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Demi
Wed, May-03-06, 02:57
The Times
London, UK
3 May, 2006


EVERY GP is to be instructed to tell fat patients that they should lose weight, putting doctors in the front line of a new offensive to tackle Britain’s growing obesity problem.



In future GPs will have to treat obesity as if it were any other medical condition and advise the overweight to slim.

It is the first time that doctors have been asked to cajole fat patients, old and young, to eat less, improve their diets and take exercise.

The move by Caroline Flint, the Public Health Minister, is directed in particular at children and young people who need help to lose their excess pounds.

However, GPs have been told not to be too blunt or bossy with the overweight, particularly children. Guidance on how to broach the tricky subject is being sent out to doctors tomorrow. Leaflets for adults and children will be handed out at surgeries and by school nurses.

Giving doctors a frontline role to get the nation into shape comes after efforts to improve school meals and remove junk food from school vending machines.

In an interview with The Times, Ms Flint said that parents had to join in the crusade for healthy living. “Parents have a huge influence over their children and they must say ‘no’ to their children,” she said.

The minister, a mother of three, said that she had to be strict with her own family.

“Like many families I find I have to ration what we have in the house. All mothers know if you buy several packs of biscuits you will come home and find they have all gone. Parents have got to make choices for their children. I know it’s not easy but these messages get through to children.”

She said that she did not want doctors to be pushy with the overweight.

“But GPs will help people get started on diet and exercise. This does not mean someone has to change their life. It’s not about people going on very detailed diets or a very extreme exercise regime. It is not about doctors and ministers telling people what to do. But it is providing support and finding ways to reach people who need help. An obese child has nearly always got obese parents.”

Doctors are advised not to tell a parent: “You know your child should lose weight.” Instead they should encourage a discussion: “How do you feel about your child’s weight?”

GPs should also encourage families to join a leisure centre and children to have at least 60 minutes’ exercise a day.

GPs are also being told to warn people off faddish diets such as the low-carbohydrate, high-protein Atkins diet because the long-term impact on health is not clear. Old-fashioned calorie counting and eating 500 to 600 calories a day less than the body needs is suggested as a realistic way to lose weight. On average men need 2,500 calories and women 2,000 calories a day to stay the same weight.

If a child and his or her parents are unwilling to change their eating and exercise habits, doctors are urged to tread softly because failure to lose weight might affect a child’s self-esteem. In these circumstances GPs are told to weigh the patient and raise the issue of weight at the next visit.
Among other slimming tips are taking a route to avoid walking past a fish-and-chip shop, not keeping crisps in the home and never offering food as a reward or for comfort.



GPs are being urged to use the body mass index (BMI) to show if patients are overweight. A rating of more than 30 is the yardstick for obesity.

BMI is calculated by dividing a person’s weight by the square of his or her height. Charts are to be included in information packs for GPs.

Despite the Government’s attempts to highlight obesity, and efforts by companies to cut levels of salt, fat and sugar in food, a new study shows that people are becoming fatter.

Nearly half of teenage girls and more than a third of teenage boys are overweight or obese, according to the latest Health Survey of England.

In the past year the proportion of boys aged 11-15 who are obese or overweight has risen from 26.9 per cent to 36.4 per cent, while the number of girls has leapt from 29.3 per cent to 45.6 per cent.

A quarter of all adults are dangerously fat.

MEASURING UP

Body mass index is weight in kilograms divided by height in metres squared

Thus a person weighing 70 kg and 1.7 metres tall would have a BMI of 70 divided by 1.7 squared (2.89) — that is, 24

A BMI of 18.5 to 24.9 is normal, 25 to 29.9 overweight, and over 30 obese




http://www.timesonline.co.uk/newspaper/0,,172-2162594,00.html

ojoj
Wed, May-03-06, 03:11
I work with gps and quite frankly an awful lot of them are obese - aome I can think of are very, very obese! How are they gonna word that one to patients??

liddie01
Wed, May-03-06, 03:50
"GPs are also being told to warn people off faddish diets such as the low-carbohydrate, high-protein Atkins diet because the long-term impact on health is not clear. Old-fashioned calorie counting and eating 500 to 600 calories a day less than the body needs is suggested as a realistic way to lose weight. On average men need 2,500 calories and women 2,000 calories a day to stay the same weight"

Looks to me like people in the UK are going to get even fatter :nono:

kebaldwin
Wed, May-03-06, 04:24
EVERY GP is to be instructed to tell fat patients that they should lose weight

as if they don't already know that ...

what they need to know is how to lose the weight

most people have tried everything and seen no progress, or unable to starve themselves every day for the rest of their lives

kyrasdad
Wed, May-03-06, 05:45
as if they don't already know that ...

what they need to know is how to lose the weight

most people have tried everything and seen no progress, or unable to starve themselves every day for the rest of their lives

EXACTLY! This reminds me of the times some "helpful" person would so politely tell me that I needed to lose some weight. Duh! I was 350 pounds - did they think I didn't know? Coming from a physician (and it did once for me from a true clod of a doc) it wasn't any more useful. Nobody fat is under a real illusion that they are not. They may build in some defenses that they aren't that fat, but even in their heart of hearts, they know differently.

