{"id":32910,"date":"2014-12-04T17:37:05","date_gmt":"2014-12-04T16:37:05","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=32910"},"modified":"2014-12-04T17:37:05","modified_gmt":"2014-12-04T16:37:05","slug":"sally-norton-open-your-eyes-to-obesity","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/04\/sally-norton-open-your-eyes-to-obesity\/","title":{"rendered":"Sally Norton: Open your eyes to obesity"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/09\/sally_norton.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-32241\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/09\/sally_norton-293x300.jpg\" alt=\"sally_norton\" width=\"179\" height=\"183\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/09\/sally_norton-293x300.jpg 293w, https:\/\/blogs.bmj.com\/bmj\/files\/2014\/09\/sally_norton-1002x1024.jpg 1002w, https:\/\/blogs.bmj.com\/bmj\/files\/2014\/09\/sally_norton.jpg 1853w\" sizes=\"auto, (max-width: 179px) 100vw, 179px\" \/><\/a>We know that we are in the middle of an obesity epidemic\u2014and we know it is really difficult to treat. But it\u2019s nigh on impossible to treat if we don\u2019t identify it properly in the first place.<\/p>\n<p>Recent research shows that many of us don\u2019t really know, or admit to knowing, how obese we really are. Think that\u2019s worrying? It turns out that doctors and other healthcare professionals don\u2019t spot the problem either.<!--more--><\/p>\n<p>According<a href=\"http:\/\/bmjopen.bmj.com\/content\/4\/11\/e005561.full\"> to\u00a0this population\u00a0survey of around 2000 adults<\/a>, only 11% of obese women accurately acknowledged that they were &#8220;obese,&#8221; with most describing themselves as &#8220;very overweight&#8221; or &#8220;just right.&#8221; Men were even less clued up. This wasn\u2019t just because they didn\u2019t want to use the term &#8220;obese,&#8221; which may be considered derogatory outside medical practice. The researchers also asked people whether they felt they were &#8220;very overweight&#8221; and the majority of those who were obese did not accept this term either.<\/p>\n<p>Researchers suggest that as bigger sizes become the new &#8220;normal,&#8221; people are less likely to recognise the health problems associated with their weight or respond to health messages directed at them. This will substantially reduce the impact of media coverage and public health campaigns aimed at improving public awareness of obesity risks.<\/p>\n<p>Further studies have found that <a href=\"http:\/\/pediatrics.aappublications.org\/content\/early\/2014\/01\/28\/peds.2013-2690.abstract\">parents underestimate the weight of their children<\/a>, which may contribute to the problem. How can our\u00a0children realise that being overweight isn\u2019t good, when their parents don\u2019t seem to notice and don\u2019t seek help?<\/p>\n<p>Why are we failing to appreciate the size of the problem? With <a href=\"http:\/\/www.theguardian.com\/society\/2014\/feb\/04\/two-thirds-adults-overweight-england-public-health\">two thirds of us now overweight<\/a>, it is becoming more normal to be overweight than a so-called &#8220;normal weight.&#8221; It is very difficult to see yourself as overweight when most of your family and friends weigh the same, if not more. Apparently, half of overweight men and a third of overweight women don\u2019t perceive it as a concern.<\/p>\n<p>It is very hard too to see your weight as an issue when shops are increasing their clothes sizes, so that you still fit a woman\u2019s size 14 even though you are a stone heavier than you used to be. The average waistband of a size 10 pair of trousers was 24 inches in 1975, now a size 10 has a 28 inch waistband (that would have been a size 14 back then).<\/p>\n<p>So, perhaps we, as healthcare professionals, should be a little less backward in coming forward and broaching this sensitive subject more often. Well, not if we don\u2019t recognise the problem either.<\/p>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25348994\">Another study\u00a0found that the majority of people<\/a>\u2014including healthcare professionals\u2014are unable to visually identify whether a person is a healthy weight or not.<\/p>\n<p>Participants were shown photographs of male subjects and asked to categorise whether they were a healthy weight, overweight, or obese according to World Health Organization (WHO) Body Mass Index (BMI) guidelines. Most were unable to correctly identify whether the models were a healthy weight, overweight, or obese. Instead, they often underestimated weight, believing that overweight men were a healthy weight.<\/p>\n<p>Even those professionals at the frontline were unable to gauge obesity, as found in a related study of GPs [1]\u2014 a serious issue as they may not therefore be offering support and advice when needed.<\/p>\n<p>The researchers also found that exposure to heavier body weights may influence what people see as a normal and healthy weight, causing people to underestimate a person&#8217;s weight. That explains why I, as a weight loss surgeon, regard someone with a BMI of 35 as relatively slim. It is a serious issue though: as obesity becomes the norm, our perceptions shift and what we regard as an acceptable weight will continue to rise.<\/p>\n<p>As healthcare professionals therefore, we need to understand that our perceptions of &#8220;normal weight&#8221; are changing and take steps to re-align them. We need to be more aware of the risks facing our patients\u00a0owing to their weight and be vigilant in identifying obesity for their sakes. We also need to be more proactive in raising these sensitive issues with them, to ensure that they are aware they are not a healthy weight, even if they are now part of the overweight &#8220;norm.&#8221; Only when we, and they, have appreciated that there is a problem, do we stand any chance of trying to tackle it.<\/p>\n<p>[1] The changing face of obesity: exposure to and acceptance of obesity. Robinson, E and Christiansen, P. Obesity. In Press.<\/p>\n<p><em><strong>Sally Norton<\/strong> is an NHS consultant, specialising in weight loss and upper gastrointestinal surgery, on a crusade to put herself out of work by promoting healthier behaviour.<\/em><\/p>\n<p>I have read and understood BMJ policy on declaration of interests and declare the following interests:<\/p>\n<p>NHS and private practice consultant in weight loss and upper GI surgery.<br \/>\nFinancial support to attend conferences as invited speaker or delegate from MID, Allergan, Ethicon, Cook Medical.<br \/>\nFounder and director of Vavista.com: offering online weight loss solutions and advice.<br \/>\nFounder and director of Vavista Awards: Free awards to industry for developing healthier products.<br \/>\nFounder and director of Health-eSupport: Free apps to educate patients and doctors about surgery.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>We know that we are in the middle of an obesity epidemic\u2014and we know it is really difficult to treat. But it\u2019s nigh on impossible to treat if we don\u2019t [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/04\/sally-norton-open-your-eyes-to-obesity\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-32910","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Sally Norton: Open your eyes to obesity - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/04\/sally-norton-open-your-eyes-to-obesity\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sally Norton: Open your eyes to obesity - The BMJ\" \/>\n<meta property=\"og:description\" content=\"We know that we are in the middle of an obesity epidemic\u2014and we know it is really difficult to treat. But it\u2019s nigh on impossible to treat if we don\u2019t [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/04\/sally-norton-open-your-eyes-to-obesity\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2014-12-04T16:37:05+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/09\/sally_norton-293x300.jpg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Sally Norton: Open your eyes to obesity\",\"datePublished\":\"2014-12-04T16:37:05+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/\"},\"wordCount\":860,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2014\\\/09\\\/sally_norton-293x300.jpg\",\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/04\\\/sally-norton-open-your-eyes-to-obesity\\\/\",\"name\":\"Sally Norton: Open your eyes to obesity - 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