Operation Transformation is Back. Despite all the criticisms, it’s back. The question I really can’t answer is – why? But here we are. So, all through this series, I’ll be watching and breaking down the good, the bad – and the why???
Like, why are we still are forcing people into lycra on television?
What I can’t get past in the opening of part I: At the core of this show’s premise are people – patients- with the complex, chronic, preventable, reversible diseases who are reduced to tears competing for a place on a television show because they cannot get access to obesity or prevention medicine through a broken healthcare system. The fact that this show even exists – or people will put themselves through it – is proof that our healthcare system is so broken. And we do have to remember that this show has its origins in broken healthcare, bad science, and patient exploitation.
OT is really the Biggest Loser
Like much of RTE content, OT is not an orignal concept. It is based off a US show “The Biggest Loswer” The double-entendre in the name is no accident. It was incredibly weight stigmatising and heavily criticised. It took years, however, before it was finally cancelled. What to know: 1. Studies done on contestants of the Biggest Loser show that few contestants were able to maintain that weight loss long term because the approaches used simply don’t work. 2. Exploitation: US does not have universal healthcare, and insurance comes with high co-pays. Obesity treatment is often not covered, and seeking treatment is outside the budget of most Americans. It’s pool of contestants competing to be publicly humiiliated for a chance to regain their health was based on desperation and no alternatives.
Worst moments: Still public weigh-ins. Still in body-shaming lycra. Still focusing on solo fast-fixes over 6 weeks. Still tone-deaf to the multiple triggering issues it raised.
Let’s have a look at some positives from meeting this year’s leaders:
Michelle:
Best moment: The importance of reducing salt when you have high blood pressure. “I don’t put salt in anything” – I believe it. Michelle then notes she has salty snacks. Bingo. Most of the salt in our diet is added outside the home (take-aways or processed foods)
What I hope we will see in coming weeks:
Take opportunity there to discuss direct and long term impact of domestic abuse (she talked about a earlier relationship) on women’s physical, let alone mental, health.
In relation to her sister died of SADS – did she have screening? Good opportunity to raise awareness.
She has anxiety – but not in treatment. Hopefully, we’ll have a deeper dive into health anxiety and seeking treatment and options available to people. This show can be triggering for people with health-related anxiety.
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Darragh
Best moment: Focusing more on the waist circumference instead of weight. Too many men sit their trousers/jeans below their belly and count that hip circumference as waist. Abdominal circumference as an independent risk factor for health problems, such as heart disease and diabetes.
What I hope we see in coming weeks:
Interesting that he (or the editing team) started his story with child nutrition and large dinner sizes. His mother told him not to discuss it but I really would like to. Childhood obesity leads to adult obesity adn long term health consequences, and we have epidemic levels of childhood obesity here in Ireland.
I have so many patients that are former rugby players. The toll that sport takes on players bodies long-term is something not discussed enough.
Will we be talking about work-life balance?
Michelle
Best moment: Probably unintentional, to be honest. But they showed a wonderful balance that she has struck between motherhood and career, and how much she enjoys her work. If they can add looking after herself into that, it will be great.
What I’d like to see in coming weeks:
Get away from the weight: “First thing we are going to look at is weight” Then body fat percentage. “Weight isn’t the most important thing” says Karl – but literally, that’s the first number they put up. If everythign else is done right, weight will just follow without having to get on scales weekly.
Fertility is a goal here; she wants a sibling for her son. Excellent opportunity to bring in actual fertility experts to talk about how getting healthy in the months before trying to conceive can really help.
Exploring her priorities and self-esteem.
Ann
Best Moment: All of it. Scrap OT. Why don’t we just have a show devoted to Healthy Aging, starting with people in their late 40’s through late 60’s focusing on how to reduce risk of future health problems, staying strong, active, and connected to their communties. (RTE – call me! We can do this. But we will have to talk about your scales and lycra obsession first)
But unfortunately — “The first number we are going to look at is your weight” That’s the least important stat is the next thing they say – but why do we start with that then?
Noel
Lots of health problems that were found as an emergency – this is an opportunity to talk about how he should have been in for a primary care check with his GP before he ended up in ED.
Best moment: “Everything I have is reversible” Yes, It is!!!
Where I hope they go with this: Talking about how much of what he has is also preventable.
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What I would have liked to see that I don’t think will change:
Talking about alcohol – drinking heavily was casually mentioned a few times and not addressed.
Partner/family approach. Solo journeys do not work. (Cheerleading from the sidelines isn’t quite the same thing.)
Skip the scales and move to more important numbers: blood pressure, cholesterol, and Fibroscan (looking at liver fat) would be really helpful
Less lycra. Because dignity.
- Some socioeconomic diversity. It is a determinant of health. Discussions on food budgets, hidden hunger, food poverty, and food deserts will missing here. The fact that convenience stores are again carrying all these ingredients is fantastic.
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