Of course, the advice to ignore "fads" like low carb are the stupidest part. Gotta get those grains eaten, at all costs.

Lez
Wed, May-03-06, 05:51
The Times
London, UK
3 May, 2006



GPs are also being told to warn people off faddish diets such as the low-carbohydrate, high-protein Atkins diet because the long-term impact on health is not clear. Old-fashioned calorie counting and eating 500 to 600 calories a day less than the body needs is suggested as a realistic way to lose weight. On average men need 2,500 calories and women 2,000 calories a day to stay the same weight.





GPs are being urged to use the body mass index (BMI) to show if patients are overweight. A rating of more than 30 is the yardstick for obesity.

BMI is calculated by dividing a person’s weight by the square of his or her height. Charts are to be included in information packs for GPs.

Despite the Government’s attempts to highlight obesity, and efforts by companies to cut levels of salt, fat and sugar in food, a new study shows that people are becoming fatter.

Nearly half of teenage girls and more than a third of teenage boys are overweight or obese, according to the latest Health Survey of England.

In the past year the proportion of boys aged 11-15 who are obese or overweight has risen from 26.9 per cent to 36.4 per cent, while the number of girls has leapt from 29.3 per cent to 45.6 per cent.

A quarter of all adults are dangerously fat.

MEASURING UP

Body mass index is weight in kilograms divided by height in metres squared

Thus a person weighing 70 kg and 1.7 metres tall would have a BMI of 70 divided by 1.7 squared (2.89) — that is, 24

A BMI of 18.5 to 24.9 is normal, 25 to 29.9 overweight, and over 30 obese




http://www.timesonline.co.uk/newspaper/0,,172-2162594,00.html

BMI my A$$. The BMI is as much use as a wooden rule to an engineer

Low carb diet, not proven? it is to me

So my GP who is over weight is going to tell my What? Eat the same as him?

KarenJ
Wed, May-03-06, 08:45
"GPs are also being told to warn people off faddish diets such as the low-carbohydrate, high-protein Atkins diet because the long-term impact on health is not clear. Old-fashioned calorie counting and eating 500 to 600 calories a day less than the body needs is suggested as a realistic way to lose weight. On average men need 2,500 calories and women 2,000 calories a day to stay the same weight"

Looks to me like people in the UK are going to get even fatter :nono:


Agreed.

When are they ever going to get their heads out of the sand? :read2:

Dodger
Wed, May-03-06, 09:09
How many overfat people don't know they should lose weight? Physicians should be spending their time helping those who their skills can help. Telling fat people to lose weight is just going to irritate them.

Caroline Flint doesn't seem to have any qualifications to be health minister to begin with. http://www.dh.gov.uk/AboutUs/MinistersAndDepartmentLeaders/MinisterOverview/MinistersBiography/fs/en?CONTENT_ID=4109920&chk=9SIEqm

fluffybear
Wed, May-03-06, 09:18
Although I grew up very skinny and was slim until I got married and had children, I now am in the obese category. Even though I gained anywhere from 30 to 40 lbs. with each of my pregnancies and have been overweight most of my adult life, few doctors have mentioned my weight. Eventually, I deveolped hypothyroidism and high blood pressure. I finally went to an endocrimologist who advised me to cut back on carbs, but even then he wasn't too specific. I would love to have a doctor who would really work with me to help me lose weight.

Uliana
Wed, May-03-06, 09:38
While doctors shouldn't state the obvious to patients, who are already well aware of thier condition, they should lay out in clear terms what the health risks of being overweight are. My DH's doctor told him in no uncertain terms that unless he lost weight, he was at risk or a heart attack or stoke within a few years.

My DH was 32 at the time and kept having his BP meds upped in strength because they were not working. He weighed over 300 lbs. His triglycerides were in the 300s (can't remember the other #s but they were bad). He couldn't walk very far without pain in his knees and lower back. Luckily, this doctor was in favor of Atkins, saying that he had seen success with it in other patients of his. He told DH that the risks of being overweight are far worse than trying a "crazy" diet.

End result: DH lost 150 lbs, his triglycerides are in the 40s and his BP is 115/70. He is now very fit from jogging/biking, though he still has some occasional pain in his knees and lower back from the permanent damage from his weight.

fluffybear
Wed, May-03-06, 09:42
While doctors shouldn't state the obvious to patients, who are already well aware of thier condition, they should lay out in clear terms what the health risks of being overweight are. My DH's doctor told him in no uncertain terms that unless he lost weight, he was at risk or a heart attack or stoke at the within a few years.

