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Prof Alberic Fiennes |
Big problem: ‘It’s a disease of civilisation’
Professor believes obesity is perpetuated by attitudes to weight
PROFESSOR Alberic Fiennes, head of the one-year-old specialist obesity unit at University College London Hospital, holds society to blame for the rise in obesity.
More than 30,000 people die in England each year from the consequences of being chronically overweight.
The pioneering doctor, a member of the Fiennes dynasty which includes explorer Sir Ranulph and his actor cousin Ralph, has performed about 950 operations to reduce the physical capacity to eat in clinically obese individuals since 1995.
“Many people with a serious weight problem still feel that society looks down on them,” he said, “but the moral dimension to their condition is no more than any other disease. It’s a disease of civilisation.
“Lean people say to themselves, ‘if I want to lose weight in order to wear nicer clothes in the spring why can’t someone who needs to lose 20 times as much as me just pull themselves together?’.”
“But it’s actually similar to asking someone to hold their breath for 20 minutes. Eating, like breathing, is a life-preserving function, so when you finally breathe in again, you gasp.”
He added: “When people become very overweight, and are for a significant period of their adult life, their body is reset to that weight which makes it even harder to lose the weight.”
Obese people have from double to triple the probability of dying prematurely, and more are prone to depression compared to people with normal weight.
Ninety per cent of type 2 diabetics – who may develop kidney failure, blindness, amputations and heart disease – are also severely obese.
Gall stones, cancer, serious sleep deprivation, reproductive and musculo-skeletal system disorders are a few of the likely outcomes of years of being overweight.
Professor Fiennes said: “These patients face a lifetime of slow deteriorating health – a lifetime of treatment. The healthcare system faces the terrible cost of looking after them.”
The National Institute for Health and Clinical Excellence (NICE) clinical guidelines recognise obesity surgery as the most cost-effective treatment in modern medicine.
The cost of dialysis treatment for one diabetic for one year to the NHS is more than £20,000, while bypass surgery will cost half that sum.
Tragically, two patients died after medical complications arose directly after surgery this year.
Forty-six-year-old Diane Abroka, who weighed 21 stone, died a week after her operation at the Whittingdon Hospital in Highgate and 41-year-old mother of three, 23-stone Tracey-Ann Korkmaz, died in similar circumstances at UCLH.
Professor Fiennes said: “It’s always better to look at the pooled results of lots of doctors and lots of patients because the risks that come out of that are the true risks.”
Gastric banding reduces the size of the stomach. The bypass procedure shrinks the large intestine restricting the amount of food that can be absorbed.
Professor Fiennes believes the risk resulting from long-term obesity often carries a heavier burden than that of post-operative fatality, which varies from one in 1,000 for banding to one in 200 for bypass.
The obesity state is a specific risk factor for anesthetic accidents. Patients may also require follow-up operations to correct complications from excessive vomiting and surgery on the overweight can result in deep vein thrombosis, pneumonia or blood poisoning.
An over-eater who has undergone obesity surgery may retch after what most people might consider a normal amount of food.
Yet patients in 15 per cent of cases do regain some weight since the will to eat may never leave them.
Professor Fiennes added: “It’s tempting to think it’s just a behavioural problem.
“But there is experimental evidence to suggest that people may be genetically and biologically pre-disposed to regaining the weight after the operation.” |
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