Page 36 Daily Mail, Tuesday, August 13, 2019
O
besity is one of the major
health issues of our age —
nearly a third of the UK
population is officially obese
(with a body mass index,bMi, of over 30), double the number
25 years ago.
in that time, as a nation we have put on
nearly a stone while remaining virtually
the same height, as the graphic on the far
right shows.
And it’s bad news for our health, with
obesity raising the risk of serious and
potentially life-shortening conditions
including type 2 diabetes, heart disease
and stroke. it is also linked to cancer —
around 23,000 cases a year in england
alone, according to recent analysis,
although alarming figures published last
week suggest the numbers ‘may be
considerably underestimated’.
but what can be done to halt this
apparently relentless change?
Last week, broadcaster Michael buerk
shocked many by stating in the bluntest of
terms that obese people are ‘weak, not ill’
and would cost the NHs less if their ‘greed
and bad choices’ did not lead them to keel
over in their 50s.
He was responding to a recent call from
the Royal College of Physicians to reclassify
obesity as a disease, in line with the World
Health Organisation’s classification, in order
to get to grips with the problem.
the college can only make statements
regarding its position; it is up to the
Government — ie, the secretary of state for
Health and/or NHs england — to make the
final decision to reclassify it as a disease.
‘Obesity is not a lifestyle choice caused by
individual greed but a disease caused by
health inequalities, genetic influences and
social factors,’ announced Professor
Andrew Goddard, the College’s president,
earlier this year.
so is obesity a disease? What role does
self-control play? Are yOU to blame if
you’re fat?
it’s a subject that has divided doctors.
Here, two leading experts, reprising their
arguments from a debate in the
prestigious journal the bMJ last month,
reveal their very different views...
‘IT MUST
BE TREATED
AS AN
ILLNESS’
The number of obese Britons has doubledin 25 years — but experts are torn over
how to battle the bulge. Here, two leading
doctors weigh in with VERY different views
in my opinion, they are succumbing
to an environment that has
changed dramatically over the past
50 years.
Obesity is caused by factors
largely outside our control, such as
the increased availability of cheap
processed food, sedentary lifestyles
encouraged by the reduction in
schools sports fields, and increased
stress, which may lead some people
to overeat.
Many also have a genetic
tendency to pile on the pounds. We
know people who carry certain
genes will tend to get fatter than
those who don’t — people with a
bMi of over 40 may carry hundreds
of genes that make it more likely
they will put on weight.
in fact, studies show that of all
the things which make us the
weight we are, our genetic
inheritance accounts for more
than half.
it is likely that this is due to the
way genes regulate our appetites
and it’s not simply a problem of
our own making. that is why i
believe classifying obesity as a
disease is so important.
According to the dictionary, a
disease is a condition that prevents
the body and mind from working
normally and this is definitely the
case with obesity.
it raises the risk of serious
conditions such as type 2 diabetes
and non-alcoholic fatty
liver disease (caused by a build-up
of fat in the liver, this accounts for
as many cases of cirrhosis as
alcohol), arthritis, heart
attacks and strokes, plus many
cancers including bowel, breastand womb. in fact, if you combine
obesity with type 2 diabetes, it is
the largest epidemic the world has
ever seen.
Around one death in ten in the
UK is now linked to carrying excess
fat, according to the Office for
National statistics.
but, because it is the underlying
cause of other diseases, it is not
usually mentioned on the
death certificate.
People who have a bMi over 30
but below 40 will live about four
years less than someone with a
normal body mass index (under
25). if their bMi is over 40 they will
live, on average, 12 years less.
Classifying obesity as a disease
could save thousands of lives in the
UK in the long term.
Lots of other countries, includingthe U.s. and Japan, taking their
lead from the World Health Organ-
isation, already classify it in this
way, which is helping them try to
tackle this epidemic by promoting
specialist treatments and allowing
people to access medical care via
health insurance.W
eRe we in the UK to
adopt this same classi-
fication, it would mean
preventative measures
could be put in place.
the NHs already offers weight
management courses to around
200,000 people with pre-diabetes
[where blood sugar levels are
higher than normal] every year,
which consist of 16^ sessions ofeducation about diet, support and
exercise. this could be extended if
obesity was classified as a clinical
condition. if it was labelled a
‘disease’, GPs could start holding
obesity clinics and inviting people
to regular check-ups, as they do for
those with asthma.
they could also refer them to
specialist clinics — at the moment,
this only happens when someone
has already been diagnosed with
complications of obesity such as
type 2 diabetes.
there could also be a programme
in schools to try to tackle the issue
of childhood obesity — currently
standing at around 14 per cent of
children aged ten and 11.
Classifying obesity as a disease
would also remove some of the
stigma, helping people ask for helpDISEASE
OBESITY:
OR JUST PLAIN
GREE
D
Professor John Wilding is
a consultant endocrinologist at Aintree
University Hospital, in Liverpool.
Obesity is not about greed. believe me, i
know. Over the years i have seen thousands
of patients in my clinics who are struggling
with their weight and very few are just eat-
ing too much for the pure pleasure of it.
in fact, they are desperate to change the
circumstances they are in and often associ-
ate food with guilt and shame.
the idea that they are weak-willed indi-
viduals unable properly to look after them-
selves couldn’t be farther from the truth —