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Has the battle of the bulge a new leader?

30 Sep 2016

Has Ireland unwittingly and belatedly found a political champion to lead the way in the implementation of initiatives to combat overweight and obesity? Lloyd Mudiwa examines the case

Acknowledgement, as expressed by the Minister for Health Simon Harris last week, that obesity is indeed a ticking time bomb in Ireland that has to some extent already discharged, and hence needs to be dealt with in pretty much the same urgent manner that we as a country tackled smoking, is to be commended.

But significant amounts of new money will need to be allocated if all proposed 60 actions of the new Healthy Weight for Ireland plan are to be implemented in order to both prevent the occurrence of new cases of overweight and obesity and address waiting lists for treatment of those who are already obese, if Ireland is not to risk becoming the fattest nation.

The plan aims to reduce the average weight of Irish people by 5 per cent over the next decade.

Already Minister Harris has got his defence in ahead of the publication of Budget 2017 telling journalists at the plan’s launch: that “we can’t reduce this all to resourcing”.

While claiming that most elements of the plan did not require extra spending, but the changing of practices and engagement of interested parties, however, he did accept the need to have a Healthy Ireland Fund, which is contained in the plan.

“Obviously I can’t announce the estimates in public today, but I will reflect the priority that we are attaching to this plan in the HSE Service Plan 2017,” the Minister said.

Minister Simon Harris

Apart from the budget and delay in implementing a sugar tax now proposed for 2018, leading campaigner on obesity Prof Donal O’Shea, who described the 2006 plan as being “dead in the water within the year”, said the new one “could not be more different” and was an “action plan” containing specific targets and timelines, while the appetite for tackling obesity was now much greater.

The Government’s view of the seriousness of the issue and the acknowledgement that it requires a cross-sectoral and inter-departmental response is to be welcomed and was signified by the attendance of three ministers at the launch of the plan, the consultant endocrinologist said. Harris was accompanied by Minister of State for Health Promotion Marcella Corcoran-Kennedy and Minister for Children Katherine Zappone.

The new plan seeks to secure a sustained weight loss annually of 0.5 per cent for both children and adults in a cross-departmental drive, which will incorporate improvements in our surroundings to make it easier to exercise. Further changes include a revised food pyramid which places carbohydrates, previously the higher bulk group, closer to the top, meaning we have to limit consumption (servings) of porridge, potatoes, pasta, brown bread and rice; in favour of more fruit and vegetables.

But with previous efforts doing little to dent the scourge of overweight and obesity, let alone reverse it, the decision to appoint a clinical lead to guide obesity policy with the HSE and Minister Corcoran-Kennedy’s openness about her own weight challenge, which she is overcoming, could yet prove to be the difference this time around.

Minister Corcoran-Kennedy has so far lost 14lb on a regime of smaller meal portions and daily exercise, she bravely told journalists attending the launch, adding that “in my case, portion size was my problem”.

Back in 2011, IMT (‘Who can lead the battle of the bulge?’ 01/07/2011) cited Prof O’Shea as suggesting that there needed to be a political champion in the fight against fat, during the Safefood ‘Stop the Spread’ campaign launch in the previous month to tackle the overweight and obesity epidemic.

Prof Donal O’Shea

But, ideally, it should be someone who is not in the Department of Health, he had proposed.

On the other hand, having celebrities, who often set out to shock, as these role models can often negatively impact an individual’s self-esteem. A case in point is when some people start to believe that an almost ‘skeletal’ body is something to aspire to, owing to the ultra-skinny size-zero bodies often seen in celeb-land, and the media contributing to and perpetuating this hype.

However, the public relate to people like them, such as the late Gerry Collins, who appeared in a hard-hitting HSE anti-smoking campaign in which he talked about his terminal lung cancer. By the time the 57-year-old father-of-three had died of his illness it was believed his ads had helped several thousands attempt to quit smoking.

Back in 2011, Prof O’Shea had argued that there were a lot of factors in terms of overweight and obesity, bridging several sectors. These include transport, the environment and education, making it preferable to have a ‘non-Department of Health’ champion, because it keeps the focus on health.

A lot to ask, but in the absence of an alternative, maybe Minister Corcoran-Kennedy could perhaps fill those shoes.

With research carried out in Ireland last year (published in the journals Forum and Childhood Obesity) finding that most GPs find it difficult to bring up the topic of child overweight and obesity with parents during consultations, Minister Corcoran-Kennedy, like the former health minister Dr Leo Varadkar, who helped destigmatise sexual orientation, can help champion the battle of the bulge.

Lloyd Mudiwa

Click here to view the full article which appeared in Irish Medical Times: Opinion