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Child Item

Experts calling for Operation Transformation to be taken off the air

kaymin

'It is now agreed that body weight is largely outside individual control and is certainly not attributed to “greediness, laziness and lack of willpower.'

https://www.independent.ie/irish-news/operation-transformation-is-adding-to-weight-stigma-and-dehumanising-experts-warn-in-open-letter-to-rte-chief-kevin-bakhurst/a573912379.html

Irish medical professionals seem to fall over themselves to absolve people of all responsibility for their obesity. HSE takes a similar position and goes as far as making no reference to food intake or lack of exercise as a cause of obesity (granted they skirt around these causes by referring instead to appetite and 'where you play').

Per HSE:

'There is no single cause of obesity. But there are many factors that can influence obesity.

These factors include:

your genetics
stress
your appetite and your appetite hormones (the hormones that control your hunger)
where you live, work and play, and how they affect your eating and activity
your sleep habits
some medicines
other medical reasons
certain times in your life'

https://www2.hse.ie/conditions/obesity/causes/

Surely absolving people of all personal responsibility will just fuel our obesity crisis and increase our reliance of obesity fighting drugs - it is at odds with medical authorities around the world who certainly don't take the view that 'body weight is largely outside individual control':

NHS:

'If you consume high amounts of energy, particularly found in high fat and high sugar foods, and do not use all of the energy through physical activity, much of the extra energy will be stored in the body as fat.'

https://www.nhs.uk/conditions/obesity/causes/

Mayo Clinic:

'A healthier diet, increased physical activity and behavior changes can help you lose weight. Prescription medicines and weight-loss procedures are other options for treating obesity.'

https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

Cleveland Clinic:

'On the most basic level, obesity is caused by consuming more calories than your body can use.'

https://my.clevelandclinic.org/health/diseases/11209-weight-control-and-obesity

WebMD

'Among the things that contribute to obesity are what and how much we eat, and how much we move.'

https://www.webmd.com/obesity/causes-of-obesity

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marilynrr

https://www.boards.ie/discussion/comment/122149356#Comment_122149356

I do actually think there's a lot of truth in it.

I think many people who become obese become obese because they're eating too much and there's no point in lying about that.

However I do believe that once someone is obese that it very much can be a disease, and that it can be almost irreversible and the weight set point can be ridiculously stubborn.

So the message really needs to be to try to avoid getting very overweight or obese in the first place because it might not be as simple as losing weight then, you may never be able get back to a healthy weight again.

I've never been overweight and have always been on the lower end of a healthy low BMI with a ridiculously rigid weight set point. I would drop to underweight sometimes when stressed but then bounce back to my same set point, and I would eat a high calorie diet and never gain.

The only time I gained was when my cortisol was out of control. I was at the higher end of a healthy BMI but by that point I was eating very very little, tiny snacks here and there because I felt like no matter what I was eating my body was suffering from inflammation. I'd been on all sorts of healthy diets to try to sort out the issue (I had previously eaten whatever I wanted) and nothing worked so I lost my love of food because everything made me feel ****.

I managed to reverse the inflammation and cortisol in the end with keto, and dirty keto at that, stayed on it for a little while after and was back to my original weight set point and now I can eat what I want again.

I've never been the type to judge obese people but that experience really gave me some proper insight into what it can be like for people who are trying to lose weight, you really can do everything right but if there's something wrong with your body then you can keep gaining.

kaymin

https://www.boards.ie/discussion/comment/122152002#Comment_122152002

I agree mostly but Ozempic works by reducing appetite so for most an inability to lose weight without drugs comes down to a lack of willpower / self control to resist the urge to eat.

So I don't agree that 'you really can do everything right but if there's something wrong with your body then you can keep gaining', with limited exceptions

seanrambo87

Bad actors profiting? Would that include Katherine Thomas? What is her field of expertise again?¿

Trampas

You think people are fat now. Just need to look at kids nowadays. A lot more obese kids now than ever was. Vast majority of their parents are on the large size also. It’s come does to lazy cooking. Easier to throw the processed stuff into whatever you use and come bang when it beeps that cut a few things and cook it.

