NSW to fund weight loss surgery

[C~Q]

We are sending some very twisted messages to our children. We are teaching them that all that matters is how you look. As long as you look like some emaciated waif on the cover of a magazine who probably lives on cocaine and cigarettes, well that's fine. People can be active and eat healthy and still be on the heavy side. But we promote this Kate Moss ideal like it's healthy. If we want people to be healthy we should stop focusing on how they look and promote healthy eating and exercise. We should stop judging people by BMI (a worthless measure) and start judging ourselves on how healthy we are.

Are you talking about the subject at hand or are you talking about the media/Aus as a whole when you say "We"?

Of course people can be on the heavy side and still be healthy, but those aren't the people that are getting the surgery. And there is no way that you can tell me that someone who is classed as able to get the surgery is "healthy". No one is saying you either have to look like Kate Moss or be Obese.

As for BMI, it is not worthless. It's a screening tool used in conjunction with other tests to give you an IDEA of somebodies body composition. It is in no way totally acurate and it will overestimate body fat in someone who is very muscualar and underestimate body fat in older people who have lost muscle mass.

I don't believe that any Dr/fitness instructor etc uses BMI alone.

What we need to be teaching, and by that I mean showing by example, our children is how to eat a healthy, balanced diet and how to exercise and have fun. If you have a parent who drags themselves to the gym and moans about it then you're teaching that exercise is boring. If more familes get outside, go to the park, go on bikerides etc together then we could be solving all the problems in one go.

[thepixie]

Are you talking about the subject at hand or are you talking about the media/Aus as a whole when you say "We"?

This was a more generalised comment about our cultural approach to weight, diet and health.

Sure in Australia it seems at the moment that the surgery is restricted to those who seem to really need it. The trend in the States is a bit different though, and that is a worry. Not something I would want to see happen here.

[/QUOTE]I don't believe that any Dr/fitness instructor etc uses BMI alone.[/QUOTE]

Possibly not - but people certainly use it to judge themselves. And when we have teenage girls using such a crude measure to judge the appropriateness of their body weight I personally feel that we are creating a problem. But then I have a twelve year old sister so I am probably biased about this.

RachelM I really don't think we disagree. I think there needs to be more of a focus on genuine health, which means eating healthy whole food and being active.

I personally don't feel that funding obesity surgery should be the government's first health priority given the other problems already existing in the health system. That's just my opinion.

[Rouge]

I don't agree with this at all.

I would rather see a ban a tax on junk food (to be reabsorbed by making healthy foods cheaper) than I would seeing this. Or better yet take on what some city's in the world are doing and ban fast food chains.

Those operations aren't cheap, and I think the money could be better spent elsewhere especially given so many other areas are in dire need.

And FYI I'm a goddessly sized girl so I'm not having a go at anyone's size etc.

I agree with society's need to change, but some days I really do wonder if we are getting too PC. Like the clothing chain "Big City Chick" recently removed "Big" from their name! I mean C'MON surely people look in the mirror, I am big its not offensive its the bloody truth! People should get over themselves, seriously. Maybe if we stopped tip toeing around the issue people wouldn't be sitting around thinking they didn't have a problem.

[C~Q]

seriously. Maybe if we stopped tip toeing around the issue people wouldn't be sitting around thinking they didn't have a problem.

Exactly! And Pixie is right, it's not about the way people look. Heart disease, Diabetes etc can affect people of all sizes. It's what you eat and the exercise you do. Just because you happen to be blessed with a superfast metabolism doesn't mean you can eat junk and sit on your bum and not be affected by these diseases.

I would say people need to be better educated about food, portion sizes, nutrition etc but honestly the info is all out there and it is readily available. Who doesn't know that a Whopper with cheese and bacon and a large coke isn't good for you?!!

[Nai]

I would rather see a ban a tax on junk food (to be reabsorbed by making healthy foods cheaper) than I would seeing this.

I agree Cai - I would also like to see PE reintroduced as a daily activity for primary schools and Home Economics in secondary schools to teach kids about healthy choices and how to cook fresh food.

I would prefer to see a more holistic approach from the government rather than just funding surgery. I have seen a number of people go through this surgery however the outcomes have never been what you would call succeessful in the long term.

I really think the focus should be on health and long term sustainable lifestyles combined with approprite messages and education.

[visitor1]

I would also like to see PE reintroduced as a daily activity for primary schools and Home Economics in secondary schools to teach kids about healthy choices and how to cook fresh food.

When i was in primary school (hmm some 20 years ago now when i started) we had 30 mins of physical exercise every morning. Whether it be dancing, skipping with rope, jogs, a game of something etc.....it was a morning MUST. Plus we had sport day on top. Our canteen never sold one piece of junk food!

HS was a different matter...was the complete opposite....junk food galore, sport day was a hit and miss event and PE classes were so easy to get out of!

[Macca79]

I just want to begin by saying it is not my intention to start anything the following is simply my own observations as a teacher and my personal opinions.

