Adapted from BMJ 27 Jan 2024
Dissecting Health by Scarlett McNally
The body positive movement correctly states that weight based discrimination can contribute to poor health and even more weight gain. Even so, obesity causes considerable health and economic damage.
The Tony Blair Institute calculated that obesity costs the UK £98 billion a year including £19.2 billion from related illnesses.
People who have obesity have seven times the likelihood of type two diabetes and the complications such as infection, amputation and kidney failure. Obesity can cause heart disease, cancer and chronic pain.
A person under the age of 50 who is obese, is more than ten times more likely to have complex multi-morbidity than someone of healthy weight. Hip and knee joint replacements are needed earlier, need longer operating times, a 50% greater risk of infections and a higher chance of needing postoperative intensive care.
Several treatments can successfully reverse obesity and type two diabetes including bariatric surgery, low carbohydrate diets, intermittent fasting, ultra-low calorie diets, and now regular injections to suppress the appetite.
Prevention of obesity is different. Obesity is caused by the type and availability of food and a lack of physical activity. Exercise alone doesn’t reverse obesity, but it can help prevent it.
Obesity is a product of our environments. People in the most deprived areas have the fewest food and exercise options and are twice as likely to have obesity (36.8%) as those in the least deprived areas (19.2%).
We need to go back to basics: affordable fruit and vegetables, unprocessed foods, less snacking, smaller portions, and less alcohol.
Many organisations have suggested such interventions such as play parks, limits on junk food advertising, and more PE in schools. We need safe cycle lanes, green spaces, and 20 mph limits in built up areas. Despite swimming being a great all round exercise, many affordable swimming pools have closed.
The obesity epidemic matters more about health than just appearance. Poor health results in unaffordable health needs and reduced tax income from the economically inactive working age group.
We cannot afford the inevitable human and financial costs of inaction.
Diabetes Diet 