The Obesity Crisis continues to deepen across the world. It is not longer a disease affecting the wealthiest population from developed nations, it affects people across all social classes in all countries. So what is causing it, what problems is it creating, what are the treatments and solutions and are they effective?
Let’s first define obesity / obese. Currently the main measure for obesity is the body mass index. This is a calculation which uses your weight and height measurements to determine how overweight (or underweight) you are.If your BMI is over 30 you are considered obese. If over 40 then you are morbidly obese (meaning that long term health problems are very likely). 25-30 and you are overweight, 18-25 and you are an ideal weight, below 18 (approximately) and you are underweight.
The BMi equation is slightly flawed as it does not take into account muscle mass – some very muscular men can be labelled obese even though they are very fit.
Obesity: From Epidemic to Pandemic, a World in Crisis
For the last decade we have been reading reports of the ongoing obesity crisis and the obesity epidemic. A recent series of articles in medical research and news journal The Lancet is now describing it as an Obesity Pandemic, which means that the problem is not on a global level.
Obesity problems are no longer restricted to wealthy Western nations. Some of the most poorest countries and now experiencing obesity problems on a larger scale the previously realised. One study in The Lancet talked of rising obesity rates in Sierra Leone. In a country which is still battling with malaria, AIDS and pneumonia, more people are developing obesity related illnesses such as high blood pressure, heart disease and diabetes.
The series of research papers in The Lancet covers 4 main areas of obesity:
- The current situation using the UK and USA as case studies
- The reasons for obesity developing on a global scale – social, economic, political, environmental
- The science of weight gain – calories, energy imbalance and bodyweight
- How to tackle the obesity pandemic – science, policy and action
It is hard to determine what is really new in this research other than the fact the problem is more widespread than previously thought. Last year I studied an Open University course, Challenging Obesity, which went into detail on many of the subjects covered by The Lancet. The latest data on the predictions of future rates and problems does make interesting reading though, here are some of the facts.
In the next 20 years we are expecting to see;
- 65 million more obese adults in America
- 11 million more obese adults in the UK
- Up to 8.5 million new cases of diabetes
- Up to 7.3 million new cases of heart disease and stroke
- Up to 669,000 new cases of cancer
- An extra $66 billion medical bill in America
- An extra £2 billion cost to the NHS in the UK
It is refreshing to see such a serious health and medical stance on obesity with an emphasis on government intervention to make changes. More funding is needed to educate and train people to tackle obesity. More effective and cost-effective solutions are required. Some small-scale trails have shown that obesity rates can be lowered. It is my belief that the only way to really tackle the problem is for governments to radically shake up the food and drinks industry. Such changes would have far-reaching effects and could seriously impact on the economy, however, it seems that action is needed.
Our Broken Society
Obesity is a problem of society. David Cameron (British prime minister) often talks about a “broken society”. Obesity is a very clear sign that something is wrong. People are literally eating their way into an early grave.
We live in a time when health and medical advancements are pushing up life expectancy all the time, when people are not only living longer lives but more fulfilling lives. But, we have the paradoxical situation that is the obesity crisis, where perfectly fit and healthy people slowly gain weight over many years without any concern or even realisation of a fast approaching and serious health problem.
Action needs to be taken and fast. However, we have already seen several times how quickly people are to rebel against new policy when it comes to health. When Jamie Oliver tried to improve the way children eat in school some parents responded by passing junk food to their kids over the school fence.
There are exercise referral schemes in the UK, however in many cases the patients are not motivated to get fit. Doctors are just passing the problem on to a different department (often a local commercial gym).
Our Obesogenic Environment
To really combat obesity we need to totally change attitudes to food and exercise. Reduce reliance on fast food restaurants, reduce advertising for fast food. Taxing TV dinners and fast food could make a difference. The reason people eat junk food is often because it is cheap.
In recent years we have seen alcohol and cigarette advertising reduce in all areas. Smoking is no longer allowed in public places in the UK which decreases not only exposure to smoke but reduces temptation to smoke. Shops are no longer allowed to display cigarettes either, they have all been pushed under the counter. Maybe a similar approach is needed for fast food? No high street signs outside shops allowed, no eating of it on the streets, no advertising. This could go some way to reducing the problem.
This is what we mean by an Obesogenic Environment. We need to change not only attitude towards eating and exercise but also reduce temptation to consume calorie dense junk food and increase opportunities to exercise.
We are becoming more obese through decades, maybe centuries, of amazing technological advancements which mean that we now consume all the calories we need and some more for a very low price. Somehow we need to change priorities and start getting the world fit again.
Millions of People are Dieting, but Obesity Still Rises
A survey by the UK supermarket chain Tesco has revealed that approximately 1 in 3 people are on what they consider to be a permanent diet to aid weight loss. However, each year there are more people recorded as being overweight or obese.
Most people in later middle age are likely to go on a diet at least once a month to try to lose some weight, or to control weight. Of these people, 15% try to restrict their calorie intake every day, which is twice as many people as in any other age group.
Experts have warned that by the 2050, 60% of adults will be overweight if action is not taken to reduce the ever increasing rates of obesity.
Exercise and Healthy Eating Required
The only way to control weight effectively in the long term is by combining regular exercise with healthy eating, as part of a healthy lifestyle. Short term fad diets and exercise routines do not work.
Weight can be lost in a few weeks on a soup diet, but long term weight control and health requires a permanent change in lifestyle.
The UK Secretary for Health, Alan Johnson, has warned that obesity poses a potential crisis on the same scale as climate change, and a government think tank has determined that 70,000 lives could be saved if Britons followed simple healthy eating guidelines.
Research has long shown that yo-yo dieting is not effective in the long term. In fact, often people put more weight on as a result of poor diet advice. In another survey, carried out by Tesco, is was revealed that 15% of adults spend up to an hour each day worrying about their weight. And as many as 5% of women worry about their figure, and their weight, for up to three hours a day.
Self Esteem and Self Confidence
Most people questioned said that self esteem and self confidence were the main reasons for dieting and trying to get into shape. About 60% of women and 45% of men said that they would feel better about the way they look, and feel more confident, if they lost some weight. 20% of respondents dieting admitted that their goal was to improve their relationships.
One surprising result of the research showed that many people are driven to want to lose weight to look more like celebrities, friends and colleagues. It is not just teenagers that desire a celebrity body, but many adults too. The research really does not reveal any startling new facts about the nature of our nation. In fact people all over the developed world are striving to attain wealthy, content lives, while at the same time paying the cost for over indulgence. For most people a permanent change in lifestyle is too great a burden to bear, so short fad yo yo diets and 2 week fat burning exercise regimes are the solution for many.
From The Android Shape to Obesogenic Pollution
Why do we keep re-branding fat? Generally, if someone as accumulated a lot of visceral fat (biological term for the fatty tissue that surrounds the internal organ and makes your belly bigger) then this is referred to as belly fat, stomach fat, beer belly or apple shaped.
However, not so long ago this body shape was called the Android Fat Distribution. When I first read this in an Open University book on Challenging Obesity, the first thing that came to my mind was Google’s Android mobile operating system, shortly followed by the androids popularized by George Lucas and subsequent science fiction novels and films. I had never heard of its use in describing fat and muscle distribution before. So, why was it abandoned in favor of “belly”, “tummy” and “beer”?