I can't speak for High School but as a teacher in a primary school in the NT we have two hours a week compulsory PE a week and have had for a long time but I can tell you this is not helping with childhood obesity. Too often I see a child do an hour of active sport to only watch them open a lunch box from home filled with lots of little packets of tiny teddies, roll ups, chips, chicken shapes etc. Once lunch from home was a sandwich and a piece of fruit. these days it seems to me that even the simple piece of fruit has been replaced with something processed. Last year I did a 10 week unit of work on nutrition with my 5/6/7 class and was amazed when kids had to ask me if what they had was healthy. They honestly didn't know. I would ask though how much is school responsibility and how much is parental?

On Lap banding...Im obese and looking at having surgery. Why? Because I feel it is for me. If a person has this done under the public system why deny them. I am not a nurse or doc but do we deny a person who has cancer from smoking treatment or even a person who has an STD from not practicing safe sex? At the end of the day if we can make a healthier society I say lets do it. anything to get the message out there that a healthy life is the best way to go.

And as for the rise in obesity I think we have to look at our society. If so many people are becoming obese it is more then just having a few too many whoppers and cokes!

[*Efjay*]

There would have to be a very strict policy as to who is accepted into this programme. It would have to only be for people who have tried everything & are on the brink of death if nothing is done. Like those stories you see on Foxtel.

I look at most people around these days who are overweight & yes Obese but I rarely see a person who I think would need to be a part of this programme. The reason for that would be these people would be house bound.
Sure there are plenty of fat people around who could use the help but this isn't the anwser. Healthy eating, exercise & an active life will see the majority of people back to a healthy weight.

Im not over weight, never have been so I wont pretend I know what its like to diet etc & fail. But my mum is overweight & I have watched her all my life wonder why she can't shed the kilo's. I know why & I'm sure deep down Mum knows why also. Let just say she didn't say No to the offering of birthday cake on the weekend.

I look at people on the biggest looser, especially that guy thats now doing ad's for diabetes Australia. THat guy was FAT, Yet he lost the weight & looks fantastic. He had alot against him, yet he still managed & has turned his life around.


at the end of the day I don't think my tax dollars should be spent on people who just can't stick to a diet or a healthy life style.

[C~Q]

I would ask though how much is school responsibility and how much is parental? !

I totally agree that it is parental responsibility but by teaching the children at school you can be sure that you are passing on correct information and educating the parents of the future.

[/QUOTE] I am not a nurse or doc but do we deny a person who has cancer from smoking treatment or even a person who has an STD from not practicing safe sex? [/QUOTE]


I know i'm going to get lynched for saying this but I believe that if someone is being treated for lung cancer and they smoke or is waiting for a new liver and is still drinking alcohol then they don't deserve the money/time that is spent/wasted on them. In reality I know there is no way of monitering this but deep down it is the way I feel. I am not comparing this in any way to Obesity, mearly responding to the earlier comparison.

I do believe however that it is similar to the treatment that can make an addict become clean without going through withdrawels. An addict has to go through the agony of withdrawel to stop themselves from doing it again. If there is no pain and suffering then what's to stop them getting high again? I think lap band surgery is similar. If the problem that made these people over-eat isn't cured then surgery isn't going to cure it. If you have lost weight by making life changing decisions about healthy eating and exercise then you are far less likely to put it back on again. If you can look back at the hard work and sweat that it took to lose weight then how much more proud of yourself will you be and how much less likely to do it all again?

[sushee]

I think as well, that the idea that weight loss surgery, is somehow an 'magic cure-all' from years of eating badly is a bit misleading. As if you say, eat drink and do whatever you like, then if you get fat, we'll slap a lapband on you is simply not true. You have to have shown a history of trying other weight loss methods. You have to show that you have or will potentially have co-morbidities from your obesity. You have to show a commitment to changing your life. The band will always only be a tool to help you change your lifestyle. It is not a magic bullet.

It makes sense already for health funds to cover the cost of much of lapbanding surgery simply because they recognise that as a generally sound and permanent solution to obesity - it can save the fund much more money in the long term from having to pay out on obesity-related health problems. It's a financial trade off they've weighed up and have since concluded that it's worth the initial cost to prevent long term payouts. If the NSW govt have come to the same conclusion, I'm not surprised. Yes I believe education is incredibly important, and more money should be spent on it, and on making good food available and affordable, but today's obese memebrs of society need help now, and as a simple financial trade off, I can see why the state govt would think it's that initial preventative cost is a sound investment.

I do believe it should not be at the expense of money spent on education though. None of my children are obese, and in part, despite my own weight, I feel I tried to make good choices for them when they were growing up. Education starts with parents, and parents should see an investment in their own education as to how best to feed their families. But I don't see why we can't have both.

Currently, if you cannot afford private health insurance, you're in the most 'no-win' section of society, because the waiting list for wls is something like 10 years in some states (yes it can be done publicly even now). So yes, help is out there, but yes, again, because you're on a lower socio-economic rung, you don't get the kind of health care someone more affluent s getting. I don't necessarily agree with that. I think there should remain strict screening measures. I think wls should not be used willy-nilly. But I do think there is a case for it to be publicly funded.

