WIMBLEDON, with its strawberries and cream (and tennis) is as much part of the British summer as rain on bank holidays. Crowds reading their papers in the ticket queue and salivating at the thought of the cream may be surprised to read that there is dispute about whether there really is an obesity epidemic — much of the argument is about the definition of an epidemic.
Few doctors will disagree that to be overweight is bad for your health, affects longevity and quality of life, and can occasionally be a nuisance to others.
The Wimbledon authorities have unwittingly drawn attention to the issue because people are now broader in the beam than they were in 1922, when Centre Court was opened. Even an adjustment to the seating in 1992, which allowed some provision for the average change in the population’s girth, has proved inadequate. It was announced recently that the All England Lawn Tennis Club will widen the existing seats by 10 per cent, but it will be another five years before the new seats are in place.
Although doctors are in general agreement about obesity, 90 per cent of those patients who are troubled by putting on weight have found that their GP gave them only the standard advice to eat less and exercise more. This is sound advice but does not help many patients with weight problems. No one denies that too many of us (50 per cent of English people are overweight) overeat and under-exercise, but greater help is needed for many overweight patients who are already eating less than their contemporaries and may well be taking more exercise.
Less than 2 per cent of patients are offered any treatment on prescription to help them to lose weight, nor are they given advice about the availability of slimming preparations or details of meal-replacement programmes such as Slimfast. Dr David Haslam, chairman of the National Obesity Forum, has said: “Preparations such as Xenical (orlistat) and Reductil (sibutramine) can make a significant difference to patients who are overweight and at risk of cardiovascular complications such as diabetes, high blood pressure and heart disease and in whom diet and exercise alone have not resulted in enough loss of weight to benefit their health.” The National Institute for Clinical Excellence has approved the use of these preparations for patients who are obese or who, if only overweight, are showing signs of ill-health resulting from their weight.
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Xenical is an inhibitor of the enzymes in the gastrointestinal tract that favour the absorption of fat. There is plenty of good evidence that patients who take it, and follow the rules, lose weight. It prevents the absorption of a third of the dietary fat, and therefore should cut 10 per cent off a person’s daily calorific intake. A word of warning before wading into the Wimbledon strawberries and cream: if a patient taking Xenical consumes high-fat foods such as cream, the fat not absorbed has to be excreted. Overdoing the cream at Wimbledon may mean that for several reasons they are not sitting too comfortably in unaltered seats.