The Monthly

Louise was an educated 35-year-old who had recently lost her high-ranking job and was making ends meet by freelance consulting. Admitted to my ward with pneumonia, she had a high fever and a fast pulse, needed oxygen and was coughing up large amounts of purulent sputum. She was also fat, weighing about 120 kg. I knew that – barring underlying lung disease – obesity was one of the greatest risk factors for life-threatening pneumonia in young people. I felt a responsibility to tell her that her excess fat had harmed her in a way she may not have realized. Every day before my ward round I would say to myself that I was going to broach the subject with her. It seemed a good opportunity to intervene. And yet each time I stood by her bed and looked at her bedside table piled high with literary novels, open blocks of chocolate and teddy-bear biscuits, each time I lifted her pyjama top and pushed my stethoscope into her soft white flesh, I couldn’t do it. I was embarrassed to mention her weight; it felt like I was a puritan taking the high moral ground. It felt mean.

As a doctor, I no longer know what to do about the obese. Australians are getting fatter, and our society is geared towards making them that way – consumption doesn’t just drive economic growth. So is fatness a doctor’s problem? Studies show that verbal interventions during an episode of serious acute illness can result in a change in behaviour – people quit smoking, cut down on their drinking and sometimes lose weight. But usually counselling people to lose weight is hopeless. Then there are the questions of morality, personal responsibility, associated diseases, resource allocation, quality of life and aesthetics. I have moments of clarity – I think of the way Emily ate – and obesity seems simple: more in than out. Then I am engulfed once again by the high science of genetics, by the concept that obesity is a disease.

I don’t think I have ever read such a candid, sensitive, harrowing and articulate essay on the subject of obesity as this one. It’s nearly a 6000-word piece written by a doctor who works in surgical intervention for extreme obesity. Yes, it takes a while to read but it’s brilliant and utterly essential if this planet does not want to continue to pour huge resources into watching people senselessly die.

Dr. Karen Hitchcock makes a simple point: Unless we quit hiding our heads in the sand, quit buying into the snow job the food industry is throwing up with the concept of disease, abandon their well-intentioned but deadly manipulation of beauty standards and face up to the twisted narrative we are being fed about what it takes to feel-good, we will continue to impotently spin in this culturally confused death-spiral while big business slowly executes our species.