'Reflections on Body Image' - it’s a doctor’s duty to tell patients about their weight-related health risks

A new report by the All Party Parliamentary Group on Body Image and the Central YMCA, Reflections on Body Image, recommends body image and self-esteem lessons for children, and possibly making use of the term ‘fat’ or ‘obese’ a crime on a par with other discrimination.

So far, so good. I feel desperately sad when I see young teenagers reduced to a shadow of their former selves by cruel taunts about their size, or an eight year-old unable to enjoy a birthday party because they are worried about the calories in the cake. As a GP, I see the consequences of discrimination or society’s pressure on the mental health of youngsters every day. I would love to see this kind of abuse clamped down on.

Rosi Prescott, chief executive of Central YMCA, has apparently suggested that people shouldn’t be told they are carrying extra weight, even by their doctors. "If they don't feel overweight, and there are no health indications, what's the problem?"

The problem, Ms Prescott, is that if you had bothered to read all the evidence, you would know that there are always health implications to excess weight. Countless studies over many decades show without any shadow of a doubt that the risk of diabetes, heart disease, cancer and arthritis rises steadily with your weight.

The traditional methods of measuring weight using body mass index (BMI) divide people into underweight, ideal, overweight, obese and morbidly obese categories. People in the overweight range have a higher risk of health problems than those in the ‘ideal’ range; risks in the obese range are higher than in the overweight and so on. I certainly don’t condone doctors crushing a vulnerable patient’s self-esteem by giving them a complex about their weight. But doctors must keep the right - indeed, the duty - to tell their patients just how they are putting their health at risk with their weight.

Low self-esteem and eating disorders are important public health issues - but so is obesity. The proportion of obese people in the UK has doubled to 25% of adults in less than 20 years, bringing with it a tidal wave of diabetes. I regularly see patients who believe their weight is ‘normal’ just because so many of their contemporaries are as overweight as they are. Political correctness gone mad, as we see from Ms Prescott, could do serious damage to our nation’s health.

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