DR MAX THE MIND DOCTOR: Admit obesity’s an addiction or NHS is doomed

DR MAX THE MIND DOCTOR: Unless we admit that obesity’s an addiction the NHS is doomed

Within ten years, it’s estimated that one in four hospital beds could be taken up by patients with type 2 diabetes. 

Just think about that: a quarter of everyone in hospital will suffer from the condition.

Shockingly, some experts say this is a conservative prediction. And to make things worse, the epidemic is hitting the young in ever higher numbers.

I don’t want our country to be in a situation where the sick and needy cannot get treatment simply because the health service has been brought to its knees by people who won’t say no to food [File photo]

Researchers this week revealed that record numbers of young adults are being diagnosed with type 2 diabetes, while experts warned that ‘young-onset’ diabetes is especially dangerous and needs aggressive treatment.

Unhealthy diets and sedentary lifestyles mean a generation of people are eating themselves into an early grave. And if this goes on, they will bring the NHS down with them.

Yet what actually does the NHS do to help patients who are overweight? What support and services are available? The answer is next to nothing. 

Patients are told simply to go away and shed the pounds themselves, or they’re shipped off to dieting classes (or, in the most extreme cases, bariatric or stomach surgery).

Within ten years, it’s estimated that one in four hospital beds could be taken up by patients with type 2 diabetes. Just think about that: a quarter of everyone in hospital will suffer from the condition [File photo]

It’s true that, for many, dieting is a successful way to lose weight and either stave off or reverse type 2 diabetes. But for others it often fails to work and many people put back on any weight they do manage to shift.

To me, this all shows we are approaching the obesity epidemic in the wrong way. We need to address the underlying cause of obesity, and this means offering people psychotherapy to address problems that led them to become overweight in the first place.

Food is often used as an emotional crutch — we even have an everyday phrase for it, comfort-eating — and research has shown that when people are taught alternative coping strategies for dealing with their emotions and difficulties, they stop using food for support and lose weight.

We need to view patients who are obese as having a psychological problem in the same way we do alcoholics or drug addicts. 

And just as we have drug and alcohol services in the NHS that use psychotherapy to help people beat their addictions, so we should have fat clinics for the obese.

I work in an eating disorders unit and frustrated GPs who are struggling to cope with obese patients regularly refer them to me. Yet the unit is not funded by the NHS to provide this kind of support, so shamefully we have to turn them away.

While such help is readily provided to people with anorexia or bulimia, obesity is still considered a personal failing rather than a consequence of multiple complex psychological factors [File photo]

One typical example was an overweight 40-year-old woman with pre-diabetes who had damaged her shoulder and leg in a fall, was confined to her home and had turned to food to help her through her misery. 

She wasn’t stupid, she knew she should stop eating — it’s just that she couldn’t.

Of course, not everyone who is obese has underlying psychological issues. Some people choose to eat certain foods; others simply lack the knowledge or willpower to lose weight. But even they can benefit from psychological input.

There is a type of intervention called ‘motivational interviewing’ that involves getting the patient to understand the benefits of changing their behaviour. It’s used in patients with drug and alcohol problems. 

It sometimes requires multiple attempts over long periods, but ultimately it does have good ‘outcomes’ and results in lasting change. 

Why aren’t we training more GPs, nurses and specialists in this type of intervention to prevent diabetes?

The brutal truth is that the obese are crippling the NHS. I don’t want our country to be in a situation where the sick and needy cannot get treatment simply because the health service has been brought to its knees by people who won’t say no to food.

The lack of psychological support in the health service for the obese is desperately short-sighted. 

While such help is readily provided to people with anorexia or bulimia, obesity is still considered a personal failing rather than a consequence of multiple complex psychological factors.

Until this attitude changes, we cannot hope to get on top of the diabetes epidemic.

This week, the eating disorder unit where I work had a visitor — Simon Stevens, CEO of NHS England. I was hugely impressed by the way he interacted with everyone.

What was most touching was the way he seemed to have endless time to talk to the patients and seemed genuinely interested about the difficulties facing patients and staff.

