The complexity of obesity

The challenges to the health and well-being of the United Kingdom’s people, both adults and children, is far greater than COVID-19. There is a tsunami of evidence that the battle is being lost, this despite a range of valiant initiatives in the National Health Service, in Primary Care, in Local Government and the range of charities of varying agendas. It is an exciting development that the Prime Minister is making the fight against obesity a personal mission. However, collectively, is it enough to overcome what the Department of Health and Social Care refer to as ‘one of the greatest long-term health challenges this country faces’? Whilst the basic issue can be presented in simplistic (and accurate terms) – obesity is the consequence of excessive fat in the human body – and the remedy – eat fewer calories than you expend to lose weight – is, likewise, practical – the complexities, in terms of physiological, psychological and social dimensions – are truly frightening. There is no escape from the realities of the situation. Millions of adults and many children have a clinical Body Mass Index (‘BMI’) of over 30 which results in them being diagnosed as obese. The terms are fully described in our brochure, ‘The Obesity Crisis’ as are the possible consequences. The threats to individual health are many. While type 2 diabetes tends to grab the headlines there are many more in terms of physiological wear and tear (the waiting list for hip replacement operations grows ever longer), in circulatory complications and many more. The social manifestations are there to be seen. Society is trying very hard to cater for those with excessive weight issues – accesses to public places, seating on planes, improved bed construction and so on. One of the consequences of the many and regular media presentations on the topic, whether it is a new approach to dietary programmes, a revolutionary slimming plan or encouragement to take more regular exercise, is to emphasise the reality that vast numbers want to lose weight. To do that they must consume less calories than they expend so the body has to call on its reserves and weight is reduced. Simple. Except it isn’t simple. Overcoming hunger is perhaps one of the hardest challenges a person can face. Some will benefit from the various ideas and aids being introduced. Some will find the motivation perhaps as a consequence of a chat with the doctor. Some will be scared into doing it as the reality of hospital intervention looms. A few will resort to bariatric surgery. But most won’t lose weight which is why there is a health crisis. [...