It seems that over the last 50 years 4 things have happened that seem to have a somewhat paradoxical result:
- Our understanding of obesity and its relationship with nutrition, activity, hormones and gender have advanced significantly.
- The language surrounding obesity and weight issues has been simplified so that the layperson can understand the concepts.
- The amount of information available on weight loss and specifically “losing belly fat” has increased considerably.
- People are still getting fatter.
We know why and how we gain weight. This information has been shared in an easy to understand format – visceral fat, central obesity and android fat distribution being replaced with belly fat and apple shaped. Also, the methods required to reverse weight gain are readily available in many formats, from websites, ebooks, real books, videos, television documentaries, government health leaflets and education in schools. Yet, we still get fatter.
There is some good news. A recent report suggested that life expectancy in Europe has risen again, in spite of the fact that rates of obesity continue to rise. Also, a report from the USA suggested that rates of obesity were starting the level off, in some places.
For a long time it was argued that education was all that was required to reverse the increasing rates of obesity. However, the facts seem to tell a different story. All the information in the World is failing to stop people overeating. Why? What are we doing wrong, as individuals and as nations?
The reason, it seems, is partly environmental, at least in terms of the social and economic environment. We are living in the World where humans no longer need to work, that is use energy, to obtain food. Instead food is literally delivered on a plate.
Obesogenic environment is the term now used by nutritionists and health scientists to describe the mess we have got ourselves into. I have a better term - Obesogenic Pollution.
Supermarkets now have multi-story car parks with travelators and elevators (one of my local supermarkets actually has both travelators and elevators, as well as car parking spaces about 20 steps from the entrance of the store). Some supermarkets deliver groceries (one of them will even carry your shopping into your kitchen for you). Fast food restaurants and takeaways seem to still be on the rise, with “coffee shops” joining in on the action.
There are more cars on the streets and fewer people on bicycles. Schools are often far from homes, and where they are close, parents fear for their child’s safety so do not let them walk. There are more indoor distractions too so kids rarely leave the house. More working mothers mean less healthy home cooked meals and more ready meals and junk food. This is all a form of pollution.
I call it pollution because it spreads uncontrollably into peoples lives. If inflicts disease and causes ill health. It is a man made problem that can be reversed if there are changes to the way we live.
To reverse this is not to change the way we think about food (i.e. educating more people), it is to change the core of society today. We have built a new world around us to make every single part of living easier, and this is backfiring. Rather than improving quality of life, we are making our lives poorer, in terms of happiness, mental health and physical well-being. Our own obesogenic pollution is slowly strangling us in visceral fat, smothering our lungs and devouring our hearts. It is slowly killing us.
How can we change it?
Pleasure Is The Cause Of Obesity
Health reporter for the BBC, Michael Mosley, looked at pleasure and how it explains the problem of obesity. The simple truth is, for many people eating is just so pleasurable. You eat, you feel good. Desire for short term pleasure is stronger than our desire for long term health.
“pleasure is simply a short-term reward for doing what your body wants”
Before the development of food manufacturing, food was generally scarce. People often would “binge” on a meal, eating far too many calories by in one sitting by today’s standards, and then not eat for several days afterwards, or only eat small items of food. The pleasure aspect of eating would ensure that when food was available we would eat until our hearts content.
However, food scarcity is no longer a problem, but gaining pleasure from eating is still there. There is a saying that we first quoted on our advice page for overweight teenagers;
“Nothing tastes as good as thin feels.”
This really does help some people to control their appetite. Making the concious effort before eating to remember your ultimate goal, to lose weight and get fit, can really help you to manage overeating.
This was actually the advice that Dr. Phil gave to a teenage girl on one of his shows too. Dr. Phil managed to explain to a teenager really well that if they adopt the attitude that the immediate pleasure they get from eating will never make them as happy as the long term pleasure they get from maintaining a healthy weight and being active then this alone can help them to stop eating.
The fact of the matter is that some people simply find it harder to control their appetite. We all need more or less the same amount of food to maintain a healthy body, something which is evident in army mess halls, prisons where the same portions are served up to everyone and generally everyone continues to stay fit and healthy.
So to overcome your weight problems you really have to first accept the fact that you are the problem, i.e. your own mind is playing tricks with you to encourage you to eat more food. If the situation is out of hand then no diet or fitness plan will actually help in the long term as you will continue to sneak in those extra calories. This is why so many diets fail to help people lose weight.
Is The Obesity Crisis Now Under Control?
In 2009 the National Heart Forum announced that the rate at which children are becoming obese has fallen. The number of boys predicted to be overweight or obese by 2020 is now 30% instead of the 42% previously predicted. It seems that girls are doing better than boys too, with predicted numbers falling from 42% to 27%. This is still a huge number of children that are likely to be of an unhealthy weight though.
The research was carried out by National Heart Forum. They had this to say on the matter:
“These trends present a more positive picture that obesity may be leveling off in children. However, prevalence and current trends of excess weight are still unacceptably high and these figures should not be taken as an argument for complacency. The government needs to keep up the work they are doing to tackle obesity.” Prof. Klim McPherson
Obesity rates have been rising since the 1970′s. A combination of more home comforts, central heating, processed foods and television have all helps to fuel the epidemic. Before the 1970′s children would play outside a majority of the time – there was simply nothing to do in the house – not even television to watch. Children played with friends, usually being out for most of the day. Now all this has changed. It has taken the nation 40 years to take some control of the obesity epidemic, but we may now be getting to on top of the problem.
The next task is much bigger – to reverse the problem. The current credit crunch is making things worse again, with cheaper and less healthy food options being chosen. However, people are now more aware of the health problems and spotting the signs of weight gain before the problem becomes almost impossible to manage. As more parents realize that they are responsible for encouraging their children to exercise more and eat healthily, the rates of obesity should decline.
However, this report does seems to conflict with the findings of other local studies from the health care community.
UK Obesity Epedimic Continues
It seems that not even with Jamie Oliver’s help can we stop the growing trend of obesity amongst children in the UK. Recent local government reports have revealed that in 2007 seven morbidly obese children had to be taken into care by social services on the grounds of serious neglect. In one case, a 6 year old boy was seriously overweight due to being constantly fed, and receiving almost no physical activity.
In other reported cases, a seven year old with a body mass index 300% higher than that of the average healthy child, and an 8 year old girl weighed 57kg (9 stone), were taking from their parents and put in to protective care. These are the first cases that we have heard of were the government has had to intervene to put child health first.
Still on the subject of child health, Redbridge council in London has adopted new rules regarding adoption. Smokers will no longer be able to adopt children. This rule is brought in to protect the human rights of children placed under adoption, i.e. the right to breath clean air. The rule will not be in full effect until 2010 – until then smoking will be factored in to the decision on whether a family can adopt or not, but from 2010 no smokers in Redbridge will be able to adopt. Cancer researchers have praised this approach, however Smokers Rights groups feel that the health of the child does not come first, and have labelled the London borough councillors as “health fascists”.
10% Of The World Is Obese
In early 2011 a project lead by scientists from Harvard and Imperial College London determined that 1 in 10 people in the World are now obese. The research was funded by the Bill & Melinda Gates Foundation and World Health Organisation.
The study period ended in 2008 but the results have only just been published. In 2008, almost 10% of all men and 14% of all women in the World were classified as obese, based on a body mass index over 30. The World leaders in the obesity race are America, UK, Australia and New Zealand. However, all countries have seen a rise in rates.
