In denial about obesity
By Niall Hunter-Editor
A good deal of research on obesity has shown that one of the main barriers in tackling overweight in the population is that most people don't or indeed won’t realise that they are obese.
This is borne out by a recent study in the US, which interviewed more than 10,000 adults.
The study found that nine out of 10 people think that most other Americans are fat, but only four out of every 10 think they themselves are overweight.
The study found that half of the respondents in interviews whose reports of their own height and weight would lead them to be categorised as 'overweight' said they considered that their own weight was 'just about right'.
The researchers said the reason for this widespread self-deception is largely 'human nature', in other words, denying something that is obviously unpalatable and would require a difficult lifestyle change.
Doctors in Ireland have also reported that this form of self-deception is common.
Critics would also say that the Government and the food industry may also be practising the art of self-deception when it comes to doing something about obesity.
This year, the HSE will provide a relatively modest allocation to the only hospital in the country providing an obesity treatment service and will appoint eight community healthcare staff for the whole country to deal with obesity.
Certainly a case of not much done and a lot more to do.
As for the food industry, it agreed last year to take voluntary measures to encourage healthier eating habits. One of its main focuses was to get rid of 'supersize' chocolate bars.
So giant bars were duly phased out, but were effectively split in two, apparently so that the new dual bars, which still weigh the same and have the same amount of calories as the single giant bars, could be shared.
This lack of action is taking place against a background of a growing obesity problem in Ireland and worldwide.
It is estimated that about 65% of Americans are overweight, and Ireland is not lagging far behind. It is estimated that around 40% of Irish adults are overweight and 18% are obese.
In addition, there has been at least a threefold increase in childhood obesity in recent years.
While interpretations of what constitutes overweight and obesity vary a lot, it is clear that many western countries have a problem-their populations weigh too much and this is leading to major health consequences.
Even UK medical sceptic Prof Stanley Feldman, who has sought to debunk many 'myths' about what food is good and bad for you, admits that we have a problem with obesity.
Speaking in Ireland recently, he said obesity was a cause for concern, particularly for those who are 20% above the body mass index measurement, and obese people have a greater risk than others of diabetes, heart disease and other conditions.
So are we doing enough about obesity in Ireland?
North Dublin GP and former IMO President Dr James Reilly doesn't think so.
He says if we had no obesity and no cigarette smoking in Ireland there would be plenty of hospital beds available for everyone and no queues in A&E departments.
Reflecting the recent findings in the US, Dr Reilly says that nearly every patient who comes into his surgery who is obese appears to be oblivious to the fact.
Speaking at the recent launch of the IMO's position paper on obesity, Dr Reilly said a number of actions need to be taken at community level to tackle the obesity problem.
Among the initiatives needed, he said, are the removal of junk food and drink vending machines from schools and effectively promoting exercise among both children and adults.
He feels there should be a 9pm 'watershed' on TV for the advertising of junk food.
Many of the actions proposed by the IMO mirror the recommendations of the National Taskforce on Obesity, published a year ago, but which has now been called into question due to the apparent lack of progress on its implementation.
Medical expert on obesity Dr Donal O'Shea says an implementation group for the report has still to be set up and that while some money has been allocated to the HSE to deal with obesity, little has been done in the area of prevention.
The Department of Health counters that it is doing something about implementing the obesity report. It says it has set up a health improvement forum which will coordinate health promotion activities across Government departments, given that tackling obesity is not just the responsibility of the Department of Health.
It says it has also allocated funding to the HSE for four dietitians and four physical activity officers (for the whole country) this year ,money is being allocated to develop the obesity treatment service at St Columcille's Hospital in Dublin (the only centre in the country for this type of treatment, which includes surgery) and plans are in hand to provide more of these treatment centres.
The IMO's position paper on obesity criticises the pace at which the Government's plan to tackle obesity is being implemented.
It says the National Taskforce did not provide a single figure to cover the total cost for implementing its 93 recommendations.
In 2006, the IMO points out, 3 million euro in revenue funding has been allocated to the HSE for obesity services, but this amount is insufficient to fully fund the desired services.
Indeed it is difficult to see how appointing only eight additional dietitians and physical activity officers for the whole country this year is going to make a major difference to the obesity problem.
The IMO points out that a partnership approach between all sections of the medical profession regarding prevention, risks, education, treatment, surgery and post-operative support would improve the lives of thousands of Irish people and save the health service millions of euro.
The IMO’s recommendations include:
*More specialist centres to treat obesity must be established
*A strategy to tackle the problem of overweight and obesity should focus on the population as a whole, with specific actions taken in schools; primary care; community organisations; workplaces; in the area of food supply, and in media and marketing, among others
*A coordinated approach between Government Departments should be initiated
*National guidelines on physical activity are needed
*Restrictions should be placed on junk food advertising targeting young people.
As for the food industry, Dr Donal O'Shea has called its voluntary initiative to date on obesity 'deeply cynical and pathetic.' He claims this provides evidence that the food industry needs to be regulated by the Government rather than being left to police itself.
He admits that the chocolate bar issue is a small example, but it indicates that the industry is not capable of honouring voluntary commitments in a meaningful way and it highlights the urgent need to implement the obesity taskforce recommendations.
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