Wednesday, 22 April 2009

A rant about a TV programme on banding

I watched a TV programme this evening on some of the ways the National Health Service is dealing with the problem of obesity in the young in the UK, with particular emphasis on gastric banding and the hospital in Birmingham which is treating them. My post has turned out a bit long - but bear with me please? I feel it's so relevant to us...

Three girls around the age of 20 were interviewed at some length, and it was clear their attitudes revolved around not knowing or not caring about why they were overweight, they were quite happy to admit to their failings, they wanted gastric bands and that was that. One and two were told they didn’t qualify for an NHS band, and were encouraged to eat healthily and do more exercise. № 1 had help from her mother, who got her a personal trainer and helped her plan her meals and disregard the unhealthy eating habits of the young boyfriend, and № 2 tried on her own but was getting married soon and knew she couldn’t lose enough by the big day so couldn’t get motivated. № 3 was given the go ahead for the band, but was told she had to lose a stone – 6 kg – before the op. She told the cameras she was doing the right things, though as her partner was as big as she was it seemed doubtful that she would manage it.

№ 1 lost a couple of stone over the next few months, and was the pride and joy of the dietician treating her, № 2 lost virtually nothing by her wedding day but was weighed several months later and had lost a bit. № 3 had the band fitted. During the op the surgeon commented that he could see from the state of her insides and her liver that she hadn’t followed much of a diet beforehand, and that she would probably have lifestyle adjustment problems in the future. The girl herself said she had “suffered a lot in the op, and that she was now finding that it didn’t always work”. She lost about the same as the other two over the same period, and the voice over pointed out in several different ways that the successes of №’s 1 and 2 hadn’t cost the system very much, as opposed to № 3’s.

The consultant, who fitted 20 gastric bands a week, thought the NHS shouldn’t waste time assessing which few people would be allowed a band, but that as many should be fitted as possible, to avoid the drain on NHS resources later on when the consequences of diabetes and joints wearing out became apparent.

The programme left me with the usual indignation – yet again the self-righteous point had been made that there’s no substitute for a healthy diet and exercise, yet it was obvious that № 1 wouldn’t be able to keep up the expense of a personal trainer and no doubt her motivation either once the TV cameras had gone home, and the same for № 2. № 3 will lose weight – a bit, a lot, who knows – but mainly because the band will bring her up short.

It may take a whole generation of people with bands to see that the solution lies in the prevention of the problem, not its long-term cure, which does not exist.

Whereas it’s too late both for those young girls and for the likes of us whose minds are set into the groove of food = pleasure = guilt, there’s the hope that in becoming slim, we are motivated, not for ourselves, but for our children. We need to be taught the skills of how to take responsibility for our children’s future, not just their present, by dealing with the psychology of their overeating, their eating for comfort, their guilt, their reluctance to exercise, and so on. I can see a future time when overweight could cease to be an epidemic because parents had learned the hard way, and with the help of school and television the message finally got through to the kids in time before the bad habits set in. One day I hope to see a television documentary that will make this point.


Dawn said...

Great post Caroline... For us banding had been the final thing after years of trying unsuccessfully to loose in the past. Teenagers of today don't seem to grasp that their future is in there hands. I love the adverts at the moment about 'me sized portions', education needs to come from the parents. I have a weight problem, but none of our children do. And I have to ask myself why? Why don't they have a weight problem? And I can only think that it was the way in which they were brought up, I walked a lot and didn't have a car till my late twenties. My mother 'fed' me as a way of showing me she loved me, but I was doing huge amounts of exercise every day - walking to school, home for lunch, back again - up a hill that was 1/2 mile and which a car needs to be in second gear to get up. Now a days cars have become our children's death warrant! Sorry to rant, but it really gets to me to see fat children.

Zena said...

I also watched this program, I do agree it is sooooo much to do with parents and upbringing but also I have to say it is not all about parents teachings. I am in the view of a bit of both, My mother never had the money to indulge us in the types of junk food that is so easily available today, We was brought up on meat and two veg. I was a bit 'dumpy' from the age of about 9 or 10. Things were quite different when I was younger and still managed to become morbidly obese, My eldest daughter seems to be following in my footprints and even with all my knowledge about healthy eating I am finding it very difficult and extremely frustrating to keep my daughters weight in check, she takes after me and does not relish the thought of having to go out of her way to exercise more. However I do not want to make the mistake of putting her on a 'diet' and introduce her to the world of yo yo dieting, that's not fair we all know what sort of hell that is. I am doing my best and I know my children know what is healthy and what is not, Just trying to guide them to make educated choices in the future, Although I would not like them to be in a situation where they feel they need to contemplate having a band, I am not totally opposed to it either in the future if they feel that they are at the last resort like I was.
Nature or nurture.... I feel a bit of both.

Zena said...

Sorry, I do have to add.... It does make me very CROSS when people say 'I cant afford to each fresh fruit and's to expensive.' But then carry on to eat take out food 2-3 times a week... What a croc of SHIT. ( sorry for swearing on your blog Caroline, but it was needed.


Nola said...

Very, very interesting...and hear hear to you and your thoughts on this!! Dawn and Zena bring up valid points also.
I grew up with a very "forward" thinking mum who used to hide bran in our meat patties and things like that....we ate Mostly very healthily. I have always been in active jobs and yet, here I am obese. I don't know....I really don't:)

Reddirt Woman said...

Amen. And amen again.


Lonicera said...

Thanks for all the comments. I think on the whole parents try to start children out with good eating habits, so I don't think the total burden of responsibility should rest with them: I think there has to be a properly structured teaching process funded by the state which is given the same importance as, for example, the high profile campaigns on road safety or school dinners. Or take it even higher: make it compulsory for parents to attend (and pass) courses on healthy lifestyles for children, then take it to the classroom and the school gym and the school dining-room... etc.
Why not - even from the mercenary viewpoint it would save the health services of wherever you are in the world millions...

Tina said...

I get so sick of this societal belief that the road to weight loss is the strong arm method (just put your arms out and back away form the table). It is so much more complicated than that and deeper. Whether our internal food-o-meter is the result of poor habits, the result of our vegas nerve failing to give us the full signal, or our metabolism to tell us when our weight is where it should be, speedup our calorie burning and shut the voices in our head that say we need more up.

Whichever it is the medical profession has finally found a series of interventions that can provide us with hope. I think the program you watched was negligent in pandering to the strong armers by discounting the band. There are plenty of successful cases and others who chose different surgical interventions who are also successful. Statistically the rate of success on our own is abysmal (that is why all those companies put disclaimers next to success stories) and for me it is worse than abysmal.

I am only 2/3 of the way to goal and I am already more successful than I have ever been on a diet. If this had been another attempt at weight loss on my own I would have already given up by now and probably gained some of what I lost back.

I am one of three children and the only one who battles with her weight-all three of us were raised with the same food and the same prompting for exercise. I have 4 children and only one seriously battles her weight and another has a smaller weight problem. I really do not think upbringing has as much to do with it as genetics and physical issues.

Shame on the BBC or whatever channel sponsored the program.

Diz said...

WOW!!! You Ladies Rock! I so agree with all of you. I saw a program with Oprah interviewing Starr Jones and asking her why she just didn't come out with her news. Why hide it? I thought it odd for Oprah, the perputual dieter, to ask that. Starr blew her chance to talk about how bariatric surgery is not taking the easy way out, etc. That it still requires the whole damned watching what you eat, amount of food, some sort of exercise, and figuring out why you are the way you are, your triggers, etc. It is not EASY! It's so easy for everyone else to judge the decision.

Great Post!

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