What Is Obesity

Obesity can mean different things to different people, and this section will show how it can be defined and measured in adults and children. But first, we have to look at what it means to be obese, and at the images the word ‘obesity’ conjures for people.

It does not make pretty reading. It is easy to see why people who are obese can quickly come to feel ridiculed, ostracised and ultimately degraded because of their obesity. This, more than anything, emphasises how important it is to consider obesity not as a single-dimension problem, but as an issue which covers many different facets of a person’s life – their family, economic and social status, psychological and behavioural profile, employment situation, leisure time pursuits and, of course, eating patterns.

Managing patients who seek help for obesity cannot, therefore, just be a matter of doing the measurements, prescribing the diet, and leaving the person to get on with it. It requires a strong determination to work in partnership with the patient to unearth new ways forward. It requires understanding of how he or she feels and thinks, and a willingness to negotiate a plan to meet clearly determined goals. Most important, it requires a recognition that obesity has complex psycho-social origins, which need to be understood and respected.

Obesity management is something which often gets pushed to the bottom of the priority tray in a busy general practice setting, where staff are working flat-out just to keep their heads above water. Have a look at the priority given to obesity management by some GPs and practice nurses in Scotland, as identified in research commissioned by HEBS/NBS/SCPGMDE (Bennett 1998).

Despite this, obesity mangement is a serious business, worthy of serious effort. Obesity is responsible for or implicated in enormous amounts of morbidity and mortality annually in Scotland, much of which impacts directly on the workloads of community based professionals. It is a problem that will not go away, and which cannot be ignored.

Obesity is a chronic disease, just as diabetes and asthma are chronic diseases. And just like diabetes and asthma, it requires skilled, knowledge-based and sensitive management from healthcare professionals to help those affected to lead safe, meaningful and enjoyable lives.

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