Thai doctors are losing the battle of the bulge

Porky physicians get a 'heal thyself' warning over pot bellies

Dr Akkaradet Pensiri slipped off his shoes and climbed onto the machine, gripping what looks like computer-game joysticks in either hand and lets the body-composition analyser do its job.

A couple of minutes later and the analyser - which looks like high-tech electronic scales - told the whole story.

Akkaradet's visceral fat area - or the amount of fat inside the peritoneal cavity, packed in between internal organs in the abdomen - was 167 square centimetres; far exceeding a red-line level of 100 square centimetres for males.

"With a high amount of abdominal fat like this you're at risk of developing diseases like hypertension and diabetes," a technical officer explained to the 58-year-old Saraburi chief health officer. He weighs substantially more than 80 kilograms.

"I already have a problem with high blood pressure and have been on medicine to keep it low for seven years," said the easygoing doctor.

"Yeah, yeah, yeah, as a medical doctor I know it all but it's simply poor discipline when it comes to dietary habits and weight control."

When he was younger Akkaradet was a lean 50 kilograms, almost half his current weight.

His overall body fat is twice normal levels and his strength is considerably compromised by a lack of exercise. He recorded a fitness score of 64 from a maximum of 100. It should be in the 70 range.

Akkaradet measures 107 centimetres around the waist; well above the 90-centimetre maximum for males.

"Good. It's time to get serious about this," he said.

He is one of many provincial health officers who need to loose weight. These doctors came together in Chiang Mai last week where they underwent body-fat checks on the analyser. Many need to do something soon.

A 2005 survey showed about 9.3 million Thais aged 35 and older had "abdominal obesity", Health Department director-general Dr Narongsak Angkasuwapla said.

Those with elevated levels of visceral fat are three times more likely to suffer from diabetes and have twice the risk of hypertension and strokes and heart attacks, he added.

To encourage the public to lose weight the department said high-ranking officials should themselves become "good examples" and start shedding those extra kilos.

Public Health Ministry spokesman and vice president of the Nutrition Association of Thailand, Sa-nga Damapong, said the ministry would launch a "healthy snack" project. All snacks and beverages served at ministry meetings would be low in fat, salt and sugar.

Akkaradet welcomed the idea and said it should have been introduced years ago.

Being a top civil servant means he must attend many meetings and is routinely invited to parties. He is a very social person, to boot.

"The longer I stayed at parties the more I ate. It's been like that almost every single day.

"I have seen the warning signs now and if I don't change chronic illnesses are coming for sure," he said.

Akkaradet is resolved to lose weight. He will start eating vegetables and low-calorie fruit instead of party fare. He intends to walk the three kilometres home from the office every day.

"My dream is to be able to show people my before and after pictures and convince them it is possible for them, too," he said.

Arthit Khwankhom

The Nation

CHIANG MAI

Obese patients 'increasing back pain among nurses'

A rise in the number of obese patients on wards could be causing thousands of NHS nurses to seek treatment for back pain, according to experts.

About 5,000 nurses are currently being treated for back pain following a surge in patients' weights and the number of patients a nurse has to care for, according to the British Chiropractic Association.

Dr Matthew Bennett, a member of the BCA who has been a chiropractor for 20 years, said: "There are thousands of nurses with work-related back pain and I think this could increase in the future.

"A lot do not turn up in official statistics because it affects employment status.

"The weight of patients is a contributory factor to back pain. It's not just a weight issue - it's a fitness issue with people unable to turn themselves over easily."

Dr Tim Hutchful, another BCA chiropractor who has been practising 18 years, said: "I think the number of nurses with back pain will probably increase in the future as people get bigger.

Unions also say workloads and a rise in patients' weight are impacting heavily on the health of NHS staff.

Barrie Brown, Amicus' Lead Officer for Nursing, said: "We are aware of this as an extensive problem because muscular skeletal problems are the biggest reason for people retiring on grounds of ill health from the NHS."

A spokeswoman for the Department of Health said: "The department advises that staff should avoid manual handling. No one working in a hospital, nursing home, or community setting should need to put their safety at risk when lifting patients manually. Manual handling of patients should only continue if it does not involve a risk of injury from lifting most or all of a patient's weight."

Independent.co.uk