I left the job after a couple of years and started working as strength and conditioning coach for which I am paid a lot less but have a lot more job satisfaction.

xhomelezz

https://www.boards.ie/discussion/2058352037/experts-calling-for-operation-transformation-to-be-taken-off-the-air

Who is watching that show anyway?

Not gonna even comment on your opening paragraph...

drury..

https://www.boards.ie/discussion/comment/122156971#Comment_122156971

You're a coach and limited by your lack of knowledge regarding obesity

marilynrr

https://www.boards.ie/discussion/comment/122155636#Comment_122155636

Well that's exactly what he said…. Weight gain is 90pc irreversible for 90pc of people, he added. You can lose it, but you will put it back on again.

I don't think some people who gain it back fall back into their old habits either. They just stop being as restrictive. Healthy people should be able to occasionally increase calories or have a binge without their body storing it all as fat. But it seems that a lot of people who have lost weight need to permanently alter their habits to a dieting state if they want to keep it off, and that's not healthy or ok either. Their maintenance calories are often low, which tends to mean the person has other issues like little energy, low libido, they're always exhausted etc, it's hard to live like that permanently and it's not healthy.

kaymin

https://www.boards.ie/discussion/comment/122156318#Comment_122156318

Can you give some specifics about what you're referring to that's relevant to what we're discussing? I read the links and all I came across were buzzwords and meaningless management speak:

'Takes a population health approach to managing
obesity'

Also the model of care you refer to is only in the process of being operationalised, meanwhile we have record levels of obesity.

This one gave me a laugh:

'To define specific services for the effective
management of obesity and overweight in
children, young people and adults across
the life course incorporating prevention,
early identification and treatment to
prevent progression of disease and
complications.'

I wonder are they referring to people getting fatter. So what exactly are they doing if Johnny down the street is getting more overweight by the day?

kaymin

https://www.boards.ie/discussion/comment/122157056#Comment_122157056

It's a contradiction to say something is irreversible when it's patently obvious many people reverse it - words matter when you're advising people that have limited self discipline in the first place.

Are you suggesting adopting a diet such that calories in equals calories spent causes those issues?

marilynrr

https://www.boards.ie/discussion/comment/122157190#Comment_122157190

I find news articles never quote what was said in its entirety so it's hard to know exactly what was said or how well he explained it. I think there does need to be clarity and factual information, but then you can't help it if you're misquoted.

He did say that people can lose it but they'll put it back on again.

What issues are you talking about? The obesity or the issues that people often report when they are restricting calories like low energy, low libido etc?

kaymin

https://www.boards.ie/discussion/comment/122157269#Comment_122157269

I don't see where he said people lose it but they will put it back on again - he just said it was irreversible:

'Commenting on the study, Dublin obesity expert Dr Donal O' Shea, said: "For some years now we have realised that weight gain is 90pc irreversible for 90pc of people. It's a very important reality that needs to be understood and accepted.'

You stated:

'Their maintenance calories are often low, which tends to mean the person has other issues like little energy, low libido, they're always exhausted etc'

And I'm asking whether this is anecdotal or based on research and is a direct consequence of people adopting a diet where calories in equals calories spent?

marilynrr

https://www.boards.ie/discussion/comment/122157391#Comment_122157391

That was a quote from 2016 from an article I posted where he was discussing prevention. He said it in the one you yourself posted earlier in the thread.

https://www.independent.ie/irish-news/doctors-warned-to-stop-telling-obese-patients-eat-less-move-more-is-their-treatment/a1838111061.html

Weight gain is 90pc irreversible for 90pc of people, he added. You can lose it, but you will put it back on again.

Well I've never looked up any studies on it because I would believe the anecdotal evidence because it makes perfect sense. If someone is on a low calorie diet and they've stopped burning fat also then of course some things are not going to be running properly in favour of other more important things, but yes the research is there.

https://www.healthline.com/nutrition/calorie-restriction-risks#TOC_TITLE_HDR_6

Did you think it wouldn't be? How would you expect everything in the body to be working efficiently if the body isn't getting enough calories and it's also not burning stored fat? It's not going to just magic up energy to run everything. Obviously some things are shutting down or running very poorly.

kaymin

https://www.boards.ie/discussion/comment/122157434#Comment_122157434

Okay but he's contradicting himself and the same issue arises when you come off the weight loss drugs. Also to counter the argument you made earlier, the hard miles are not losing the weight gains (they aren't irreversible) but keeping them off. So drugs are not the solution he is making them out to be unless he is condemning half the population to being on drugs for the rest of their lives.

To your other point, the body is getting enough calories if calories in = calories out?

Their strategy and communications seem confused and contradictory, on the one hand drugs and surgery are the solution yet then he goes onto say:

'There is a model of care for obesity but the recruitment embargo has impacted the hiring of dieticians, he said'

marilynrr

https://www.boards.ie/discussion/comment/122157469#Comment_122157469

It gets enough to keep functioning at a very reduced rate……….but some things will be shut off like the reproductive system, libido, the person will be very fatigued, some people will suffer hair loss, their body doesn't have the energy to keep growing healthy hair, the immune system can be impaired, the person can have brain fog etc.

It's not 'enough' if the body can't function in a healthy way on that many calories.

It's 'enough' as in they'll stay alive, but it's not healthy.

jackboy

https://www.boards.ie/discussion/comment/122157434#Comment_122157434

That is referring to an unhealthy diet where the calories taken in are too low. This is obviously unhealthy and unsustainable, just like a diet where too many calories are taken in. A healthy diet is what should be recommended. It might take a lot longer to lose the weight than a crash diet but it will be more sustainable

Also, it's not all about calories, you could eat a big ice cream cone and get close to the target calories for the day, but not a good idea and you would be ravenous for most of the day. Speaking of ice cream cones, I noticed plenty today that were disgustingly big, like close to toppling over. You would be fair sick after eating one of those.

