‘People who are obese need our help and support’

She took three medications for hypertension, statins for cholesterol, two drugs for her diabetes, a step-two analgesic and laxatives. These were prescribed to treat her conditions – but what she really had to do was lose weight. Her 5ft 2in frame was never designed to carry over 100kg. A body can only take so much strain before things begin to fail.

It’s difficult to maintain a normal weight in a society where fat is the norm and those of a healthy weight are in a minority. The forces against slimness are enormous. Clothes are bigger, furniture is wider and bariatric equipment is now being fitted in hospitals.

We need to act on two levels. We need to design cities and buildings that promote activity. Green spaces within a 10-minute walk of people’s homes reduce health inequalities, encourage exercise, reduce blood pressure and improve health. Sadly, we’ve been building flats and shopping malls. Buildings have lifts, escalators and travelators. It can be hard to find the stairs.

As professionals, we have to encourage people. Mrs X had come to see me because of recurrent falls. She had problems with her knees and asked if she needed knee replacements. I bit the bullet and mentioned the word ‘fat’. I told her that she needed to lose weight. Knee pain improves significantly in obese people who lose weight. I told her how losing weight would help her to feel less tired and improve her blood sugar, hypertension and all that ailed her.

She looked aghast. She assured me that she ate healthily, exercised and never, ever ate anything fattening. She said that she had big bones. Her hands were the same size as mine and she wore size three shoes, so I had my doubts. She’d come to me so that I could make her well. I told her that I would support her but the power to improve her health lay with her not with me.

I thought that she might complain but instead she joined a slimming club. Mrs X lost half of her body weight over 18 months. She regained her health and her zest for life. She brought me a basket of fruit and told me about the importance of dietary fibre.

Linda Nazarko is a nurse consultant at Ealing PCT

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