Can’t talk to your doctor about weight?

Nine out of 10 people with obesity have been stigmatised, criticised or abused, according to a new Government report, but many of us feel awkward discussing weight problems with our family GP.

It’s not just the patients who feel embarrassed, as the survey found that doctors find it difficult to tell their patients they need to lose weight too.

As a result, four out of 10 people with obesity found it difficult to access advice and treatment, and services that may help them to change aspects of their lifestyle, according to the report by the Obesity All-Party Parliamentary Group.  A total of 1,450 obese patients and healthcare professionals were asked about their experiences for the online survey.  

The report criticises the NHS for not doing enough, and recommends weight management training become part of the syllabus in medical schools.

London Nutritionist, Stephanie Moore goes further and suggests that many GPs simply do not know how to advise patients who are suffering from over-eating. In her article Five Myths about Weight Loss she, says, "Reducing one’s intake of calories as a means to lose weight has been proven time and again to fail yet it continues to be promoted by GPs, fitness experts and health practitioners as an essential and effective weight loss tool.  The concept of energy in = energy out, i.e. if you eat less and exercise more you will lose weight, can only ever work in the very short term".

How can we help solve our weight problem now?

Obesity is reaching epidemic proportions, and has been dubbed the ‘new smoking’ as it causes preventable diseases. The UK has the highest level of obesity in Western Europe, ahead of countries such as France, Germany, Spain and Sweden. Twenty-seven per cent of men are counted as obese in the UK, and 30% of women.

Many health experts agree there are things you can do now to help maintain a healthy weight. Consultant Rheumatologist and Osteoporosis specialist Prof David Reid uses a Dexa (dual energy X-ray absorptiometry) scanner with patients to help them keep tabs on their body fat and stay motivated during their weight-loss journey.

‘Perhaps the hardest thing for anyone to find in life is a healthy life balance, and many of us are in denial about how much extra weight we’re carrying,’ says Prof Reid.

‘These scans can be used to measure how muscle and the type of fat that’s distributed around your abdomen and crucially, where fat is located in the body. Visceral adipose tissue (VAT) is the most dangerous kind of fat, as it appears around the organs and increases your risk of diabetes, heart disease, high blood pressure, liver disease and certain cancers.

‘Dexa body composition scans are an incredibly effective diagnostic tool, as they act as an early warning to patients who need to change their lifestyle and eating habits before disease develops.’

Costing around £160 for a scan with a report interpreted by a doctor, this is a relatively inexpensive way to gain insight into your current and future health. It’s accurate, measuring fat and muscle to the nearest few grams, and non-invasive as the Dexa machine uses levels of radiation well below a standard X-ray.  You also get the advice of an expert who is not your family doctor.

Rob Smith from Suffolk, was suffering from excruciating back pain and thought that carrying extra pounds might be a contributing factor.  A Dexa scan carried out by Prof Reid revealed he was in fact obese. Following a year of working out with a personal trainer and following a healthy diet, a second scan taken a year later showed he had lost more than 500 grams of bad (VAT) fat, and was no-longer in the category considered to be at high risk of developing a number of diseases. While the amount of his body made up of fat had decreased the percentage of his body made up of muscle had increased.

Rob enthused that, ‘I was at least a stone and a half overweight, but I’d got into the habit of comfort eating and being too busy to exercise. Being confronted with the images of fat distribution in my body made it difficult to be in denial any longer.

‘My fitness journey was a team effort. I had an exercise partner in my son, who I share a personal trainer with, so we kept each other going during the squats and resistance exercises to build up core muscles, as well as the cardio workouts.  And I spoke to sports dietician Rick Miller, who reassured me that it’s normal to feel constantly hungry to start with!  It’s a psychological transition from habitual to healthy eating.

‘My crippling back pain has practically disappeared which is evidence enough that losing weight is worthwhile. I’ve lost over a stone by cutting out processed fats, and the weekly takeaway, as well as reducing my meat and alcohol consumption. This has been replaced by healthy and social family vegetarian cooking, experimenting with recipes at a fraction of the cost.

‘As a result I feel better than I have for years, with much higher levels of energy.’

Prof Reid adds, ‘Doctors looking to recommend diet and exercise plans to patients would do well advising them to consider making use of DEXA scans to measure body composition as part of monitoring of their treatment.  Having scans at intervals can help people to track their improvements and stay motivated, too.’


The part of the body that contains the stomach, intestines, liver, gallbladder and other organs. Full medical glossary
A fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. Full medical glossary
Abnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. Full medical glossary
A disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects. Full medical glossary
A means of measuring bone density. Full medical glossary
A sudden outbreak of infection that affects a large proportion of a population. Full medical glossary
One of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. Full medical glossary
A large abdominal organ that has many important roles including the production of bile and clotting factors, detoxification, and the metabolism of proteins, carbohydrates and fats. Full medical glossary
Tissue made up of cells that can contract to bring about movement. Full medical glossary
Any test or technique that does not involve penetration of the skin. The term 'non-invasive' may also describe tumours that do not invade surrounding tissues. Full medical glossary
Excess accumulation of fat in the body. Full medical glossary
A condition resulting in brittle bones due to loss of bony tissue. Full medical glossary
Energy in the form of waves or particles, including radio waves, X-rays and gamma rays. Full medical glossary
The ability of a microbe, such as a type of bacteria, to resist the effects of antibiotics or other drugs. Full medical glossary
A group of cells with a similar structure and a specialised function. Full medical glossary
A type of electromagnetic radiation used to produce images of the body. Full medical glossary