“The USA had the highest BMI of high-income countries. In 2008, an estimated 1·46 billion adults (1·41—1·51 billion) worldwide had BMI of 25 kg/m2 or greater, of these 205 million men (193—217 million) and 297 million women (280—315 million) were obese.”
High Blood Pressure and Cholesterol Falls
Some good news from the study – rates of high blood pressure and cholesterol have fallen. This may be the result of the changes to diet with less high fat food and salt eaten.
“The good news is that there have been impressive declines in blood pressure in many high-income countries and in cholesterol in many Western high-income countries” Dr. Majid Ezzati.
However, fats have been replaced with refined carbohydrates which are causing problems of their own.
Diet and Exercise to Lose Weight
The problems and causes of obesity are known and understood. People are eating too much and not exercising enough. To overcome obesity the developed World needs to change its attitude towards food and leisure. For many the easiest way to start losing weight is to follow a structured diet and exercise plan.
People generally overeat due to the fact that food is now in such plentiful supply and the food on sale is often energy dense. Refined carbohydrates are the biggest problem, along with the increase use of sugars in processed foods.
Europe Is Getting Fatter – Half of Europeans are Overweight
Latest figures from the The European Commission and the Organisation for Economic Co-operation and Development (OECD) show that half of Europeans are now overweight. Europe is quickly catching up with America in the obesity race. Children continue to suffer, with 1 in 7 children being overweight or obese. Overweight children tend to go on to become overweight or obese adults, and rates of diabetes and cardio vascular disease caused by weight problems continues to rise.
European Commissioner for Health and Consumer Policy, John Dalli, told the BBC: “In order to reverse the growing trend in obesity and other health problems in the EU we need reliable and up-to-date data to underpin the action we take as policymakers.”
However, there has already been so much research into the causes of obesity, researchers already know the main problems:
- Food advertising and marketing
- Under-regulated fast food industry
- Under-regulated processed food industry
People becomes overweight because energy dense food is so readily available. A study in Singapore showed a very close relationship with the growth of fast food shops and rising type 2 diabetes rates between 1975 and 1995. This trend has been seen all over Europe and America in the last 30 years, and continues to rise.
Although exercise and activity is important for good health, the main cause of obesity is not that people are living a more sedantary life, it is that they are eating too much. Overweight people tend to be less active, not vice versa.
Who Are The Healthiest People in Europe?
According to the study to top 10 healthiest countries, in terms of obesity, are (% figures related to the percentage of the population that are obese):
- Romania – 7.9%
- Switzerland – 8.1%
- Italy – 9.9%
- Norway – 10%
- Sweden – 10.2%
- Netherlands – 11.1%
- France – 11.2%
- Denmark – 11.4%
- Bulgaria – 11.5%
- Austria – 12.4%
On average 15.5% of people are obese across all of Europe. The UK is the most obese nation, with 24.5% of people obese. Ireland is not far behind with 23% obese.
Catching Up With America
Some European countries are certainly catching up with America. Obesity rates in many American states are now over 30%, with 34.4% obese in Oregon and 33% obese in New Mexico. Some states are fairing better though, although still worse that the best European countries. In Colorado 18.6% of people are obese (the slimmest state in America), and in Washington DC 19.7% are obese. (Source: www.cdc.gov/obesity/data/trends.html)
Figures in America are now suggesting that obesity rates have actually hit a plateau, which means that although Europe is lagging behind, it could soon match American obesity levels. Latest statistics from the Centers for Disease Control and Prevention suggest that obesity rates have remained constant over the 5 years from 2005-2010.
Also, African-America tend to have higher rates of obesity than non-Hispanic whites which could be the main factor for the lower levels of obesity in Europe, and the higher than average levels in the UK. Demographics may be playing a greater role now than exposure to junk food.
The OECD’s report, Health at a Glance Europe 2010 Report, is available in their online library for members. It provides a wide range of data on the current health of Europe.
Even Australians Are Now Too Fat
In 2009 statistics revealed that 60% of Australians are overwieght. Australia has for a long time had an image of being a healthy and fit nation, enjoying outdoor pursuits in the sunshine. However, like the USA and UK, they are getting fatter and fatter.
Also Australian children are becoming more overweight, which are signs that the problem is increasing, as overweight children generally become overweight adults.
This news comes out at the same time that Jamie Oliver, the cheeky Cockney chef famous for his school dinners campaign, is flying off to America to carry his campaign on there. The USA now boasts a staggering obesity rate, with 1 in 3 people being obese. Jamie Oliver has signed up with ABC TV to showcase his healthy eating philosophy.
Jamie plans to educate America about the problems of a junk food diet. For many Americans, junk food is normal, and they just do not know the difference. A nation brought up on fast food chains considers a quarter pounder with cheese and a side salad to be a healthy choice. We wish Jamie the best of luck, but are also reminded of the Supersize Me documentary, and have to ask, will America listen to Jamie Oliver? Maybe we should send in Gordon Ramsey, as Americans respect his more forward approach. Jamie, forget about America, Australia needs you!
Supermarkets a Key Part of Obesogenic Environment
Researchers at the University of North Carolina and Art Carden of Rhodes College have shown that there is a strong connection between the spread of Wal-Mart Supercenters across America and rising rates of Obesity.
What is an Obesogenic Environment?
An obesogenic environment is a term used to explain circumstances that make a person more likely to become obese. Humans have not changed genetically or intellectually in the last 100 years, however, we have become fatter. The increasing tendency to be obese is not caused by any hormonal, genetic or social changes, as these have remained mostly unchanged. The problem of obesity stems from a changing environment. Some factors affect the environment more than others.
Wal-Mart Superstores Increase Obesity by 2.3%
According to the latest research published in the Journal of Urban Economics for every single new Wal-Mart superstore per 100,000 residents the chances of becoming obese are increased by 2.3%. This is a relatively massive increase in obesity. The researchers go on to suggest that the spread of Wal-Mart stores is the cause of 10.5% of all new obesity cases in the USA since the 1980′s. One of the reasons given is that Walmart has managed to significantly reduce the cost of food.
“An additional Supercenter per 100,000 residents increases average BMI by 0.25 units and the obesity rate by 2.4 percentage points. These results imply that the proliferation of Walmart Supercenters explains 11% of the rise in obesity since the late 1980s, but the resulting increase in medical expenditures offsets only a small portion of consumers’ savings from shopping at Supercenters.” Charles Courtemanche, University of North Carolina.
However, during this time when Wal-Mart supercenters were on the increase other factors that leads to increased obesity have also been increasing.
Other studies have shown that there is a perfect correlation (when one increase follows another) between the number of fast food restaurants and rates of type 2 diabetes. It could be a case that when a new Wal-Mart store opens other services follow that also change the obesogenic environment for the worse.
One additional effect supercenters have is they reduce daily total energy expenditure (number of calories burned). Before supermarkets and the car women would generally shop many times each week, and often walk with their shopping. So each week a woman would clock up a lot of miles walking, while carrying heavy bags. Nowadays people can drive to a supermarket, fill a trolley with enough food to last 2 weeks, then push the trolley to their car and drive home. This massively reduces the amount of calories that a person will burn in a week.
Other factors such as increasing numbers of women in employment, more ready meal options available, an increasing reliance on cars and more disposable income also contribute to rising obesity rates.
