Rapid Responses to:

VIEWS & REVIEWS: Theodore Dalrymple The wisdom of Falstaff BMJ 2008; 337: a1417 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Make the healthy choices the easy choices.

Michael Craft   (1 September 2008)

Obesity saves money?

Stephen R Workman   (2 September 2008)

What is fun?

Hugh Mann   (9 January 2009)

Make the healthy choices the easy choices. 1 September 2008
Michael Craft, Health Promotion Advisor Retired Send response to journal: Re: Make the healthy choices the easy choices.	Theodore Dalrymple is right to be amused by a bingo hall full of elderly people having a lovely time, and admiring of Jack Falstaff as an outrageous non conformist. Shakespeare also said that all progress depends on the unreasonable man. But are we to believe therefore that there no reason to plan for healthy living or take account of the massive evidence showing the huge impact of those many powerful and vested influences whose side effects include illness, disease and death, or the impact of long established cultures where, for example, diets high in fat are there from the earliest age and are thus just fine? Are we mistaken in making smoking more and more difficult, or suggesting that unprotected sunbathing can be a killer? I think not. Equally I do not support putting undue pressure on people who suffer ill health, including those who are overweight, and targetting their behavour, for the simple reason that such pressure is to blame the victims of influences like commerce, cultural values or peers. What we desperately need is sufficient political courage combined with clear evidence to change central policies, example and practice for healthy living at all levels. This does not have to be killjoy or devoid of foolishness and humour. The devil may not have the best tunes. Competing interests: None declared
Obesity saves money? 2 September 2008
Stephen R Workman, Physician QEII HSC Halifax Nova Scotia Send response to journal: Re: Obesity saves money?	The commonly held belief that lifestyle diseases result in excess health care costs, and thus that preventing them would save money, may be wrong. (1) 1. Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure van Baal PHM, Polder JJ, de Wit GA, Hoogenveen RT, Feenstra TL, et al. PLoS Medicine Vol. 5, No. 2, e29 doi:10.1371/journal.pmed.0050029 Conclusions Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures. Dr Stephen Workman Halifax, Nova Scotia, Canada Competing interests: None declared
What is fun? 9 January 2009
Hugh Mann, Physician Eagle Rock, MO 65641 USA Send response to journal: Re: What is fun?	The Shakespearean character of Falstaff is a tragic-comic embodiment of self- indulgence in vices. Unfortunately, many people equate such self-indulgence with fun. This is unfortunate, because most fun is imaginary, harmful, and expensive. The fun of being tipsy from alcohol, high from marijuana, or sated from sweets, is flimsy and ephemeral, compared to the lingering and painful after-effects of addiction. The sad truth is that most fun is hell you enjoy. Competing interests: None declared