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UK obesity crisis needs a bold prescription from doctors UK obesity crisis needs a bold prescription from doctors
(7 months later)
Obesity is a massive and multi-factor problem – so big and potentially so costly and diverse that no single department of government or specialist group can take it on alone. The potential usefulness of the Academy of Medical Royal Colleges report is that it goes well beyond the silo mentality.Obesity is a massive and multi-factor problem – so big and potentially so costly and diverse that no single department of government or specialist group can take it on alone. The potential usefulness of the Academy of Medical Royal Colleges report is that it goes well beyond the silo mentality.
Reports from doctors' organisations have tended to stick to what they know best – how to treat people who have become obese. They focus on more resources for weight-loss surgery and diabetes. It is the problem as seen from the consulting room rather than the street.Reports from doctors' organisations have tended to stick to what they know best – how to treat people who have become obese. They focus on more resources for weight-loss surgery and diabetes. It is the problem as seen from the consulting room rather than the street.
The academy report may well be criticised for straying outside its area of expertise, but it has to be given credit for looking at the big picture and making recommendations that would seem common sense to non-doctors. It does want more money for training (and rewarding) doctors in tackling obesity – crucial particularly at the GP level, because many family doctors are reluctant to raise the issue of weight unless the patient mentions it first. It also wants more investment in weight management services, including bariatric surgery, to give the GPs somewhere to refer those patients with a serious problem, and training for health visitors to educate new parents in nutrition.The academy report may well be criticised for straying outside its area of expertise, but it has to be given credit for looking at the big picture and making recommendations that would seem common sense to non-doctors. It does want more money for training (and rewarding) doctors in tackling obesity – crucial particularly at the GP level, because many family doctors are reluctant to raise the issue of weight unless the patient mentions it first. It also wants more investment in weight management services, including bariatric surgery, to give the GPs somewhere to refer those patients with a serious problem, and training for health visitors to educate new parents in nutrition.
It also calls for healthy food in hospitals, with standards similar to those imposed in schools. It makes no sense to treat a man for his heart condition but feed him food that will help further clog his arteries and have his family wait in a lobby stuffed with sweet-vending machines. It does not help the hospital staff either, many of whom are overweight themselves.It also calls for healthy food in hospitals, with standards similar to those imposed in schools. It makes no sense to treat a man for his heart condition but feed him food that will help further clog his arteries and have his family wait in a lobby stuffed with sweet-vending machines. It does not help the hospital staff either, many of whom are overweight themselves.
But it is good to see doctors get involved in tackling the much wider issues of the obesogenic society we live in, outside the clinic doors, that cause the queue of patients for the diabetes and heart clinics. They part company with Michael Gove, calling for school meal nutritional standards to be enforced in academies and free schools as well as the rest. They want the new Public Health England body to find ways to help councils stop fast food outlets setting up near schools and leisure centres, and they back a ban on junk food advertising before 9pm. Their report calls for a sugary drink tax, universal traffic light food labelling and a mandatory health assessment before local authority planning decisions in the hopes of encouraging bike lanes and green spaces.But it is good to see doctors get involved in tackling the much wider issues of the obesogenic society we live in, outside the clinic doors, that cause the queue of patients for the diabetes and heart clinics. They part company with Michael Gove, calling for school meal nutritional standards to be enforced in academies and free schools as well as the rest. They want the new Public Health England body to find ways to help councils stop fast food outlets setting up near schools and leisure centres, and they back a ban on junk food advertising before 9pm. Their report calls for a sugary drink tax, universal traffic light food labelling and a mandatory health assessment before local authority planning decisions in the hopes of encouraging bike lanes and green spaces.
None of these suggestions is new – Sustain called for the soft drinks tax recently and the National Institute for Health and Clinical Excellence has produced guidance for local authorities on planning for a healthier built environment that encourages people to walk, run and cycle rather than get in the car. But those concerned about the obesity epidemic will be glad the medical royal colleges have joined the fray on educational, environmental and food issues.None of these suggestions is new – Sustain called for the soft drinks tax recently and the National Institute for Health and Clinical Excellence has produced guidance for local authorities on planning for a healthier built environment that encourages people to walk, run and cycle rather than get in the car. But those concerned about the obesity epidemic will be glad the medical royal colleges have joined the fray on educational, environmental and food issues.
A more joined-up approach is on the cards across the UK because of the government's shifting of public health funding from PCTs to local authorities in April. While there are concerns about whether enough of the pot of public health money will be spent on obesity by councils – that will depend on how much of a prority they consider it – it does give them a new opportunity to think laterally about the problem. Sadly, the attempts at cross-departmental thinking on obesity by central government foundered. A cabinet committee that was supposed to have representation from all the involved ministries was axed because not enough ministers turned up.A more joined-up approach is on the cards across the UK because of the government's shifting of public health funding from PCTs to local authorities in April. While there are concerns about whether enough of the pot of public health money will be spent on obesity by councils – that will depend on how much of a prority they consider it – it does give them a new opportunity to think laterally about the problem. Sadly, the attempts at cross-departmental thinking on obesity by central government foundered. A cabinet committee that was supposed to have representation from all the involved ministries was axed because not enough ministers turned up.
Perhaps what is needed to pull all the strands and departments and special interest groups together is something that was proposed by one of the member colleges of the academy just a few weeks ago. The Royal College of Physicians says what we need is a leader who is independent of party political allegiances – a sort of obesity tsar who could be possibly a member of the House of Lords or even a Michelle Obama figure, as in the US, who could proclaim loudly and repeat often that obesity is a problem for the whole of society.Perhaps what is needed to pull all the strands and departments and special interest groups together is something that was proposed by one of the member colleges of the academy just a few weeks ago. The Royal College of Physicians says what we need is a leader who is independent of party political allegiances – a sort of obesity tsar who could be possibly a member of the House of Lords or even a Michelle Obama figure, as in the US, who could proclaim loudly and repeat often that obesity is a problem for the whole of society.
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