| Increasing numbers of waiting list patients | | | | denial of erstwhile civil liberties, is a |
| are now being forced to slim before being | | | | major stepping-up of these institutionalised |
| allowed to have routine operations on the | | | | pressures. |
| British National Health Service. | | | | |
| | | | Some would also argue that the extension of |
| A newspaper investigation claims that the | | | | public health care intervention into wider |
| localised policy is now to be rolled out | | | | and wider aspects of modern living is not so |
| nationally by the end of 2007. | | | | much a wellbeing aspiration as a symptom of |
| | | | the current western governmental drift |
| Doctors will allocate treatment to patients | | | | towards an increasing micromanagement of the |
| according to their Body Mass Index, the BMI | | | | whole lifestyle. |
| being the formula relating putative optimum | | | | |
| weight to height. | | | | This is not necessarily a claim either of the |
| | | | left or the right, as both perspectives would |
| If people have a BMI over 30, which is | | | | be critical of an excessively big state |
| commonplace in the UK and very much towards | | | | overriding basic liberties. |
| the average zone in the US, they will be | | | | |
| denied non-emergency operations such as hip | | | | The problem with all of this in relation to |
| and knee surgery, or procedures including IVF | | | | the overweight arena is that it is leaving |
| treatment. | | | | those already involved in failed fad dieting |
| | | | with nowhere to turn except straight back |
| The new guidelines already apply to about 1 | | | | into more fad dieting. |
| in 15 of the PCTs in the UK and, when | | | | |
| implemented nationally, the BMI-rule will | | | | Gradual lifestyle adjustments, new coping |
| affect about 1 in 5 of the population. | | | | strategies for the emotional stresses which |
| Failure to achieve the threshold for | | | | trigger overeating, a relaxed appreciation of |
| operations will result in being recommended a | | | | the cultural drivers towards fad dieting |
| crash slimming regime and reassessment after | | | | cycles and the fostering of a choice to move |
| six months. | | | | in fresh directions all of these healthful |
| | | | options are blown away by the official |
| Health officials state that their rationale | | | | decrees to lose weight fast. In the absence |
| behind the strict new qualification for | | | | of alternatives, what are people to do except |
| treatment is justified by research which | | | | to plunge back into the fad dieting |
| shows that slimmer people have better | | | | mainstream? |
| recovery rates from surgery. Whatever the | | | | |
| proven scientific case for this viewpoint and | | | | Government, unchallenged, is always going to |
| also not forgetting the debatable validity of | | | | be relatively short term in its outlook; it |
| the now 150 year old BMI standpoint, a | | | | is simply the way that it tends to work. |
| considered critique reveals troubling | | | | |
| implications within this clampdown. | | | | The short termism in this instance is |
| | | | exacerbating the very issues it is seeking to |
| One of the central paradoxes of the current | | | | address. The macho tough love approach will |
| major debate surrounding obesity is the | | | | do little except deliver tough luck on those |
| question of why people persist in long term | | | | problem dieters who now have less freedom |
| dieting cycles when dieting is increasingly | | | | than ever to break away from fad dieting. |
| discredited as an effective means of lasting | | | | |
| weight control. | | | | This is another expression of the growing yet |
| | | | implicit official view that the overweight |
| It can be argued that individuals are being | | | | are deviants who must be brought back within |
| driven into fad dieting not so much by the | | | | the correct moral line. Is this fair or |
| long standing notion of Yo Yo Dieting | | | | accurate? |
| (itself, we would contend, simpliste and | | | | |
| flawed) but rather by overwhelming | | | | With the overweight in the UK now being |
| institutionalised and cultural pressures. | | | | banned from some surgical operations unless |
| From this perspective, the creeping | | | | they crash diet, weight control charity The |
| criminalisation of overweight, which is | | | | Weight Foundation discusses the growing |
| advancing steadily deeper and deeper into the | | | | stigmatization of obesity. |