Tuesday 23 July 2019

Dear Dr Nina: I've tried everything to lose weight. Can I take tablets?

There is no magic pill that will help you lose weight more easily
There is no magic pill that will help you lose weight more easily

Nina Byrnes

Question: I really need some help losing weight. I have tried everything - all the slimming clubs, Atkins, personal trainers - you name it. I am very obese and am worried that I will never be able to be a normal weight. I haven't been to a GP in 10 years because I am so ashamed of myself. What I would like to know before I take that step is if there are any tablets that a GP could prescribe to help me lose weight. Please don't suggest lifestyle changes as I have truly tried everything.

Dr Nina replies: Obesity is a frustrating and difficult condition to treat and yet it is incredibly common in Ireland. You are not alone in your concerns and distress. Obesity is defined as having a body mass index (BMI) over 30. It is estimated that one in four Irish adults is obese. Irish people are among the heaviest in Europe.

The reason we talk so much about obesity is this condition is serious. It has been linked to heart disease, diabetes, liver problems, breathing difficulties, arthritis and cancer. Most people are aware of the link between obesity and heart disease or diabetes but not many know that it can lead to cirrhosis or sleep apnoea and makes arthritis worse.

Obesity can be a causative factor in cancer of the breast (after menopause), bowel, kidney and womb. Studies have suggested that for a BMI between 30 and 34, life expectancy is reduced by two to four years. Having a BMI over 40 reduces life expectancy by eight to 10 years. It is estimated to cause approximately 2,500 deaths a year and costs the taxpayer billions of euros.

So what is the cause of this problem? The answer is fairly simple. We are eating more calories and exercising less than previous generations. The problem doesn't lie entirely with individuals but the way we live as a society as a whole. Sales of ready-made meals, fast food and high-calorie snacks are booming and one in five adults report no physical activity on a weekly basis.

It is a battle for many. A total of 43pc of people admit to being concerned about their weight. The focus of weight loss shouldn't be about how you look. We need to shift the focus around to being a healthy weight in order to remain physically well. You shouldn't be ashamed to talk to your doctor about your struggle to lose weight. Nor should you feel ashamed that you find this difficult. Weight should be discussed in the same way as a smoking habit or blood pressure. Health professionals are sometimes reticent to discuss someone's weight for fear of coming across as insensitive or unsympathetic yet these are exactly the people best poised to dispense accurate weight loss advice.

It sounds like you have tried various weight loss methods without much success but there is no magic pill that will make weight loss easy. Healthy sustained weight loss comes from long-term lifestyle and diet change. It may be that from your years of dieting your metabolism has suffered and it may take you longer to lose weight than others but staying the course is important.

Don't focus immediately on being a normal BMI. A 5pc to 10pc weight loss from wherever you start will bring health benefits. Bariatric surgery is an option for some. There are obesity clinics in hospitals and although the wait is long they may be an option. I'm sorry I can't suggest a quick fix but it strikes me the doctor visit you have been avoiding is the best place to start.

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