by JENNY HOPE

Last updated at 16:52 17 September 2007

The obese are being treated as if they have a medical problem when often they simply eat too much and exercise too little, a leading doctor has said.

Dr Hamish Meldrum, head of the British Medical Association, argued that the "over-medicalisation" of weight gain meant that many individuals failed to take responsibility for their own health.

Doctors are being expected to dish out pills and carry out surgical interventions that have "limited benefits", according to Dr Meldrum, a GP practising in Yorkshire.

He added: "We are tending to say, 'This patient has a hyper-appetite problem' rather than maybe they are eating too much.

"People like to put fancy labels that suggest things are a medical problem, but obesity is not just a problem for GPs, it is societal.

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"All of us, myself included, need to take some responsibility for our own health.

"Obesity is in danger of becoming overmedicalised.

"Patients may think that surgery and medication are the answer but these are measures that offer limited benefit, even to the grossly obese.

"They should be seen as a last resort and I believe prevention is much better than cure."

Almost one in four adults and 11-to-15-year-olds in Britain are obese. NHS guidelines issued to doctors last year about dealing with the obesity epidemic recommend drugs and surgery.

Even under-12s can be prescribed anti-obesity drugs - despite the medication only being licensed for adults - if the problem is bad enough.

More than a million anti-obesity prescriptions for drugs such as Xenical and Reductil were issued in England in the last financial year at a cost of £47million.

Dr Meldrum said evidence for their effectiveness was "weak" and it was difficult for doctors to help people change sedentary lifestyles dominated by energy-dense foods if they were not committed to losing weight.

He added: "I'm not saying we should not look at how we can medically treat people who are very obese.

"But obviously prevention is better than cure."

He said the problem of "overmedicalising" also affected other conditions such as attention deficit hyperactivity disorder (ADHD) and dyslexia.

He said he did not dispute that ADHD or dyslexia existed and were debilitating, but they are being diagnosed inappropriately.

Dr Colin Waine, chairman of the National Obesity Forum, said although medical intervention such as pills and surgery did not dramatically reduce a patient's weight, it was sufficient to cut the risk of illnesses such as heart disease and diabetes.

He said: "I think that neither approach excludes the other, but you need a medical approach for this problem as well as a social one.

"I think that there's a tendency always to oversimplify these things.

"But if people are clinically obese they've often got risk factors for major diseases, and this is where you need medical help to reduce these risks.

"If we don't do something, by 2020 one fifth of the NHS budget will be spent on treating type two diabetes, which is associated with obesity, so I think that medical intervention is very important."

Neville Rigby, director of policy and public affairs on the International National Obesity Taskforce, agreed with Dr Meldrum that individuals needed to take responsibility for their weight, but said society made it hard for people to make healthy choices.

He said: "If someone is surrounded by fatty food, and has little money, convenience food is very cheap and highly promoted. It's part of a social norm to eat fatty food.

Every hospital should have an operating theatre specially equipped for seriously overweight patients, says the Association of Anaesthetists of Great Britain and Ireland.

Larger recovery beds, gowns, stockings, blood pressure cuffs and tourniquets must also be routinely provided, according to the association, which has issued safety guidance on treating "morbidly obese" patients - those whose weight exceeds 23stones (150kg).

There has been a significant increase in the use of labels to describe conditions which some doctors claim are behavioural problems rather than medical disorders. Here are some of the most common examples:

• Hyper-Appetite Problem: Otherwise known as overeating which can lead to obesity.



• Female Sexual Dysfunction: Also known as lack of libido. It has been criticised as exaggerating women's dissatisfaction with their sexual partners. Drug company-backed researchers claim 43 per cent of women aged 18 to 59 suffer from it and treatments are being developed.



• ADHD, or Attention Deficit Hyperactivity Disorder: Once considered to be naughty behaviour, this is now treated with Ritalin and similar drugs. Symptoms are lack of concentration and disruptive behaviour. It is estimated 400,000 youngsters between five and 19 are being treated each year.

• Total Allergy Syndrome: This describes allergies to "modern life" including chemicals and artificial materials in the environment which cause multiple symptoms.