A weighty issue

03 September 2020

There is something rather strange about an overweight prime minister taking action against obesity, just as there is something rather incongruous about the initiative going hand in hand with the new ‘Eat Out to Help Out’ policy where the public is being encouraged to eat out at restaurants and fast food places including Burger King and McDonalds in order to get the economy back on track.

The issue of weight is an interesting one – prior to the pandemic the idea that an individual’s weight was anyone’s business but their own was somewhat controversial. But with lockdown came the slogan “protect the NHS”, and the realisation that no aspect of healthcare exists in isolation. As such the use of any resources were subject to scrutiny, and with obesity linked to a number of health conditions, and more serious outcomes from the coronavirus, suddenly an individual’s weight became the legitimate concern of everyone. This is of course in complete contrast to the message of the body positivity movement, which had long preached that judging an individual for their size was wrong. Although in truth this only seemed to apply to plus-sized people – skinny people could still be criticised for their size – particularly if they were formerly overweight. For example, singer Adele was lambasted as some kind of weight traitor for her weight loss – I am not entirely sure which is more ridiculous; body positivists shaming someone for their size, or the specific criticism that her decision to lose weight was wrong because she was a role model for young girls.

Whilst I understand the dangers of social pressure, particularly amongst young girls, to look a certain way and the potential risk of anorexia and other eating disorders, that has to be balanced against the dangers of obesity. And given the statistics it seems fairly clear which should be of greater concern in today’s society.

In this issue we have a number of articles on the subject of diet and food – on page 46 Kimberley Lloyd-Rees discusses obesity, whilst on page 50 Nik Sisodia explores the dental professional’s role in helping to combat eating disorders. Then on page 54 Deborah Lyle looks at the impact a vegan diet can have on oral health, and following that on page 58 Phil Silver explores the damage caused to teeth by chemical corrosion of food and drink.

At the heart of the obesity debate is the issue of responsibility; who is ultimately responsible for an individual’s weight? Is it society at large, the healthcare profession or each and every individual person? Dentists are healthcare professionals who may have relatively regular contact with their patients, and so they are in a perfect position to notice differences in a patient’s appearance and offer advice and guidance where appropriate. But they are not the ones making the decisions on what patients eat, drink or how much exercise they do. In the same respect they can offer dental treatments and oral health advice but they are not in each patient’s home brushing their teeth every morning and night. This is why judging a dentist on the oral health status of a patient is problematic – as homecare is completely outwith their control. This is a constant source of frustration to dentists, and adds more stress to an already demanding role. The mental health impact of working in practice can be huge – this is something discussed in an interview with Lauren Harrhy, founder of Mental Dental, on page 42. So whilst it is tempting to look at dentistry and see the opportunities for dental practices to take on more responsibility in terms of the wider healthcare system, the flip side of the burden of responsibility needs to be considered. There is an obvious benefit to the community, and practices can perhaps use any extra services to build their reputation, but what is the likelihood that practices will end up being fairly remunerated? Let’s be honest – even with a government focus on obesity – there is fat chance of that happening!