SECOND OPINION:WITH ALL the media coverage of Queen Elizabeth and Barack Obama's visits to Ireland, it is easy to miss the Safefood campaign that has been running throughout May.
Stop the Spread has received very little media coverage even though obesity has the potential to cause more harm to Irish people than our economic problems. Of course, the financial situation will mean we can’t afford to provide health services to people who are obese, so we had better try to prevent it instead.
The campaign consists of distributing free measuring tapes at your local pharmacy. If your waist measures more than 32 inches for a woman or 37 inches for a man, then you are overweight. This focus on overweight as opposed to obesity is a good move as many people don’t realise they might be on their way to becoming obese. However, selecting pharmacies as the distributors was an unfortunate choice.
I collected my tape last week and the first thing that struck me when I entered the pharmacy was the huge array of weight management and slimming aids that were for sale.
Shelves were laden with expensive dietary products claiming almost miraculous cures for weight problems. One product offered a diet of a “shake” for breakfast, a “shake soup” for lunch and various shakes and bars for dinner. I called into four more pharmacies and the same products were for sale.
In fairness to the pharmacists, these products were probably available before the campaign started, although a cynic might conclude that the campaign is being used to make money from people with weight problems. Apart from the fact that a person surviving on these products would be hungry for real food and the products are ridiculously expensive, these diets DO NOT WORK. The only effective remedy for overweight is to eat and enjoy real food when you are actually hungry, and be physically active all your life.
Two in three Irish people are now overweight and this leads to many chronic health problems. A new report from the National Obesity Observatory highlights the link between obesity and common mental health problems such as depression and anxiety. The report shows that obese people have a 55 per cent increased risk of depression and people with depression have a 58 per cent increased risk of becoming obese, making it even more important for us to solve our unhealthy relationship with food.
Mood should be monitored in obese people and weight should be monitored in depressed people. Unfortunately these two conditions are treated as separate health problems as are most chronic health conditions, and in fact people often have several health problems at the same time. In America, for example, people over 65 have an average of eight chronic conditions, many of which are weight related.
The HSE Service Plan 2011 outlines the development of separate clinical care programmes for chronic conditions such as asthma, stroke, diabetes and heart disease, all of which are related to overweight, smoking and lack of exercise. When chronic diseases are treated separately, the chances of negative outcomes is greater, including unnecessary hospitalisation, duplicate tests and conflicting medical advice.
Since nearly all chronic diseases have the same causes and solutions, why is the HSE not developing a single wellness programme? Even patient management of a single condition has not translated consistently into day-to-day practice within primary care systems, and there are virtually no effective multiple morbidity intervention models anywhere in the world.
In fact, a recent report shows that up to 37 different techniques are used by health professionals in their efforts to get patients to change their behaviour, most of which don’t work. Favourite ones are advice-giving and awareness-raising, which not only don’t work but can disempower the patient and frustrate health professionals when the patient does not change.
What does work in terms of patient behaviour change is help with self-monitoring and social supports. This is where the tape measure does the job better than an obsession with weighing scales and calories. We need to move to a model where the patient manages their condition and clinicians are just guides or coaches.
You have a week to collect your free tape measure as the Stop the Spread campaign ends on May 31st, safefood.eu.
The Bealtaine festival organised by Age and Opportunity also ends on May 31st, bealtaine.com. The Dawn Chorus on May 29th sounds like fun.
Dr Jacky Jones is a former regional manager of health promotion with the HSE