Saturday, December 29, 2007

A bad year to be fat in Britain

The year kicked off with the news that an overweight boy from North Tyneside could be taken from his mother by child protection officials. Her apparent crime: overfeeding her son. He was allowed to stay at home, but in the months to come various investigations - including one by the BBC - would uncover that obesity had been a factor in perhaps as many as two dozen child protection cases.

Some professionals said allowing a child to become obese had to be viewed as a form of neglect, given the potential health consequences. Others believed that to treat childhood obesity as a parental crime was foraying into unchartered - and potentially rather sinister - territory.

Other obesity-related headlines rolled in thick and fast. From fire chiefs considering charging to move large people from their homes to government equating obesity with climate change, fatness was never far away. "When we first started talking about obesity as a problem, it was very hard to be heard," says Dr Ian Campbell, medical director of the charity Weight Concern. "Now the pendulum has swung too far the other way - we hear nothing but. And the net result is that the kind of moralising the obese and overweight have always suffered has somehow become institutionalised."

One of the recent developments that particularly concerns the National Obesity Forum (NOF) is the move towards what has been described as "rationing" healthcare for the obese. According to one tally, there are at least eight NHS trusts which have introduced some form of restriction for non-urgent operations on the overweight. Such measures, which range from patients having to prove they have tried to lose weight to straightforward refusal to refer those above a certain BMI (body mass index), received something of an endorsement from then health secretary Patricia Hewitt earlier this year.

The fact is, doctors say, there are sound clinical reasons to delay treatment until patients lose weight. The operation is likely to be more successful, the recovery time shorter. But Dr Colin Waine, NOF chairman, believes that the obese are simply being used by hospitals as a convenient way to cut down on expenditure. "This is really about resources. You can't argue that denying a hip-and-knee operation to an obese person is in their interests, as it may well be the inability to walk about and exercise which is making their problems worse."

Recently the British Fertility Society has joined in, arguing that the obese should be barred from IVF as extra weight put the health and welfare of both mother and baby at risk. This, Dr Waine claims, is "discriminatory".

And the constant debate about the problems fat people pose can get very tiresome for those on the receiving end. "There's always been prejudice," says Vicki Swinden, founder of Fat Is The New Black. "But what's changed is that this now seems to be totally acceptable. It's perfectly legitimate now for a person standing in an airline queue to say: 'I'm not sitting next to that person, they're too fat.'" Fat Is The New Black argues that being fat does not necessarily mean you are not fit, or prone to ill health, and indeed this stance has been backed up by several studies. Most recently, a major US investigation found the overweight had no higher risk of dying of cancer or heart disease and overall lived longer than those of a "normal" weight.

Yet no-one seriously contends that obesity is not a problem - even if there is debate as to how great a risk it poses. But there is suggestion that perhaps we are harping on too much about it. "It's got to a stage now where it's actually hard to get any useful messages across because people have heard so much, often contradictory, information, that they just think: obesity blah blah blah," says Mrs Swinden.

The Health Secretary Alan Johnson recently said obesity was a problem "on the scale of climate change". Increasingly there are fears that we hear so much about the doom and gloom of global warming that we have started to switch off. "We don't want this to happen with obesity. We know what the problem is. We don't need more reports, more studies, more talking," says Dr Waine. "We just need to get with it now: the government, the food industry, the community and the individual - we need to get cracking."


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