Obesity levels set to spiral further

A leading activist on weight control says the Government has done little to stem the increasing trend towards obesity

A leading activist on weight control says the Government has done little to stem the increasing trend towards obesity. Barry O'Keeffe reports.

The Government has been accused of doing nothing to try to stem the spiralling problem of obesity, now recognised as a worldwide phenomenon.

Despite a major report on the problem, published over a year ago, which called for a number of "simple but important" steps to be implemented, little or nothing has been done, according to one of the members of the National Taskforce on Obesity.

"Very little has changed since the report was published," says Dr John O'Riordan, who represented the Irish College of General Practitioners (ICGP) on the taskforce.

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O'Riordan, who is also chairman of GP Now (National Organisation for Weight Control), says there are still no extra dietitians available to advise people (one of the report's recommendations) and that "even in terms of practical support - such as providing properly calibrated scales and height measurement equipment in GP surgeries", nothing has happened.

When the report was published in May 2005, the Taoiseach, Bertie Ahern, promised to look at a range of measures proposed by the taskforce. He expressed alarm at the estimated €500 million per annum cost of treating obesity and related illnesses.

It was felt the Department of the Taoiseach should lead on the issue, and a number of healthcare sources have told The Irish Times that it was very disappointing that this did not appear to have happened.

The obesity report's major emphasis was on prevention, says O'Riordan, "but nobody is taking responsibility for it".

He says there was "a lack of joined-up thinking" from various departments regarding the issue.

The taskforce ruled out a so-called "fat tax" on foods high in fat. However, O'Riordan says subsidies for high-fat foods such as dairy products should be reviewed and perhaps switched to other foods "which are not helpful to weight gain".

He says the obesity taskforce and industry has had very positive discussions on reducing so-called "big bar" versions of certain foods. "It is now up to the Government to move on that," he says.

O'Riordan also says the changes envisaged in the report regarding the role of schools in fighting overweight and obesity "do not seem to be occurring".

"It is a very practical and balanced report and was realistic about what could be achieved," he says.

"It did not require a huge financial outlay, but needed a genuine effort to combine the thinking of Government Departments and a genuine commitment to physical activity being made an integral part of our children's lives and progressing that into adults."

The taskforce report estimated, for example, that more than 300,000 children were overweight.

O'Riordan says the changes envisaged by the national taskforce will take eight to 10 years to have a "major slowing effect" on incidents of obesity.

"We have already lost a year and a half since the report was published."

He says that, on current trends, both GP surgeries and, by extension, the State's hospitals, will be unable to cope with the problem within a few years.

"We are about eight years behind the US in terms of obesity," he says. "If nothing is done to tackle the problem, then we will be where the US is now, where virtually all US states have an obesity level greater than 25-30 per cent among its population."

O'Riordan says previous studies using BMI (Body Mass Index) - which is not now regarded as the most accurate measure - had shown that about 18 per cent of the population in 2000 could be termed obese, up from 10 per cent in 1990.

He also says the Government should examine providing tax relief on gym fees, rather than treating it as a benefit-in-kind, if such fees are paid for by an employer.

Being overweight can lead to a host of problems, including high blood pressure, heart disease, cancer, arthritis and gall bladder disease.

However, a major problem with being overweight is that it can lead to diabetes, a potentially life-threatening condition.

"Currently about 10 per cent of the population has a pre-diabetes condition," says O'Riordan.

This condition is characterised by the presence of higher-than-normal blood glucose levels. The patient is not yet in the diabetic range, but a high percentage will go on to develop diabetes, according to O'Riordan.

"Once you have diabetes, it is even harder to lose weight because the medication used to treat diabetes, for example, can lead to weight gain."

O'Riordan says that one recent large Finnish diabetes prevention study showed that a 5 per cent reduction in a person's weight, combined with exercise, had reduced incidents of diabetes by 40 per cent.

"Small changes in diet, medication and exercise have shown marked reductions in the development of diabetes."

He says studies have also shown that there was a 20 per cent fall in mortality rates among those who lost 10 per cent of their body weight, a 30 per cent fall in diabetes-related deaths and a 40 per cent fall in obesity-related deaths. "It is important to note that the 20 per cent fall in deaths occurs no matter what your starting weight is," O'Riordan adds.

A Department of Health spokesman said last night that responsibility for implementing the report's "relevant recommendations" had been passed to the HSE. The HSE had been given €3 million to progress them.

In a statement, the department claimed a number of moves were in train and said that approval had been given for recruiting four physical activity officers to target obesity "in all settings" and providing four specialist community dietitian posts for obesity and weight management.

It also said that discussions had recently taken place between the department and Ibec and several issues regarding nutrition and obesity were identified. In a statement, the HSE said it was "committed to tackling the growing problem of obesity" and had recently established the HSE taskforce on obesity to implement the recommendations of the obesity strategy report. "This group will be broadened to include external stakeholders in the near future," it said.

It said the Population Health Directorate, Health Promotion recently undertook an audit of the initiatives and services that were in place that contributes to preventing and treating obesity.

"While current services are provided by health promotion departments and community nutrition and dietetic services, a population health approach to obesity will involve a broader multidisciplinary, multi-sectoral approach of which health promotion will be a partner," the statement said.

It said health promotion work was carried out on a "settings basis" ie in school, workplaces etc to help organisations and "systems" to refocus on health.

GP Now was established two years ago for health professionals in primary care with an interest in weight management because many GPs felt the problem of resolving obesity was "randomly foisted" on them.

It is holding its second scientific symposium on preventing diabetes in adolescents and adults this Saturday in Dublin. As well as addressing diabetes and weight management issues, speakers will discuss topics such as Hollywood fad diets. The conference is open to healthcare professionals and is being held in the Westin Hotel.