My DH was 32 at the time and kept having his BP meds upped in strength because they were not working. He weighed over 300 lbs. His triglycerides were in the 300s (can't remember the other #s but they were bad). He couldn't walk very far without pain in his knees and lower back. Luckily, this doctor was in favor of Atkins, saying that he had seen success with it in other patients of his. He told DH that the risks of being overweight are far worse than trying a "crazy" diet.

End result: DH lost 150 lbs, his triglycerides are in the 40s and his BP is 115/70. He is now very fit from jogging/biking, though he still has some occasional pain in his knees and lower back from the permanent damage from his weight.

Yep, my husband's doctor told him to lose weight also. Unfortunately his doctor is a VEGETARIAN, so he would never be in favor of low carbing.

potatofree
Wed, May-03-06, 09:57
I'll bite...

Yeah, I knew at nearly 300 lbs I was fat, and I know I'm still fat now... but I don't feel my doctors did me any favors by pussyfooting around the issue or ignoring it altogether.

It's not in telling a patient "You're fat." but in helping them find a way to cut through the bullsh** excuses like the ones I made, and to a certain extent, STILL make... like "I'm not THAT big, really... my health is fine right now, so I don't need to worry... " while helping them to solve the problem. I know a lot of doctors fall WAY short of the mark there, so I agree they all need a good education in how successful "faddish" low-carb really is.

I just don't think weight should be any different than any other health factor when it comes down to it. Would you worry, as a doctor, about trying to get a lung cancer patient to quit smoking for fear of hurting their feelings?

kyrasdad
Wed, May-03-06, 10:52
I just don't think weight should be any different than any other health factor when it comes down to it. Would you worry, as a doctor, about trying to get a lung cancer patient to quit smoking for fear of hurting their feelings?

That I can agree with. Making sure that they understand all the risks associated with the condition should be done. I never had a doctor do that, but I knew those risks. The one doctor who did talk with me about it was a complete choad, never got into facts, and was generally useless. I fired him for other reasons, but that didn't help his case.

If a doctor approaches it correctly, I think it can be a good thing. I know people are more emotional about beging fat than they are, say, being a smoker. It's just more personal, and they get tired of the judgment and lectures. They do not need to be informed that they are fat, but they do need real information on what the consequences may be, and help on fixing it. My new doctors, by the way, are very open to Atkins and low carb. There is the standard warning about vegetable eating, but that's to be expected. I think many doctors still believe that low carb eating is no carb eating.

Frogbreath
Wed, May-03-06, 13:30
When are they ever going to get their heads out of the sand? :read2:

I'm not sure that's where their heads are. :lol:

potatofree
Wed, May-03-06, 16:29
The first doctor to ever speak to me about my ballooning weight was an OB/gyn who had basically just saved my life. I had a rupturing ectopic pregnancy that had been obscured by my "fat pad" making timely diagnosis more difficult.

He was a lot bigger than I was, and he stated up front that he realized his own struggle with weight might make advice from him harder to take, but when he spelled out the risks my weight had caused in the immediate crisis as well as the future... well I actually took it MORE seriously because I could hear the concern in his voice and because he applied it to himself as well. He didn't talk TO me, but WITH me about it.

I wish I had been really ready to listen back then.

ItsTheWooo
Wed, May-03-06, 21:02
as if they don't already know that ...

what they need to know is how to lose the weight

Friend you have just summed up my exact line of thinking when my endo told me that my "weird hormone problems" would go away if I lost weight. As if I was choosing to be hungry, choosing to eat too much, choosing to be fat.

Oh and the "caution against fad high protein diets" is a riot... way to ensure NO ONE succeeds in their goal to be thin (hint: eating less of something that isn't energizing you to begin with is destined to fail)

BTW: she was wrong and within like 5 minutes of the Atkins diet, bye bye PCOS symptoms.

kebaldwin
Thu, May-04-06, 03:45
People know that heavy drinking does bad things to your health over time.

People know that smoking does bad things to your health over time.

People know that drugs do bad things to your health over time.

Most people have no idea what the "western diet" (what most doctors are telling them to eat) will do to them over time.

so many health problems disappear within weeks to months -- if I was a doctor and it was not an absolute emergency -- I would put everyone on the Atkins diet (including supplements) for two months first.

First I would scare the %#$~ out of them about what happens if they don't improve their nutrition - then I put them on the atkins diet.

If you stop eating bad things and start doing good things about your nutrition (i.e. eat low carb and take supplements) the body has an amazing ability to heal itself.

liddie01
Thu, May-04-06, 04:54
My doctor told me for years to cut down on my drinking [I am a recovering alcoholic] so i am 14 years sober, soon as i was sober a year, he started on my smoking, I quit that, finally, 6 years ago, and then he started on my weight, and finally i am losing it, Now when I am a healthy weight, I do not know what he will find to nag me about :lol: