Battle

of the Bulge

Why an integrated approach is the only way to solve the

obesity crisis.
Mark Sinnott


Many of us carry a few extra kilos, but how many of us would be prepared to have our weight
discussed on TV in front of millions?
That was the case with Jennifer Livingston, a Wisconsin TV journalist, who attracted
worldwide attention in 2012, as she emotionally responded on-air to a viewers email
attacking her weight and saying she was a bad role model for children.
The mother of three, (left), contended the sender was being cruel and hurtful, in a YouTube
video seen nearly 15 million times, and received support from across the globe, not least her
brother Ron Livingston, the former Sex and the City actor, as she called out against bullying
based on weight.

The sender was criticised for a mishit attempt to draw attention to the issue of obesity, which
has reached a crisis point as doctors worldwide now
regularly treat younger people with weight-related illnesses
once found almost solely in the middle aged and elderly.

More recently, alarm over the weight of the worlds
population has been sounded by a report from the World
Health Organisation (WHO), which paints a frightening
picture of a catastrophic global epidemic.

Published as part of the
Obesity: Key Facts
WHO's Global Strategy for the Prevention and Control of
1 billion adults now
Noncommunicable Diseases, the report warns that over one
overweight, and this will
billion adults are now overweight, including more than 300
reach 1.5 billion by 2015
million clinically obese.
300 million are obese

42 million children under five
This global battle of the bulge is killing an estimated 2.6
are overweight
million people each year, and causing around 44% of cases of
2.6 million weight-related
diabetes, 23% of blockage-related heart problems and up to
deaths per year, including
40% of certain cancers.
from cancers, cardiovascular

illnesses and diabetes
In recent years, Ireland has fared poorly in several reports,
being overweight classed as
and an estimated one in four of us is now obese, with the UK
BMI above 25
being the only European country to exceed that level. Faring
obesity is a BMI of 30 or above
worse are some Middle East and Pacific countries where

average public body mass index (BMI) levels may be classed
as obese.

Certificate in Journalism Course Project: Mark Sinnott, March 2014


Many consumers are unaware about balanced diets or
their own waistline situation- a recent British online
survey of overweight people found that 27% incorrectly
thought their weight was normal. Other British research
indicates todays children are about 15% less fit than
their parents were at the same age.

British expert Professor Terence Stephenson says this
challenges doctors whose obese patients face greater risks in surgery and labour. They may
also need more staff help, stronger equipment and outsized beds. Its expensive too- an
outsized MRI scanner may cost around 75,000 more than a standard type.

The WHO report cites multiple causes, as Social and
economic development as well as policies in the areas of
agriculture, transport, urban planning, environment,
education, food processing, distribution and marketing
influence children's behaviour.

Some experts blame living in obesogenic
environments, where fast food is cheap and easily
available, cars are necessary for almost every trip, and
exercise is unusual for older adults. The entertainment
industry is also criticized for encouraging sedentary
lifestyles.

British psychologist Professor David Kerrigan emphasises psychological factors, where initially
food is a crutch for unhappy patients, but later appetite control is distorted, so they lose their
sense of satiety. High smoking rates can compound problems.

Controversially, the American Medical Association recently declared obesity to be a disease,
and British campaigner Dr Tam Fry concurs, as otherwise it would not get sufficient attention,
and lead only to increased instances of comorbidity, the presence of additional disorders.

Critics argue that obesity has multiple causes, outcomes and treatments, and should not be
classed as a distinct disease. Some experts believe that physicians, hospitals and drug
companies are happy to profit from the crisis.

Also culpable are global food giants, says Australia- based nutrition expert Rob Moodie, as they
have copied how the tobacco industry promotes and funds biased research findings, co-opts
policy makers and health professionals, lobbies politicians and officials to oppose public
regulation, and influences voters to oppose public health measures.

Serious action is needed as the benefits unhealthy businesses bring are outweighed by the
costs - in terms of premature death, chronic illness, limited healthcare finances, overcrowding
of hospitals and loss of productivity from unhealthy employees.

Its not all bad news. Dr Fry attributes the recent drop in US child obesity to the determination
of President Barack Obama and his wife Michelle, who made combatting the problem a major

Certificate in Journalism Course Project: Mark Sinnott, March 2014

presidential goal. Fry says this focus on child obesity is the correct one, as by around ten, most
peoples lifestyle habits have been set out.

Fry states national governments are the stakeholder most capable of taking necessary actions.
It is they who can regulate and invest in information campaigns, and their urban planners can
create spaces that are safe to walk, cycle and play sports in.

Nutritionist Kawther Hashem, of London-based Action on Sugar, argues for reduced marketing
of junk food and beverages to children, "traffic light labelling", and taxing unhealthy foods,
similar to a recent Danish initiative, which was later scrapped. The Danes have also banned the
use of deadly trans fats.

US lobbyist James Zervios, of Obesity Action Coalition, says there is no one-size-fits-all
approach. Treatment options include pharmacotherapy and surgery, but regardless of
treatment choice, all must include lifestyle and behavioral changes. Dr Fry also advocates
surgery as an effective and cheap solution, with potential in newer, less-invasive forms.

What seems clear is the unsuitability of the traditional model of healthcare, where a patient
becomes ill, goes to a doctor and receives treatment. As many illnesses are avoidable,
prevention is now the healthiest, most cost-effective approach, and this means diverse
healthcare professionals should act in teams to manage individuals and encourage sustainable
living.

Hashem says Solutions need to be multifaceted, with initiatives throughout governments and
across several sectors. Even small interventions may still constitute important components of
an overall strategy.

The rest of the effort must come from individuals, who can take whatever steps they can to
ensure the health of themselves and their loved ones, without the hurtful misguidedness of the
viewer who emailed Ms Livingston.

Without such radical and immediate effort, it seems we are condemning our children to
unfitness, poor health, bullying and early death.



Topics:
World Health Organisation , Obesity, American Medical Association, BMI, diabetes, Rob Moodie,
Professor David Kerrigan, Professor Terence Stephenson, Denmark, Jennifer Livingston, Ron
Livingston, Tam Fry, Kawther Hashem, Action on Sugar, James Zervios, Obesity Action
Coalition, Barack Obama, Michelle Obama


Well researched, plenty of further reading provided by the links and good use of photos.
Impressive.

Certificate in Journalism Course Project: Mark Sinnott, March 2014