It is a fact that the children of mothers that are in full time work are on average more overweight than moms that stay at home to cook healthy meals and raise their own children.
There could also be a link to moms staying home and higher rates of breastfeeding which may affect future obesity (research not conclusive on this at the moment).
Although supermarkets such as Wal-Mart are certainly a part of the ever developing obesogenic environment, they are not the sole cause. The way we live, interact, eat and play have all fundamentally changed since the middle of the last century, and all of these factors have increased the likelihood of becoming overweight.
Also, many supermarkets are now trying to combat obesity by encouraging healthy living. Although in A Supermarket’s Guide To Healthy Eating we did point out that at the time of writing their website was not offering any visible advice on healthy eating and weight management.
McDonalds Start Displaying Calories on Menu Boards in the UK
From Sep 5, 2011 McDonald’s started to display calories on menu boards in restaurants across the UK in the scheme set up by the Department of Health called “The Responsibility Deal”. It is a voluntary scheme.
A typical salad meal at McDonald’s contains in the region of 400 kcal, a burger meal (burger, chips and a drink) contains 1000 Calories which is 50% of all calories an average woman should eat in a day. The Sky News health correspondent Thomas Moore has pointed out that there are not really any “healthy” options at McDonald’s because even the salads are very high in calories. A healthy diet not only contains a good balance of macronutrients (carbs, fats and proteins) and micronutrients (vitamins and minerals) but also a healthy calories restriction.
A study carried out by McDonald’s found that only 17% of their consumers were likely to take any notice of the calorie figures on menus. Some people are simply not interested in improving their health with many others refusing to believe that their lifestyle will eventually cause serious health problems.
UK Health Secretary, Andrew Lansley MP added that 1 in 6 meals are now taken out of the home and these are often very high in calories. Many people still under-estimate the number of calories that is in the food they are eating.
KFC, Pizza Hut and Starbucks have also signed up to the Department of Health scheme. It is hoped that this will go some way to teach people not only how many calories are in the food that they buy but also how many calories are needed each day.
One big question is, why is this scheme only voluntary? The evidence is there that it is the rising power of the food industry that is causing obesity. When will governments take more radical intervention to reduce the influence of advertising and marketing on food choices?
The very businesses which are on the one hand now trying to convince us that they are providing a healthy way of eating are now agreeing to display calories on menus. But how many people know how many calories they really need or have already consumed that day already? Will this scheme really deter anyone from ordering burger, fries and a soft drink instead of buying some fruit and cooking some fresh chicken?
Problems with Anti-obesity Drugs – Rimonabant Suspended Due to Psychiatric Risks
In October 2008 an anti-obesity drug that has been successful at aiding weight loss in morbidly obese patients is being retracted due to evidence that it poses a psychiatric risk. The European drugs watchdog is recommending doctors to stop prescribing the anti-obesity drug rimonabant, (aka Acomplia). The European Medicines Agency has stated that it believes there to be serious risks of psychiatric disorders developing as a side effect of the drug. There is no way to determine who is at risk, and who is not, therefore the recommendation is for the drug to be withdrawn completely. It is advisable that people taking Acomplia should speak to their GP as soon as possible, although they do not need to immediately stop taking the drug.
Approximately 97,000 obese or overweight people in the UK have been prescribed rimonabant. The drug is prescribed with a diet and exercise regime. Currently about 20,000 are on the drug. It was only approved in June of 2008 for use by the NHS.
The concerns are not new however, as trails suggested that it could cause depression and even suicide. In July last year, the EMEA warned it may be unsafe for patients who are also taking anti-depressants. GP’s were also warned not to prescribe it to patients with a history of depression.
Recent studies have indicated that the risks are much higher than previously thought with around double the risk of psychiatric disorders in obese or overweight patients taking rimonabant compared to those taking a placebo. Between June and August 2008, there were five suicides among patients taking part in a trial who were on the drug, compared with one among those taking a placebo. These were seen in a total of around 36,000 patients.
“Prescribers should not issue any prescriptions for Acomplia [rimonabant] and should review the treatment of patients currently taking the medicine. Patients who are currently taking Acomplia should consult their doctor or pharmacist at a convenient time to discuss their treatment. There is no need for patients to stop treatment with Acomplia immediately, but patients who wish to stop can do so at any time.” EMEA statement.
In a statement, Sanofi-Aventis said it would comply with the EMEA’s decision, but that it believed rimonabant would remain “an important therapeutic answer to a highly prevalent and increasing unmet medical need”.
“My patients were doing very well on it, and they will now have to stop and come off it. Patient safety must be foremost, but I always thought that if you ruled out the patients with depression, you ruled out the problem with the drug.” Dr Colin Waine, chairman of the National Obesity Forum.
Some doctors still believe that the risks of temporary mental disorders is acceptable considering the serious ill effects of long term obesity, i.e. heart disease, stroke, diabetes and increased risk of cancer, plus the fact that many morbidly obese patients suffer from depression also. However, this latest research, showing that there is a real risk that the drug can lead to severe cases of depression, and suicide, would suggest that the risk factors are no longer acceptable.
Unfortunately there is no safe way for the morbidly obese to lose weight, as invasive measures such as stomach stapling and gastric band surgery both have known risks associated with major surgery. The long term solution is improved education in schools, with physical education classes emphasised from a younger age. Many people feel that physical training should be brought back into schools, as traditional “old school” fitness training is often the most effective means of getting people fit, and teaching people how to stay fit.
This highlights the problems of trying to tackle a diet and social problem with medication. The side effects are can be more dangerous than the condition.
Type 2 Diabetes Cases Rise
The number of people in the UK with diabetes has risen rapidly over the last year, according to UK charity Diabetes UK. Type 2 Diabetes is mostly caused by poor diet and obesity. This trend is being seen all across the world.
The number of cases of diabetes in the UK increases by around 150,000 every year. Around 3 million people now diagnosed with diabetes in the UK.
“Once again we see a shocking rise in diabetes and obesity rates in the UK,” said Simon O’Neill, Diabetes UK Director of Care.
Diabetes UK has described the statistics as “shocking”. The reason for the rise is attributed to an increase in the number of people overweight or obese. Obesity is leading to a Type 2 Diabetes epidemic.
Most people are still unaware of the serious nature of diabetes and the fact that obesity is a major trigger. Diabetes causes increased risk of heart disease, stroke and kidney failure, as well as limb amputations and blindness.
Diabetes UK say that people at increased risk of Type 2 diabetes can often decrease or even reverse their risk by losing weight, increasing their physical activity levels and improving their diet.
A healthy diet that is low in sugar and regular exercise can lead to rapid improvements in health and wellbeing.
Find out your risk of Type 2 diabetes
The test will tell you the likelihood of you having diabetes now and also the chances of developing it in the next 10 years. Take the test, and if you need to lose weight, come back here and we can help you.
Diabetes Causes 100 Limbs To Be Amputated Every Week in the UK
Diabetes is responsible for approximately 100 limbs being amputated each week in the UK. Type 2 Diabetes is mostly caused by obesity, and the obesity epidemic is still on the rise. People suffering from diabetes are 15 times more likely to have a limb amputated than those who do not have the disease. In addition to the risk of losing limbs, due to ulcers and infections, diabetes also causes blindness, kidney failure, heart disease and heart attacks, and strokes. These are some of the biggest killers facing society today, and many cases are as a result of being severely overweight and obese.