Wanderer2010

https://www.boards.ie/discussion/comment/122149583#Comment_122149583

Yes it's very odd. Obesity is not a disease. You cannot catch it from being in the same room as an obese person. The only reason it was categorised as a disease was to allow doctors and pharmaceutical companies to prescribe tablets to "cure" it, surgery to control it and in the process make billions in profit from this miscategorisation. Same with the BMI, which is totally flawed and inaccurate. Back in the 80s the limits of normal and overweight on the scale were lowered in one day, meaning billions of people went to bed as a normal weight and woke up overweight! Again, to fuel profits as more patients could be officially included as being overweight and have access to a raft of dangerous diet pills and very risky.procedures like bariatrics surgery and tummy tucks.

I'm not surprised OT was cancelled. Focusing solely on one factor, weight, was a reflection of our extreme fat phobia and bias towards obese people fuelled by society in thousands of ways plus social media. There is not one illness which only exists in obese people and tonnes of thin people die of strokes and heart disease each year but that doesn't fit the narrative of thin = healthy fat = unhealthy and the majority of people are brainwashed by the dieting industry but facts are facts and humiliating people week after week after stepping on the scales has a short shelf life. Even when OT pretended they weren't only focused on weight, their daily calorie meal limit was still 1200 to 1400 which is way too low for a significant population.

drury..

https://www.boards.ie/discussion/comment/122152160#Comment_122152160

Processed food is the norm for lots of persons

Not helped by the fact that processed food is 95% of supermarket shelf space

jackboy

https://www.boards.ie/discussion/comment/122152179#Comment_122152179

Yes, the obesity crises can be understood by taking a walk around any supermarket. Most sections are filled with highly processed junk food with only small sections containing non processed food that everyone should be eating. F

[Deleted User]

I think obesity is a societal problem, that is true, but individuals clearly can make improvements by eating less and exercising. They will inevitably succeed if they do that.

What they’re saying would be true for people who are extremely obese, but Operation Transformation definitely was helpful for people carrying a stone or two who wanted to lose a bit of weight.

I think it was a fairly positive programme, it did promote better health, better nutrition and exercise. That said it had kind of run its course and was repetitive.

drury..

https://www.boards.ie/discussion/comment/122152203#Comment_122152203

It become normalised. People think what's on the supermarket shelves is proper food.

Same way in the US fast food is part of many peoples regular diet

Akrasia

Obesity is pernicious and linked with mental illness and addiction.

People know they shouldn't eat that extra portion or buy that packet of biscuits, but the entire economy is based on getting people to want to do things that are profitable to corporations.

People are manipulated from the moment they wake up till bed time with powerful targetted, carefully developed marketing designed to get them to buy more of the things, to get addicted to them.

Once an overweight person becomes an obese person their last defense mechanism, self esteem, slips away, and they lose the motivation to resist these powerful urges, instilled in them.

They're already 'fat and ugly' so a healthy lifestyle and the benefits of that are out of reach or would require too much of a change and take too long, so they put it off, or decide to accept their life with the limitations obesity brings, and with that acceptance, they give themselves permission to stop trying to be healthy and that's a very negative downward spiral that many people never recover from.

Will power requires motivation. It also requires support from friends and family to encourage good behaviour and discourage bad behaviour. Goals and short term targets are needed too, as well as skills and knowledge. Not everyone knows how to cook a healthy nutritious range of meals from fresh ingredients. Most people know what the really 'bad' foods are, but marketing tricks people into thinking some of the bad foods are actually healthy, and if they're quicker easier and cheaper than preparing healthy meals from scratch then it can impede even people with the best of intentions.

Then there is depression. A depressed person stops liking themselves, and stops thinking that they have any value as a person other than the things they can do for others. When your self esteem is really low, self destructive behaviours can easily take over. Self care becomes late night snacks or a bottle of wine.

Telling people that obesity is a disease can be good, and it can be harmful depending on the frame of mind that person is in. Are they looking for an excuse to be sick, or are they looking for something to focus on fighting against?

If you're looking to excuse your weight then you're never going to become healthy, but maybe you can find happiness in that body the same way people with incurable disease can accept their situation and maximise their happiness.

If you're looking to beat the disease then telling them that it's not a character flaw, that they can make changes to their lives or take medication to overcome it can be the motivation they need to beat obesity.

