England’s Chief medical Officer – Dame Sally Davies warned, last week that obesity is the biggest threat to women’s health and should be considered a greater threat than terrorism. In England in 2013, 56.4% of women aged 34-44 and 62% of women aged 45-54 were classified as overweight or obese. The figures [sorry about the pun] are even worse for men with 72% of those aged 35– 44 overweight, rising to 80% of the over 45s. Dame Sally said tackling obesity should be a national priority to avert a “growing health catastrophe”. England’s top doctor said obesity was so serious it should be a priority for the whole population, but particularly for women because too often it shortened their lives.
Obesity seriously increases the risk of many diseases including breast cancer, bowel cancer, cancer of the womb, type 2 diabetes, strokes, heart disease, joint and muscle problems. Only a third of adults manage 30 minutes of exercise once a week. It seems that the British are now the fattest in Europe!
What can we do about it? This week the BMA demanded a tax on sugary drinks and a ban on unhealthy food adverts targeted at children. This of course raises questions about the infringement of personal liberties. But in this country and others such as the USA and Denmark, which have introduced similar legislation, there is the growing realisation that unless we do some thing and try and tackle our unfit, overweight population our health systems might not be able to afford the consequences.
As a GP I refer the overweight to dieticians and gyms [they can attend for free – courtesy of the NHS] but doctors and dieticians get notoriously bad results – hence the rise in gastric bypass operations. Many have argued that we should pay people to lose weight and exercise, give them a monetary incentive and this would be far cheaper in the long run for the NHS. Some health bodies have already tried this. What do you think? Is this a step to far?
Childhood obesity is a major problem in the Western world. The vast majority of obese children become obese adults. About 60% of children in the USA and 50% in the UK are over weight or obese. These children will have major health issues and often psychological problems. They are not only deemed to be less attractive than their peers but less intelligent and lazy with poor will power. No wonder self esteem issues are the norm. Fat adults are likely to be less successful in their career and are passed over for promotion. However studies in the USA have shown that 75 % of parents of obese children do nothing about their child’s weight problem. The editorial of the journal of the Royal College of GPs quoted the UK National Child Measurement Programme which found that 79% of parents of overweight children do not recognise this fact and of those that do only 41% perceive this as a health risk. The state of Georgia in the USA has run a series of hard hitting adverts to try and change attitudes – see ads below.
Critics argue that this is further stigmatising fat children and adults and will increase bullying. As a GP I have had a number of difficult consultations with patients. As a doctor I feel I have a duty to tell them that their weight is probably contributing to their suffering and long term health. Last week I explained to an overweight patient with backache and knee pains that her joints and muscles were having difficulty trying to support twice the weight they were meant for; that it is like carrying a grown up person around all the time and she would feel so much better if she could lose weight. The patient reacted quite angrily and told me she had come to terms with her weight and she objected to me raising the issue. Commenting on weight has become an ethical and social mine field that reflects the stigma and psychological suffering as well as physical suffering that is a consequence of being overweight.