SECOND OPINION
and the general population; obesity and other diseases; obesity and medical train- ing; obesity in schools; obesity in the work- place; obesity and the UK economy.
1. Obesity in society and the general population
People in the UK today are not excessively more gluttonous, do not have signifi cantly less willpower and do not have fundamen- tally different biology compared with pre- vious and recent generations. Society has evolved. Transport, food production, work and leisure patterns have all changed, in- creasing the tendency for people to gain and maintain weight. It follows that for many weight gain is largely an involuntary consequence of a modern day lifestyle; a normal response to an abnormal environ- ment. Hippocrates said: “It is very injuri- ous to health to take in more food than the constitution will bear, when, at the same time, one uses no exercise to carry off this excess.”
Antony Worrall Thompson concurred in this report saying: “We can use all of the ex- cuses in the world, but if you eat too much,
without compensating with exercise, you will become obese.” The Quality Outcomes Framework (QOF) rightly incentivises GPs to register obese patients, but it does not incentivise them to do anything about it.
We strongly endorse greater powers and greater freedom to local government to tackle factors that affect health and well- being in their area, for example, access to shops, sport facilities and green areas. Fur- thermore, as Professor Haslam, chairman of the National Obesity Forum explains, the QOF must change to incentivise GPs to manage their patients so that they lose weight. The current system is not working and therefore needs to be reformed.
2. Obesity and other diseases
Obesity is the primary risk factor underly- ing type 2 diabetes and sleep apnoea and a signifi cant risk factor for many different types of cancer, cardiovascular disease, and for complications in patients under- going surgery. How many patients realise this? Probably very few. The population at large must be educated through public health campaigns, making them aware of
the enormous health risks associated with being overweight. There must be improved access to supermarkets, green and open space and leisure facilities in poor areas.
However, in isolation these measures are inadequate. Better access must be accom- panied by improved education from health, social and education services so that people are not only made aware of the obesity as- sociated health risks, but that they also un- derstand how they can tackle these issues effectively and sustainably.
3. Obesity and medical training
Effectively training our future doctors and healthcare professionals in the causes, management and prevention of obesity is essential. After all, if medical professionals do not have a full and proper understanding of the underlying causes of obesity, and the best available treatment pathways for people struggling with their weight, there is little chance or hope for the wider population.
Despite being recognised as a primary pub- lic health challenge, it is shocking that obe-
national health executive Sep/Oct 11 | 17
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