• Young people at risk
  • Not enough activity
  • Fast food
  • Education is key
  • Morbidly obese

    Obesity is a modern plague that makes people more prone to disease and shortens their life, Dr Donal O'Shea tells Deborah Condon.

    An obese adult is three times more likely to develop diabetes, compared to someone who remains within a healthy weight range. The news is even worse for children and adolescents. According to consultant endocrinologist, Dr Donal O'Shea, young obese people are five to 10 times more likely to go on to develop diabetes.

    Even more shocking is that between 1990 and 2000, the number of obese people aged 16-24 has more than tripled, rising from 3% to 10%.

    Obesity is the medical term used to describe the state of being overweight to the point where it is harmful to your health. The World Health Organisation defines obesity as a body mass index (BMI) of 30 or more. BMI is calculated based on 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.

    Young people at risk

    According to Dr O'Shea, there is huge 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 of them.

    'The calorie intake of Irish people today is broadly the same as 20 years ago, but activity levels have dropped off. 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 says.

    Not enough activity

    Dr O'Shea says some of the activities that were commonplace 20 years ago, like walking to school, are not possible today. He says these activities must be replaced with new ones.

    However, Dr O'Shea also acknowledges that the food we eat today is different. Convenience undoubtedly plays a huge role in people's choice, as reflected by the ever-expanding range of 'ready meals' now available, as well as the plethora of fast-food restaurants which continue to pop up.

    He believes that 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.

    'I would like to see them endorsing healthier foods too, to make healthier foods attractive to young people', he says.

    Fast food

    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 believes this was an important stand to make as it 'sends a real message to people that we have allowed a passive lifestyle to take over'. However he adds 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'.

    Dr O'Shea believes that 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 lifelong habits?

    Education is key

    '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.

    Dr O'Shea says that the statistics relating to stroke tend 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 GP or a hospital clinic and you are overweight or obese, you should be warned about the dangers.

    Morbidly obese

    He warns that no hospital service in the country is 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.

    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 does not bear thinking about'.

    He says the problem of obesity is going to get worse in Ireland before it gets better. The question, he says, is 'how much worse?'

    He hopes that today's school-goers won't face the problem, thanks 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 got frustrated given that obesity was a largely preventable problem, Dr O'Shea said no, not frustrated, but at times, 'incredibly sad'.

    Issue date March 04