Re: Nutrition matters
As a formerly morbidly obese GP I would like to write in support of Fiona Godlee's editorial that challenges us as a profession to take nutrition in its widest sense more seriously. I am from a generation of doctors who had little or no training in nutrition at any stage of our careers. As I was morbidly obese for most of my life and career I have over the years extensively read around the subject in a desperate attempt to find anything to help myself. Most of this journey has been in the last 10 years when I quit being a partner due to the long hours. By this time I had a BMI of 48. Years of stupid hours, lack of sleep and stress had taken their toll and so I absolutely concur with Margaret McCartney in her piece in this issue too (1). We need our working conditions to be conducive to healthy choices and they rarely are. Stigmatising fat doctors or other health professionals is hardly good practice; we know it doesn’t work with patients and I think it borders on bullying.
I found The Diet Delusion by Gary Taubes (Vermillion, 2008) to be very helpful in opening my eyes to an alternative to the mainstream received wisdom. Consequently I found personally that I could stop my weight gain and even lose slightly by following a ‘low carb’ diet. Prior to this I had exercised regularly and tried every diet under the sun. I either did not lose weight, or regaining it quickly – a fairly common experience. I finally passed through the excellent Bariatric Service at Musgrove Park Hospital in Taunton. After extensive help and preparation I had a gastric bypass a year ago. It was the best decision I have ever taken and I would highly recommend it (and do often to patients). I have achieved a BMI of 32 which is still not healthy but a great deal better, and now I can exercise more easily and feel generally so much better. Also I am now more likely to continue working as a GP until retirement age.
I believe as a fat doctor I can be very good at counselling people who are overweight or obese because I can empathise and I know all the excuses and how to manage them. However the culture we live in is so opposed to healthy choices that it is clear to me that as a profession we must campaign for national and international controls on unhealthy foods and the promotion of a healthy lifestyle. To do this we need more high quality research that looks for more than mere associations. This is complex and hardly likely to be supported by the usual vested interests, especially the food and drink industry; indeed, attempts to make progress may even be opposed and rubbished, which is very the experience of John Yudkin, the British Professor and founder of the Nutrition Department at the University of London’s Queen Elizabeth College (2).
So I would encourage colleagues to get a grip on the complexities of nutrition and activity, and remain compassionate on themselves and others. This more than anything else is fundamental to holistic health and is public health writ large.
1 BMJ 2014;349:g6464
2 John Yudkin, Pure, White and Deadly: How Sugar Is Killing Us and What We Can Do to Stop It, Penguin, 1972, with an introduction by Robert Lustig http://www.telegraph.co.uk/health/dietandfitness/10634081/John-Yudkin-th...
Competing interests: No competing interests