Sunday, September 24th, 2017

Life in the Fast Lane- Fast Food, Fast Medicine, Fast Surgery

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Everyone knows that we are experiencing a global pandemic of obesity that shows no signs of abating. Some of us would like to blame ‘fast food’.

And, if you were not aware, the medical conditions caused by obesity are placing a significant strain on peoples’ health and health systems. Doctors are overloaded and many are burning out, often before they leave medical school!  Their patients are complaining about the limited time the doctor spends with them, and the doctor’s seeming lack of interest and engagement with them. Very few of us have Family Doctors anymore and instead attend the big medical centres, which have surfaced. The high turnover of medical staff in these medical centres means we rarely see the same doctor twice. Given these changes, it was hardly a surprise when the term ‘fast medicine’ emerged in the media.

Now, while some of us may feel like we are just pieces of product in some medical processing plant when we visit the doctor, others of us have become immune to the lack of interpersonal warmth and brevity of our encounters with doctors because it matches our ‘fast’, time pressured lives – we don’t want to spend too long with them either because we live in our own time famine!

Unfortunately, ‘fast medicine’ doesn’t work for weight management. In a three minute, ‘fast medicine’ consultation the doctor’s prescription for weight loss is likely to be, “You need to lose weight”, or “You need to exercise”. They don’t have time to find out what caused your weight gain, or to provide strategies on how to lose weight, and many don’t have the training. The research literature has clearly identified that many doctors agree that time constraints in consultations and lack of training in the weight management area impact on their ability to address this important health issue.

Anyway, enter ‘fast surgery’. While the criteria for bariatric surgery are that you have a BMI>40, or a BMI>35-39.9 with a serious medical condition related to obesity, and have attempted previous weight loss using diet, exercise or medication, surgery is sometimes being recommended without really ensuring that the patient has genuinely attempted weight loss previously. We have become an instant gratification society. We want everything, and we want it now, and are prepared to pay for it later. Surgery to some offers an easy and quick solution. However, although research confirms the success of bariatric surgery in achieving more substantial and permanent weight loss outcomes than conventional forms of treatment incorporating diet and exercise, it is simply not realistic to depend solely on surgical or, even pharmacological treatments, to manage ‘globesity’.

We live in an obesogenic environment and must learn to adapt to it. Diet, exercise and behaviour modification retain their position as the most accepted approaches for weight management and offer the opportunity for multiple positive health outcomes such as improved nutritional status through to a level of mental and physical fitness that a ‘fast surgery’ approach does not promote.

So, enter the ‘slow movement’. Obviously, the ‘slow movement’ has evolved in reaction to the ‘fast movement’ – fast food, fast medicine, fast surgery! The ‘slow movement’ is about making a connection, about freeing us from our ‘nearly pathological’ need for instant gratification and living a life as pawns in a totally man-made time famine. Fast does not free us. We could all slow down and take time to smell the roses. Effective weight loss and lifestyle changes are not fast. They are best taken one day at a time, and don’t forget you have the rest of your life to do it.

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