When Irish Medical Times reported only two years ago (early July 2009) that surgeries for morbidly obese people alone could cost the public almost €6 million every year by 2019, one could have been forgiven for assuming that the issue could be put on the backburner for a while.
However, this major expense, due to the need to meet a rising demand for weight-loss procedures across the country, appears to be fast becoming a reality. This makes effective health promotion increasingly relevant.
In February, the Healthcare Section of the Institution of Occupational Safety and Health’s Ireland branch hosted an event in Dublin, placing seriously obese patients on the health and safety agenda.
The issue of how seriously obese patients can be better cared for from home to hospital and through to discharge was discussed, bringing to light the extra burden that severe obesity places on the health system.
Dr Sue Hignett, a Senior Lecturer in the Healthcare Ergonomics and Patient Safety Unit at Loughborough University, UK, presented on ‘Bariatric patient handling’ together with Lucy Canning, Manual Handling Co-ordinator at the Mater Hospital. She spoke about the need to design equipment (stretchers, scales, lifters, walking and bathing aids, beds and theatre tables) to allow health or social care professionals to properly look after plus-sized patients.
Dr Hignett said although the UK and Ireland have pockets of excellence, most organisations were less well prepared with the necessary procedures and equipment.
A new awareness campaign by all-island food safety body Safefood called ‘Stop the Spread’ aims to prevent overweight from developing into obesity in the first instance.
Unlike previous efforts to get people to find out their BMI, which required complex calculations, the advertising campaign encourages people to simply measure their girth around the belly-button area as a first step to ‘stop the spread’. Having a waist size greater than 32 inches for a woman or 37 inches for a man is a clear indication they are carrying excess weight.
Prof Donal O’Shea, who runs an obesity clinic at Loughlinstown Hospital, Co Dublin, said focusing on waist circumference was moving the battleground for the fight against obesity into the overweight category.
“That’s really important, because you can make a difference much more easily when you’re just overweight,” commented Prof O’Shea, adding that a measuring tape would not go around patients by the time he sees them in his clinic, where there is now a three- to four-year waiting list for assessment, because they are so obese.
The campaign follows research commissioned by Safefood revealing that being overweight was a much more common problem than we thought, with only 38 per cent of people believing they were overweight when in fact 61 per cent were carrying excess weight.
It also addresses the ‘social contagion effect’ of obesity. The Director of Health and Nutrition at Safefood, Dr Cliodhna Foley-Nolan, explained: “We’re all part of social networks and are influenced by the appearance and behaviour of those around us. Being overweight is now the norm and this norm is widespread in our communities throughout our families and friends. We need to stop the spread of this health epidemic by encouraging and motivating ourselves and others to reassess their own waist and weight, take realistic steps to tackle any excess weight, and begin to live a healthier future.”
Are we measuring up?
While Minister of State at the Department of Health with responsibility for Primary Care Róisín Shortall lauded the two-year Safefood campaign for its simplicity, it has, however, not been without its critics.
Labelled a ‘shock and awe’ campaign by some, critics have warned that the campaign, inspired by a similar Australian drive in 2008 called ‘Measuring Up’, was offensive.
Personal weight problem
Dr Foley-Nolan, however, maintained the €450,000 campaign would continue, despite some negative feedback, and was not intended to cause offence but was a direct and forthright way of getting people to address their personal weight problems, which cost Ireland €0.4 billion annually.
While it will take time to assess the campaign’s impact, a review of the Australian equivalent, conducted prior to its extension from 2010 for a further four years, showed that waist measurement was widely acknowledged as an element of weight overall, indicating that there has been some cut-through of the ‘Measure Up’ campaign (Irish Medical Times)