Obesity and its consequences by Derry GP Dr Tom Black

A local GP told me that the solution, if patients are more than 24 stone is to use two sets of scales, put a foot on each and add the two readings together. This would be funny if the consequences for obesity weren’t so serious for local people.

Obesity in Northern Ireland has become a huge problem with about 2/3 of adults and a quarter of children overweight or obese.

This is worse in areas of deprivation where the levels of obesity are higher for children and adults with more than one-third of children overweight or obese in these areas.

There are many factors causing this obesity epidemic which is getting worse every year and most of us know that it’s a combination of eating too much of the wrong types of food and not taking enough exercise. Many of my overweight patients tell me that they can’t lose weight because they’re unable to exercise but they aren’t keen on the alternative of eating less.

The biggest problem with obesity is the diseases that it causes such as diabetes, heart attacks, strokes, cancer and high blood pressure.

There are five times more patients with diabetes in my practice than there were 30 years ago and no one wants to have diabetes as it has a huge impact on your health and life expectancy.

Obesity is rivalling smoking as the number one cause of cancer and obese people are three times more likely to get colon cancer.

Waiting lists are huge but part of the problem is the increasing burden of disease overwhelming the system.

We’re seeing increasing numbers of patients with bowel disease such as diverticulitis as people aren’t eating their five portions of fruit and vegetables per day and aren’t taking enough exercise.

As a result the gastroenterology service in the hospital has very long waiting lists. The total cost to the NHS in Northern Ireland from obesity is about £500 million per year.

How do we solve this as individuals? The first thing with individual responsibility is recognising you have a problem is the key.

Look at each of your three meals per day and focus on low sugar, low-fat alternatives aiming for five portions of fruit and vegetables per day and if you’re sending out for a takeaway as a fourth meal in the evening you have an easy problem that needs fixed.

Then look at your exercise and try to walk, run, cycle or swim more and a lot of people find that walking 10,000 steps a day is a good target. An old GP colleague long dead would get frustrated with patients failing to modify their intake of food and he distilled his advice down to a pithy phrase: “Your top hole is bigger than your bottom hole, stop eating so much”.

In our modern world of being careful about weight stigma, we try to approach the issue with greater kindness and respect but we can still boil our advice down to “eat less and move more”.