More shocking than the amputations themselves is the fact that about 70% of amputees die within 5 years of the operation. The amputations lead to greater immobility, and this in turns leads to even more weight gain and further health problems.
Amputations are required when ulcers in the feet and legs become infected and lead to gangrene. Once gangrene is set in, the only option is to amputate. However, if infections are caught early, amputation can be avoided. Greater awareness of the risks of diabetes and obesity is required to reduce the number of amputations that are carried out each week.
The easiest way to mitigate the risk of losing a limb to diabetes is to not become diabetic in the first place, and to do this, a healthy diet, and exercise are essential. Keeping your weight down to a healthy level (ideally below BMI 30) and limited refined sugars in your diet are the best ways to prevent type 2 diabetes. Research has shown that women with high blood pressure are 300% more likely to develop diabetes, and diet and exercises are the easiest way to reduce blood pressure.
Both type 1 and type 2 diabetes can lead to ulcers and amputation. Although type 1 diabetes often develops in childhood, whereas type 2 is mostly diet and health related. It is estimated that there are half a million people in the UK suffering from type 2 diabetes who are unaware of their condition.
Symptoms of Type 2 Diabetes:
- Excessive thirst
- Passing of excessive amounts of urine
- Fatigue and tiredness
- Mood changes
- Frequent skin infections e.g. boils
- Genital itching or recurrent thrush
- Muscular weakness
- Severe hunger pangs
Both types of diabetes can be treated by diet and exercise, to ensure that levels of glucose in the blood are as near to normal as possible. Together with a healthy lifestyle, this will help improve well-being and protect against possible long-term damage to the eyes, kidneys, nerves, heart and major blood vessels.
Type 2 diabetes is really treated by losing weight and reducing intake of sugar. Eating well balanced meals with plenty of healthy salads, fresh fruits and fresh vegetables, and limiting all forms of sugar, such as junk food, cakes, biscuits and ice cream. A low GI diet can help, and also the Atkins Nutritional Approach has been shown to help, although the high fat content of this diet can cause problems.
If you are suffering from any of the above symptoms on a regular basis it is essential to seek medical advice as soon as possible. Diagnosis can be the greatest motivation for some people to make the effort to lose weight and eat healthily.
Research Shows That Obesity Increases Risk of Death from Heart Disease by 82%
Research carried out by scientists at the Karolinska Institute in Stockholm and published in the British Medical Journal in 2009 has shown than obesity is more dangerous to health than previously realized. The study looked at a million families and analysed the health and weight of the father and sons. The results showed a strong indication that obese sons of healthy fathers are 82% more likely to develop and die from cardiovascular disease.
The purpose of the study was to actually determine the effects of weight on the development of cancer. Results showed that contrary to the previous held idea that being underweight lead to an increased risk of cancer, that being overweight was the real problem. As people tend to lose a lot of weight when suffering from cancer, it was concluded that a low bodyweight increased risk. The reverse is true.
“Our analysis of the effects of BMI on mortality using offspring BMI as an indicator of adult BMI shows positive associationsbetween offspring BMI and parental mortality from cardiovasculardisease, diabetes, and some cancers.”
What was previously understood on this topic
- A high body mass index was connected with higher rates of cardiovascular disease and some forms of cancer.
- Having a low BMI was related to increase in respiratory diseases and specifically lung cancer.
- Although there is a known connection between low BMI and incidence of lung cancer, it was not known if low BMI increased the likelihood of lung cancer, or if it was caused by the effects of the cancer.
What This Study Has Proved and Added
- Using data from father and sons they have proved that a high body mass index is linked with increased mortality form heart disease, diabetes and some cancers.
- The results have shown that having a low body mass index not lead to increased risk of respiratory disease and lung cancer.
- The results have shown that having a high BMI, i.e. being very obese, leads to greater risk of serious illness than previously thought.
Obesity Is Increasing Cancer Deaths
Recent studies have proven that obesity is the cause of an increasing number of cancer related deaths. And obesity is still on the increase. It is expected that the credit crunch will actually increase the number of obese in America and the UK.
It is estimated that cancer will affect twice as many people by 2050. Prof. Martin Wiseman, from the World Cancer Research Fund, said that after not smoking, maintaining a healthy weight is the most important thing you can do to help to prevent cancer.
However, these results are not new, as research published in 2003 revealed that being overweight or obese may account for 20% of all cancer deaths in US women and 14% in US men. At the time, that meant that 90,000 cancer deaths could be prevented each year if Americans maintained a normal, healthy body weight. Since 2003 rates of obesity have risen further.
In 2007 research by the U.S. National Cancer Institute revealed that obesity can double a man’s risk of dying from prostate cancer. Men with a BMI of 35 or higher had twice the risk of dying from prostate cancer as men with a BMI of less than 25.
“The growing prevalence of obesity in Western countries is alarming, and reducing the risk of prostate cancer death is only one among many health reasons to maintain a healthy weight through diet and exercise,” Dr. Wright, NCI Division of Cancer Epidemiology and Genetics.
Once again, the advice is clear – lose weight and get fit to live longer. Although this research is vital in finding cures and improving medicine to treat cancer, it is not actually providing anything fundamentally new with regards to the problems that a poor diet and being overweight can cause. The big question is really, how to we persuade a nation to lose weight and get fit? Are the scare tactics working on enough of the population to make a difference? In fact, are the people most at risk reading this?
Cancers Linked With Obesity
By choosing a healthy diet and avoiding alcohol you could reduce your risk of the following cancers:
- breast (in post menopausal women)
- mouth, pharynx and larynx
Obesity and Pancreatic Cancer
Research carried out by Sweden’s Karolinska Institute, and published in the British Journal of Cancer in July 2008, shows that obesity increases risk of developing pancreatic cancer. The research revealed that obese women are 70% more likely to develop pancreatic cancer than women of a healthy weight. Carrying excess weight around the stomach is the greatest cause of the increase in risk.
Previous research had highlighted that obese men are at the greatest risk of developing cancer due to the excess belly fat - men naturally get fat around the stomach, whereas women put fat on around the thighs, buttocks and breasts first.
Surviving Pancreatic Cancer is Extremely Uncommon
The study follows 138,000 post menopausal women over a period of seven years. During this time, 251 women developed pancreatic cancer.
Lead researcher Dr Juhua Luo said: “We found that the risk of developing pancreatic cancer was significantly raised in obese post menopausal women who carry most of their excess weight around the stomach.”
Pancreatic cancer is the 6th most common cancer in the UK, and it is very difficult to treat once diagnosed, with mortality rates being at 97-98% after 5 years of diagnosis. Surviving pancreatic cancer is extremely uncommon.
Obesity is still on the increase in the Western world. Although many people, such as celebrity chefs, politicians and athletes, are working hard to help combat the obesity crisis, more people are becoming overweight and obese, which will cause an increase in cases of pancreatic cancer as well as cancer of colon, heart disease and diabetes.
The reasons for the increase risk of pancreatic cancer amongst the obese is not clear. Researchers have suggested that insulin plays a role.
Dr Luo said: “We know that carrying a high proportion of abdominal fat is associated with increased levels of insulin, so we think this may cause the link between obesity and pancreatic cancer.”
