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Some of you might be considered obese. Even I myself, the very essence of fitness and health, have been instructed by my other half to stop eating biscuits whilst watching TV, and it seems that either the plates in our house have become larger or the food portions huddled together for warmth in the middle are now smaller.
Giving those in need of advice some encouragement to lose weight used to be the right thing to do, but with modern sensitivities and the effect of an all-pervading social media, doctors telling someone to lose weight may now find themselves accused of ‘fat shaming’ by those who feel humiliated and whose response to this bombshell is not what health promoters would have wanted.
Perhaps it all hinges on how one goes about handling the discussion: Clearly most overweight people are storing up health problems for themselves so it seems entirely appropriate that, like smoking or alcohol consumption they should be told what their lifetime risks have become and how much better life would be for them when they reach the age of 95 and are strapped to a chair in an uncaring nursing home.
We have disease-related images on the back of cigarette packets to impress smokers but I haven’t yet seen the equivalent for overweight people on chocolate biscuit packets. Maybe graphic images of wobbly bellies would put some off their chocolate hobnobs, or how about pictures of blocked coronary arteries sitting alongside the menus in fast food outlets to encourage water to replace the ironically named ‘go-large’ fizzy drink.
The assumption is that preaching at people will change their behaviour, but I’m not convinced that this is the case. The NHS says that obesity reduces life expectancy by three to ten years on average and that obesity is costing it £6billion per year but the counter argument recently propounded by Michael Buerk, presenter of The Moral Maze, is that we should leave obese people alone as their early deaths will save the NHS money in the long run.
‘The obese will die a decade earlier than the rest of us in a selfless sacrifice against demographic imbalance, overpopulation and climate change. Who can calculate how much an obese person would have cost if they were slim?’ he wrote.
‘How much would he or she cost if, instead of keeling over with a heart attack at 52, they live to a ripe, dementia-ridden old age, requiring decades of expensive care?’
As a result I’ve stopped telling other people that they’re too fat and won’t live to see their receding pension, but now focus on the truism that we’re here to help when their knees and hips give way, when they can’t walk because of breathlessness, when they develop sleep apnoea, and when their heart finally gives out, assuming that there are firefighters who can extract them through their bedroom window and that we have a spare large-sized trolley and a cast of staff members with strong backs.
Charles Lamb is a consultant in emergency medicine. He writes using a pseudonym
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