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ABC of obesity

A journey from A to obesity, with everything except grounds for optimism

A journey from A to obesity, with everything except grounds for optimism

‘The obesity epidemic in the UK is out of control, and none of the measures being undertaken show signs of halting the problem, let alone reversing the trend.'

So begins the ABC of Obesity, another publication in a series that started as weekly instalments in the BMJ and now includes over 40 books on a variety of subjects.

Just how you react to this first sentence may predict how you will react to the book as a whole.

Do you embrace its sense of journalistic urgency or question its evidence base? Are you seeking information and challenge or would you prefer reflection and balance?

The title gives it all away of course – this is an ABC book. It is concise, didactic and packed with information of great relevance to almost every practising doctor, yet still it leaves me strangely unsatisfied.

Twenty authors contribute to a book of just 45 pages and I think it is a real challenge for any editor under such circumstances to produce a coherent account of such a complex and rapidly evolving problem.

Nonetheless, in the early chapters the editors manage this task remarkably well.

Once the epidemiology and management options have been scoped, though, the book drifts for a while before returning to a general issue – childhood obesity – and the final chapter: Obesity – can we turn the tide?

The answer appears to be No and perhaps this is why, despite enjoying much of the book, I ended on a low note, for although you can make small differences by diet, exercise and behavioural modification, the evidence presented is incomplete and (on page 16) rather alarming:

‘Most obese adults who have chosen surgery and had complications (including death) have been satisfied with their choice because their lives as obese individuals were often not worth living.'

And so we are left with a problem which the authors care passionately about, but for which they have no SMART (specific, measurable, achievable, relevant and time-limited) solutions.

‘The profession must unite the forces of public health and acute services to generate sustainable changes in food and lifestyles, matters at the heart of our cultural identities.'

Dr James Heathcote

Rating: 3/5

ABC of obesity

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