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The fat of the land


The fat of the land

Withering favours a bit of direct action to deal with a growing problem

There’s no disputing the facts: Britain is overweight. In December 2015, in her annual report, England’s Chief Medical Officer, Dame Sally Davies, said obesity was the biggest threat to women’s health.

Of course, not only women are affected by obesity. In its 2014 report on obesity, Public Health England noted a number of very worrying trends: the proportion of obese men in the population is about the same as women, and both are getting worse, not better; the link between obesity and type 2 diabetes, cardiovascular disease and breast cancer; the fact that type 2 diabetes is 40 per cent more common in the most deprived areas than in the least deprived; the high rate of premature death; and, not least, the economic impact (direct costs to the NHS approaching £10 billion per year and accounting for 10 per cent of prescribing costs). And, of course, England is not alone in facing this epidemic – Scotland, Wales and Northern Ireland are all affected, too.

Can we do anything about it? As one ‘size acceptance’ campaigner said in a heated interview on the BBC, if it were easy to lose weight, people would simply do it; the fact is, it’s very difficult. And on top of this we have to contend with the nay-sayers, those who tell us to leave overweight people alone, to stop blaming them for the ills of the NHS, and that dementia is a bigger killer than obesity.

Among other things, Dame Sally suggested the imposition of a sugar tax to reduce calorie consumption. That may help, and could possibly be used to fund care for obese people, but I think we need more direct action than this. There needs to be a major, integrated and prolonged public health campaign.

Yes, I know, there have been campaigns in the past that clearly haven’t worked, but they were often local rather than national, and sporadic in nature. The problem is that the benefits – in better health, reduced demand on the NHS and lower costs – from preventative work aren’t seen immediately. It may be years or even decades before they appear, but that doesn’t mean we shouldn’t start. Of course, I want community pharmacies to feature strongly in any campaign. You don’t need me to trot out all the arguments in favour of this, but I want our participation to be more than just putting a poster or two in our windows. We should be doing measurements of weight and height to give people their BMIs; we should be offering education and information programmes about the consequences of being overweight and what to do about it; we should be screening for type 2 diabetes; and we should be referring people to other practitioners, including GPs, dieticians, and even Weight Watchers.

You will all know what’s available in your local areas. There is a local authority-run sports centre near me that provides aquarobics classes for the over-60s, for example. We should be able to make direct referrals to such activities without reference to the GP. How about a national pharmacy obesity service? Does it sound ridiculous? But why not? GPs are already too busy and who else is there? Dame Sally is convinced it’s a major issue. Perhaps our new year’s resolution should be to talk directly to her.

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