HEART BEAT Maurice Neligan 'Yon Cassius has a lean and hungry look; He thinks too much. Such men are dangerous." Once more I am prodded off the path of gentle reminiscence into the tangled undergrowth of contention. Indeed, there are times when I feel more comfortable off the beaten track.
What sidetracks me on this occasion is correspondence received on the subject of the next holocaust, i.e. obesity.
In my medical student days when we learned about these things, obesity was defined as a body weight 30 per cent above ideal. We have all sorts of standard height-weight tables, often derived from life insurance companies, even taking into account basic differences in physique as in ectomorph (skinny), mesomorph (muscles) or endomorph (cuddly).
I wish I hadn't looked at them again as no amount of juggling the above will place me within normal parameters. Nowadays we usually define obesity in terms of the body mass index (BMI) - weight in kilograms divided by the square of the height (in metres).
This simple calculation is readily done on the bathroom scales preferably in the nip and before breakfast.
Tucking in your tummy and breathing out doesn't work.
The significance of all this I console myself is all a matter of degree. Certainly extreme degrees or what we call morbid obesity is a risk factor for coronary disease and hypertension. It is also a risk factor for adult onset (type II) diabetes and also for congestive heart failure.
It goes almost without saying that major problems with bones and joints may be the lot of the seriously overweight. There are also links to depression. It is also almost impossible for the obese to maintain any reasonable level of cardiovascular fitness if overburdened by surplus pounds.
Having said all that there is really no definite start point at which a person is obese despite all the formulae e.g. a BMI of 27.8 for men and 27.3 for women. I am not even going to describe the waist-hip ratio. For all reasonable purposes, the eyeball test is sufficient. If a person looks fat, the person is fat.
All of this is well known , so why get worked up about it now? We have just appointed yet another task force to advise on and presumably monitor the problem. What is it going to tell us that is not already known? Very little I fear, and I am afraid that the simple message "you eat too much and you take too little exercise" may be overlooked in regimes and prohibitions. Yes, we are getting fatter and also taller and we are living longer but at all times we must exercise common sense.
Another King Canute campaign would be costly and ultimately futile. My views on the diversion of monies needed to treat sick people into this kind of nebulous nonsense are well known.
The magazine, the New Yorker, in a recent cartoon has two witches outside a gingerbread house deep in the forest gazing sourly at rather plump Hansel and Gretel figures and remembering past times when they had to fatten them up first.
Hysteria is building, task forces are in place and the same dreary nonsense that characterised the tobacco wars is being duly rolled into place, as we follow the charge of our brethren in the US.
The modus operandi is the same as in the tobacco wars, first saturate the media with fears and scare stories so that people actually begin to believe that a Big Mac or a Mars bar is bad for you, and when they and similar products have been sufficiently demonised then it's open season for the lawsuits.
Don't think I exaggerate, the first such suit against a fast food provider has just been struck down in the US. It may not be clear to the zealous here that they are following a well demarcated pathway to a specific end. I recommend all who are interested in this subject to read a most revealing book The Rule of Lawyers - how the new litigation elite threatens America's rule of law by Walter K. Olson. Don't bother telling me it couldn't happen here in this second most litigious country on earth.
Back to common sense, we are responsible for ourselves and we are responsible for our children in matters both of diet and exercise. Educate by all means but compulsion is for the birds.
Obesity is treatable if there is a problem, but it is not easy. Weight can be readily lost as all dieters know but keeping it off is the challenge. Modest weight loss of 5 per cent to 10 per cent improves most people and avoids most problems.
The pursuit of the ideal body weight in adults is seldom attained and even more rarely maintained. There are many realistic weight management programmes available to help.
Besides, maybe it's not all our own fault. The role of the hormone Leptin is being slowly understood with its relationship to weight control.
Me, I'm with Caesar - "let me have men about me that are fat, sleek headed men and such as sleep a-nights".
Dr Maurice Neligan recently retired as a leading cardiac surgeon