What your waist is saying about your health

To measure one’s waist, governmental guidelines tell me, you wrap the tape around the midway point between the lower rib cage and the top of the hips, then breathe out naturally before reading the bad news. 

Oh dear. My svelte 34-inch stat is actually a horrifying 36 – perhaps even 36 and a half – but I’ve passed the test, my 36 inches of waist being almost exactly half of my 73-inch height. 

Now it’s time to step on the Salter and calculate my BMI. The scale is, obviously, irreparably broken. There is no way that this Jagger-esque sex god weighs … 15 and an effing quarter stone. Nevertheless, I go straight to the cruel and fast-talking truth-teller that is the NHS online calculator, to learn that I have a 28.3 BMI and an official status of “overweight”. The NHS bot’s advice is to lose 11lbs, preferably from the hidden “visceral body fat” stored deep inside the belly, or wrapped around the liver and intestines … and rolling over my reasonably sized waistband. 

So, overweight according to Monsieur Quetelet, but not according to the tape measure. Which to trust?

The eminent writer, physician and general practitioner Michael Fitzpatrick believes the Government’s new campaign to be based on flawed assumptions. “People are already well aware of where they stand on the scales and no indicator will undermine denial and self-delusion,” says Dr Fitzpatrick. “Greater awareness of obesity may produce despondency and fatalism. It may also encourage obsessional responses. It is the responsibility of doctors to rescue patients from the consequences of their unhealthy lifestyles – not to make them virtuous.” 

Which might well be true. But right now, this possibly overweight, unvirtuous, fat-backed, despondent, demoralised middle-aged man is going out for a run. Just in case.

‘Our role as GPs is not to judge, but to support’

​Dr Sarah Levy, GP in Wigston, Leics

It can be tricky to talk to patients about their weight. They can get offended if you mention it. A colleague was telling me the other day about a patient who was very sensitive about his weight when the subject was broached. He felt that his health problems were nothing to do with his weight, but that when he saw his GP they would always mention it. 

But it’s still important to have the conversation. Usually I ask my patients if there is anything I can do to help them with their weight, or say I am concerned, rather than being accusatory. The patients are usually not denying that they are overweight. They know it, and they don’t need me to tell them. But they feel criticised, and that their weight is a reflection on their failings. They’re embarrassed. Parents, in particular, can be very sensitive if you mention their children’s weight. That can be a difficult consultation, because it’s not a young child’s fault if they are overweight. While there are complex genetics involved, if you are a parent you must accept that if your child is overweight it is partly your fault. Accepting that responsibility can be difficult. 

People don’t realise the risks of being overweight. There’s an increased risk of cancer, heart attack, diabetes, strokes and blood clots when you fly. But the problem has worsened since the pandemic, when lots of people were inactive and sat at home, thinking which meal to have next. Partly because of that, the NHS has lots of services available for people hoping to lose weight. There are exercise and weight-loss programmes, as well as online assistance. Our role as GPs is not to judge, but to make people aware of the risks and offer support. We know it can be very hard to lose weight, but it can be done.

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