Intended for healthcare professionals

Rapid response to:

Practice ABC of obesity

Obesity—can we turn the tide?

BMJ 2006; 333 doi: (Published 14 December 2006) Cite this as: BMJ 2006;333:1261

Rapid Response:

Chartists and Encyclopaedists are everywhere in hospitals - 17 December 2006

In the clinical environment of the medical/surgical ward, I have
witnessed the professional ascendency of the previously working class
hospital dietician over the last decade or so. This may have some
relevance to the discussion about the problem of obesity[1]. Hospital
patients are now on so many different diets[all with a code name/letter],
that discussing diets with the patient is difficult since I can’t remember
what half of the diets are.

The laser printer and Microsoft[R] have made all health care workers
into publishers, with the number of hastily conceived A4 charts to fill
out in the document folder at the foot of the bed verging on
encyclopaedic, and in seeming proportion to the number of clinicians with
professional aspirations.

Not the least of these charts is the “food chart”, along with; the
“enteral feeding chart", the “stoma chart”, the “drain chart”, the “TPN
chart”, the “fluid chart”, the “fluid summary chart”, the “National
Medication Inpatient Chart”[NMIC], the “vital signs” chart, the “chronic
pain infusion” chart, the “acute post-operative observations” chart. One
senses the inevitable "Meta-chart" looming.

Just when you thought it safe to put your biro away, with the patient
asleep, comes that most perverse of charts – the “sleep chart”. I say
perverse, because tree felling at night in forests, is part of the
shameful repertoire of the environmental vandal. And charts really do come
from trees. The catchcry of our time seems to be “more”. More of
everything. Including food. And more of us.

[1] Lean M, Gruer L, Alberti G, Sattar N. ABC of obesity. Obesity--
can we turn the tide? BMJ. 2006 Dec 16;333(7581):1261-4.

Competing interests:
Being relatively thin.

Competing interests: No competing interests

17 December 2006
Phillip J. Colquitt
Independent Comment