If I was king for the day, I would launch a national voucher scheme. Everyone in the country gets 1000 euros a year, from birth to death. That money can only be spent on activities that promote healthy lifestyles, whether mental or physical health. With proper safeguarding, this should encourage people to be more active, engaged and remove barriers to participation in local community organisations and would have so many benefits for individuals and communities

NIMAN

But calling obesity a disease is giving people the excuse they need, it's enabling them. And when you have the country's primary obesity expert coming on the radio and refuses to ever say these people are overeating, you are only confounding the problem.

"I don't eat too much, I have a disease".

I know several people who are very overweight, and eat all the wrong types of food. Some are back and forth to the medical people, trying to get themselves diagnosed with underactive thyroids and the like. I often wonder are the GPs honest with them in the meetings, telling them they are simply eating too much, or are they so PC now they don't want to offend them? These same people could eat takeaways 4 or 5 nights a week. Yet its not the food, it's something else causing them to put on weight.

I think O'Shea and others are failing these people. Lying to them isn't helping anybody. You would have to wonder what the nations waistlines are going to be like in 50 years time.

ToweringPerformance

Buy a pair of runners and eat less sh1t food. It's not rocket science.

People are actually stupid for giving credence to the "it's a disease" nonsense. I know of a family member who spends a fortune on gym membership but get's take out's every other day and is depressed because they can't lose weight. When someone tried to talk to her about it they are accused of fat shaming. You can't win with these folk.

Dtoffee

What if the food we are eating includes a certain additive that creates an addiction?

When you eat any processed food, you would struggle to understand the ingredients list and we are now looking seeing ultra processed foods becoming the norm. Does you think that the food production industry is beyond adding a tincture of some magic dust that makes a small percentage of the consumers addicted? I doubt any of us would volunteer to drink arsenic, but yet we are if we drink tea. For example https://pubmed.ncbi.nlm.nih.gov/25526572/ says exposure of adults was estimated in relation to the Benchmark Dose Lower Confidence Limit (BMDL05) as set by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) that resulted in a 0.5% increase in lung cancer (3.0 μg/kg body weight (b.w.) per day) and that's before we get to the tea bags https://www.publichealth.com.ng/which-tea-bags-contain-plastic/ .

The reality is we have no clue what we are eating anymore and the ingredients list does not have to declare a full list as items under a low percentage are often ignored….. I think we are in the middle of a chemical war with the food industry using chemicals to help sell their products and the health pharma industry pushing their solutions. I don't have any proof, but just look at all the issues that are around today compared to 50/60 years ago.

I think the medical profession are now starting to see the obesity issue as no longer a lifestyle choice issue and treating it as an addiction. Look at how the smoking industry promoted their product for decades and denied any addictive issues along with links to cancer.

All of this is just my opinion and not proven, its OK to have a different opinion.

marilynrr

https://www.boards.ie/discussion/comment/122152152#Comment_122152152

I don't know really know much about Ozempic, what happens when people come off it?

They've lost weight but do they have a healthy body that's functioning well?

Are they then able to eat a healthy amount of calories ensuring their body is working well and stay slim?

marilynrr

@Wanderer2010

Yes it's very odd. Obesity is not a disease. You cannot catch it from being in the same room as an obese person

There's loads of diseases that you can't catch from being in the same room as someone!

The only reason it was categorised as a disease was to allow doctors and pharmaceutical companies to prescribe tablets to "cure" it, surgery to control it and in the process make billions in profit from this miscategorisation.

They're not actually miscategorised. You just don't seem to know what diseases are. Lots of diseases are preventable and reversible (in some at least). Lots of heart disease can be reversible with lifestyle changes etc.

yagan

A few years ago I was chatting with an ambulance manager in north west England and he said they had a fleet of ten bariatric ambulances based in Manchester. He told me a recent call out was for a woman who became a shut in the upstairs of her house which meant they had the fire brigade to remove her bedroom window and get a crane to light her out.

About ten years ago I was back in my home town for a short spell and was doing a contract that required a few house calls. At one house the door opened up and they guy immediately recognised me from school but for the life of until he told me his name I had no idea who he was. He was enormous, so big and heavy he couldn't stand without leaning against something, whereas we had been on the same teams in school and he'd been a great hurler.

I could well imagine him some day needing a bariatric ambulance.