It’s easy to criticise those in charge as faceless bureaucrats. But credit where it’s due. Yes, there are problems with the NHS. 

Yet watching him, I was struck by what an impossibly difficult job he has, yet how well he tries to do it.

We’ve got to keep tackling HIV fears

I was pleased to see the public support that former Welsh rugby player Gareth Thomas got when he disclosed he was HIV positive this week.

When I started training to be a doctor in the 1990s, an HIV diagnosis was largely a death sentence.

Now, thanks to medication, people with HIV live as long as those without it. Yet they still suffer, because of the stigma it carries. 

Rugby legend Gareth Thomas revealed he has been living with HIV ‘for years’. HIV still has the status of a scary disease — and, tragically, that’s down to society’s attitude, rather than the virus itself

It is a shaming, degrading illness, not because of what it does to you but because of the way other people respond to it.

Discrimination and misunderstanding mean HIV attracts hostility like few other diseases. 

When, in 1987, Princess Diana was pictured shaking the hand of an HIV positive man, she showed in a single gesture that this was a condition that needed compassion and understanding.

Yet the spectre of that era of ignorance, with its tombstone public information adverts and a public gripped by fear, still haunts those with the disease even now — rates of depression among those with HIV are nearly ten times higher than among the general public.

HIV still has the status of a scary disease — and, tragically, that’s down to society’s attitude, rather than the virus itself.

It’s good to talk

The secret to a happy marriage is to have the occasional good row, according to research. 

Which made me think about why a row might be so helpful — and I came to the conclusion that it’s because during one we often say what we really mean.

I would say 90 per cent of all relationship problems are down to a failure in communication. 

Communicating is key in every successful relationship, and certainly a row is a good way to air problems. But it’s easier and more effective to learn to say what we are really thinking without resorting to screaming and throwing things [File photo]

Too often we expect people to be able to second-guess things, to pick up on subtle clues or telepathically know what we mean. 

When someone then doesn’t respond the way we want, we see this as a rejection or as evidence that we aren’t important or loved or valued. 

Often, it isn’t the case at all — it’s just that we haven’t been clear, yet tension and difficulty arise.

Communicating is key in every successful relationship, and certainly a row is a good way to air problems. 

But it’s easier and more effective to learn to say what we are really thinking without resorting to screaming and throwing things. Your neighbours will thank you as well.

It feels un-British to ring a cancer bell

In recent years a new tradition — originating in the U.S. — has emerged on many cancer wards over here. 

When a patient completes treatment, they ring a bell on the ward in celebration and often fellow patients burst out clapping.

It seems a nice idea. But not everyone is pleased, and debates are raging about how appropriate it is to celebrate ending treatment while others on the ward might have a terminal illness. 

The Lingen Davies Oncology Centre at Royal Shrewsbury Hospital removed a bell this week, as they felt it could be ‘upsetting’ to others. 

My usual response to this kind of thing is that people take offence too easily. No harm is meant by the ringing. 

But, still, there is something I find distasteful about it. It’s smacks a bit of gloating and attention-seeking.

Public displays like this seem rather un-British. We tend to be far more reserved and understated. 

When I worked on a cancer ward, long before this bell-ringing caper had caught on, a patient would shake everyone by the hand when their treatment ended, then leave quietly, often having a cup of tea and a slice of cake in the canteen before heading home. This seems far more appropriate.

Yes, it’s great news someone has finished their treatment, but it’s a personal victory — to be celebrated in private.  

Dr Max prescribes…

The Happy Kitchen by Rachel Kelly

This book gives quick, easy, healthy recipes and meal plans to help boost your mental health. 

The recipes all include ingredients with a good evidence-base for improving mood, increasing energy levels, balancing hormones and helping sleep. 

While these recipes aren’t intended to replace medication or psychotherapy, I think it’s a really empowering idea that when you’re feeling down or struggling emotionally, you can reach for a book like this and give your mental health a bit of TLC.  

Source: Read Full Article