Pills not the answer to obesity, says top doctor

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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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.

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?"