Don't weigh to die
After smoking, obesity is the biggest single cause of premature death in the UK, and much more besides. Overweight patients have lower self-esteem and more psychological problems than any other single patient group, including cancer sufferers.
Lots of them never go near a chocolate shop, and others eat no more than slim patients. Yet many have been ridiculed by doctors' remarks such as: "There were no fat people at Belsen." This is a snide way of saying: "If you ate less, you'd lose weight," which is true, but it's so offensive that patients are left feeling stigmatised.
I recently met a woman who had conquered her obesity but said at the time how it took over her life. "I was buying a pair of shoes and the sales assistant asked me if I wanted some polish for them. She chose a shade I was certain was wrong, but I didn't say anything because I'm sure she'd have thought 'Silly fat cow, what does she know?' so I let her sell me the wrong one." If overweight patients can feel so threatened by shoe fitters, imagine what a few thoughtless doctors do to them.
Each year, there are dozens of new diets and wonder drugs that claim to offer the answer to obesity, but none live up to expectations. By far the biggest breakthrough would be cultural acceptance, but at present you're still less likely to be offered a job or promoted if you're overweight. Half of us are, with a quarter of us obese. These numbers have trebled in the past 25 years.
Diets don't work because obesity is a life-long illness part genetic, part environment and any temporary change of habit is doomed to failure. So, the only way to make a lasting difference is to eat sensibly and take exercise every day for life, or have your stomach stapled.
If you can manage to lose weight permanently, the benefits are enormous. A 10kg weight loss for an obese patient cuts your risk of dying from diabetes by a quarter and your risk of dying from cancer by half. Your blood pressure and blood cholesterol also fall, your exercise tolerance improves and it halves your chances of developing diabetes.
The trick is to get in there early. Many children become overweight by the age of three and face an uphill battle with their weight for life
Phil Hammond is a GP and broadcaster and chairman of governors at a primary school in Somerset. His new book, Medicine Balls, is out in October