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Pills not the answer to obesity, says top doctor
Last updated at 09:38am on 03.08.07Obese people are often simply greedy and should not always be treated with pills, the head of the British Medical Association has said.
Dr Hamish Meldrum believes an obsession with medical labels may be stopping overweight people addressing their own problems.
He said the obesity epidemic is being mistakenly targeted with medical treatments and doctors' appointments.
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The obesity epidemic in Britain is mistakenly targeted with medical treatments and doctors' appointments, says Dr Meldrum
Dr Meldrum told our sister paper, the Evening Standard: "We are saying, 'This patient has a hyper-appetite problem' rather than, 'They are just greedy.'
"People like to put fancy labels that suggest things are a medical problem. But [obesity] is not just a problem for GPs, it is societal.
"We are in danger of over-medicalising. The evidence of anti-obesity drugs is not good. The evidence for effective intervention in primary care for obesity is very weak."
Almost one in four adults and a quarter of 11 to 15-year-olds in Britain are obese, according to the World Health Organisation.
The Government wants to halt the rise in childhood obesity within three years but is likely to miss the target. Primary care trusts, which "buy" care for their communities, are under pressure to get the numbers down and GPs were issued with guidance last year. But Dr Meldrum fears this may be the wrong approach.
Controversial: Dr Hamish Meldrum, head of the British Medical Association, says obese people are just greedy
More than a million anti-obesity prescriptions were issued in England in the last financial year at a cost of £47million. It means about 88,000 people could be on a course of treatment.
The drug Xenical, which inhibits fat absorption, and Reductil, an appetite suppressant, were recommended for use on the NHS by the National Institute for Health and Clinical Excellence (Nice) in 2001.
There was a dramatic uptake and prescriptions rose by more than 16 per cent in the 12 months to March.
Dr Meldrum said the pills only worked if people permanently altered their lifestyle but "their effectiveness is under dispute". Guidelines say children as young as 12 can get drugs and stomach surgery to combat their problem.
Dr Meldrum said: "I am not saying we should not look at how we can medically treat people who are very obese. But to me it is obviously an issue where prevention is better than cure."
He said the problem of "over medicalising" also affected other conditions such as attention deficit hyperactivity disorder(ADHD)and dyslexia.
He said he did not dispute that ADHD or dyslexia existed and were debilitating. But they are being diagnosed inappropriately.
Colin Waine, chairman of the National Obesity Forum, said: "How can obesity not be medicalised if there are 45 core morbidities associated with obesity and overwhelming evidence of a causal link?"
Reader views (32)
Here's a sample of the latest views published. You can click view all to read all views that readers have sent in.
True, obese people pay tax and NI too, but if they consume more of the NHS resources to have their conditions treated for something avoidable than those who are well because they look after themselves better, then they should contribute more than the basic proportion.
It takes months, if not years, to become obese. During that time, it isn't just appearance, one can 'feel' it if one's fitness, energy levels and endurance have changed.
I exercise regularly and I go up four flights of stairs at work. I stopped exercising for a few weeks when on holiday, did I notice the difference when I took those stairs after I came back!
No, obese people don't purposefully put on all that weight, and it could have become a downward spiral when they didn't keep themselves in check. So, the key is to be MINDFUL: check intake and activity levels. However, that's already too much to ask for some people.
- Renee Trance, Kingston, UK
I entirely agree with him! Due to ever increasing portion sizes and wide availablity of processed rubbish, with society's demand to have everything 'now', people are getting fatter and fatter and taking no responsiblity for their action. It's ludicrous. I am severely hypothyroid and thus have a slow metabolism but I have a healthy bmi maintained through balanced diet and exercise. No one seems to want to take responsibility for their own actions any more - even when their actions of shoving vast amounts of lard into their faces is making them fat. The pounds don't pile on by breathing.
- Fiona, Aberdeen
Absolutely spot on - we are fast becoming a nation of big fat slobs - and you just cannot hide the facts away. In fact I sometimes wonder how surgeons must be in absolute awe when they contemplate operating upon such people.
- Robert, Kirk Ella, East Yorks.,
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