Small falls in weight can improve health provided they are long term, says NICEBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g3576 (Published 28 May 2014) Cite this as: BMJ 2014;348:g3576
All rapid responses
Its clear to anyone out & about on our streets and in our shops, or who listens to radio phone-ins, that obesity is now a badge worn with pride and indeed that the obese have become untouchable. Ryanair boss Michael O'Leary discovered as much when he was met by outcry for very sensibly suggested that passengers pay for their seats by the kilo.
For some reason we can make smokers into modern pariahs whilst being unable to condemn obesity. Now seems that NICE, who has seen fit to deny tertiary level drugs to cancer patients lacks the courage to confront an issue which is already starting to have profound adverse effects on the personal health of hundreds of thousands of citizens and on the resources of the NHS.
Its time to stop pussyfooting around the impending crisis and direct incentives and responsibility towards the obese themselves. In the context that the Kings Fund has stated that an NHS funding crisis is a certainty within 3 years, an effective answer would be to scrap National Insurance and move rapidly towards
a compulsory personal insurance-based system such as exists in Germany. Since insurers charge premiums according to risk, the obese and indeed others who lead unhealthy lifestyles would suddenly have a huge financial incentive to improve their condition. Moreover, the move towards an insurance system for healthcare would solve the NHS funding crisis at a stroke. NICE's approval for plans to offer "support" for "diet, activity and lifestyle", as reported by Nigel Hawkes, is fatuous nonsense in the face of the magnitude of current challenges.
Competing interests: No competing interests