I'd rather we funded the prevention of obesity-related problems, than fund the costs of treating those same issues later in the patients' lives.

[TheBear]

Rachel - BMI is a totally worthless screening tool - the fact that it has been seized upon by the government as primary test for public health care decisions is irresponsible.

BMI attempts to use height and weight to estimate body fat percentages, on the assumption that increased weight correlates to increased body fat. However there are numerous studies that shows that this is not a valid correlation.

As you point out not only does the BMI indicate that muscular, fit healthy people are obese, it also indicates that those that are malnourished to the point of muscle wastage are in the normal category. There are plenty of other measures and indicators that are considerably more accurate and simple to use.

I totally agree on on teaching by example, but I do have an issue with the amount of health education that is focusing on BMI based estimates of health to the detriment of the rest of the whole lifestyle/nutrition/exercise issue.

Many medics will provide referrals to available public treatments if they can, without really considering if it is in the broader best interests of the patient - they know that if it is what the patient wants then they will find another GP that is willing to refer them and go elsewhere. Our family is full of medics, this happens a lot with many different health issues.

If the health minister is able to stand up and announce that this is NSW's answer to tackling obesity then it will allow the focus on all the other, more politically challenging, aspects of the problem to be put on the back burner.

Sure, most people know that a Whopper Meal isn't an ideal part of a balanced diet, do they know how bad the "diet" products in the stores are? There is a strong case for much better public education about diet and nutrition, but there are some very powerful food businesses that are lobbying against it - many of these are not obviously in the 'junk' food business.

[C~Q]

I can't speak for the medical community but I am studying to become a personal trainer and I know that we (in the fitness industry) have been taught to use BMI in conjunction with at least 3 other body composition tests ie Waist to Hip ratio, skinfold measurements and % body fat using bioelectrical impedance. None of these by themselves are completely accurate, hell, none of them together are completely accurate but body compostion is a hard thing to determine.

I really don't understand why this thread has become an attack on BMI? Are you saying that because there is no accurate way of determining who is "Obese" and who isn't then it doesn't exist? We should all bury our heads in the sand?

There are two main factors here and I don't think anyone is disagreeing with this...diet and exercise. I agree that food companies should be more open about there products and what 'low fat' and 'diet' really mean but people also have to take responsibility and find out for themsleves.

Some of the information we were given when we touched on Nutrition last weekend was shocking to say the least. We all left the college shaking our heads wondering if it was at all possible to have a balanced diet from the food that is made available to us, the public. The worst being that a huge amount of the fruit and veg we buy in the supermarket and most independant shops can be up to 3 years old with barely any nutritious value at all - and whats left is destroyed upon cooking.

*shakes head* I don't know what the answer is but when you look at the statistics you know that something has to be done or the cost on our health system is going to be huge in the future.

[Neenee Jellybeanie]

Some of the information we were given when we touched on Nutrition last weekend was shocking to say the least. We all left the college shaking our heads wondering if it was at all possible to have a balanced diet from the food that is made available to us, the public. The worst being that a huge amount of the fruit and veg we buy in the supermarket and most independant shops can be up to 3 years old with barely any nutritious value at all - and whats left is destroyed upon cooking.

Whaaaaaaaaaaaaaaaaaat the heck?!

[C~Q]

Thats pretty much what we said! She told us to always ask if the fruit and veg was this years season - even at a Farmers Market, it's scary. She said if you weren't sure then frozen veggies were best but RAW(!) fresh veggies were best.

I think Nai's ideas are great. I couldn't believe it when I found out that kids didn't do PE every day. And HE in senior school would be fantastic.

Perhaps the government is just emabarrassed with Australias new "fattest nation" tag and it just wants to fix the problem the quickest way possible...

[TheBear]

Food Provenance will hopefully become a hot topic soon - in the same way that retailers have to disclose ingredients now, it would be great for them to display the complete history of the item - growth, harvest, storage, treatment just so that you can actually know what you are eating and make better choices. Even the organic certifications usually only have requirements pre-harvest at present.

We buy all of our fresh produce at Farmer's Markets, most of the stalls can provide this sort of history for their products - only one of the stalls tries to sell imported/stored produce and it is avoided by regular visitors to the market. Try asking the same sort of questions in your supermarket and see what sort of response you get.

Nai's ideas are spot on, but with school funding cut to the bone already these non-core academic areas of education are likely to continue to be neglected for some time.

[C~Q]

Nai's ideas are spot on, but with school funding cut to the bone already these non-core academic areas of education are likely to continue to be neglected for some time.

That's just so crazy...and sad. If we can educate people early enough then we could save ourselves so much money in the future Perhaps something extra run by the P&C using volunteers? Perfect world, I know...

ETA - I think i'm going to start another topic on Nutrition.