Personal responsibility in health
An excellent editorial is linked below from today's Observer highlighting the complicated scenario we face in current nutrition choices (among food industry corruption and so on):
'...“choice” in diet is complex. It is influenced by income, class, culture and societal pressure among myriad other drivers, not least the seductive practices of the marketplace in disguising what goes into processed food and employing the hard sell in honeyed words that are particularly effective on children'.
Choice in dietary choices is indeed, immensely complex, and many people (I see them too frequently, mostly through my NHS work) are born into environments where making a healthy choice is so rare, it is probably non existent. I leave consultations in despair of how to even begin with a child who has absolutely no one in their environment even eating a piece of fruit as a snack - all foods should come in a package, don't you know? People subsisting on processed food ONLY. Very difficult to see when you know how to make them feel like a different self, but lack the tools to reach them, because society simply is not built to facilitate it.
I ponder it often; what to do? None of us want a nanny state, we do want freedom of choice. But freedom of choice in the current food environment is not a pure force at all (see the article below for some enlightenment on it). And I strongly feel a sense of personal responsibility is lacking in a lot of lethargic society members. I have to say that the longer I work in my field, the longer I feel a strong sense of peace in feeling that people who have clearly lifestyle related conditions, who do not adhere to lifestyle changes given to them by specialist professionals, should start to pay for their medications and therapies. For example, if someone with type 2 diabetes who eats a mountain of crap daily, has had three meetings with a specialist dietitian and committed to trying some basic goals e.g. replace a bag of crap with an apple, and fails to complete this simple goal, should start paying for their metformin + blood pressure meds + appointments + cholesterol drugs + blood thinners + reflux meds...the list goes on.
I am not thinking this because I am unsympathetic. I am incredibly sympathetic with the fact that something and someone needs to kick a person like this up the bum to get them to have a wake up call. Society cannot carry the weight of everybody's poor choices indefinitely. And the more people we have who wake up and smell the roses about processed food, the more we can have laws changed e.g. advertising sugar laden crap to our children, making supermarket shopping for all of us parents a nightmare, me included.
It is simply not right that people who were born with certain conditions have their benefits cut because the health service is so poor largely as a result of the cost of lifestyle related diseases. I would safely say that if given the chance and having a willing participant, I could help to reduce 90% of people's medication needs using nutrition therapy. That is not an arrogant statement about my own skills, it is a basic statement about life: Food is our best medicine coupled with moderate physical activity, good sleep hygiene and stress management. This fact will never change. Medications often lead to more medications which lead to more medications - cost, cost, cost.
There's nothing wrong with letting a person feel the consequences of their choices. Is that not the Universe's way of making us grow and develop as people? Money is a great motivator, and perhaps it is time to put it into action. It will certainly help to motivate the disheartened nurses, dietitians and doctors who bang on about the same thing all the time, to the same people, who are too unmotivated to make the changes because they cannot feel the impact of their actions because they are cushioned by misguided laws. If you eat shit, you need to feel like shit - in body, mind and wallet. Food, real food, makes you feel well (and is much cheaper if you're paying for your health care).