DR MAX PEMBERTON : Obesity threatens the NHSmore than Covid…


Here we go again! A new war is declared on obesity and this time it’s personal.

For it’s the Prime Minister himself who is leading the charge. After his brush with death courtesy of Covid-19, he has undergone something of a Damascene conversion. Now he knows the high price to be paid for those excess pounds, he’s embracing the nanny state he once so reviled.

Yesterday, Boris Johnson told the nation that, when he was admitted to intensive care back in April, ‘I was way overweight . . . I was too fat.’ This was undoubtedly a factor in the severity of his symptoms.

So he has embarked on a lighter, fitter life and is determined to persuade the rest of Britain to do the same.

Who could argue with that or with the raft of public health initiatives unveiled yesterday, from a ban on junk food TV advertisements before 9pm and ‘buy one get one free’ offers on sugar-laden fare to calorie counts, first on menus and then with alcohol likely to follow?

Who could argue with that or with the raft of public health initiatives unveiled yesterday, from a ban on junk food TV advertisements before 9pm and ‘buy one get one free’ offers on sugar-laden fare to calorie counts, first on menus and then with alcohol likely to follow?

Who could argue with that or with the raft of public health initiatives unveiled yesterday, from a ban on junk food TV advertisements before 9pm and ‘buy one get one free’ offers on sugar-laden fare to calorie counts, first on menus and then with alcohol likely to follow? 

Admirable

Confectionery displays will be outlawed and supermarkets expected to promote fruit and vegetables. Oh, and exercise will be ‘prescribed’ on the NHS.

It’s all very admirable, to be sure. There is no doubt that the NHS is groaning under the burden of overweight Britons.

We are the second fattest nation (after Malta) in Europe, with almost one adult in three clinically obese and two thirds clocking up an unhealthy weight. One child in three aged ten to 11 is also overweight or obese.

Obesity and all its related health complications — from heart disease and cancer to stroke and joint pain — are estimated to consume nearly half the entire NHS budget of £114 billion.

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Managing type 2 diabetes (being overweight increases the risk of the disease) alone costs £10 billion a year.

The situation is escalating out of control. But this new obesity strategy is just one of many unveiled by successive governments and then abandoned.

Nothing in the list of ‘initiatives’ is new and I can’t be the only doctor who is getting battle-weary of this endless, failing fight against fat.

To recap: in 2015, Public Health England (PHE) called for restrictions on supermarket promotions and junk food advertising but the recommendations were ignored.

A year later, the then-Health Secretary Jeremy Hunt announced that childhood obesity was a ‘national emergency’. He reiterated PHE’s recommendations.

Again, nothing happened. Three years passed and yet another official report was released just before then-PM Theresa May left office. Same recommendations, same end result. No change.

It’s effectively Groundhog Day. To make matters worse, the instinctively libertarian Boris Johnson has previously railed against the ‘elf and safety’ madness of interventions by the state that he is now promoting.

Yet in all this blizzard of initiatives new and old, it is clear to me that we are being denied one painful truth about obesity. It’s not the job of government or even food manufacturers to ‘do something’.

Confectionery displays will be outlawed and supermarkets expected to promote fruit and vegetables. Oh, and exercise will be ‘prescribed’ on the NHS

 Confectionery displays will be outlawed and supermarkets expected to promote fruit and vegetables. Oh, and exercise will be ‘prescribed’ on the NHS

It’s not their fault that too many people prefer junk food to jogging and pizza to Pilates. It’s not their fault that willpower is in such short supply.

As a nation, we have lost any sense of personal responsibility for our health. People are affronted at the mere suggestion that they might be to blame for their bulk. They castigate ministers for mismangement and underfunding of the NHS, yet political meddling is nothing compared with the ruination the health system faces because of the overweight.

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If one good thing has come out of the Covid-19 pandemic, it is that no one can plead ignorance of the danger of being fat. Throughout lockdown, as we watched the horrors of the crisis unfold on TV news, it was soon clear that obesity was a key risk factor in mortality rates.

What really sticks in my craw is that each Thursday millions stood on their doorsteps and clapped for NHS workers — and then went back inside and unthinkingly devoured junk food.

The truth is that anyone who cares about the NHS should make it a personal mission to maintain a healthy weight.

Responsibility

I’m aware that this is a controversial view and by all means stay fat if you want to, but don’t expect me to keep quiet about it while you’re expecting taxpayers to pay for the disproportionate burden on services that the nation’s extra weight causes.

We have every right to be disapproving — and doctors have a responsibility to point this out to patients.

Some fat people argue that being overweight is not a choice. It is. I accept that there may be complex reasons involved in obesity but this doesn’t absolve people of responsibility for their size.

Ultimately, it does come down to a choice — people choose to light up a cigarette, just as people choose to eat more food than their body needs. I abhor cruelty and fat-shaming, but that’s not the same as pretending that being fat is fine or, worse, perversely celebrating fatness, as the warped ‘body positivity’ movement would have us do.

This has fuelled an industry (which has its roots in private medicine in the U.S.) that sells obesity as a ‘disease’, its victims powerless against their rapidly expanding waistlines.

But the harsh truth is that being fat has a straightforward explanation in the vast majority of cases (though there are psychological and metabolic exceptions). If the amount of energy (as calories) that we put into our body exceeds the amount of energy we expend, this excess energy is stored as fat. So fat people are fat because they eat more food than their body needs.

Tackle

Why has pointing this out become taboo?

There is evidence that part of the problem is down to current attitudes towards obesity. A Department of Health study comparing obesity rates from 1967 with 2010 found that while less than 10 per cent of those who were obese in the 1960s failed to do anything about it, by 2010 that number had risen to more than half.

People simply don’t bother trying to lose weight any more. They see being fat as normal because there are so many more people just like them.

They have been brought up on a diet not just of junk food but on something far more damaging — a belief that nothing is their fault, that there is always someone else to blame, that they should be able to have and do whatever they want and not have to deal with the consequences.

Until we tackle that way of thinking and make a healthy weight a personal responsibility, no war on obesity or initiative stands a chance.

I will leave the last word to the newest convert to the cause. Boris Johnson: lose weight, save the NHS.

If we don’t, then it won’t be Covid that eventually brings the health service to its knees, but fat. And that really is shameful.



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