Should we use the ‘O’ word?

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Last month the National Institute for Health and Care Excellence (NICE) issued draft guidelines suggesting that doctors should not blame patients for being fat. Doctors are even being told that they should avoid the use of the term ‘obese’ for fear that larger patients might be upset. Instead, NICE recommends that corpulent patients should be advised to seek a ‘healthier weight’.
Whatever the rights and wrongs regarding this viewpoint, I am sure that the debate will have touched a nerve with many of us who have struggled with weight at some point in our lives. You know how it is…..You’re in the doctor’s surgery explaining symptoms which, in your own opinion, might be totally unrelated to your weight. The doctor ‘mmmms’ thoughtfully and then says, ‘Jump on the scales, would you?’ Immediately the palms of your hands become clammy; you palpitate and your mouth goes dry. You know it isn’t going to go well and that if, after this humiliation, your blood pressure is also taken, it will be sky high, if only because of the anxiety the doctor’s scales have produced. You feel cornered; the games up! You can kid yourself when you weigh yourself at home that the scales are inaccurate (always errant on the high side, of course) but the doctor’s scales are different – they never lie!
Then you are told the result, first of all in a foreign language called ‘metric’ – which doesn’t sound too bad and then – if you look puzzled – in stones and pounds. If the doctor then asks your height you know you’re in deep trouble because then he/she is going to consult the BMI chart on the surgery wall and put you in a category: 18-25 + normal weight; 25-30 + overweight; 30+ OBESE. Argh!! (NOTE: I little lie here of adding an inch to your height will lower your BMI!)
I am, as you might discern, speaking from experience – an unforgettable one about 20 years ago when I was in my mid-forties. I can still feel the shame I felt when the doctor told me bluntly –‘You are obese,’ but looking back, I am personally glad that he didn’t pussyfoot around using euphemisms. I needed to be told the truth, no matter how hurtful it was. Far better to be told that I am obese now than for this obvious fact to be ignored and then have to be told, later down the line, that I have diabetes, heart disease or stomach cancer!
The outcome of that visit to the doctor was that I was referred to the practice nurse who for a about three months kept a watchful eye over me whilst I, compliantly, did lose over a stone in weight. I would like to have been able to report that that was the end of the matter, but it wasn’t. Ten years, and several diets later, I had arrived at my all-time high of more than 14 stone, which at 5’ 3” gave me a BMI of 33. During those 10 years I avoided the doctor’s totally, knowing full well that my weight might get a re-visit, but at least I could boast that, generally speaking, I seemed to be in reasonable health.
So, getting back to the NICE recommendations, should doctors use the word ‘obese’ when describing a patient’s condition? In my personal opinion, yes they should be told. It is, after all, an objective medical term based on statistics and not a value judgement. But is it useful to the patient? Again, in my opinion it can be. Medical research has been playing the same record consistently over many years – that obesity increases the risk of contracting many life-threatening diseases. But if I don’t know that I am obese I may remain ignorant about my own risk. In this case, ignorance is NOT bliss!
But where do we go from here? Such information needs to be examined and acted upon if it is to prove helpful. So if I am obese, then why? NICE recommends that doctors should not blame patients for being fat, but if we are not to blame then who is? This is a trickier question.
Personally, I would like to lay a good portion of blame on our processed food industry which so often makes profit its overriding consideration and seeks to fill our bellies with low nutrient, high calorie junk. Real food is being replaced with laboratory-invented look-alikes which if they weren’t artificially coloured and given chemical flavourings would be unpalatable to us all. They may be made to taste good, with all their sugar, fat and salt, but the bottom line is they do make us FAT.
So what else can we blame? Perhaps our genes – for medical science has found a so-called ‘fat gene’ which does seem to predispose certain of us to gain weight more easily than others.
But do we not, individually, bear some responsibility for our weight? Research shows that obesity may be a combination of many diverse factors such as genetics, diet and exercise, social background and emotional factors. The Stop Dieting ~ Start Living programme takes the view that much inappropriate eating is often linked to our emotional state which in turn may well be linked historically with negative experiences which have taken their toll on us, leaving us with low self-esteem, guilt and shame, unresolved pain and profound inner emptiness. In such cases, obesity is a symptom of a much deeper malaise and until these underlying issues are identified and resolved then all attempts to conquer our weight issues stand little chance of success.
Thankfully our God not only knows all about us; He is not only our Creator who programmed our physical make-up, but he is acquainted with all our ways. He has seen our journey and the toll which experiences, often beyond our control, have left on us. He does not judge us for being overweight or obese, but knowing how damaging this is on our health, he does want to set us free. In order for this to happen we need to shake off any semblance of self-pity and take personal responsibility for our lives and our chosen lifestyle.
It isn’t good to be obese – it does impede our quality of life. God’s desire is for us to be in health and to prosper as even our souls prosper. Of course, we can be obese and still be deeply spiritual; we can be obese and still usefully serve the Lord in all manner of ways, and being obese certainly won’t keep us out of heaven (the gate isn’t that narrow!) But if we truly want God’s best for us in every department of our life, then we need to be willing to surrender our appetites and allow him to be Lord of our entire relationship with food.
Are you obese, as I once was? Owning this truth, unpalatable as it may be, is the first step towards being set free. Such disclosure doesn’t need to shame us. Providing we are willing to let God do a work within us, not only will we develop a healthier lifestyle but our entire situation can be turned to his ultimate glory. Isn’t that we want?

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