Health « Dr Alf's Blog

This Guardian article by bariatric surgeon, Richard Welbourn is full of contradictions. He argues that we should stop judging Britain’s obese people and start treating them surgically, as our European counterparts do.

Source: Obese people deserve surgical treatment, too | Richard Welbourn | Opinion | The Guardian

Welbourn argument highlights different causes of obesity. At one extreme, he suggests:

For severely obese people, the hormonal effects of being obese mean that medical therapies, lifestyle changes and attempts at dieting rarely succeed in maintaining long-term, clinically beneficial weight loss.

But on the other hand, he argues:

The World Health Organisation identifies obesity as a chronic disease. But on the other side we have the popular perception – shared by some healthcare professionals – that it is purely a lifestyle choice. This totally disregards the fact that, driven by powerful food industry advertising, it is those who are poor who are most affected.

Reality is more complex. We can imagine a continuum of triggers for obesity, ranging from hormonal effects from birth to lifestyle choices of junk-food and laziness. Whilst, there’s a strong case for those with hormonal defects, the case for the other end of the continuum is less robust as many clinicians know – for many of these people obesity is a lifestyle choice.

In a world of severely rationed healthcare, surely improving cancer outcomes takes precedence over bariatric surgery for the obesity driven by lifestyle choice? Surely, governments have better options to tax junk food and promote healthcare?

Thoughts?

Register and read the original full text on dementia prevention, intervention and care published by The Lancet. It recommends that acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society.

Source: Dementia prevention, intervention, and care – The Lancet

Whilst this is a research article, it is highly readable with good summaries and graphics. Try reading the original rather than a sanitized version of the findings in the mainstream media.

The commission of experts have detailed evidence-based approaches to dementia and its symptoms. They recommend that services should be available, scalable, and give value. However, they caution that professionals and services need to use what works, not use what is ineffective, and be aware of the difference.

Optimistically, the conclusion is that there is good potential for prevention and, once someone develops dementia, for care to be high-quality, accessible, and give value to an underserved, growing population. It’s argued that effective dementia prevention, intervention, and care could transform the future for society and vastly improve living and dying for individuals with dementia and their families. They maintain that by acting now on what we already know can make this difference happen.

The article provides ten core thematic messages on dementia: