A press pho­to­graph show­ing HSE di­rec­tor Tony O’Brien as obese acted as a wake-up call, prompt­ing him to tackle his weight

The Irish Times - Weekend Review - - NEWS REVIEW - Paul Cullen Health Cor­re­spon­dent

It was a press pho­to­graph, taken from a low, un­flat­ter­ing an­gle while he was ad­dress­ing a nurs­ing conference, that con­vinced Tony O’Brien things had to change. The pic­ture from 2012 shows a jowly mid­dle-aged man, his fa­cial fea­tures al­most ob­scured be­hind rolls of flesh. The man’s bulk is hid­den un­der a con­ven­tional busi­ness suit but there is no mis­tak­ing he is, in his own words, sig­nif­i­cantly obese.

Noth­ing un­usual there in to­day’s so­ci­ety, you might say, ex­cept this man had just been ap­pointed as di­rec­tor general of the Health Ser­vice Ex­ec­u­tive.

“The photo was a bit of a shock. I’d have felt very self- con­scious con­tin­u­ing that way as head of the health ser­vice.”

What he calls “my wake- up call” pro­pelled O’Brien on a five- year jour­ney in search of bet­ter health and fit­ness. A visit to the doc­tor told him what he al­ready knew – he was mor­bidly obese and had high blood pres­sure. Di­etary changes kick-started his weight loss and, later, a daily fit­ness regime helped to ac­cel­er­ate it.

To­day, with­out fol­low­ing any par­tic­u­lar diet, O’Brien has lost more than one-quar­ter of his body weight – up to 35kg. He feels health­ier and more en­er­getic, even if he be­lieves his per­sonal weight jour­ney is still “a work in progress”.

“I was at a cross­roads,” the 54-year-old re­calls. “I was ei­ther go­ing to end up with high blood pres­sure, go­ing on statins and hav­ing a lifestyle con­di­tioned by that. Or I was go­ing to take a dif­fer­ent turn.”

He says he wanted to “walk the walk as well as talk­ing the talk” as a leader in health, but there were other, more per­sonal rea­sons. His fa­ther had died at 62. “You want to be there for your loved ones. I’m a hus­band, a fa­ther, a son. I want to be around for a while, to out­live my fa­ther.”

He had to has­ten slowly, due to an un­der­ly­ing health con­di­tion. O’Brien has late on­set myas­the­nia gravis, an auto- im­mune con­di­tion that can make ex­er­cis­ing dif­fi­cult due to mus­cle weak­ness. “It meant an al­ready seden­tary lifestyle be­came even more seden­tary.”

Slip­ping into obe­sity

‘ Like many peo­ple, he hadn’t re­alised he was slip­ping into obe­sity. “I was slim­mer, fit­ter and a gym-goer in my 30s. I could run up a hill and beat teenagers. Then, in my 40s, I gained a bit of weight. Grad­u­ally, it creeps up on you.”

It was just a “per­sonal no­tion”, he says, to give up bread and pota­toes. “One day I said to my wife ‘ I’m not in a good place, health-wise. I’m just go­ing to give them up and see what that does for me. When you’re in this job, you’re bounc­ing from meet­ing to meet­ing. Wher­ever you go, ev­ery­one thinks they have to feed you. Usu­ally there’s a tray of sand­wiches, or a bas­ket of scones. I just stopped eat­ing those things.”

He shed over 5kg quickly and that weight loss al­lowed him start an ex­er­cise pro­gramme to con­sol­i­date his gains. “I started to go to the gym but not to do stupid stuff. I wanted to do a tai­lored pro­gramme that I could com­plete in 45 min­utes, four or five times a week.

“That’s im­por­tant to me as I can con­trol the start of my day but I can’t pre­dict the end. Also, with an un­der­ly­ing con­di­tion, you can’t pre­dict how tired you might be later in the day.”

He hasn’t eaten bread since June 2012 and says he feels “way bet­ter” as a re­sult. “I’ve al­ways loved hot toast with jam, but mod­ern bread is rub­bish. It’s full of things like preser­va­tives that bread didn’t use to have.”

He found he was eat­ing “more food, but bet­ter food”, es­pe­cially sal­ads, veg­eta­bles and cold meats. “I was very con­scious not to re­place pota­toes with co­pi­ous amounts of rice and pasta.”


Build­ing on this foun­da­tion, and now at­tend­ing early- morn­ing gym ses­sions al­most daily, he started shed­ding the pounds dra­mat­i­cally. About a year ago, his weight loss be­came ev­i­dent and tongues started wag­ging. “The ini­tial re­ac­tion was ‘are you not well? There must be some­thing wrong, maybe the job is get­ting to you’?”

In fact, the op­po­site was true, but the ex­pe­ri­ence prompted O’Brien to be more open about his regime. He is now about fives sizes smaller in a suit than he was five years ago. “As I’ve gone down in size, I’ve con­sis­tently given away clothes that no longer fit. I’ve had to adopt a pol­icy of buy­ing rel­a­tively cheap clothes be­cause they don’t last me that long.”

O’Brien did not sug­gest this in­ter­view, and he i s anx­ious i t doesn’t l ook l i ke self-pro­mo­tion. “I’m not cast­ing judg­ment on any­one. Ev­ery­one has their own rea­son why they are the weight they are. Some peo­ple are blessed with me­tab­o­lism that al­lows them to eat a horse and never be over­weight. Oth­ers are un­for­tu­nate in their cir­cum­stances, or have eat­ing dis­or­ders for which they need as­sis­tance.”

Nei­ther does he want to seem fa­nat­i­cal about di­et­ing or ex­er­cise. “I don’t want to ap­pear like a zealot. Ev­ery­body is dif­fer­ent. Lots of peo­ple ask me how do you have the willpower to do it and I tell them it’s the re­verse. If I had real willpower, I’d have cut down on [some] foods and con­tin­ued to eat them. For me, it’s eas­ier to just not eat some food groups. But ev­ery­thing I’ve done has made me feel bet­ter – cut­ting out dif­fer­ent food groups, not feel­ing bloated. There is sim­ply no in­cen­tive to go back.”

Weight loss doesn’t al­ways progress “in a straight line”, he stresses. “At any time you can go up again in weight and you have to ac­cept that. It hap­pens. The year and your life have their own pat­terns – Christ­mas, a wed­ding – you can’t be ob­ses­sive.”

If he does gain a few pounds, he takes cor­rec­tive ac­tion by, for ex­am­ple, cut­ting out all desserts for a few weeks.

Still, he be­lieves any­one can tackle their weight is­sues by iden­ti­fy­ing the most in­flu­en­tial com­po­nents of lifestyle and diet, and then mak­ing changes. “It’s all too easy to be de­feated by the moun­tain, but those two changes could l ead to two other things. It would have been all too easy for me to say when I weighed 120kg ‘ this is a moun­tain and I’ll just not bother’. Recog­nise it takes time, and don’t beat your­self up. Ask, what is it you are eat­ing most of? Are you phys­i­cally ac­tive and, if not, what ex­er­cise might be suit­able for you?”

One of the images that drives him on, he says, is that of six 5kg bags of pota­toes. “I tried car­ry­ing six of them around and it ain’t easy – but that’s the weight I used to carry around in body fat.”

Lots of peo­ple ask me how do you have the willpower to do it and I tell them it’s the re­verse. If I had real willpower, I’d have cut down on foods


Tony O Brien, head of the HSE, af­ter his 35kg weight loss. Right: O’Brien shortly af­ter he had his weight wake-up call in 2012.

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