We used to look down on the Americans for their huge backsides, but the latest research shows that the Irish are gaining weight faster than Oprah when she falls off the wagon. Irish men are developing breasts and Irish women are getting used to buying size 20s. One in two Irish men and one in three Irish women are "fat", according to the Department of Health, which used the word "fat" rather than "overweight" without regard for political correctness. Ten per cent of the Irish population have gone beyond fat to frankly - in the words of the Department of Health - "very fat".
I don't know about you, but I'm fed up with the Government telling me to lose weight. It's inducing a fat phobia that makes overweight adolescents develop low self-esteem and encourages anorexia. The fat education campaign has been accompanied by an intolerance that is quite frightening. On Marian Finucane's radio programme during the week listeners were outraged to hear that a teacher slagged one of his students for being fat. That's emotional abuse in my book.
We've recently had another National Healthy Eating Week, and if even one person can prove to me that they successfully lost weight as a result of this bit of guilt-inducing hype I'll give up chocolate for a month. Such campaigns are cruel to the 10 per cent of the population who are dangerously obese. Telling people they must lose weight to save themselves from diabetes, heart disease, arthritis and cancer, without offering them specialist, individualised help over a long time, is like telling a drowning man to drink the ocean to save himself, or a cancer patient to administer her own chemotherapy.
Irish research has clearly shown we don't need a health promotion campaign to know how to eat. We know very well that we should be eating more fruit and vegetables, more whole-grains, and fewer fatty foods. We're just choosing not to because the temptation to do otherwise is irresistible. Where's the crime in that? As Prof George Ewan described it in the six-part TV series, Fat (RTE 1, Tuesdays, 8 p.m.), "we're living in a toxic food environment".
Contrary to popular prejudice, fat people are not making the wrong food choices and stuffing themselves with desserts. Research just published by the International Journal of Obesity has proved that lean people are more likely to prefer sweet foods, whereas obese people derive more energy from salty/savoury foods. The self-discipline of avoiding sweets, as they have always been told to do, is not helping them to lose weight in a food culture where so much processed food is too fatty and salty.
If the Government seriously wanted to do something about obesity, it would make fruit and vegetables more affordable; fund nutritious school breakfasts and lunches; put health warnings on fast food; ban the national dish, chips; monitor the processed food industry and demand that it take out hydrogenated fats and stop beating the goodness out of grains; and it would put some of the Lotto money into ensuring that every community had a first-rate swimming pool and gym. It would tax biscuits and use the money raised to fund hundreds of nutritionists, whose help would be available to the public free of charge. But simply issuing press releases and radio ads telling people to eat less fat and more vegetables, without giving them the essential one-to-one professional support, will never work.
Yes, 53 per cent of Irish men and 33 per cent of Irish women are overweight, but that in itself should prove that dieting is a total waste of time. The diet industry of books, videos and money-spinning fads is in overdrive, yet the medical profession views this industry with contempt. Food combining, mythical food allergies and the other fads are rubbish. Obesity is the result not of lack of willpower or greed or moral weakness but of a genetic predisposition, as a raft of international experts in nutrition argue in Fat. In a more enlightened age - before science took control of our bodies - the ability to lay down fat in preparation for lean times was seen as a sign of health. The difference then was that the lean times inevitably came and people burned the fat off.
Now we're living in times of outrageous plenty and no longer have to strive for our food. We're taking in more calories than we're burning off and this is not because we are eating more, but because we are exercising less and eating fattier foods. The Irish diet is 45 per cent fat, on average, as opposed to an ideal of 35 per cent. It is fat, not sugar, that makes you fat, and the fantasy of every fat person on the planet is a pill that makes dietary fats go through your system without being absorbed, so that you can eat without guilt. Hold on to your croissants, folks: that drug has arrived. And just in time for the middle age of the X generation.