Researchers reminded that being overweight may also be responsible for other forms of cancer, such as breast cancer, cancers of the kidney, oesophagus and endometrium, and bowel cancer, which is biggest cancer killer after lung cancer.
To reduce risk of developing cancer, losing weight is essential. Check your body mass index, and if you are overweight, start exercising and dieting to lose your belly fat.
Cost of Obesity Could Cripple Government Programs and Health Insurance Companies
The Obesity Epidemic continues to impact on the American economy as well as its people. Over the past 10 years spending on obesity related medical problems has incrased by 87%, reaching $147 billion in 2008. It is estimated that each obese patient costs health insurance companies and government health programs approximately $1429 more each year than a person of a healthy weight. This means that obese people are costing the country 42% more in health bills.
Obesity rates continue to rise in America (and most other developed nations) which is going to place further burden on health services in future years. It is now thought that 32% of all American adults are obese (i.e. BMI is over 30).
President Barack Obama has pledged that he wants to reduce the rising cost of health care and to provide improved services to the American people. It is becoming apparent that action has to be taken on a national level if America is to ever have a state funded health care system, as currently obesity is going to cripple the economy.
Abstract: In 1998 the medical costs of obesity were estimated to be as high as $78.5 billion, with roughly half financed by Medicare and Medicaid. This analysis presents updated estimates of the costs of obesity for the United States across payers (Medicare, Medicaid, and private insurers), in separate categories for inpatient, non-inpatient, and prescription drug spending. We found that the increased prevalence of obesity is responsible for almost $40 billion of increased medical spending through 2006, including $7 billion in Medicare prescription drug costs. We estimate that the medical costs of obesity could have risen to $147 billion per year by 2008. [Health Affairs 28, no. 5 (2009): w822-w831 (published online 27 July 2009; 10.1377/hlthaff.28.5.w822)]
- Medicare is a social health insurance program administered by the American government, which provides health insurance to people from 65 year old, or who meet other special criteria.
- Medicaid is the United States health program for people on low incomes that cannot afford private health insurance.
Health Policy Should Focus on Obesity and not Inactivity
There is a clear link between inactivity, obesity and associated diseases such as cardiovascular disease, type 2 diabetes,reduced functional capacity, and poorer mental health. However, a recent paper published in the British Medical Journal explains why Government health policy should focus on the obesity problem and not the inactivity problem.
Timothy Gill is the principal research fellow at Sydney University and says in his paper that although for longterm good health we need to be active and eat a healthy, balanced diet, focusing on activity alone is often counter productive to helping people to lose weight. A strategy that only targets inactivity, encourages people to exercise more without providing advice and support on healthy eating and other lifestyle factors. Therefore it is not very effective at helping people to lose weight and become fitter people in the long term.
The biggest problem is due to poor quality nutrition, such as the consumption of energy dense junk food, foods low in nutritional value, high in sugar and salt, low in dietary fiber, over-sized portion sizes and sweetened soft drinks (soda especially) which are all major contributers to the obesity problems. These nutritional factors also lead to an increase in dental problems, hypertension (high blood pressure) and many forms of cancer. The argument put forward by Gills is that any health policy that ignores nutrition and only looks at exercise is flawed.
Exercise alone does not have a big impact on reducing obesity. Studies have shown that overweight people that exercise but do not diet rarely are successful in losing weight. Another factor that is overlooked when promoting only physical activity is that social attitudes towards food and health do not change. Many people that are unable to exercise and overweight, especially the less able, may feel that they have no chance of ever losing weight as they cannot exercise.
“initiativesmust include efforts to improve physical activity in additionto diet and other behavioural issues, but also require greaterattention to the pervasive structural, economic, and socialfactors that influence our ability to change behaviours favourably”.
To really help people lose weight, in addition to improved advice and support about nutrition and exercise, governments need to seriously look at urban planning to discourage reliance on cars, improving distribution of locally produced fresh food as well as food pricing. Our society now sees healthy food as the expensive, middle class option. Fast food is cheap, healthy organic food costs the earth.
Much progress has been made in recent years in educating children and adults on the need for a more complete approach to weight issues, however often this advice falls on death ears. When Jamie Oliver tried to improve children’s school dinners parents protested and passed junk food through the school fence. People still continue to either ignore the advice given or simply fear fresh fruit and vegetables. Many people say that they cannot eat fruit, or do not like vegetables, without ever really trying them.
The only way to really make a difference is to really shake up how food is produced and distributed and place more regulation on junk food. A few years ago there was talk of taxing high fat foods. Although this method is flawed, there is certainly scope for taxing processed foods and fast food and provide more incentives for farmers to produce a variety of produce that can be sold locally.
However, saying all of this, healthy policy must not do a complete U-turn and forget about the importance of exercise too. For a healthy society diet and exercise need to go hand in hand. Everyone needs to be encouraged to be more active and to eat a healthy diet. These two factors alone will go a long way to reducing overweight and obesity levels, as well as cutting other chronic illnesses such as diabetes, cancer, heart disease and stroke.
Should Junk Food be Taxed To End Obesity?
The BBC’s Panorama show asked “Would taxing junk food help tackle the UK’s obesity crisis?”. Jeremy Vine presented the arguments.
The UK is that fattest nation in Europe, and health experts are now suggesting that we need to now look to “tax the fat”.
By 2050 1 in 4 children will be obese, and recent studies have shown that obese children are very likely to go on to become morbidly obese adults. Children often shop for junk food themselves – it is not just parents and schools that control their eating, they have pocket money and can buy junk food whenver they want. Type 2 Diabetes is on the increase and this leads to many serious health problems.
One case study looked at 11 year old Danny who is clinically obese. His mother is a boxing coach, but Danny’s condition puts him off wanting to train due to low self esteem. Danny and his mom do not think that a 25% tax on chocolate would not make a difference. A 50% increase may stop her from buying.
Public Health Disaster
Adults so obese that they cannot walk, many have serious heart problems and are literally disabled as a result of eating. People still consider obesity to be a harmless condition, just an inconvenience. The truth is that it leads to many serious illnesses that result in early death and a much lower quality of life.
Taxation on unhealthy food is needed
There is an argument that unhealthy food should be taxed. However, this could just result in more budget brands being sold in place of the premium and well established brands. Would a tax encourage people to buy less of the unhealthy foods and more of the healthy foods?
The UK Health Secretary, Andrew Lansley, does not think that a tax can be a good idea. He explains that a nudge is good, a tax is a shove. He does not think that the public feel that a covert tax would be accepted by the public.
The Smoking Story
Smoking was taxed and this has had a direct impact on the reduction of new cases of lung cancer. Many health experts are asking then, why not tax unhealthy food? If food causes obesity, heart disease, cancer, diabetes, stroke and other diseases, then why not treat it the same way as we treat alcohol and cigarettes?
“When cigarettes were taxed there was an immediate decline in the number of cigarettes bought. As the tax went up this continued. There was also a decline in the diseases that complicate cigarette smoking – lung cancer, heart disease and so forth.” Prof. Peter Kopelman, Royal College of Physicians.
Prof. Peter Kopelman strongly believes that government taxation is an answer to the growing obesity crisis.
Debate in America
Americans are debating the proposal to put a tax on junk food at the moment.
“Sugar, sweets and beverages are the single greatest cause of added sugar. ” Prof. Kelly Brownell, Rudd Center for Food Policy and Obesity.