TheChizler

I've heard stories from people working in the HSE health promotion department, from people who would normally be tasked with reading the most up to date research, recommending policy and coming up with campaigns. Basically upper management decided they were going to bring in consultants rather than listen to their own staff. Deloitte (fairly sure it was them) basically said people don't like being held personally accountable so recommended the HSE medicalise obesity. Not popular with the people now tasked with implementing these new policies.

They've been told to stop saying obese people or people with obesity, they're now people living in bigger bodies...

kaymin

I

https://www.boards.ie/discussion/comment/122157598#Comment_122157598

No surprise really, the whole campaign is a series of mixed and contradictory messages - when people really need to hear facts. Here's another from Mr O'Shea:

“Eat less, move more is not the treatment for obesity. Get over it,” he said. “Stop thinking it."

Lifestyle, including exercise and nutrition, is part of weight management and prevention of ill-health, he said, citing studies showing the negative impact of sedentary lifestyles.

https://www.irishexaminer.com/news/arid-41368447.html

JayRoc

https://www.boards.ie/discussion/comment/122157036#Comment_122157036

Would you mind elaborating on that? Do you mean the psychological issues, specifically? Metabolic factors, medical conditions etc?

marilynrr

https://www.boards.ie/discussion/comment/122157565#Comment_122157565

Yep but that's what people think they have to do because they are so used to hearing messages like what you say that "it's calories in < calories out….simple".

Many start off cutting calories a sustainable amount and doing well for a bit but then stall and can't lose anymore so the message they're receiving is they have to keep cutting every time they stall. And then their calories are very low and they're still not losing weight but they're suffering from the effects of a restricted calorie diet.

Agree that it's definitely not all about calories, and all calories are definitely not equal when it comes to weight gain or weight loss.

65535

Only watched it once or twice when it came out first - then found that they are back in the stone age by weighing in Stones ?

We need to move on to Kilo's - we use them everywhere now

marilynrr

https://www.boards.ie/discussion/comment/122157057#Comment_122157057

Why did that give you a laugh? Do you feel the same about other things like heart disease or type 2 diabetes? They do try to advise people to live a healthy lifestyle to try to avoid progression of disease and complications, why should obesity be any different. They have now reached the conclusion that once people are obese that it is extremely unlikely that they will be able to reverse that so of course they should be trying to 'prevent progression of disease and complications'.

Yeah they're referring to people getting fatter, but they're also referring to all of the other stuff that is going on in the body that goes along with it, they're not just gaining weight, many are on a road to damaging their bodies.

Being 'fat' wouldn't be nearly as big of a deal as it is if it didn't often lead to all sorts of other health complications and reduced quality of life.

JayRoc

https://www.boards.ie/discussion/comment/122156391#Comment_122156391

I think you may have taken me up wrong, to a certain extent. My point was that weight loss is a simple proposition. It's not complicated (generally speaking, obviously). People that make it complicated should be treated with a certain amount of skepticism.

I'm not judging anyone who is overweight. It's difficult for a lot of people to lose weight. But it's not complicated

marilynrr

https://www.boards.ie/discussion/comment/122157682#Comment_122157682

He's saying that exercise and nutrition is part of weight management and prevention of ill-health but that alone it's not going to treat obesity. Which does indeed seem to be a fact even if people don't want to believe it.

I think you're seeing mixed messages and contradiction because you're choosing to read it that way. It's hard to know exactly what he said without reading an actual transcript but I would imagine any official campaign would state it in clear facts but again it will still probably be misquoted and deliberately misinterpreted.

marilynrr

https://www.boards.ie/discussion/comment/122157598#Comment_122157598

Have the previous campaigns actually had any success in reducing the obesity crisis? or have any of the previous policies had any notable success? It doesn't seem that that is the case….what up to date research out there is genuinely going to make a difference?

Obesity is now considered a disease by many countries and also by WHO and the European commission, surely it would be only a matter of time before Ireland were forced to classify it as a disease if the EU were saying it.

And if it's a disease then how could they not medicalise it there is medication available and the previous 'treatments' have not had a good success rate?

kaymin

https://www.boards.ie/discussion/comment/122158122#Comment_122158122

No, heart disease is 40% hereditary though granted obesity is hereditary to an extent. Depends on the circumstances for Type II diabetes - obesity and inactivity are contributing factors. I laughed because how they describe putting on weight as the progression of a disease - if I don't do exercise for a few weeks I'm now suffering from a disease - nonsense.

Galwayguy35

It doesn't help that people like Lizzo are seen as some kind of role model when she is a walking heart attack.

If she wants to eat herself into an early grave let her off but stop calling it body positivity.

Eva Orsmond was the only one on that show who gave it to them straight and pushed them to do more and RTE got rid of her.

kaymin

https://www.boards.ie/discussion/comment/122158162#Comment_122158162

I haven't taken it up wrong.

Eat less, move more is not the treatment for obesity

But, but

It is part of the treatment for obesity.

Maybe he should choose his words more carefully.

I'd be curious what previous campaigns / policies were - I don't recall anything about them. A radical approach might be to ban the branding of sh!t food similar to how they banned branding of cigarettes.

marilynrr

https://www.boards.ie/discussion/comment/122158555#Comment_122158555

Right, but some isn't hereditary so do you feel the same about it then?

No you're not suffering from a disease after not exercising for a few weeks, you're the one who brought that nonsense into the debate so that nonsense comment must have been directed at yourself 🤔

kaymin

https://www.boards.ie/discussion/comment/122158659#Comment_122158659

tbh I don't feel anything about what you're asking about.

What's the cut-off for when putting on weight becomes a disease?