By Aaron the Humanist
Over many years, Aaron has gone from overweight to perfect Body Mass Index, and back again. A constant battle over what he puts in his mouth and the consequences that follow. In this article, he entertains the view that we are responsible for our choices, and that others shouldn't have to pick up the bill.
“Who are you to tell me what I can or can't do with my body?”
This was the question in my head as I started writing this article. But how much of your body are you responsible for? All of it, or just some of it? I'm writing from a UK perspective, where we have a free-at-the-point-of-need National Health Service. No matter what you do to yourself, the state (that is, everyone else) will pay the bill.
According to the Health Survey for England 2019, 67% of men and 60% of women were classified as overweight or obese, with obesity affecting 26% of adults.
In my view we as citizens hold some, if not total, responsibility for our bodies. We should take more than reasonable care to keep ourselves out of hospital. What “reasonable care” means may be a matter for debate, but at the very least I think it means that obesity should be under our control, along with smoking, drinking, drugs, and other known recreational hazards.
When I’ve made this argument in the past, friends have mentioned high risk sports as recreational hazards and yes, they can be. So maybe our healthcare systems should have exclusions for some dangerous sports. But, by and large, the health benefits from sports and fitness is positive, potentially saving the NHS money rather than being an additional cost. Most people do not suffer regular injuries as a consequence of sporting activities, but some high-risk activities such as parkour, tombstoning (jumping off high cliffs into water), or free climbing can be very dangerous and sometimes fatal.
Returning to obesity, which is not just a UK epidemic but a planetwide phenomenon, as sugars and foods have become cheaper, people are eating more. As technology grows, we move less. Do you remember when you used to have to get out of your chair to turn the TV over, answer the telephone, or go get a book? Now, we need not move from our couch for hours or entire afternoons at a time. If we didn’t need bathroom breaks, we could effectively stay there all day, if self-discipline didn’t get us to do other things.
I’m very conscious of putting on weight, and I’m running three miles every day to counter it. I’m very aware that my diet isn’t the greatest or healthiest (I love roast potatoes and chocolate, although not together), so I move more to make up for it. Being healthy, to me, is also a logical thing. I want to be able to climb a flight of stairs when I’m sixty. I want to be fit, mobile, and self-reliant up to my deathbed. Many, it seems, do not have the foresight to look that far ahead and to think, if I don’t catch this now, it's going to get worse. That in a year’s time, the three stone I put on this year will be six by next year. I would have put on three stones in 2023 based on the calories burned in that year, had I not taken up regular exercise.
When fat turns into overweight and lapses into obesity, some people turn to the state to make them thin again. But when they have neglected themselves to such a degree, why should the state pick up the very expensive bill? We could find reasons for obesity, including poor mental health, thyroid problems, and addiction, but isn't the fundamental problem eating too much and not exercising enough? The NHS is not a 'make me beautiful' service. But for certain types of surgery, particularly elective surgeries such as hip or knee replacements, patients might be required to lose weight before the procedure. This is because obesity can increase the risk of complications during and after surgery, including infections, delayed wound healing, and poor recovery outcomes. There may be BMI restrictions for treatments like IVF (in vitro fertilisation). Higher BMI levels in women can affect the success rates of fertility treatments, and losing weight can improve the chances of a successful pregnancy. In cases of diseases related to lifestyle, such as type 2 diabetes or heart disease, the NHS may offer weight management programmes as part of the treatment plan. The aim is to help patients reduce their disease risk factors through healthier lifestyles, which can sometimes be a precondition for certain treatments.
I'd like to see a national debate about taking personal responsibility for our health and fitness and to what extent the National Health Service should be expected to pick up the tab for our own neglect and bad habits.