WHO report: 74% of men & 64% women in UK overweight by 2030

[RogerThat]

http://www.theguardian.com/society/2015 ... -men-women

This is more frightening than I thought. Previous NHS projections were 5% lower than the WHO report. We've noticed a steady 1 % per annum increase in the overweight and obese (over 30% fat of body composition) coming through our clinics since 2010. Is your weight a problem for you, and do you think it's being adequately addressed by the medical services available to you locally?

What help (if any) would you like to get the weight off?

This will certainly lead to a significant rise in (currently 3.2 million) diabetes sufferers which has surged dramatically in the age group 45-55 since 2012. Diabetes now contributes greatly to increased stroke, heart disease, mobility and infirmity, liver failure, renal failure, blindness and even amputation (especially legs, feet) in this age group.

For anyone unfamiliar with the disease (and more importantly symptoms to be aware of) there is a good laypersons guide here:

http://www.news-medical.net/health/Diab ... ology.aspx

[al_yrpal]

A few years ago our health centre ran a course lasting 12 weeks for diabetics and overweight people. There was lots of good dietary advice and the GPs set an example by all participating in walks, cycle rides and other activities. When he was a GP here Dr William Bird initiated the Health Walks and the Green Gym which went national. These schemes are still running in our village today along with a weekly cycle ride for all abilities, lots of people participate, they are very popular. All local health centres should be funded to initiate and maintain schemes like these. Although I cannot prove it I am certain that this would be a better way to spend on the NHS than simply providing remedies for disease caused by being overweight.

Al

[RogerThat]

Absolutely agree, preventative programmes like this are very much underfunded and often trivialised by NHS service providers. The stark reality is that we're looking down the barrel of a diabetes disaster in less than 10 years time. The burden in the NHS will be truly collosal, likely precipitating collapse and/or huge restrictions on free health care to those who will not, or have not previously taken action to improve their own health.

[beardy]

Where as the problem is a big fat one, I think this announcement may be not quite what it seems.

The problem is that we are expressing a distribution of weights by how many cross a cut off point and that cut off point is chosen somewhat arbitrarily to be roughly indicative. To then use people crossing that rough marker point as a precise measure as done here is wrong.

If, as I expect, we already have a roughly bell distribution of BMIs and it is peaking just below the cut off point and then everybody in it gains just a couple of kilogrammes you will get this increase in the overweight population, but not a sudden increase in the number of people who's risk has significantly increased.

I can use myself as an example here, my BMI is about 25, during the week I can fluctuate between healthy and overweight several times. To make better sense of the data we would want a few figures about average BMIs too.

Another question in my mind, is do they use the correction for taller people when they collect these figures or not? If I bother to use the corrected calculator then I am no longer near or popping into the overweight class and when I look around I see far more youngsters my height or taller than people of my own age.
Then of course BMI is itself an over simplistic measure, failing to distinguish fat from muscle, the diseases on the other hand may or may not make such a distinction.

Having said all that casting doubt on the severity or significance of the predicted increase, that doesnt at all change the fact that we have a big problem regardless of the dubious precision of any predictions. The prediction of a third to be obese is good enough to give the right impression and if that includes a few that are just below the line, it doesnt matter because they were still quite a way from healthy.

I expect the first response to be a re-definition of what constitutes overweight, to reflect modern times and values.

[pete75]

Obese and Overweight is mentioned in the article as being defined by BMI - a crude calculation based purely on height and weight that takes no account of a person's build, musculature etc. Would have thought that body fat percentage is about the only reliable way of telling if someone is overweight.
I don't know if exercise is the answer either - every time I've engaged in a series of gym sessions my BMI has increased - put more muscle on so end up weighing more.

[Edwards]

Obese and Overweight is mentioned in the article as being defined by BMI - a crude calculation based purely on height and weight that takes no account of a person's build, musculature etc. Would have thought that body fat percentage is about the only reliable way of telling if someone is overweight.
I don't know if exercise is the answer either - every time I've engaged in a series of gym sessions my BMI has increased - put more muscle on so end up weighing more.

You are correct BMI is no use for anything we have been told by somebody who claims to know about this sort of stuff. So if it was used as the basis for this prediction then by definition it must be flawed as we have been told.

[RogerThat]

You are correct Bmi has been widely discredited. We use this Bod Pod, an air displacement method to determine body fat composition : (I'm sure I've pointed this out to you before, maybe you just 'forgot ').

It's a recognized Gold Standard for % body fat composition. Many UK hospitals and clinics (the 9 we run use these exclusively) use this or a similar device.

