1. People go to doctors for advice and cures. Often they don't wish to be told that the way for them to feel better, to be more healthy is to make lifestyle changes. They would rather take a pill and continue business as usual. Of course this is not everyone, but the vast majority of those seeking help from doctors do fit into this category. If they actually want to make lifestyle change, they select health professionals who can help them with this, they join gyms, see dieticians, buy and cook healthy food, spend on naturopathy, yoga, all that positive feel good stuff, which is extremely effective. They don't come to doctors for diet pills.
I like to think I am a doctor who tries to motivate patients to make lifestyle change. I spend a lot of time working with this issue individually, but my patients often don't have the educational, emotional or financial resources required to break bad eating habits. I like to think I'm at least not contributing to the problem by prescribing unnecessary medication, but I'm not ever going to take credit for a patient who does manage to change their life around. It's their victory, not mine, I'm merely an enabler (occasionally).
2. I can't compete against the golden arches and other big fast food franchises. We now, in a town of 38,000 people, have 2 McDonald's and I've heard there are plans to build a third! Apparently our Maccas is one of the best performing, i.e. turnover, Maccas in Australia, and yes, try and spot a person over 45 who isn't obese in this town, along with countless children and younger people as well. Fast food is everywhere, it's poisonous, addictive and us in the health profession are helpless against the tide of oversupply, aggressive advertising to children, and just plain convenience.
OK, I don't have kids, but why oh why would you poison your children? Why???
3. Alcohol consumption is getting out of control. It isn't just the young who are binge drinking to within an inch of serious illness, it's everyone, and particularly women. Have you noticed how many memes there are on Facebook supporting the notion that it's OK to have a good drink of wine at the end of a hard day. This is subtle and pervasive. My advice: go for a walk, do some exercise. Don't self medicate. Oh, and if you don't know what I'm talking about, here's a selection:
And how about this one? Might as well drink a bottle of wine a night through December....
Not OK. Not funny. Brainwashing.
4. The way that the Medicare system is structured makes it really difficult for people with low finances to access resources to help them. If you're well educated with a well paid job, you're likely to be much skinnier than someone on a pension. And have less health problems. (BTW, no one use Gina Rhinehart as an exception, she may have lots of money but no education and thick as 2 bricks, you can't be that obese and live a long healthy life). The amount of allied health care a person can get through the public health system to prevent them getting an expensive chronic disease is dismal. There's a bit more once you get a chronic disease but it's still inadequate. Better to spend it on bypass surgery and renal dialysis? I think not!
As a doctor I can't buy and cook patients healthy whole foods (that by the way don't cost lots of money what a load of hogwash), I can't prevent them from driving through MacDonalds drive through and ordering poison for them and their family, I can't compete against huge food and soft drink conglomerates who peddle poison by using misleading advertising showing pictures of healthy young people having the time of their lives. I also don't find it funny, or amusing, or kind of cute when memes like the above are mindlessly shared around social media, pushing a message of alcohol over consumption and self medication that is plainly unhealthy and contributing to increased cancer risk. Including breast cancer risk.
No medication I prescribe can counteract the poison that is refined sugar that people shove in their mouths daily. That they are hopelessly addicted to.
I'm not the problem, and to be honest, I can't provide the solution either.
I can give advice, provide support, direct people towards resources, but only people can change. But no pill or quick fix is out there. Patients have lap bands and then just drink milkshakes and high calorie shit that they've blended so they can get it down past the band. Go figure hey?? Most people who take diet pills end up gaining twice as much weight when they stop.
You gotta own the problem, stop the poison and change your lifestyle. No quick fix, one step at a time, no instant gratification, and lots of hard work.
A word here on fat and obesity. If you eat healthy food, and engage in regular exercise, are aerobically fit and do some weight bearing exercise within your regimen, then your weight itself is no big deal. It's what you put in your mouth that matters, and whether you maintain your fitness. So if you are skinny and eat shit, smoke and do no exercise, you're fucked. If you're fat and eat healthy food and exercise daily for more than 30 minutes that makes you a bit sweaty, well your beautiful luscious body is a big healthy one. So fuck off skinny bitches who eat crap and put shit on healthy buxom lasses.
Obesity is a different ballgame. If you eat healthy and exercise regularly, you might be fat but you won't be obese. And with so much obesity around, your fat is the new skinny. Aside from those chain smoking biarches and triathlon fitness junkies. (word of caution, too much exercise doesn't confer longevity, too much oxidative stress too often is also harmful)
Obesity isn't genetic. Your mum is fat cause she learnt bad eating habits from her parents. You're fat because you learnt bad eating habits from yours. You can change that, the research now proves it. And all those "hormonal" causes, all dietary related. Eat proper food, food that comes from an animal or a plant, not from a factory, is barely processed, and cook things from scratch. All you need is a recipe, it really is that blindingly simple.
If you want to change. If you want to own the problem and the solution.
I'd also like fast food taxed, bans on advertising of any food or beverage at all during children's television hours (newsflash: parents decide what their children eat, why do kids need these ads??) and some serious debate around restricting the number of available fast food outlets. We've done this successfully with cigarettes, it's time to put the boot into the fast food and beverage, and alcohol, industry.
If we dare.
But don't blame me and my colleagues for not fixing your health problems, we're outnumbered and out manoeuvred folks!