Opinion: The 'South Auckland Full House' of obesity needs to fold

  • 08/02/2017

Should body positivity be embraced or is it contributing to New Zealand's obesity epidemic? Join the debate on Newshub's Facebook page. Here, Middlemore Hospital intensive care specialist Dr David Galler says we have failed as a nation.

OPINION: At Middlemore Hospital, we've sort of coined a term known as the "South Auckland Full House".

It's when an obese patient comes in and has the full hand of obesity related illnesses: sleep apnoea, heart failure, diabetes, impaired kidney function, high blood pressure and ischaemic heart disease.

Obesity really is a modern day plague.

The obesity epidemic is a result of choices we have failed to make. Whilst nations fiddle, the diabetes epidemic spreads and we spend more and more on hospital care and expensive medicines to manage the rising tide of its complications.

Take John, for example. John was not always obese, in fact he started out like most of us - small, weighing a healthy 3.5 kilograms when he was born. Later, John was a slim kid too but all that changed when he hit adolescence and the impact of his diet and lifestyle began to take its toll.

When John was thirsty he would drink fizzy drinks loaded with sugar - five or six cans a day; when he was hungry he ate fast food rich in fat and salt. All cheap choices and easy to get, and cool choices too because this had become the favoured diet of his friends.

Not a particularly tall man, by the time he was 22, John weighed over 120 kilograms. As his weight continued to rise, his energy levels fell and he became more sedentary. It was about that time that John began to snore at night and nod off during the day: a condition we call sleep apnoea, caused by partial obstruction of the airway when asleep. That airway obstruction causes a drop in the amount of oxygen in our blood, which in turn causes changes in the blood vessels of the lungs and eventually leads to heart failure.

On this occasion both of his legs were more than just swollen - they were red and extremely tender to touch and the toes on his left foot were black with gangrene. Over the next week or so three toes were amputated and a week later, his left leg was amputated below the knee. On the way his kidneys completely failed and he needed to be dialysed.

Two months later he was discharged in a wheelchair but needing to return three times a week for dialysis.

Sadly, a year later John was dead.

Although his story is at the extreme end of the ill health caused by being grossly obese, he is not alone – in fact there are more and more of us slowly becoming like John.

Some are still just babies, some are slim kids; huge numbers are suffering right now from the ravages of diabetes as a result of obesity. As time goes by, more and more of those people will be lost from their families and friends, whilst at the same time costing our society millions and millions of dollars.

It doesn't need to be this way but life is really tough for the Johns of our world. They have little chance in the face of the market forces stacked against them that actively encourage, reward and promote the kinds of behaviours that drive this modern-day plague.

As a nation we are quite capable of making different choices - as we have with tobacco - by using a combination of government regulation, social marketing and slowly shifting the culture to change individual attitudes about what we will in the future find acceptable to eat and how much.

Dr David Galler is a Middlemore Hospital intensive care specialist.

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