Viagra, move over. Xenical is set to be the blockbuster drug of the next few years and, like Viagra, it is being manufactured in the Republic. Since it was launched in the US two weeks ago, Xenical has been prescribed one million times. The 200 workers at Roche's Clarecastle, Co Clare, production plant will produce 250 tons a year of Xenical, which was launched on the Irish market on Thursday. Brian (we've changed his name to protect the innocent), an information technology entrepreneur with a dynamic business in Temple Bar, found his weight creeping up when an injury put a stop to his daily visits to the gym. At 16 stone and 5 foot 10 inches in height, he was clinically obese.
He tells me that his GP prescribed him Xenical on a named-patient basis before the drug was generally available. Brian was encouraged by the fact that Xenical had been clinically proven to boost weight loss by 68 per cent in obese patients. A European trial published in the Lancet said Xenical was twice as effective as diet alone and also helped people keep the weight off for two years. And there are other benefits: Xenical lessens the risk of diabetes in the long term by lowering glucose and insulin levels, and it substantially decreases the risk of cardiovascular disease by lowering blood pressure and decreasing cholesterol counts.
Xenical is a synthetic derivative of Lipostatin, a naturally occurring lipase inhibitor. It acts as a "fat blocker" by binding to gastric and pancreatic lipase digestive enzymes and interfering with their ability to hydrolyse and digest fatcontaining food. When taken before meals, approximately 30 per cent of the fat passes through the digestive tract unabsorbed.
Before being prescribed the drug, Brian had to prove his commitment by losing 2.5 kilograms in one month, which he did. He started on the drug three months ago and has already lost a stone and a half - without dieting, without exercising and while continuing to eat restaurant meals at least once a day. His only chore has been to ensure that none of his meals are high-fat. A Chinese meal, he discovered, will result in a gastric incident akin to the Exxon Valdize disaster. The managing director of Roche, Mark Rodgers, thinks one reason Xenical works so well is that it amounts to aversion therapy to high-fat food. Anyone who has had to flush three or four times after a high-fat meal consumed on Xenical doesn't want to do it again.
Part of Brian's success was that he also had the help of a specially trained nurse, who followed a diet programme prescribed by Roche. This ongoing nursing support is a condition of using the drug because Roche is convinced that, even with Xenical, obese people need continuing support to lose weight.
Xenical costs £51.82 a month but, despite the expense, the State will cover it on the GMS scheme. The Department of Health reasons that Xenical will save it money in the long term by preventing cardiovascular disease, cancers, arthritis, type 2 diabetes, gall bladder disease, and other obesity-related health problems. Up to 8 per cent of the total health budget goes on treating health problems resulting from obesity.
Rodgers insists that "Xenical is not a lifestyle drug". So if you were thinking you could go rushing to your GP first thing on Monday morning you may be disappointed. The drug is licensed only to be used by the clinically obese, so that the rest of us who are merely overweight - about half the population - cannot use it, which seems terribly unfair. In case you're wondering how fat you actually are, obesity is measured by Body Mass Index, which is arrived at by dividing weight (in kilograms) by height squared (in metres). If your BMI is 30, you can get Xenical. If it is 28 and you have obesity-related problems such as arthritis-ridden knees or diabetes, you may also be prescribed the drug.
Dr Stephen Murphy, a GP in Cabinteely, Dublin, has prescribed Xenical for a dozen patients and found that about a third of them succeeded in losing weight extremely well, about a third succeeded moderately and about a third didn't lose anything - probably, he suspects, because they did not stick with the low-fat diet. One of his more successful patients lost more than two stone in five months.
"Xenical certainly worked better than the standard medical advice. In the past, the only advice we've been able to give our obese patients is to eat less and exercise more, but that message isn't always well received. Xenical is not the next fad. It's simply a means to an end that does require a certain amount of will-power as well. I'm happy to keep prescribing it."
When there's a drug like Xenical available, the Department of Health should either do something genuinely positive for obese people, or let them alone. The last thing people need are condescending health promotion campaigns that merely add to the stigma of being fat.