I’m not fat, I’m sick!

I’ve just read a scientific report from the prestigious Royal College of Physicians (RCP) which seeks to reclassify obesity in all its forms as a disease.

Now I have no problem with the arguments put forward by the College here but the Collins Dictionary gives me the definition of disease as:

variable noun:   disease is an illness which affects people, animals, or plants, for example one which is caused by bacteria or infection.

noun – in British (sic):   any impairment of normal physiological function affecting all or part of an organism, esp a specific pathological change caused by infectionstress, etc, producing characteristic symptomsillness or sickness in general

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While this isn’t comprehensive, the implication is that a disease is caused by some external agent such as a pathogen, infection or something invading the body from outside.   Until now there has been little if any suggestion that what is often criticised as a lifestyle choice is in fact some sort of infection caused by….

Reading the article more carefully, the RCP wants to see obesity recognised as an ongoing chronic disease to allow the creation of formal healthcare policies to improve care both in doctors’ surgeries and hospitals, and so that significant and far-reaching preventative measures can be put in place.   I’m afraid that the cynic in me sees an ulterior motive in almost anything a major organisation does these days and I can’t help feeling that this is a preliminary push towards increased health budgets and pet research projects for tenured professors.   Please prove me wrong.

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[Obesity] is not a lifestyle choice caused by individual greed but a disease caused by health inequalities, genetic influences and social factors.

 Professor Andrew Goddard, RCP president

My Experience

Of course obesity is much more than a label for fat people.  I started putting on weight not long after I got married, having been a lithe 6ft, 160lb (73kg) I rapidly shot up another 60lbs.   This wasn’t to overeating or any devotion to burgers and chips.   The fact was that both my wife and I were working professionals but our income was so low that we could only afford the basic foods, no restaurant dining, no 6ast food or takeaway treats (except Saturday lunch of fish and chips, a family tradition).   We were working every hour available to meet our basic needs, nine to five in our normal jobs and then bar work or some other second job.

Then I got divorced and without any effort the weight simply dropped off again.   I’m still looking for an explanation for that.   Of course I eventually got married again and, yes, the weight began to steadily rise up to a massive 260lb (118kg).   At that point we were relatively comfortable financially although less secure in our employment.   I would imagine my stress levels were sky high and I know we ate some large and unbalanced meals and takeaways.   Both MBH and I were working long hours at some distance away and when we finally got home we were often too tired to start cooking nutritious food from scratch.  Alcohol, while not at problem levels, was a regular feature of my intake.

Then I found myself the victim of redundancy for the 4th or 5th time and realised that I was unlikely to find work ever again.   Income wasn’t a vital issue, I was receiving two pensions from previous work and had only a year or so before retirement.   As the weight of responsibility dropped off my shoulders it also dropped off my waistline and with little effort I began to gradually lose all that excess weight.   At no point in this saga could I have been described as lazy (I climbed mountains and played squash), feckless, or uneducated.

obesity

What are my conclusions?

It seems my weight fluctuations could be directly attributed to two personal factors.
  1. Stress was causing me to eat compulsively, eating in the night, snacking on high sugar foods.  I may not have realised it at the time but I was comfort eating big time.  The times when I was under less stress, such as being single again and not responsible for  anyone else then I lost weight.   When I became finally unemployed the stress of finding and keeping a job dropped off me.
  2. Lifestyle.  Working in management means you never leave the job.   Extensive travelling and late returns to home makes pre-prepared foods almost a necessity.   We used package meals more than we should despite being parents of a chef and experienced in every aspect of meal preparation.

There is one further factor in my submission.   The medical experts seem to be totally unable to agree on what is and what isn’t a ‘good’ diet.   For decades we were brainwashed to consider butter and other organic fats to be the source of all obesity.  ‘Eat fats, get fat’ was almost the daily mantra coming from our experts.    We were forced into eating shovelfuls of prepared butter alternatives such as margarine with delightfully scary stories about each (see here).  There is little doubt that much of this propaganda was funded, created and disseminated by the vested interests of big businesses.   Then we were advised that the proper diet had at least 50% carbohydrates regardless of the deleterious effects of sugar on health and obesity control.

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This was the recommended dietary composition in 2016 and is still the guidance of the British Heart Foundation.

This is still posted on the noticeboard of many hospital outpatient departments including my own.   The dietary consultant who has the office where this poster is displayed told us recently  “There’s lots of evidence either way.  The argument against carbohydrate danger is not proved beyond doubt.”   With this sort of vacillation from the experts how can we develop a cogent guidance to busy men and women stressed by the demands of modern life.

So should obesity be recategorised as a disease?   If it can get the medical fraternity off their butts to agree guidance free of vested interest from business then it must be a good thing.  You choose.

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