Junk food contains no nutrition at all. Most foods with sugar contain a little nutrition, but sweets and soda / sugar beverages have none. To not tax them is to say that unhealthy food is OK.
Howevr, ordinary families need to be won over. Even though many families are very overweight, they still do not want to be taxed. Many Americans feel it is their right to be able to buy cheap junk food whenever they wish. There is an idea that food should not be restricted and that people should be left to chose what they eat and how much of it they consume.
So far the food industry in America has won the first round of the battle.
“There are complicated issues of personal freedom, governments role. The real question is whether obesity and diabetes represent sufficiently serious problems that justify government action like we have with things like alcohol and tobacco. I feel that we are there.” Prof. Peter Kopelman, Royal College of Physicians.
Americans are starting to form lobby groups to fight the tax on food. They are saying that they do not want a “nanny state” intervening and forcing them to change their food choices. Although, are they really making the decision themselves, or are the food marketing companies driving their desire for junk food?
Lobby groups such as nofoodtaxes.com are spending $100 million in advertising and lobbying the government against the tax on junk food and sugar. “Leave Our Grocery Budgets Alone”.
One example of how a simple tax can make people healthier is that a small soda tax could lead to 2kg weight loss per adult per year. The aim to drop consumption by 15-20% with a small tax increase of around 1 cent per can.
Coca-cola’s sugar sweetened coke is still the biggest seller in the USA, and unsurpirsingly Coca-Cola are fighting the tax. Their chief scientific officer explained their stance on the tax on sugar:
“Taxes don’t work, if they did work, there would be evidence to that effect…… Tabacco at any level is not healthy. You cannot say that about our Coca-Cola or any of food or beverage. Coca-Cola is a safe product, all the ingredients are safe and all the ingredients have a purpose. When it comes to sugar, sugar has gotten a rather bad rap. We inspire moments of happiness. There are enjoyments associated with eating, with socialising.” Dr. Rhona Applebaum, Chief Scientific Officer, The Coca-Cola Company.
The message is clear – sugar is not unhealthy. Consuming dangerous amounts of sugar is unhealthy, but it is not for Coca-Cola to tell consumers how much to consume. Really, her argument supports a tax on junk food. She accepts that the product is healthy, it is just people that buy too much. So the solution has to be to find a way to encourage people not to buy it – taxation.
Taxes Should Provide Subsidies On More Healthy Foods
Prof. Peter Kopelman suggests that if a tax on junk food was used to subsidise healthy food this would help the population. People still need to be convinced that junk food is bad and that they should be eating a different diet.
Can we be expected to exercise self control when there is temptation everywhere, or do we need someone to save us from ourselves?
As a nation the UK is still increasing its chocolate intake. On average each person eat 3 bars of chocolate a week, and this is increasing.
The Danish Tax Example
Denmark has introduced a tax on fat. Obesity rates on younger children are falling for the first time in 60 years. Adults are still getting fatter though. Taxes on food is helping to cut income tax, although many people feel that it should really balance against healthy foods.
Danes are already the most taxed country in Europe. Sugar and fat ingredients have been reduced in the major confectionery brands as a result.
More Than Willpower Is Needed
It’s hard to lose weight on willpower alone. Dierdre and John Milne have a blog, the Quarter-ton Couple, which they are using to help them keep on track with their weight loss. They know that it is hard to say no to the bad foods.
John Milne suffers from gout, type 2 diabetes, mobility problems and arthritis. He also says that he suffers psychologically - the first thing he thinks in the morning is “I am fat”. He loves of fast food and often eats many burgers in one session. John agrees that a tax would deter him from buying the wrong foods.
Change4Life Obesity Campaign
The UK government created the Change4Life initiative to tackle obesity with the aim to reverse obesity levels by 2020. Cuts in funding have now meant that the government is working closer with the food industry to tackle these issues.
Diet, Not Exercise, Is the Way To Lose Weight
Studies have shown than diet is needed to lose weight, not exercise. Nobody can exercise enough to lose weight. See Exercise Does Not Help You Lose Weight for more on this.
- 20 minutes of running to burn off 2 cans of coke
- 60 minutes of aerobics to burn off 1 cake – see cake burner workouts
Most people just do not understand how much exercise is needed to balance what we eat. An average meal of 400 calories is all we need, most meals are double that.
Obesity Education is Expensive and Takes Time
Research has shown that education is effective at helping with obesity but it is expensive and takes years.
We believe that education should be the core of the program to tackle obesity. However, government intervention is also required. The is little doubt that increase the cost of buying junk food will reduce consumption.
Tax is really the only direct government intervention that is possible on the food and drinks industry, otherwise it will have to radically change the rules on what companies can manufacture, and how much sugar, fat and salt they can add to different products. This may not actually work though. The key is to get people to consume much less, not to slightly decrease the amount of energy in these foods.
Hopefully change will come to the UK and to America in time. Hopefully the lobbyists will not win and governments will make unhealthy food a more expensive option than healthy food.
Alcohol and cigarettes are taxed to reduce consumption and raise money for health services, the same should be done on junk food. Treatment for obesity related issues is crippling the health service, diabetes, stroke and heart disease are all very costly conditions to treat.
Panorama: Tax the Fat, BBC One, Monday, shown on 15th November 2010.
Takeaway Food is Unhealthy!
It must have been a slow week for health news, as the BBC reported that takeaway food is unhealthy. Most takeaways, whether they be Indian / Banlgdeshi curries, Chinese, pizza, kebabs, burgers, or fish and chips, are high in fats, salts and sugars. This really is not a recently discovered fact, and I would be extremely surprised if anyone honestly was not aware that a takeaway meal may not be quite as healthy as a home prepared salad, or roast chicken and steamed vegetables.
The research was carried by Which? magazine. In on test, it revealed that some curries contain twice the amount of fat a woman should consume in a day, in just one serving.
The research was really carried out with the aim to highlight the need for takeaway food companies to provide nutritional information on labels, in the same way as food purchased from shops. But, how can this work? Takeaways are often not prepared with the same mechanical accuracy as mas produced tinned and vacuum packed ready meals. Nutritional information will only ever be a guide, and if that is the case, what is the point in printing it on a label?
Takeaway Nutrional Information:
Based on ‘standard’ portions sampled by Which?
|Indian||Chinese||Pizza (thick crust)||Pizza (thin crust)||GDA (men)||GDA (women)|
|Total fat (g)||55.5||60.4||31.5||48.3||95||70|
|Saturated fat (g)||23.2||9.3||15.5||22.5||30||20|
Takeaway portions: 350g meat dish; 200g rice; 100g naan or spring rolls
Thick-crust pizza: 300g cheese and tomato; Thin-crust: 300g pepperoni
WHO Study Shows Under-eating Leads to Longer Life
Many years ago the World Health Organisation studied life expectancy and lifestyle in populations all across the globe and found that on average people who ate fewer calories than recommended by health organisations they tended to live longer and healthier lives (cannot find the reference…). Although there is a fine line between being malnourished and being of a healthy weight it seems that generally consuming fewer calories causes fewer health problems.
Diabetes is a relatively recent burden on our society. Although there are documents from Egyptian times of people suffering from diabetes it has only really been since the second half of the twentieth century that cases of type 2 diabetes started to rise. This was at the same time that the food industry started undergoing major changes with increased mechanisation and processing, resulting in a constant supply of high energy food all year round.
