Obesity - the shocking
by Deborah Condon
Obesity is the medical
term used to describe the state of being overweight to the point where
it is harmful to your health. It may be hard to believe but some Irish
patients are so overweight, they cannot be admitted to a hospital
bed as it will not sustain their weight.
An obese adult is
three times more likely to develop diabetes, compared to a person who remains
within a healthy weight range. The news is even worse for children and
intake of Irish people today is broadly the same as 20 years ago, but activity
levels have dropped off", according to consultant endocrinologist, Dr Donal
O'Shea. "The way in which society has changed means that everything is
now done for us. We don't even have to roll down our car windows anymore,
we simply press a button. When we enter a building, we rarely have to use
stairs because of lifts. These very small changes in activity have led
to this", he explains.
Even more shocking
is the fact that between 1990 and 2000, the number of obese people aged
16 - 24 has more than tripled, rising from 3% to 10%.
The World Health Organisation
defines obesity as a body mass index (BMI) of 30 or more. A person's BMI
is calculated based on their weight and height. A person with a BMI of
under 25 is considered normal and the risk of developing conditions such
as diabetes is minimum. A BMI of 25 - 30 is considered overweight and the
risk to health is increased.
According to Dr O'Shea,
a consultant endocrinologist at St Columcille's Hospital in Loughlinstown
in South Dublin and St Vincent's University Hospital, there is much concern
over the number of overweight and obese young patients attending not only
diabetes clinics, but general medical clinics too.
recent study in the UK found that children as young as three were presenting
The strain that this puts on the pancreas...it simply would not be able
to cope. This is a completely new phenomenon which has only been seen in
last 10 to 15 years", he says.
While there are many
factors that contribute to obesity, Dr O'Shea believes that one of the
key issues is activity levels, or more precisely, the lack thereof. Young
obese people are five to 10 times more likely to go on to develop diabetes.
Activities that were commonplace 20 years ago but which may not be possible
today, such as walking to school, must be replaced, he says.
However, Dr O'Shea
also acknowledges that the nature of food is different today too. Convenience
undoubtedly plays a huge role in people's choice, as indicated by the ever-expanding
range of 'ready meals' now available, as well as the plethora of fast-food
restaurants which continue to pop up.
In dealing with this
issue, balance is the key. We need a balanced diet, but the messages we
receive about food also need to be balanced. This is why Dr O'Shea would
not necessarily support a ban on celebrities endorsing foods such as crisps
and McDonald's, but would instead like to see more balance. "I would
like to see them endorsing healthier foods too, to make healthier foods
attractive to young people", he says.
Fast food bans?
He has a similar view
in relation to fast-food restaurants. When McDonald's proposed opening
a new outlet in Ennis in Co Clare recently, the Mid Western Health Board
lodged a formal objection, citing health concerns, particularly in relation
to obesity amongst children.
Dr O'Shea says he
believes this was a 'fantastic stand' to take as it 'sends a real message
to people that we have allowed a passive lifestyle to take over'. However
he believes that people should be able to go into McDonald's 'once in a
while'. "The problem is people are not going in every once in a while,
they are going in regularly and they are not balancing this with activity".
When it comes to the
issue of obesity and children, ultimately, responsibility lies at home.
message needs to come through school but it must be delivered at home.
to be a campaign for parents to make them aware of this issue", he
But what about adults,
particularly older people who may have developed diabetes late in life
and are finding it difficult to change their life-long habits?
a person does not want to change, then we as health professionals are wasting
time dealing with them. However it is a question of educating people. We
need to let people know that obese people die an average of seven years
younger. They are three times more likely to develop diabetes, three times
more likely to have a heart attack and three times more likely to have
a stroke", he explains.
Dr O'Shea says that
the statistic relating to stroke tends to be 'more frightening'. "When
people hear the word stroke, they get worried". He says that this
information needs to go out in a major public campaign, similar to the
anti-smoking campaign of recent months. The issue also needs to be part
of every GP and hospital review, so if you are attending a family doctor
or a hospital clinic and you are overweight or obese, you should be warned
about the dangers.
Dr O'Shea warns that
no hospital service in the country is currently able to deal with people
who are morbidly obese. "A hospital bed can take a weight of 170 kilos
(26 and a half stone). We have at least 20 patients who are above that
weight, therefore they cannot be admitted to hospital", he explains.
Hospital beds cannot
withstand a weight of more than 170 kilos
Dr O'Shea expresses
concern about the current rate at which obesity is increasing in Ireland,
particularly in relation to the 16 - 24 age group.
obesity rate trebled amongst this group within 10 years. If that rate continues,
30% of this age group will be obese in the next 10 years. If that happens
- well it doesn't bear thinking about".
He is under no misconception
that the problem of obesity is going to get worse in Ireland before it
gets better. The issue, he says, is 'how much worse?'
school-goers will face less of a problem in this area, due partially to
the SPHE (social, personal and health education) programme, which has already
been introduced into a number of primary schools nationwide. The aim is
to introduce SPHE as a subject on the primary and secondary curriculum.
The SPHE programme will include a wide range of topics, including healthy
eating, alcohol and safety.
hope that today's school-goers will be ok. We won't know if they are for
10 to 15 years though".
When asked if he ever
gets frustrated with his work, given that obesity is a largely preventable
problem, Dr O'Shea says 'no, not frustrated', but at times, 'incredibly
Use the irishhealth.com 'Body
Mass Index' calculator to find out your BMI at...