Unless we admit that obesity’s an addiction, the NHS is doomed
WITHIN ten years, it’s estimated that one in four hospital beds could be taken up by patients with type 2 diabetes. Just think about that: a quarter of everyone in hospital will suffer from the condition.
shockingly, some experts say this is a conservative prediction. And to make things worse, the epidemic is hitting the young in ever higher numbers.
Researchers this week revealed that record numbers of young adults are being diagnosed with type 2 diabetes, while experts warned that ‘youngonset’ diabetes is especially dangerous and needs aggressive treatment.
Unhealthy diets and sedentary lifestyles mean a generation of people are eating themselves into an early grave. And if this goes on, they will bring the nhs down with them.
Yet what actually does the nhs do to help patients who are overweight? What support and services are available? The answer is next to nothing. Patients are told simply to go away and shed the pounds themselves, or they’re shipped off to dieting classes (or, in the most extreme cases, bariatric or stomach surgery).
It’s true that, for many, dieting is a successful way to lose weight and either stave off or reverse type 2 diabetes. But for others it often fails to work and many people put back on any weight they do manage to shift.
To me, this all shows we are approaching the obesity epidemic in the wrong way. We need to address the underlying cause of obesity, and this means offering people psychotherapy to address problems that led them to become overweight in the first place.
Food is often used as an emotional crutch — we even have an everyday phrase for it, comforteating — and research has shown that when people are taught alternative coping strategies for dealing with their emotions and difficulties, they stop using food for support and lose weight.
We need to view patients who are obese as having a psychological problem in the same way we do alcoholics or drug addicts. And just as we have drug and alcohol services in the nhs that use psychotherapy to help people beat their addictions, so we should have fat clinics for the obese.
I work in an eating disorders unit and frustrated GPs who are struggling to cope with obese patients regularly refer them to me. Yet the unit is not funded by the nhs to provide this kind of support, so shamefully we have to turn them away.
One typical example was an overweight 40-year- old woman with pre-diabetes who had damaged her shoulder and leg in a fall, was confined to her home and had turned to food to help her through her misery. she wasn’t stupid, she knew she should stop eating — it’s just that she couldn’t.
OF COURSE, not everyone who is obese has underlying psychological issues. some people choose to eat certain foods; others simply lack the knowledge or willpower to lose weight. But even they can benefit from psychological input.
There is a type of intervention called ‘motivational interviewing’ that involves getting the patient to understand the benefits of changing their behaviour. It’s used in patients with drug and alcohol This week, the eating disorder unit where i work had a visitor — simon stevens, CEO of Nhs England. i was hugely impressed by the way he interacted with everyone. What was most touching was the way he seemed to have endless time to talk to the patients and seemed genuinely interested about the difficulties facing patients and staff. it’s easy to criticise those in charge as faceless bureaucrats. But credit where it’s due. Yes, there are problems with the Nhs. Yet watching him, i was struck by what an impossibly difficult job he has, yet how well he tries to do it. problems. It sometimes requires multiple attempts over long periods, but ultimately it does have good ‘outcomes’ and results in lasting change. Why aren’t we training more GPs, nurses and specialists in this type of intervention to prevent diabetes?
The brutal truth is that the obese are crippling the nhs. I don’t want our country to be in a situation where the sick and needy cannot get treatment simply because the health service has been brought to its knees by people who won’t say no to food.
The lack of psychological support in the health service for the obese is desperately short-sighted. While such help is readily provided to people with anorexia or bulimia, obesity is still considered a personal failing rather than a consequence of multiple complex psychological factors.
Until this attitude changes, we cannot hope to get on top of the diabetes epidemic.