I was telling this story to an undertaker friend and he said they were now having to buy and keep more bigger coffins, and according to him they mostly seem to be men in their 50s and 60s.

kaymin

https://www.boards.ie/discussion/comment/122153569#Comment_122153569

According to this article:

'Taking Ozempic reduces appetite by promoting a feeling of fullness, helping you to lose weight.

However, discontinuing the medication can lead to a return to normal appetite levels, potentially resulting in weight gain if dietary habits are not adjusted accordingly'

https://lifemd.com/learn/what-happens-when-you-stop-taking-ozempic

So the solution from Dr O'Shea and all the Irish experts is to have half the population on drugs for the rest of their lives instead of, you know, adjusting dietary habits to start with.

marilynrr

@kaymin

Presumably and hopefully if that is going to be the approach they take with obese patients then they will put more emphasis on the risks of becoming obese in the first place (This may not be reversible on your own, you could face a lifetime of medication etc.) and they will continue to promote that people adjust their dietary habits if they are still in the overweight category.

On a different article on the examiner discussing the same thing they said Donal O’Shea said "eat less, move more" should not be the treatment plan for people who are already obese.

In this article it says that Researchers say less than 1 percent of people with obesity get back to a healthy body weight. https://www.healthline.com/health-news/obese-people-have-slim-chance-of-obtaining-normal-body-weight-071615#:~:text=Researchers%20say%20less%20than%201,to%20a%20healthy%20body%20weight.

and that Researchers with the National Institute for Health Research (NIHR) in the United Kingdom used a decade’s worth of digital health records for 278,982 people — 129,194 men and 149,788 women — and concluded current methods of getting people to lose weight aren’t working.

Surely many of those people are going to face a lifetime or decades of medication as it is, that is if they live that long.

Presumably some of the people who go on Ozempic do manage to keep the weight off when they come off the drug if the body is healthy afterwards (as I said I don't know much about it) so they won't all be on it for life, but the alternative seems to be that pretty much all obese people are going to stay obese, because as they said they current methods aren't working.

kaymin

https://www.boards.ie/discussion/comment/122153903#Comment_122153903

Something doesn't add up with some of the stats in that article, e.g.

'A third of all patients had fluctuating weight, signifying many battles were lost and won before any kind of victory could be achieved.'

Yet:

'Losing 5 percent of their weight was successful for about 10 percent of women and 1 in 12 men.'

You would hope the medical professional would emphasise the risks of becoming obese in the first place but instead they emphasise that it's outside of people's control leaving little incentive for people to watch what they eat or how much they exercise.

marilynrr

https://www.boards.ie/discussion/comment/122153947#Comment_122153947

I think that means that a 3rd of them had many battles of fluctuating weight before they managed to reach the 5% weight decrease target….and that 10% of women and 1 in 12 men reached the target of losing 5%……but then it also says that 53% had regained it all in 2 years and 78% regained it in 5…

So basically only 22% of that 10% of women and 1 in 12 men who had lost 5% of their body weight managed to keep it off after 5 years…….so that's around 2% so the stats add up….presumably losing 5% also wouldn't take some of them from obese to just overweight anyway. They remain obese which is why the figure is less than 1%

Yes they really need to think very carefully about the message that they are sending out and emphasise that it is absolutely an avoidable disease……before you actually become obese.

I also think they need to emphasise that just because you have obesity and can't lose weight then there are still a lot of benefits to eating a healthy diet. Choosing the wrong foods and excessive amounts of food is going to make everything worse, weight, mobility, overall health.

lumphammer2

I'm glad Operation Transformation is scrapped …. I never liked that programme and agree with the reasoning why it should be scrapped …. people were brought to tears several times on the programme ….. it also was a vehicle dreamt up by Noel Kelly to promote initially the late Gerry Ryan …. and then Kathryn Thomas …. and the Henrys …. all clients ….

The programme besides its harmful influence and association with the RTE of the Tubridy era …. it simply was too long on as well …. it had run its course …. it represented the lack of invention …. I know it was popular back around 2008 when it started but I don't think it was watched much in the last few years …. a lot of these programmes go on too long and this is one of the biggest examples of all ….

