Pills not the answer to obesity, says top doctor

Obese people are often simply greedy and should not always be treated with pills, the head of the British Medical Association has said.

Dr Hamish Meldrum believes an obsession with medical labels may be stopping overweight people addressing their own problems.

He said the obesity epidemic is being mistakenly targeted with medical treatments and doctors' appointments.

Dr Meldrum told our sister paper, the Evening Standard: "We are saying, 'This patient has a hyper-appetite problem' rather than, 'They are just greedy.'

"People like to put fancy labels that suggest things are a medical problem. But [obesity] is not just a problem for GPs, it is societal.

"We are in danger of over-medicalising. The evidence of anti-obesity drugs is not good. The evidence for effective intervention in primary care for obesity is very weak."

Almost one in four adults and a quarter of 11 to 15-year-olds in Britain are obese, according to the World Health Organisation.

The Government wants to halt the rise in childhood obesity within three years but is likely to miss the target. Primary care trusts, which "buy" care for their communities, are under pressure to get the numbers down and GPs were issued with guidance last year. But Dr Meldrum fears this may be the wrong approach.

More than a million anti-obesity prescriptions were issued in England in the last financial year at a cost of £47million. It means about 88,000 people could be on a course of treatment.

The drug Xenical, which inhibits fat absorption, and Reductil, an appetite suppressant, were recommended for use on the NHS by the National Institute for Health and Clinical Excellence (Nice) in 2001.

There was a dramatic uptake and prescriptions rose by more than 16 per cent in the 12 months to March.

Dr Meldrum said the pills only worked if people permanently altered their lifestyle but "their effectiveness is under dispute". Guidelines say children as young as 12 can get drugs and stomach surgery to combat their problem.

Dr Meldrum said: "I am not saying we should not look at how we can medically treat people who are very obese. But to me it is obviously an issue where prevention is better than cure."

He said the problem of "over medicalising" also affected other conditions such as attention deficit hyperactivity disorder(ADHD)and dyslexia.

He said he did not dispute that ADHD or dyslexia existed and were debilitating. But they are being diagnosed inappropriately.

Colin Waine, chairman of the National Obesity Forum, said: "How can obesity not be medicalised if there are 45 core morbidities associated with obesity and overwhelming evidence of a causal link?"

Sorry I’m not a sugar coating kind of guy. I’m blunt and truthful, it’s something that makes me very good at my job. For over 25 years I’ve always said the same thing when people get upset at hearing the unvarnished truth from me: “if the truth hurts then change the truth.”

Only a dumb person, or a person deliberately BSing themselves (denial is the longest river in Africa after all), would think Doritos make a healthier dinner than salad. Doritos are a flagship junkfood product, right next to Twinkies. Salads are a flagship healthy food, right next to low fat turkey versions of fattier and tastier meats. Only a serious dumb dumb would bother to count the ounces in deciding to eat Doritos or salad to help them lose weight. And you know it’s true. Complain about it being a poo all you want it IS the truth and you CANNOT deny it.

I have the brains to understand tha not everyone is as knowledgable as we are. You however, are the typical, “What’s wrong with you” person. Ex-smokers, ex-drinkers and ex-overweight, with the “I’m better than you and you’re too stupid to understand.”

Truth is truth. The actual truth is you have NO CLUE as to what it takes for an individual person to lose weight. Your ideas are yours and work for YOU. If they worked for everyone, everyone would be thin, and you’d be rich for thinking of them.

Have your fun, haughty in your beliefs and of course absolutely right. Well other posters here have proven you wrong, FRiend, and you don’t want to admit it.

That horse you’re on is pretty high.

And, I’m done with this. There is no discussing with someone who revels in offending people by being blunt. My mother taught me tact. It’s a fine lesson she taught me.

Actually you make the common error of the intelligent person, and I went to geek school starting in 4th grade, and have spent more than a decade working in geek field, so I’ve known plenty of intelligent people. You make things more complicated than they have to be, because you can look past the surface you think you always must. The common cliche is you can’t see the forest through the trees, though I’ve known many who can’t get past the leaves. It’s not a matter of anything being wrong with anybody or anybody being better than anybody, it’s a matter of Doritos vs salad being a no brainer.

It’s really ashame you got so hung up on the Doritos vs salad thing. Go back and read the other parts of my posts. There’s a lot of good general stuff friendly helpful advice in there, that is completely contradicting what you’re saying about me.

Eat less and exercise more works for EVERYONE. It’s the basis of the most successful weight loss program in the world, Weight Watchers. Also Jenny Craig and TOPS. It’s not a gadget diet like Atkins or Scarsdale, it’s a program that goes to the heart of the problem: the calorie imbalance. You can throw a lot of additional complicated things in there but when you reduce it down to brass tacks it is ALWAYS about the calorie imbalance, 100% of the time no exceptions.

There are really only 3 times eat less and exercise more doesn’t work for someone:
1 - they don’t stick to it, because America has become an instant gratification culture a lot of us just don’t have the will to stick to a weight loss program that averages 2 pounds a week.
2 - the person confuses “eat less” with “starve”, when a person goes to starvation mode they completely break the model, the model is gradual weight loss through a healthier life style, not crash dieting to gain quick results.
3 - they’re trying to weigh less than their body wants, we all have a body type which comes with a minimum weight, if you’re not getting any results without going to starve then you’re trying to drop below it and it’s just not going to work. Of course there isn’t a diet program in the world that will allow you to safely get and stay below your body’s minimum.

I’m not on any horse at all. I don’t look down on overweight people, I work in a sedentary industry (software) with lots of overweight people, I wouldn’t have lasted this long if I looked down on them at all. The only time I will EVER look down on someone because of their weight is if they constantly complain about it but never do anything about it. But that’s a universal thing not a weight thing, I don’t care what the person’s “problem” is if they complain about it without doing anything about it I look down on them.

My mom taught me tact too. She also taught me that sometimes you just need to get the point across. Sorry if that bothers you, but there it is.

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