[Edwards]

You are correct Bmi has been widely discredited. We use this Bod Pod, an air displacement method to determine body fat composition : (I'm sure I've pointed this out to you before, maybe you just 'forgot ').

I for one find it strange that you were rude and obnoxious (plus a few more) when BMI was suggested as a very crude but general idea of obesity.
Yet now you link to an article that uses BMI as the base for making a prediction. Using your words the conclusions for that article in a newspaper must be very wrong and people will be wrongly diagnosed.

I am wondering why you feel the need to post a picture of the new toy now and not earlier? The thing is not exactly something one could carry on their bike.

[Paulatic]

Perhaps the cure for obesity is to send them out to cycle, swing and run LEJOG. This could be their end result.

[RogerThat]

I understand your problems. Though I'm afraid they may be nothing to do with me.

[RogerThat]

You are correct Bmi has been widely discredited. We use this Bod Pod, an air displacement method to determine body fat composition : (I'm sure I've pointed this out to you before, maybe you just 'forgot ').

I for one find it strange that you were rude and obnoxious (plus a few more) when BMI was suggested as a very crude but general idea of obesity.
Yet now you link to an article that uses BMI as the base for making a prediction. Using your words the conclusions for that article in a newspaper must be very wrong and people will be wrongly diagnosed.

I am wondering why you feel the need to post a picture of the new toy now and not earlier? The thing is not exactly something one could carry on their bike.

If you took the opportunity to read the WHO paper in full (as I have) you'd have the answer to your question.


If you re read the thread where I was (with concern) critical of BMI you'd see I posted the same Gold Standard measuring equipment there too. It is not a new device, it's been used in UK hospitals and specialist clinics like my own for several years now.

[beardy]

The point that I was trying to make is not that the methods of measuring are inadequate and need improving but that they are unnecessary and the need for action and the nature of that action is unchanged by the results posted here.

That BMI capsule is in my opinion a waste of money (though obviously those who make their living from it will disagree ). A look in the mirror is adequate and a corroboration is available through a quick use of finger and thumb in a pinching movement. There is absolutely no need for greater precision or accuracy of measurement than this, in order to determine an individuals' needs!

It is not that important if people are overweight by an amount that is not visibly obvious. Nor is it critically important if their BMI is 24 rather than 26, they are just a fraction worse off rather than crossing a line between healthy and unhealthy. The remedy to an individuals' problem is equally obvious, the problem is making the motivation greater than the motivation for sitting and eating.

[Edwards]

rogerthat I do not need to read the article to understand that you have stated that using BMI is wrong and incorrect now you claim that an article you recommend (using the same data) is correct.
You can not have it both ways either BMI is incorrect and doctors do not know what they are on about or BMI is a useful tool and doctors do.

Beardy has the best solution to this problem for some people a simple cost effective mirror. With a pair of simple scales (no the useless toy recommended by rogerthat). The person in question then does not waste valuable resources using a gimmick of a device to tell them what they can see.

Rogerthat maybe you could learn from an old phrase KISS.

[RogerThat]

Unfortunately, for most of my patients being overweight or obese is not simply a minor inconvenience, it's literally a matter of life and death.

Many, many treatments will soon become 'means tested', like fertility treatments, they will be flatly refused unless the patient can show a significant weight loss. There's also plans in the offing to increase the NI contributions for those whose weight management has become a significant health problem.

So, on that basis I'd say it was essentially a non trivial matter.

Oh, and this machine has nothing to do with BMI, it's a % body fat composition tool. We also use X ray techniques to gauge the hidden fat surrounding internal organs which can be much more dangerous to health. So, a look in the mirror would also be a frivolous measurement!

[beardy]

BMI does have its place. It is a cheap easy rough rule of thumb that can help us get an idea of the magnitude and direction of the problem at a population level. For that purpose it is useful.

What I am objecting to is then using that rough data to make more precise statements like 74% will be overweight in 2030 which is unreliable in three significant ways.

The 74% is more precise than ability to measure the problem.
This arbitrary cut off point of BMI=25 as a border between healthy and unhealthy.
It is only a prediction, it hasnt happened so it is the prediction which has been modified rather than our future.

At an individual level BMI is far less useful than a mirror or pinching an inch, yet when you have been pinching much more than an inch for a few years it may make another redline which fear of crossing may cause you to finally take the action that you know you should have taken years ago. However that could equally hold for some other arbitrary point like 14 stone or 90Kg.