At the beginning of this week The Academy of Medical Royal Colleges released the latest report entitled:

“MEASURING UP: THE MEDICAL PROFESSION’S PRESCRIPTION FOR THE NATION’S OBESITY CRISIS”

There are 10 key recommendations which it is believed are necessary if progress is to be made in tackling the obesity crisis in the UK.

 

Unfortunately it trots all the same arguments which not only exaggerate the dangers of people being overweight/obese but also continue to proclaim that the problems will be solved by applying the approach which has manifestly failed to deliver the results expected.

 

I will just deal a selection of the flaws contained in this report which apparently is supposed to represent the views of almost the entire medical profession.

  • According to the report:

Obesity is one of the largest public health threats facing many of the wealthiest nations in the 21st century. Every day doctors treat people, young and old, who are facing the health consequences of being overweight or obese, such as high blood pressure, type 2 diabetes, heart disease, strokes, depression, and some major cancers. These illnesses are putting our nation’s health – and the budget of the NHS – under strain, and the contributions of overweight and obesity are growing.”

It is simply not true that people who are overweight have serious health problems. There are several reliable and comprehensive studies which demonstrate that those who are “overweight” as determined by BMI have a greater life expectancy than those with the so-called ideal BMI “normal” category. In fact within the last few weeks a paper in the Journal of the American Medical Association from the prestigious Center for Disease Control(CDC) found that those who were mildly obese(BMI 30-35) had the same life expectancy as those with a normal BMI( see BLOG 11).

Furthermore for any given BMI value there are huge differences life expectancy. Those who take regular exercise have a much greater expectancy than those who are sedentary. While I recognise that those at the extremes (and we need to be just as concerned about those who are seriously underweight as well as those with excessive weight) it is totally irresponsible to advise people with a BMI in the range of 25-35 that they should be attempting to lose weight. For these weight per se is not necessarily a problem and the emphasis should be encouraging those who are sedentary to get out and take some exercise. This must include those with a BMI considered normal (See BLOG 12).

  • The report makes numerous references which imply that there is too much salt, sugar and fat in the diet. Saturated fat also comes in for criticism.

It is a great pity that there is a failure to appreciate that since the dietary recommendations were introduced over 25 years ago, there has been a substantial fall in the proportion of fat in the UK national diet. The target to reduce saturated fat by 25% was actually achieved some years ago. Anyone who takes the time and trouble to evaluate the relevant research dispassionately will soon reach the conclusion that fat is not the problem. The reality is that the case for avoiding saturated fat is completely bogus and that by doing so we are depriving ourselves of vital nutrients which are present in foods such butter and meat. The fundamental problem is too much carbohydrates, especially those which are refined (eg sugar). Because many people have been convinced they must reduce their fat intake there has been an enormous increase in the demand for “low fat” products. It just so happens that most of these are formulated by removing fat and replacing with sugar!

  • It is clearly implied that the obesity crisis will be solved if only those affected would reduce their Calorie intake and thereby lose weight.

There is absolutely no doubt that the attrition rate amongst those who attempt to lose weight is extremely high. On top of this, the vast majority of those who succeed re-gain the lost weight within a short time. Ironically there is sound research which shows that those who weight cycle(ie repeatedly lose and re-gain weight) have much poorer health than those who steadily gain weight throughout life.

The fundamental problem is that the health professionals have been providing governments with the wrong advice and then blaming the politicians because it has not worked. If we are to make any progress then the politicians have to challenge the “experts” and not meekly accept their recommendations