Obesity - the shocking facts

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 adolescents.

"The calorie 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.

"A recent study in the UK found that children as young as three were presenting with obesity. 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 the 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.

Ready meals

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.

"The message needs to come through school but it must be delivered at home. There needs to be a campaign for parents to make them aware of this issue", he says.

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?

"If a person does not want to change, then we as health professionals are wasting our 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.

Frightening messages needed

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.

"The 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?'

Hopefully today's 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.

"I hope that today's school-goers will be ok. We won't know if they are for another 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 sad'.

Use the irishhealth.com 'Body Mass Index' calculator to find out your BMI at...

http://www.irishhealth.com/calc/bmi01.html