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Slim Chance – Addressing the obesity epidemic

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Obesity has been identified as a major contributor to ill-health. Dietary and lifestyle changes over the last three decades have been predominantly responsible for an obesity pandemic in much of the developed world. Our diets have increasingly developed a higher proportion of fats, particularly saturated fats. Worst of all is the high consumption of white sugar and high fructose corn syrup. Both products are used in soft drinks, canned and processed foods and ready-made meals.

Compounding the problem is the lack of physical activity endemic in most modern lifestyles. Most of us do far less physical work than our great-grand parents. Gone are the jobs in foundries, mines, shipyards and farms. Most work has become generally less physically demanding. Cars, buses and a superb railway system – in the UK at least – means there is little need to walk or cycle to work.

Increased technology further contributes to a less demanding physically active existence. No need to mimic the heroes of the Six Nations when you can play computer games or watch sport on a huge TV screen.

What is obesity?

Obesity is a term used to define being overweight to an extent that damages your health. Someone with a Body Mass Index (BMI) of more than 30 is obese.

BMI is a measure of the relationship between height and weight. To work out your BMI divide weight in kilograms by height in metres squared or check the NHS online Healthy Weight Calculator.

Anything from 18.5 to 25 is healthy, 25-30 is considered overweight and anything over 30 is deemed obese.

Bear in mind the body is made up of many different tissues and some people, particularly athletes with a very high proportion of dense muscle, may appear heavier but in fact can be considered to have a very healthy constitution.

Around a quarter of men and women in Britain are obese. Child obesity is rising too.

Problems associated with obesity

Although rather obvious, size can be a considerable hindrance and impairment to everyday activities. Most equipment, clothes and services are designed for people within a fairly narrow range of size and shape. Outside these limits there can be considerable difficulty in undertaking many tasks without modified aids. Chairs can be too small, corridors are narrow and other equipment inappropriately designed. This can clearly be an impairment in many areas of activity and employment which is compounded if reasonable adjustments are not feasible.

Sleep apnoea is becoming increasingly recognised as a respiratory condition that prevents individuals obtaining a deep level of sleep with the result that they will suffer from general drowsiness while awake. The consequences will be shown in the form of diminished alertness, general cognition, reaction times and overall functional capability. This condition is now recognised as having serious implications for all those who undertake safety critical responsibilities.

The effects of obesity on the cardiovascular’s system increase significantly with only minor rises in the BMI. This includes raised blood pressure and all the long-term health problems associated with this condition, angina together with resultant heart attacks and heart failure.

Again these conditions will have serious implications for individuals undertaking safety critical duties where sudden incapacity could have serious consequences.

Type II diabetes is another condition that is increasing in prevalence, probably due to dietary factors and associated weight issues. A male over theageof40withaBMIof27when young has an approximate increased risk of developing type II diabetes by a factor of six. Although usually manageable, the long-term side-effects of type II diabetes can damage vision, have neurological complications and other systemic disorders all of which can interfere with occupational capabilities.

As weight increases there are other adverse conditions usually less documented but with fairly clear associations. These include psychological hazards such as depression, low self-esteem, social exclusion, some cancers and, to the community as a whole, obesity represents a substantial burden on the wider economy.

In general terms it can be seen therefore that all the medical conditions that we commonly associate with the ageing process such as muscular skeletal compromise, type II diabetes and raised blood pressure will all be accentuated and aggravated by being overweight.

Impact on employment

Although obesity is usually seen primarily as a public health issue there are obvious implications for the workforce:

  • Is equipment appropriately designed to accommodate the overweight, such as ladders, chairs, workspace and personal protective equipment?
  • Are there specific tasks that obese people are unable to do or find more difficult?
  • Does obesity with a higher percentage of body fat make an individual more prone to absorption problems from toxic chemicals?
  • The correlation with musculoskeletal problems particularly back conditions may be a cause of increased sickness and absence from work.
  • Problems with sleep, as outlined above, may cause issues with fatigue and the possible loss of cognitive function and general impairment, leading to accidents and other safety issues in the workplace.
  • The long-term side-effects from associated conditions such as diabetes may affect vision and neurological problems for overall capability and safe working.

Can obesity be considered a disability?

A recent employment tribunal ruling indicated that, on the face of it, obesity does not in itself amount to a protected characteristic under the Equalities

Act 2010. However, in cases where the obesity has reached a degree that attitudinal and environmental barriers hinder full participation in professional life due to physical or psychological impairment, could be considered a disability. In summary, it concluded that it is not so much the underlying obesity as the impairment that this condition may produce that needs to be considered.

Role of employers and government

Employers will increasingly need to take obesity into account when undertaking standard risk assessments, particularly to ascertain whether any special modification, restrictions or other adjustments need to be made in the workplace.

However, there is also a much wider issue of the expected role that employers are now playing in counteracting obesity due to the increased emphasis on well-being alongside health and safety in the workplace.

Employers may be expected now to be responsible for ensuring there is healthy food in staff restaurants, opportunities to use exercise facilities and many workplaces can be seen to have a “captive audience” with an opportunity to educate and influence their employees diet and healthy lifestyle.

Obesity is already a significant problem and this is likely to increase unless current trends can be reversed.

The Health, Work and Well-Being Strategy (DWP, DoE and HSE) set out the need for action on the development of a new cross- government campaign on obesity to raise awareness of the steps that people can take to prevent this problem.

Dr Ian Campbell, former director UK National Obesity Forum, said, ‘Jamie Oliver has highlighted the positive effects that healthy eating has on children in their school – we now need to ensure this principle is applied to the workforce.’

By Express Medicals


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