Obesity is causing a health crisis – but NHS doctors just seem to shrug

Doctors standing around in their white coats saying tut-tut is not going to solve the problem

Eating less and moving more, is a bit like telling someone with a broken leg to get a bandage and some paracetamol (Getty/iStockphoto)

About halfway through my mission to lose weight, I went to the doctor – nothing serious, just a small thing I wanted to have checked. I haven’t always felt confident about my health: when I was numbered in the morbidly obese statistics, I would waddle into the doctor’s surgery, hoping like mad I wouldn’t leave with a death sentence.

But on this visit, with nearly three stone gone, I was rather looking forward to it – anticipating gasps of amazement at my reduced size and rapt attention while I explained how I did it.

I suppose that since my last visit, the GP had seen one or two other people, and my previous colossal size might have escaped her memory, but it is a terrible moment when you realise your mother was right when she said that you were not the only pebble on the beach.

Eventually (not a long eventually – NHS GP appointments do not allow for a long anything), when her awestruck rapture failed to materialise, I told her about my dramatic weight loss. I assumed that she would be keen to hear all about it. This was not merely my ego working overtime: the NHS never stops bemoaning the problems of dealing with an obese population, and I thought she would want to know about something that actually worked.

She did not. She didn’t have time. Of course, she didn’t – she had a waiting room full of fat people to see. She said that the main problem was that people weren’t motivated.

I did not pick up my chair and hurl it at her skinny person’s immaculately smoothed haircut, but any reasonable judge would have seen my point. I did briefly consider dumping a lorry-load of my diet books onto her front lawn. But instead, I told her – in my most reasonable voice – that it is not that we aren’t motivated, but by the time we are seriously fat, most of us have tried every which way to do something about it. Nothing has worked, or at least not for very long (95 per cent of people regain all the weight they have lost) – and we have given up in despair. She gave me a pitying look. I had just confirmed her belief in our pathetic lack of motivation and total absence of willpower. 

But I was undeterred: ignoring her obvious lack of interest, I asked her if I could tell her about Weight Watchers. Her eyes glazed. She had my sympathy: other people’s diets are right up there with paint-drying and short cuts around the Birmingham ring road, and Weight Watchers gets no prizes for charisma. 

But it is famously effective, and as a doctor, in the middle of a global obesity crisis, I thought she would at least have a professional interest. In fact, as it is so famously effective, I half expected her to say, “Oh yes, I know all about it, and we’re looking into how we can use it to help our patients,” or perhaps, “Well, it’s OK, but the NHS has done extensive research and developed a much better one – do you want to try it?”

She did not. She said, “Well, it might work for you, but everyone is different, and the NHS does not do individually tailored approaches.” So that’s it. There is a weight loss plan and help for obesity on the NHS website. But, in truth, it lacks cohesion because some people need one thing and some people need another.

I later met one of the other GPs while I was out walking. I sounded him out on the subject, wanting to check that his colleague wasn’t just spouting her own thoughts on the matter. He said much the same thing, with the addition of a diatribe about people needing to use self-control, and the fact that the state shouldn’t have to do everything.

I wasn’t exactly surprised by his response. Over the 20 years that I had known him, he had watched me grow from the upper end of overweight to morbidly obese, and occasionally muttered something about eating less and moving more, which is a bit like telling someone with a broken leg to get a bandage and some paracetamol from Boots: if it were that simple, we wouldn’t be fat.

I don’t expect everybody to keep up to date with the latest medical and scientific research on obesity, but a cursory acquaintance with the genetic, hormonal, biochemical, and metabolic factors, and the addictive nature of junk food and the impact of marketing, product placement, and nudge techniques on hunger and food choice might be more helpful to doctors than relying on prejudice and ignorance. And it would also be helpful if they could tell the difference between a person feeling defeated by a problem they have tried and failed many times to address, and a person who just can’t be arsed.

The particular thing I would like them to be bang up to date on, is the growing body of evidence that obesity can be a symptom of metabolic disorder, not a character defect.

As I made my disgruntled way home, I thought about a young woman with significant learning difficulties who works in the local Co-op. Whenever she sees me, she asks me about how I lost my weight, and tells me how unhappy she is about being fat; and then she tells me that there had been a slimming group in the village, which she had found really helpful, but it had moved. Without transport – she can’t drive, and the bus service is not designed for anyone who actually needs to get anywhere – she couldn’t go to another one.

There was nothing wrong with her motivation, but without help she was in despair. And she was right to despair: since our first conversation a couple of years ago, her weight has ballooned – doubtless helped by the daily assault on her self-control from working in a shop that for much of the year displays chocolate and snack food in 16 different places. I can think of few better ways of making sure my self-control goes AWOL than spending my days next to mountains of chocolate.

Obesity is the most successful pandemic since the bubonic plague, and it’s not going to be sent on its way by doctors standing around in their white coats saying tut-tut.