Y o u r H e a l t h Your
Health What Can be Done? by Flt Lt Joanna Sherratt-Wyer, Junior Medical Officer at RAF Cranwell I
t may be because I’m focused on this article, but I don’t seem to be able to open a newspaper or magazine, or watch the TV, without some mention of the
problems we face with increasing obesity. Not only does it seem that obesity is an epidemic, but it is obviously a hot topic in the press right now. The government is keen to keep this issue in the media, but why?
Sadly, the problems associated with obesity just seem to get worse. Much like global warming, the outlook seems bleak. We read about ever increasing obesity rates not just amongst adults, but also with our children. Certain TV stations seem to love the voyeuristic element to be gained out of watching immensely obese people struggle with daily tasks like walking, cleaning oneself, and even getting access to food when bed-bound. There’s a lot of talk about, but it doesn’t seem that much is changing for the better.
So, what is it about obesity that has the government, health professionals and even economists interested? Well, it’s costing the country a fortune, for a start. It is estimated that over 30,000 deaths a year are caused by obesity in England alone. In 2002, it was estimated that obesity costs the NHS £500 million a year. That is a lot to pay in tax! With all the pressure on any government to cut spending, that would be a fabulous amount to save. And don’t forget, if it’s costing the NHS that much per year, it’s costing other agencies also in terms of disability, sick leave and even unemployment.
At local levels, our hospitals and other medical resources are stretched to their very limits. The pressure on beds becomes ever greater as hospitals are closed and units function on low staffing. If we could reduce the admissions and subsequent problems caused by obesity, our local services could potentially function better.
And finally, but most importantly, it is the effect on an individual’s health that is important. It is a startling fact that most adults in the UK are already overweight due to the modern
lifestyle we lead. By 2050, 60% of men and 50% of women could be clinically obese. This is important because the evidence really does show that this is bad for our health. Being obese puts an individual at a greater risk of type 2 diabetes, high cholesterol, heart disease, arthritis and even some cancers. Obesity is having a major impact on fertility, and as couples leave the decision to have children later and later, infertility rates are soaring.
As for children who are obese, these risks are the same if their weight problems persist into adulthood. In addition, children can find being obese makes them a target for bullying which can lead to low self esteem and feelings of self- loathing. This may not seem as severe as heart disease, but any child or teenager will tell you just how damaging it can be.
So, what is to be done? Well, the consensus is that this requires a major shift in thinking not just for individuals or families, but also for society as a whole. In much the same way that the ‘green’ revolution seems to be affecting our behaviour (we never contemplated ‘air miles’ or our ‘carbon footprint’ when buying those peaches five years ago!), we need to be fighting for change across society. It is only when we do this that we will be able to change the way we think about food and obesity, and start to make a difference.
I recently came across an article in the British Journal of Medicine about the EPODE campaign in France which aims to prevent obesity in children. In a bold new approach, the campaign was taken on by the whole village, and involved lessons in schools and colleges, talks in factories, the distribution of breakfasts, the involvement of teachers, doctors, parents and children. Other healthcare professionals such as dieticians also became involved in classrooms and gave talks to parents on healthy eating. With this kind of approach (80% of the original two towns’ populations participated), not only did children have a better understanding of nutrition, but they modified their behaviour, obesity levels did not rise, and even the mothers of the children gained less weight. This amazing project has spread across France, and 113 French communities are now involved.
The military places a huge emphasis on fitness, which has implications for obesity levels. Despite the tougher new standards and increased frequency of the fitness test, obesity remains as much a problem for people in the military and their families as for the wider population. The difference is that in general, we are much better able to support each other as a community. More and more, stations are looking at steps to encourage weight loss and fitness as part of a general programme of health promotion.
At RAF Cranwell, a new initiative aimed at the joint issues of obesity and poor levels of fitness has seen the first signs of the community tackling the problem together. Everyone from the physiotherapists, nurses, doctors, remedial instructors, physical training instructors and catering staff have combined their efforts to make it possible for people to find the help and support they need. Whilst this is aimed at helping military staff to be able to pass the new fitness test standards, the team recognises that it is only with the co-operation of individuals, families and communities that these changes can be made.
So, where can you start? All health care professionals should be interested in health promotion, and this involves eating healthily, exercising and keeping weight down. Your own doctor or practice nurse (be it on camp or in the NHS) should be happy to discuss a plan for weight management, and will help in the setting of realistic goals. It may even be possible to get exercise prescribed (to help you get into the gym), or to discuss other interventional measures to help with weight loss. You may find that there are local groups which promote healthy eating, or lay on regular exercise classes. Indeed, you may even want to lead the way in your community and set up an initiative of your own!
Those villages in France have shown the need for whole communities to tackle the problems we face with rising obesity levels. It is important for our health as individuals that we confront these issues, and the communities we are part of by being in the military may just be the key to making the necessary changes.
Spring 2008 31
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