Jayne Dowle: Honesty the key to lightening £5bn burden

It hurt for someone to look me in the eyes and tell me my face was a mess. For years, I had tried to pretend it wasn’t. Now there was no getting away from it. The doctor prescribed a six-month course of antibiotics and eventually my skin was transformed. If she had hesitated, I’d probably still have acne today. If you’re wondering what my teenage skin condition has got to do with anything in the news, I’ll tell you. Painful memories are flooding back because controversy is raging over whether doctors should tell patients they are fat.

New guidelines from health watchdog NICE advise medical staff to be “respectful” and “non-blaming” to obese patients to avoid hurting their feelings.

If that doctor had been respectful and non-blaming to me all those years ago, my face would still be a mess. It wasn’t nice, what she said, but I am eternally grateful that she said it. Harsh words can cause depression, say NICE. So can an awful body image. And just think. My acne cost the NHS nothing, except for the cost of the tablets it took to sort it out. Health and medical problems caused by obesity cost the NHS £5bn a year. I simply cannot see the justification for sweetening the pill. If you’re fat, you’re fat, and you need telling.

I know that sounds hard. Then again, I’ve been called various expletives and survived. When I was pregnant with my daughter, Lizzie, I put on four stone. Huge portions of comfort food, too much chocolate and collapsing on the sofa every evening like a sloth meant my pregnancy weight didn’t shift. For about two years. Until one day Lizzie’s older brother, Jack, came home from nursery and said to me: “You’re fat mummy, aren’t you?” Words like that don’t come out of the mouth of a four-year-old unless they are true. I knew in an instant that I had to get a grip. I cut down the portions, cut out the chocolate, and started a gentle programme of exercise. Nothing extreme. Just sensible habits. Eat less. Move more. Simple as that.

It’s so easy to be sanctimonious about weight. I’m certainly no diet obsessive and have no time (or money) for fancy gyms. I also have no time whatsoever for excuses. I accept that some of us might be genetically predisposed to being a little on the larger side. “Big bones” my grandma used to call it. And at 5ft 10in with size eight feet, I definitely fit into that category.

However, there is big. And then there is big. When you look around and see the size of some people today, there is no argument. The vast majority have got that way because they have allowed their eating habits to get out of control. Not only that, they refuse to take any exercise whatsoever. They won’t even go to the shops to stock up on the unhealthy rubbish they stuff themselves with unless they can park directly outside.

Fat people are happy, are they? Well, they’re selfish too. While the repercussions on personal health and well-being are bad enough, the taxpayer-borne cost of treating the outcomes on the NHS is terrifying. Diabetes, heart and circulatory conditions, arthritis and gastric problems – all aggravated by being seriously overweight.

What is worse though is the way that society is adapting to accommodate the obese. Given that an estimated 25 per cent of the adult population of Britain now fits into that category, you could argue that certain changes are inevitable.

What worries me is that rather than tackling the problem head on, we are beginning to accept it as the norm. Can it be right, for instance, that fire brigades are spending their valuable time rescuing huge people stuck in their own baths?

According to official figures, over the past five years, crews have been called out more than 2,700 times to assist “severely obese” people who have got themselves into such difficulties. Should we smile indulgently when we hear that the East Midlands Ambulance Service must spend £27m upgrading its entire fleet because existing vehicles can’t cope with the number of patients who weigh in excess of the 28-stone maximum? Shake our heads but make no comment when those too lazy to diet are given gastric bands while children are refused cancer drugs because of “priorities”?

Why should medical staff be muzzled when this is happening all around them? The Government predicts that 60 per cent of men, 50 per cent of women and 25 per cent of children will be obese by 2050. The consequences of this should disturb us even more than the sight of jumbo school uniforms hanging next to the over-sized pizzas in the supermarket. Family doctors are our first line of defence. They must be allowed to tell it like it is.