Yes to Counselling and weight-loss plans, but doctors must ensure they treat each case of obesity individually

As new guidelines are issues in the US, specialist causes must not be overlooked

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The Independent Online

New guidelines for tackling obesity in America have been issued by medical professionals. Under the changes, doctors will calculate the body mass index (BMI) of a patient, come up with a weight-loss plan accordingly, and recommend them for counselling. While this is undoubtedly a positive change, and, many would say, long overdue, the individual causes of obesity must not be overlooked. It is vital that these differences are recognised, and that the message given by the doctors is not the same in all cases.

One comment on an online news report on the topic of the new guidelines highlights an example of when a simple message can be beneficial. Barbara writes:

Eleven months ago I weighed 192 lbs. at 5'4 in tall. My dear doctor told me I was headed for diabetes and told me what to do. Now, eleven months later, I am 155 lbs. and still losing. My goal is 125 lbs. and I am 63 yrs. old. I am more active, eat smaller portions and feel better than I have in the last three years. His advice? Eat less, move more. Yes, I have other health issues, one being hypothyroid, but I refused to let that be an excuse for my overweight condition. I was eating and drinking too much and spent way to [sic] much time watching TV and the computer. It's all limited now...the sitting around, nibbling and eating big portions, and this worked for me.

In America over a third of adults are obese; millions more fall into the category of overweight. It is crucial that those such as Barbara are provided with the information they need in order to strive for a healthy weight. Conflicting media messages don’t help. While the prevalence of slim people in advertising remains, ensuring that the world is bombarded with subconscious (or not-so-subconscious) messages promoting the ‘thin as beautiful’ notion, the media also presents us with an apparently divergent concept. At a more obvious level, we are told to love our bodies for what they are, to stop comparing ourselves to others, to accept our lot. But this omits the message that sometimes, loving your body means doing what is best for your body: accepting that while there are some things you can’t change about it, you have the ability to treat it well, rather than damage it.

If an individual has chosen to embrace the surface message that ‘big is beautiful’ – not realising that big in this case can be referring to a size 16 as opposed to a size 4- they might not mark the difference between a larger body size and a health risk. To hear it from a doctor might be the changing factor. It is mad to suggest that now the health risks are so clearly evident, GPs should be withholding information from patients. One argument suggests that this is not the domain of doctors - once people are adults and have access to the necessary information, they should be left to make their own decisions. This is flawed since many people, though noting the health risks of obesity, will not realise it applies to them.

However, for many people suffering from obesity as a result of their lifestyle (i.e. excluding those whose weight is a result of medication), they are fully aware of the damage they are causing to their bodies. This doesn’t mean that they have the means to stop doing this. Many of the comments on the news reports of the recent changes say things like "Eat Less, Exercise More. It's not that hard to figure out, people". They demonstrate the lack of public understanding about the many conditions and mental states that both contribute to weight gain, and prevent weight loss. If you are suffering from depression, for example, you may well lack the motivation to do anything about your behaviour. Eating can be a coping mechanism, too. Caitlin Moran writes, "Overeating is the addiction of choice of carers…It’s a way of f*cking yourself up whilst still remaining fully functional, because you have to." And this is without even touching on actual eating disorders. Clearly, it is frequently not just a question of eating less, and can often require a complete change in mental attitude - a change that can be difficult to achieve.

So for some, it might really be as simple as informing them of the risk they are putting themselves under, and highlighting the options available to them if they wish to make changes. Others will require more specific help, and there may be an underlying issue that needs to be dealt with first. As long as we remember that many have a more complex relationship with their weight than others, these new guidelines can only be a good thing.