Overall the message remains: eat less and exercise more!
The Obesity Time Bomb
Obesity is fast becoming the most serious health issue for many governments across the world, with American, the UK and Australia leading in the battle against the bulge. Why is obesity a problem? Here’s a reminder:
- Obesity increases risk of type 2 diabetes
- It increase risk of high blood pressure
- Raised risk of stroke
- Increased risk of developing coronary heart disease
Those are the main problems. Some forms of cancer are also linked with obesity. Diabetes is one of the biggest problems as once diabetes develops it leads to many other problems, including heart disease and kidney failure as well as loss of sight and limb amputation. Diabetes is now one of the most costly diseases to treat as most people require a range of daily tablets and then insulin injections to manage their blood sugar levels.
Have The Obese Been Abandoned?
Over the years there have been several studies into attitudes towards obesity and the obese, and the results of these studies have shown some very worrying trends.
Even though healthcare professionals know that obesity poses serious health risks, many people simple do not believe that overweight and obese people are interested in losing weight. Also, many doctors never raise the subject of weight with a patient as they know that it is a delicate subject for many people, and feel that it is better not to mention it.
In 2003 a study by Dr. Foster found that more than half of the doctors questioned felt that their obese patients were simply lazy and would not lose weight even if they were given great help. In 2005 a study by Dr. Brandsma revealed that many patients picked up on this attitude and felt that their doctors just did not care about their condition.
Many parents questioned by Dr. Edmunds in 2005 also felt that doctors were not providing adequate advice to help their children to lose weight and reverse obesity. Parents generally felt that doctors needed more training in dealing with obesity. This study concluded that many doctors are simple unsure of the best way to advise the overweight and obese. Many GP’s feel that overweight and obese patients are simply frustrating to deal with and often have no motivation to lose weight, and many are also non-complaint, meaning that the doctors feel that they simply ignore most of the advice given anyway.
Doctors are well aware of the risks but many are so sure that most patients are unwilling to make the lifestyle changes required, with many patients actually not believing that their diet and lack of exercise is the cause of their problems, that doctors simply chose not to spend any more than the minimum amount of time dealing with such patients. Dr. Campbell noted in his paper that many doctors fail to follow up with patients after they have advised them to lose weight.
Of course, the only way to really combat overweight problem and obesity is to determine why people are lacking motivation and often non-compliant. This requires therapy and group sessions managed by professionals that understand the root causes of obesity and are skilled in explaining, educating, motivating and guiding people in weight loss.
So, what is the solution? There have been many initiatives over the years and yet cases of obesity are still rising in many countries (although there is a suggestion that obesity levels in male population in the USA may be leveling out).
If doctors cannot provide adequate advice and support, then people are left to seek their own methods. As self motivation to change diet and start exercising is a major problem, many people are tempted to try quick fixes, fad diets, gadgets, pills and other products that are aggressively marketed to the overweight and obese.
With more contextual advertising online, more companies are showing their products specifically to people searching for quick ways to lose weight. We have mentioned many of the gimmicky weight loss fads over the years, but the market is so saturated with such items that many people feel that they simply must work. This of course is never the case. To lose weight people need to be motivated, need a diet plan and exercise plan or weight loss is just impossible. We are here to help, but we cannot help everyone. So, have the obese been abandoned by society? Are they now preyed upon by commercial enterprises?
Have you sought professional medical help for your weight problems and been let down? If so, share your experiences below.
References and Further Reading
- “Obesity” – http://www.thelancet.com/series/obesity – accessed on 27th August 2011. Links to the following 4 papers:
- “The global obesity pandemic: shaped by global drivers and local environments” by Boyd A Swinburn, Gary Sacks, Kevin D Hall, Klim McPherson, Diane T Finegood, Marjory L Moodie, Steven L Gortmaker.
- “Health and economic burden of the projected obesity trends in the USA and the UK” by Y Claire Wang, Klim McPherson, Tim Marsh, Steven L Gortmaker, Martin Brown
- “Quantification of the effect of energy imbalance on bodyweight” by Kevin D Hall, Gary Sacks, Dhruva Chandramohan, Carson C Chow, Y Claire Wang, Steven L Gortmaker, Boyd A Swinburn
- “Changing the future of obesity: science, policy, and action” by Steven L Gortmaker, Boyd A Swinburn, David Levy, Rob Carter, Patricia L Mabry, Diane T Finegood, Terry Huang, Tim Marsh, Marjory L Moodie.
- All published in The Lancet, Volume 378, Issue 9793, 27 August 2011.
- “National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants.” by Mariel M Finucane AB, Gretchen A Stevens DSc, Melanie J Cowan MPH, Goodarz Danaei MD, John K Lin AB, Christopher J Paciorek PhD g, Gitanjali M Singh PhD, Hialy R Gutierrez BS, Yuan Lu MSc, Adil N Bahalim MEng, Farshad Farzadfar MD, Leanne M Riley MSc, Prof Majid Ezzati PhD. The Lancet, Early Online Publication, 4 February 2011
- “Supersizing Supercenters? The Impact of Wal-Mart Supercenters on Body Mass Index and Obesity” by Charles Courtemanche, University of North Carolina at GreensboroArt Carden, Rhodes College. Journal of Urban EconomicsVolume 69, Issue 2, March 2011, Pages 165-181
- McDonald’s starts to count the calories - Dept. of Health website, accessed Monday 5th September 2011.
- Interview with Thomas Moore on McDonald’s and calories – Sky News, Monday 5th September 2011.
- Interview with Andrew Lansley MP – Sky News, Monday 5th September 2011.
- The association between BMI and mortality using offspring BMI as an indicator of own BMI: large intergenerational mortality study. George Davey Smith, professor of clinical epidemiology, Jonathan AC Sterne, professor of medical statistics and epidemiology, Abigail Fraser, Medical Research Council postdoctoral fellow in health services research and health of the public, Per Tynelius, statistician, Debbie A Lawlor, professor of epidemiology, Finn Rasmussen, professor.
- Diabetes: the sweet irony of modern technology WHO. Accessed 5th Sept. 2011
- National Obesity Forum
- The European Medicines Agency
- “Should health policy focus on physical inactivity rather than obesity? No” by Timothy P Gill, principal research fellow, Louise A Baur, professor, Lesley A King, adjunct senior lecturer. Published 25 May 2010, doi:10.1136/bmj.c2602
- Boden Institute of Obesity, Nutrition and Exercise, University of Sydney
- Foster, G.D., Wadden, T.A., Makris, A.P., Davidson, D., Sanderson, R., Allison, D.B. and Kessler, A. (2003) ‘Primary care physicians’ attitudes about obesity and its treatment’, Obesity Research, vol. 11, pp. 1168–77
- Brandsma, L. (2005) ‘Physician and patient attitudes towards obesity’, Eating Disorders , vol. 13, pp. 201–11.
- Edmunds, L.D. (2005) ‘Parents’ perceptions of health professionals’ responses when seeking help for their overweight children’, Family Practice , vol. 22, pp. 287–92.
- Campbell, K., Engle, H., Timperio, A., Cooper, C. and Crawford, D. (2000) ‘Obesity management: Australian general practitioners’ attitudes and practices’, Obesity Research , vol. 8, pp. 459–66.