Overweight people are not necessarily lazy

Recently there was a very public spat between journalist and radio presenter Chrissie Swan and fitness expert and “FITmum” Sharny Kieser. Swan accused Kieser (who wrote a book about how she lost 24kg after having her fourth baby) of being a bully by calling fat people “lazy”. Kieser countered that she felt it should be a priority to have a healthy lifestyle and set a good example to children.

I felt for both sides of the argument. Firstly, from Kieser point of view: she felt railroaded into a hostile debate about something she had not expecting discussing on air. She was invited to speak about combating morning sickness and cravings. Also, I fully support her belief that health should be a priority. Swan is a woman of considerable influence: if her long hours are impacting on her being able to fit exercise into her week, she could consider a re-jigging of her work week. (I must say I know little about her battle with weight, or her personal circumstances). A healthy lifestyle is something we should all be modelling for our children. Having successful careers or successfully running a household but not balancing this with a lifestyle that promotes health is not success, from my point of view. Our children grow up valuing these pursuits over regular exercise and healthy eating.

However, poor Kieser needed some media skills training. Anything can and will come up in an interview. Kieser needed to be aware that her comments had caused controversy and may be targeted anytime she speaks to the media.

I see many overweight patients in clinic. I know that quite a few of them are physically active and eat reasonable diets. Overweight people are not necessarily lazy. However, at some stage earlier in their lives there was an energy imbalance and they consumed more calories than they burned. This may have been in very early childhood and often happens during pregnancy. Their bodies reached a convenient “set point”. Our bodies seem to dislike change – every effort is made to return to the status quo. Of course there are other complex factors as to why they remain overweight, and I am not saying lifestyle changes are not the key to losing weight. I certainly see a lot of overweight people who don’t exercise and admit to loving their daily Cadbury Dairy milk habit. I am simply pointing out that a proportion of overweight people are currently in energy balance but were not previously. Also, someone who appears overweight might have lost 5 kg in the past 6 months. Sure they’re still overweight but they’ve made the difficult switch from energy balance to energy deficit. They’ve managed to burn more calories than what they consume.

It’s very very easy to consume more calories than you burn, if you consider how much sugar and fat is in the “normal Western diet” and the sedentary nature of our lives. I’m not surprised at all that overweight and obesity is now at epidemic levels. Losing weight comes down to a basic equation – consume fewer calories than you burn – but this can be challenging to execute. It’s much easier to prevent weight gain. Weight loss is not impossible but it will involve a complete lifestyle change, almost daily physical activity, and reducing calorie intake. Basically, don’t do what everyone else does if you don’t want to end up a statistic.

Being overweight is a problem beyond social acceptance and appearance. Obesity increases the risk of many chronic conditions, including Polycystic Ovarian Syndrome and its accompanying reduced fertility, complications in pregnancy and labour, diabetes, high blood pressure, high cholesterol, heart disease, strokes and cancers. I always tell my patients that they need to aim first to lose 10% of their body weight. Research shows that by doing this, they will significantly reduce their risk of developing chronic disease. They may still be considered overweight after losing this 10% – but they would have given their health a life-giving boost. This is why overweight people are not necessarily lazy. Not everyone needs to look like Kieser, as inspiring as she is to many mothers.

However, there are enormous benefits from a complete change in lifestyle. I try to focus on this when counselling patients, and seek to “treat” overweight in the context of overall physical health, such as improving blood pressure and cholesterol levels. Losing weight does not involve a short-term diet. It involves eating the right foods, cutting out the crap, and learning to love exercise. Improving fitness and nutrition should be the priorities, not just dropping dress sizes.