Jane McCredie: Sizing up reality

MOST humans on this planet — past and present — would count themselves lucky to face the health problems we confront today.

“What?” the world’s subsistence farmers might ask. “You’re worried about being too fat?”

Well, yes, we are, though perhaps we’re not worried enough.

The World Health Organization says overweight and obesity are now linked to more deaths worldwide than is underweight, and you only have to look around you to see that the lean, athletic Aussie is an endangered species.

It’s not that we haven’t been told about the risk posed by our spreading waistlines; hardly a day goes by without a media article on the obesity epidemic or the rising tide of chronic disease that accompanies it.

But we just keep on getting fatter and, if anything, we seem to be becoming less worried about it.

The latest data from the University of Sydney’s Family Medicine Research Centre’s BEACH study show that 62% of adults presenting in general practice in 2010‒11 were overweight or obese, up from 55% a decade earlier.

Perhaps even more disturbing was that the extra kilos were accompanied by a decrease in GP counselling about nutrition and weight over the same period (from four to three per 100 problems managed).

It’s not clear from the study, which was based on 100 consecutive consults from a random sample of 1000 GPs, whether this decline was the result of GPs being less likely to broach the issue or patients becoming less likely to seek help.

Either way, it seems we as a society are starting to accept overweight as the new norm, a trend to be lamented perhaps but not something we can really do much about.

After all, when everybody around us is also overweight, it’s easy to convince ourselves we’re looking good. (Men are better at this than women, as Canadian researchers found.)

And the fashion labels don’t help. They may use anorexic models to promote their brands, but they also surreptitiously redefine the standard sizes to make us feel good about ourselves and thus their products.

In the ABC comedy series, Kath and Kim, Kim protests, “I’m not a size 16, Mum, I’m a size 10”.

“Country Road size 10”, Kath replies disparagingly.

Country Road may no longer be into “vanity sizing” but there are plenty of other brands that would have me believe I am a smaller size now than I was as a teenager — clever marketing perhaps, but hardly designed to promote good health.

Overweight is a notoriously intractable problem: health professionals have few proven interventions in their armoury and patients are not exactly known for their compliance with recommended lifestyle changes.

But it does seem that we need to try to hang on to an image of what a healthy human body looks like: not the stick-figure celebrities that populate the glossy magazines, but not a “Country Road size 10” either.

American researchers reported earlier this year that overweight and obese people in that country are now more likely to consider their weight normal than they would have been 20 years ago.

But doctors could make a difference, they found. Overweight patients were more than eight times as likely to have a realistic view of their weight — and more than twice as likely to have tried to do something about it — if a doctor had told them they were overweight.

However, more than half of the overweight patients, and more than a third of the obese ones, had never had this conversation with a doctor.

Of course, trying to do something about it doesn’t necessarily equate to success, but maybe we need to be more honest with each other — and ourselves — on this weighty question.

Jane McCredie is a Sydney-based science and medicine writer.

Posted 28 November 2011

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