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Margaret McCartney: Fat doctors are patients too

BMJ 2014; 349 doi: (Published 10 November 2014) Cite this as: BMJ 2014;349:g6464

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Reading Margaret McCartney's heartfelt words I am glad she has the courage to try and lance this ugly boil. The NHS, from top to bottom, is bursting with a toxic mix of prejudice, obtuse blindness and ignorance when it comes to obesity and fattism. The 2007 Foresight report identified 108 causal factors contributing to obesity, the strongest of which are modern 21st century lifestyles and genetic predisposition. Our bodies were physiologically designed to hunt and gather but nowadays we spend our waking hours in front of computers and TVs eating fast food.

NHS staff show similar obesity statistics to the general population; there is a universal disinclination to address this issue - broadly comparable with the taboo around death and dying on the one hand and alcoholism on the other. Being lectured by people who simply lack both personal experience of what they are talking about and the compassion that should be every healthcare professional's touchstone is not only unhelpful but deeply shameful for everyone in the room. Figures published this month once again demonstrate that bariatric surgery rapidly pays for itself in healthcare expenditure savings.

Yes we need to have a national conversation about this issue by yesterday - but the unacknowledged problem is that doing so might lead to an indictment of consumer capitalism and knee-jerk state authoritarianism, and such prospects already recently killed rational alcohol pricing and drugs policies stone dead. We are the architects of our own destruction. Every NHS trust needs to develop and support Health & Wellbeing initiatives for its staff - failing to do so is tantamount to a declaration of corporate abrogation of responsibility. But will we see it happening? Don't hold your breath ...

Competing interests: No competing interests

10 November 2014
Kai Rabenstein
Anaesthetist & critical care physician; CertObMgt
East Sussex Healthcare Trust
St Leonards