All the WRONG programmes end up going on and on …. and the right programmes are ended too soon …. Love/Hate et al …. I hope Kin will be back for a 3rd series …. it is this sort of show we want to see more of …. not OT and the rest ….

bilbot79

https://www.boards.ie/discussion/comment/122149435#Comment_122149435

This is scary because in nearly all of the shows about weight loss I've seen and from what I've seen from food addicts/other addicts I know, it doesn't take much for excuses to get the better of them. Food addicts will latch onto statements like that to say there's nothing I can do so may aswell order pizza

marilynrr

https://www.boards.ie/discussion/comment/122155581#Comment_122155581

It's true though so the conversation should lead with the facts.

He gave the same figures back in 2016

"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.

"Then prevention - and in particular in childhood - becomes the primary goal. "The research we are doing with the National Children's Research Centre is focused on the immune system and regulation of weight - and that's where the explanation for this dynamic defence against weight loss is to be found.

"Ultimately understanding that will lead to treatments for obesity, but it really should be prevention, prevention, prevention."

https://www.independent.ie/life/health-wellbeing/weight-gain-is-often-irreversible/34691464.html

That's the message that needs to be getting out there to those who are currently normal weight or overweight, prevention. Chances are if you become obese you will not be able to get to a healthy weight without medication, and even medication doesn't work for everyone. I'm not sure what the chances are of being able to lose it if a person is just overweight and not obese but it does seem to have a decent success rate because I think we would all know quite a few who went from overweight to normal/slim and stayed at a healthy weight.

And for people who are already obese who think well I can't lose the weight I might as well order pizza I think to those people there needs to be a large emphasis that even if the weight isn't shifting that a healthy diet can still benefit them in numerous ways and that an unhealthy diet and overconsumption is going to make things a lot worse. As bad as you feel now you're going to feel a lot worse in 2 years or 5 years if you keep ordering pizza.

I think the facts are kinder in some ways and harsher in others, but they are the facts regardless and the conversation about obesity and preventing it and reversing it has to lead with the facts.

kaymin

https://www.boards.ie/discussion/comment/122155603#Comment_122155603

Weight gain is not 90% irreversible for 90% of people though - maybe on a permanent basis it is because people fall back in to their old habits but weight can be lost without drugs and many people achieve it - far more than the 5 or 10% that are being quoted - the stats and research is being presented in a very misleading way.

The emphasis needs to be on a permanent lifestyle change not on short term diets or drugs whose effects are also only temporary. That's something I felt OP emphasised which is why I find the letter from the Irish experts to cancel OP a bit bizarre.

jackboy

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

It is the word 'irreversible' that is incorrect. It is more accurate to say that 90% of people will not reverse weight gain. That has a very different meaning. 'Irreversible' implies not possible to reverse rather that the truth which is 'will not reverse'.

Almost everyone that goes on a diet will not sustain weight loss as the concept people have of a diet is not useful as a fix for weight gain. Instead of going on a diet people should be correcting their diet permanently. Unfortunately too many diets are started with the full intention of going back to eating mountains of junk after the diet.

kaymin

https://www.boards.ie/discussion/comment/122155765#Comment_122155765

It's like they're trying to get the research results to fit their own agenda. I also think '90% of people will not reverse' is also incorrect as many people do reverse their weight gains, albeit not permanently. Ultimately it boils down to a need for a lifestyle change - change of eating habits and activity levels permanently, but the Irish medical experts seem to want to rule this out as a solution.

lawred2

https://www.boards.ie/discussion/comment/122149435#Comment_122149435

Follow the science

[Deleted User]

They should replace it with You Are What You Eat. Sit the fatties in front of a table filled with all the crap they eat on a weekly basis, and then ask the experts to explain how over consuming of calories is not the reason for their disgusting waistlines.

jackboy

https://www.boards.ie/discussion/comment/122155816#Comment_122155816

I think it goes way beyond that. Many people that are of normal weight or slightly over weight also have a diet based on junk food, which is going to make them sick. Its staggering that most people go into supermarkets and fill their trolleys with junk, thinking they are buying healthy food. Breakfast cereal, sliced pan, yoghurts full of sugar, most people think such things are healthy food.

The Black Oil

https://www.boards.ie/discussion/comment/122150433#Comment_122150433

In the course of this work did you address people's underlying reasons for overeating?