British women are now the fattest in Europe – with one in four classified as obese and men not far behind with one in five being seriously fat. Obesity now affects over 15 million people in the UK, a figure expected to rise by 11 million over the next 20 years.
A staggering 75 per cent of the population is now technically overweight according to their body mass index – the most accurate way to calculate obesity – and yet losing as little as 10 per cent of your total weight will have significant health benefits, such as a reduction in blood pressure and a lowering of harmful lipids in the blood.
We also all know how important our doctors are to our health, so it should follow that help and advice from GPs is a foregone conclusion when we are dealing with a weight problem. Well, no actually. Not all overweight people have been advised to lose weight at any time by their GP despite the obvious health promotion opportunities available during a consultation.
Why should doctors be so bad at helping overweight people when they spend much of their time dealing with the long-term risks of obesity, such as diabetes, heart disease and stroke? The answer is of course not a simple one, and responsibility to improve the situation lies with both patient and doctor. Where GPs are concerned, many of them do not equate significant underlying psychological problems with obesity and so a lack of control with food in a patient may not be taken as seriously as lack of control in, say a gambler or an alcoholic. This is despite the fact that compulsive eaters use food in exactly the same way as money or alcohol is in these groups.
Secondly, the GP may assume someone is comfortable with their size unless that person expressly asks for help – in a consultation lasting an average of 6 minutes in the UK there’s often only time to discuss one problem, and unless that’s put on the table early any opportunity to talk about what may be bothering you most but which you may be reluctant to discuss – your weight – may be glossed over or simply ignored.
It must also be remembered that many family doctors have become rather cynical over the years about diets and slimming groups because of people wanting ‘quick fixes’ or a ‘magic pill’ to help them lose weight, neither of which exist. This does not excuse a lack of sympathy in a doctor towards someone desperate for help with their weight however, and there are ways to improve the situation all round.
First, does your doctor have an interest in obesity or weight problems? There are a great many around who do. And if yours doesn’t, is there another partner in the same practice who does? It may be a surprise to learn that during their long training to be a doctor, medical students are actually taught very little about diet, nutrition and the problems associated with trying to lose weight. As a result, it can be a matter of luck whether you have a sympathetic GP who wants to spend time in helping you with your weight problem.
If you need to actually change your doctor to achieve this, it’s a simple matter these days and no one should worry about doing it – remember you are a health consumer and you can vote with your feet! Should you be embarrassed about seeing a male doctor, the same principle applies. Many women feel more relaxed and at ease seeing a female doctor than a male one when talking about weight-related health issues, and women doctors recognise this. With such an important issue, it’s always best to wait slightly longer if necessary to see the doctor of your choice rather than have a disappointing consultation and feel even worse at the end of it about your weight.
Once you are sitting in front of your chosen doctor, what should you say? The simple truth is that what most doctors want to hear is honesty. Saying you hardly eat anything, whereas you know you actually cheat on your calories all the time, is a quick way to frustration on both sides and helps no one. What your doctor should be trying to do is build up a picture of your eating habits and assess if it’s a simple one of overeating and a question of psychology or whether there may be a possible physical element to your weight gain.
So-called ‘diet pills’, such as Orlistat, are used by doctors only when they feel the health risks to that patient from their weight are so great that this is an option that should be taken. They are therefore not a panacea for easy weight loss. Asking for them to lose a few pounds for your holiday will never go down well! However, a sympathetic GP will always be prepared to use them if all else fails in seriously obese people.
Finally, remember that many surgeries now run weight loss clinics, and if you’re embarrassed to attend conventional slimming clubs for any reason, you may find using your own surgery more acceptable. This opens up the whole area of health professionals other than your GP who may be able to help you with your weight battle. Practice nurses play a major role in GP slimming clinics and often do the brunt of the work, weighing and encouraging overweight people on a weekly or monthly basis with additional advice and help from the doctor involved.
Your GP may take the step of referring you to a state-registered dietician at your local hospital, especially if there are other existing problems such as diabetes or gluten allergies involved. These referrals are on a one-to-one basis, ie the dietician will sit down with you and go through your diet in considerable detail, looking at what you eat and what areas you need to change in order to lose weight. We all know motivation is the key to getting and staying slim, but it’s often forgotten this is a two-way road – your doctor gets almost as much satisfaction out of you doing well as you do!
Be honest with yourself and them, don’t be afraid to vote with your feet if you are unhappy or dissatisfied and talk to other people in the same situation since this is certainly a situation where the more information you have at your fingertips the greater your chance of success.
