Last Tuesday 30th May, the Daily Mail published an article, written by Tammy Hughes, quoting Prof Dame Carol Black. I saw it retweeted a few times on Twitter and was intrigued by the headline. Having read the article, I felt compelled to put my opinion and comments forward.
The first line of the articles stated “Almost 900,000 people in Britain are too fat to work”.
My first thought was along the lines of ‘What is the definition of being too fat to work’?
Too fat to be able to travel to work?
Too fat to sit at a desk taking phone calls or using a computer?
Too fat to do manual lifting work?
Too fat to fit into the standard required work uniform?
Too fat to be accepted in the social arena of the workplace?
The article goes on to bemoan the poor design of a question on the application form for Employment & Support Allowance. Apparently only one condition can be listed – the argument being that other co-morbidities alongside obesity get mentioned more often, so the true figure of obese people off work is under-reported.
Obesity is indeed a very complex condition. It has many varied causes, and requires a multi-disciplinary ‘Big Picture’ synergy if we are ever going to combat it. Obesity is a major risk factor in many conditions: several cancers (endometrial; breast; colon; gallbladder; prostate), respiratory problems, sleep disturbances, cardiovascular disease, back pain, arthritis, Type 2 diabetes to name a few. As well as these physical effects, it also impacts on you mentally (depression, anxiety, stress) and socially (stigma, weight bias, relationships).
When asked “if obesity influences your ability to work and for those recorded as obese, can we get them back into work?”, Dame Black responded in her report to the DWP (2016) by saying, “obese people on benefits should be forced to see a health advisor”.
From the age of 5 yrs old I can remember being taken by my mum to see a hospital dietitian. It was an embarrassing, humiliating experience. From this I learned that ‘to lose weight meant I was a good girl, and to put on weight meant I was a bad girl’. This stuck with me. Being forced to see anyone about your weight is not a good starting point.
When teaching Personal Trainers how to work with overweight and obese clients, I talk about Locus of Control (LoC) and also Health Behaviours.
Locus of Control covers areas of accountability and responsibility. If you have a low LoC, you are likely to blame outside issues and other people for the things you do and your circumstances. When you’re thinking like this you’re unlikely to change as you don’t see your part in the issue. On the other hand, a high LoC allows you to take control of the things happening to you and be assertive – looking for ways to change the things you can control.
Health behaviours are those things you do which affect your health – either positively or negatively. When these have been identified, they can be worked through and strategies can be developed to alter the bad health behaviours, and to strengthen the good ones.
Prof Black’s report to the DWP also stated that “Job Centres should refer those with a weight problem to slimming classes”.
Those who work in Job Centres are there to help people find jobs. It is not within their professional boundaries to decide who must attend weight loss appointments! I was recently chatting with a friend who, as a doctor, was saying he struggled with helping people in need of behaviour change. My response was that it wasn’t his mandate. He was required to diagnose general medical conditions and then signpost on to the appropriate area of expertise. When we lose sight of our professional boundaries we can become bogged down in issues that aren’t ours to deal with. Know your level and area of expertise and pass over when and where necessary.
Continuing with her comments, Dame Black went on to say that she would like public opinion to turn against obesity as it turned against smoking. Well, if she had spoken to anyone who is or who has been obese, she’d soon find out just how much public opinion IS against obesity.
I work with a colleague, Matt Haines, who is BASES certified and a Senior Lecturer at Huddersfield University. In his lectures on the L4 Obesity & Diabetes Management course for Personal Trainers, he states that “obesity is the last socially acceptable form of prejudice”.
Being obese myself, where I’ve shared my personal story of continuing weight loss to a variety of people from various walks of life, I’ve come across some people who have the attitude of “why did you let yourself get into that state in the first place?!” There is a general disgust for obese people, especially morbidly obese people (BMI >40).
Being overweight on the other hand (having a BMI of 25 – 29.9) is I feel a lot more acceptable. It has become the new ‘norm’. Healthy weight people (BMI 18.5 – 24.9) have been thought / perceived to be underweight.
However, the one statement in the Daily Mail article which really annoyed me was from Dame Black: “It seems the public doesn’t mind it (obesity). I’ve seen no feeling that it would be a good thing that we all try to be a more normal weight. It hasn’t caught on”.
The diet industry is worth billions of pounds worldwide!! Does that not go some way to showing that we’d all like to be a ‘more normal weight’?? However, it is NOT that simple. Diets don’t work. For people to lose weight AND to keep it off long-term in this obesogenic environment we live in, it calls for lifestyle change and digging deep to find the root cause of the obesity in the first place. If this isn’t achieved, any diet will only form a ‘sticking plaster’ over the real wounds.
I would LOVE to be a more normal weight, and slowly and steadily I am getting there. However, there is so much more to a person than just their weight. When we focus on pure weight loss we can create even more problems – especially in the areas of self-worth and self-confidence, which are usually low in people who are obese anyway.
Instead of worrying about offending fat people by pointing out the obvious, we should endeavour to get to know the person behind the obesity. Get to know what makes them tick. Gain their trust and respect for who they are as whole people. Encourage them in their skills and attributes.
Finally, for any weight loss intervention to have any chance of working, the person concerned needs to be at the point of wanting to change. Until I reached the age of 41, (with a BMI of 52, wearing size 32 clothes, and on lots of medication) I didn’t want to change. I was sick of being ‘educated’ about my condition and of being subjected to diets and food plans. Food was my best friend, my coping mechanism with life, and I wasn’t prepared to give that up for anyone or anything. Yes I admit I wasn’t happy with the way things were going – in fact I was desperately unhappy, but I couldn’t see how to change, or even know if it was possible.
For me the turning point came when I was told about Overeaters Anonymous. For the first time in my life, I was shown a way of dealing with the underlying emotions I experienced, and the reasons why I turned to food to help me cope.
In the first year of attending meetings I lost 4.5st – no dieting involved! I then started working with a mentor and Personal Trainer to turn my life back up the right way, losing a further 5.5st the following year. The journey continues – I have another 3st to lose.
I now spend my time helping people who have a range of health conditions to become more physically active and healthy. I also lecture on a range of health issues and the beneficial effect exercise and activity can have on them.
If I can be of help, please feel free to get in touch with me through the Contact Form.