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In perspective - weighty challenge

Are doctors really the only ones who can take the lead in tackling the rise in obesity in the UK? Clare Claridge thinks physios are ideally placed to respond

Like most of us, I started the new year with some ambitious resolutions.

Armed with a predictable list of work and lifestyle changes, I sat down on my first day back at the CSP’s headquarters to read the Royal College of Physicians’ (RCP) new publication, Action on obesity: comprehensive care for all.

The report, describing how the health sector must adapt to the increasingly obese nation, stimulated strong media attention. Obesity is on the rise.

One adult in four, and nearly one child in five children, is now obese.

But as the media shifts its focus from obesity to the more newsworthy ‘super obese’ could they be perpetuating a hidden problem?

While the proportion of the population who are overweight is increasing, the proportion considering themselves to be overweight is falling.  

Society still considers obesity to be isolated to the weak-willed, sweet-toothed or slothful among us.

But in reality we are all living in, and are affected by, a changing environment, dominated by the food industry, motorised travel and reduced opportunities for regular activity.

It’s not just that the obese are now becoming morbidly obese. Body mass index is increasing across the population and, as it shifts, our perception of what constitutes normal weight is changing.  

Are we at risk of becoming desensitised to weight issues?

As outlined in the RCP report, the health sector needs to adopt a population-wide approach to obesity.

All healthcare professionals must be able to recognise when support is needed.

We need to know the RCP’s ‘10 essential facts about obesity’; provide routine lifestyle advice and targeted brief interventions; signpost to local physical activity opportunities and make onward specialist referral.

Activate8 is one of a number of specialist obesity and bariatric services in the London borough of Tower Hamlets, run by or heavily supported by physiotherapists.

Through delivering intensive programmes and preventative outreach work to the local community, the hugely successful, physio-led service saw childhood obesity rates fall, against the rising national trend and despite the local deprivation.

Lack of awareness of this expert role of physiotherapy in the RCP report was disappointing.   

The RCP is calling for a named ‘obesity champion’ to be appointed in every trust.

A physician in that post could ‘interact with commissioning groups, be a source of patient information and act as a link between the hospital and the community’, we are told.  

But, while embracing the need for change, has the time come for the health sector to challenge whether these leadership roles can only be provided by physicians?  

It seems we have an added challenge in this weighty issue: we need to make others aware of the specialist skills we can offer.  Clare Claridge is a professional adviser at the CSP

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