Driving home one evening last week, after a relatively early finish, we caught a piece towards the end of the Radio 4 PM programme about a BMJ obesity report with the incredibly media friendly Dr Sarah Jarvis talking with a surgeon who was advocating annual weight checks.
(The scientists among us here at ND like her media appearances particularly her one during the great flu Panic(demic) saying that a sneeze is the speed of a bullet. It got us thinking if one accidently sniffed a piece of lead shot up ones nose before seeing a favourite patient it would have to be death by natural causes?)
But we digress, Dr Jarvis was countering a surgeon who had only lost weight by gastric banding by saying it would make very little difference. We agree with what she said. She may actually do some real general practice from time to time from what she said.
Obesity is basic thermodynamics although lard arses never have the same problems with their cars. Some basic facts:
1)You are what you eat.
2) Eat more than you burn off then you get fatter.
3) Put more fuel in your car than you burn off when you drive your car and it gets heavier and slower.
Try watching Formula 1 for a believable explanation of the above thermodynamic principles but remember what happens to petrol in a Formula 1 car does not ever apply to food or patients.
However, you can bet that your average lard arse will be an expert on fuel strategy as they will watch a Formula 1 Grand Prix and then spend hours at their GPs saying they cannot understand why their weight goes up after a hard worked Grand Prix watching session of burgers and tinnies combined with a heavy physical workout on their remote control.
If you are fat it is not because:
you are big boned that is just a longer version of the word fat,
you eat healthy foods and have a “good” diet as healthy eaters are not fat,
and
it is not because your metabolism is slow (OK you may have a roughly 1 in 50 chance of thyroid disease.)
You are fat because you are greedy and idle so please do not waste your doctor’s time trying to convince them that your case is different - unless you have an under active thyroid gland or you have some incredibly rare metabolic condition (other than eating too much and doing sod all) which we will happily look for but rarely, if ever, find in patients who can’t lose weight.
Some of us here at ND Central have stopped giving anti obesity drugs because all that happens is that people keep coming back and pleading for them as they do not loose weight on them for the very simple reason that they are missing the point.
They eat too much and do even less. Rant over (well actually several rants by us here at ND Central which is what prompted this post.)
People like their food and what they want is to lose weight but carry on eating the same as before. Listen up people it does not work.
So as we trundled along the high moors and forests of rural Northernshire heading home for a healthy calorie rich Chinese take away, Double Choc Sara Lee gateau washed down by bottles of a well known Northernshire brown ale which our patients insist is healthy eating we got thinking as to how could we help the Party with the obesity problem?
Of course the Party resent paying anyone other than lawyers and management consultants huge salaries for dealing with huge numbers of patients and feel that giving GPs the task of reducing obesity is a most excellent and cost (and benefit) neutral idea as it won’t work and so GPs won’t get paid. This is why they have been trying to introduce obesity into the points for payment scheme called QOF (Quality and Outcomes Framework) for GPs.
Given the success of supermarkets we thought why not introduce a Lard Arse Tax (Latax) at the point of sale?
Historically Governments have not liked the idea of taxing food but why not tax the person buying the food?
A new Porky Poll tax perhaps?
It might work like this:
If a person of ideal BMI (Body Mass Index) buys their groceries they get charged no tax as they stand on a scale at the checkout which says welcome to supermarket X you are healthy no tax to pay please come again. Have a nice day.
If your average “I don’t eat anything, I eat healthily and I am always on the go” lard arse steps on the supermarket taxometer scales and it says you are a fat b*****d, soory have a high BMI, you have to pay double/triple/quadruple or more for your food based on a sliding scale based on your BMI can you see what might happen?
Well certainly the surgeon on Radio 4’s PM program will be very happy as they will get much more than a just annual weight check. Twice weekly perhaps even better as for some reason an annual weight check would have stopped him, a very intelligent person, putting on 10 stones.
The Treasury will be rubbing its hands with glee as given the increasing amount of obesity and the fact that food is essential for life they are on an instant earner to rapidly reduce the National Debt. Just like if you pollute the atmosphere with a gas guzzling car you have to pay more road tax and fuel duty and so stop driving the same could apply as an environmentally friendly “green” tax as food production causes pollution too.
A most Prudent idea perhaps?
Of course it is unlikely to cause a rapid drop in weight in those poor “ill” people who “don’t eat anything, eat healthily and are always on the go” but we are sure that sales of helium, light weight clothing and methods of fiddling the scales will be devised very rapidly as people try to avoid paying tax.
There might be a few, probably those who hire accountants to reduce their tax bills, who might invest in personal trainers but most will do nothing about it.
We imagine that that there will develop a black economy where cachectic, malnourished, underweight people will be seen repeatedly wheeling trolleys round different supermarkets loading them up to the gunnels (as they might qualify for a tax discount?) and so the fat will employ "personal shoppers", not personal trainers, to avoid tax and get fatter as they won’t even have to walk round the supermarkets anymore.
They will probably go to see their GPs to get “tax exemption” certificates with spurious medical conditions saying that it is physically impossible for them to lose weight and so they can avoid paying tax but carry on eating.
People like food. Historically producing more food has been both Government and a European policy to protect against war. We have been so successful in that it has led to grain, butter and beef mountains together with wine and milk lakes due to over production.
Obesity is a consequence of food policy, production, cost and availability. Oh yes we forgot “choice” which is why it is never the lard arse’s fault but always the doctor’s responsibility.
GPs are powerless against Government policy and plenty of food.
And yet in most of the world for some reason obesity is not a problem. If you do not have enough food you do not get fat(ter). We can’t work that one out here at ND Central but then nor can our patients.
We must be very thick here up North.
Praise be to the Party and all it has done for the obesity epidemic.
We were surprised they weren’t boasting about it at their conference as an area of consistent year on year growth over the last 12 years but no doubt it will be used to save money on health expenditure as pay back time approaches to service the National Gordon Debt at GPs’ expense.
We really must stop thinking on our long drives home.
