British docs can't move the fat man of Europe

Britain is the fat man of Europe yet health professionals appear unable - or unwilling - to do anything about it.

The latest worry for the one in five British men who are obese is the devastating impact weight appears to have on sperm count. American research found that obese men have only a fraction of the healthy sperm of men of normal weight - less than one million of the little wrigglers compared to over 18 million in Mr Average. 

A combination of bad practice, prejudiced attitudes and poor training appears to be preventing obese men - and women - getting the help they need.

Additional training does not appear to help. In a recent report in the British Medical Journal those GPs practice who had had training in obesity were found to be no better at tackling it than those who hadn't had training. The researchers found that in many cases, doctors and nurses simply didn't discuss the subject properly. They didn't advise on diet or set a suitable target weight.

In a separate independent analysis of GPs practices, over half had no strategy for tackling obesity despite the publication of government targets in this area three years ago. Over a third had no access to a dietician and many refused to fund drug or surgical treatments for obesity even though Nice, the government body which approves and recommends treatments, backs them. 

To make matters worse, doctors also appear to have old-fashioned attitudes to weight. Obesity is responsible for some 30,000 avoidable deaths a year yet doctors still tend to see it as the patient's fault. In research counducted at Yale University in the USA, health professionals associated all the usual stereotypes with obese people - lazy, stupid, worthless. Younger professionals were the worse. Doctor attitudes make a major difference to patient outcome so if British doctors prejudices match those of their American colleagues, Britain's overweight generation are in trouble.

Dr Ian Campbell of the National Obesity Forum sees this prejudice as totally unfair. 'There are many cases where it is not in the patient's control,' he told the BBC. 'It is becoming increasingly clear that as many as 80% people who are obese are predisposed genetically.'

The researchers in the BMJ study concluded that the NHS may need to look to professionals outside itself to find help in tackling obesity including weight-watching groups and gyms.  'Other strategies to manage obesity in primary care urgently need to be considered and evaluated. These might include motivated and dedicated obesity specialists placed at the level of the primary care trust, use of leisure services and use of the commercial weight loss sector.'

Would you know if you were obese? This is defined as having a body mass index (BMI) of over 30. Click here to check your BMI.