# data[].attributes.body
Fat is a Sociological Issue: Obesity Rates in Late Modern, ‘Body-Conscious’ Societies

# data[].attributes.attachment_link.readable_text
This paper seeks to explore the sociological dynamics of the current escalation in rates of obesity in late modern societies, focusing both upon the causes of this escalation and its consequences. The paper has three aims. Firstly, I aim to open up a sociological debate on obesity and to show that this is an issue we can both contribute to and learn from. While lifestyle and the body–society relationship are of obvious importance in current debates on obesity, the input of sociology to these debates has been minimal. The debate has been pulled onto the territory of psychology, genetics and related disciplines. I hope here to make a preliminary step towards correcting this. Secondly, I juxtapose the trend towards obesity with sociological claims regarding our allegedly 'body conscious' societies. Many sociologists claim that late modern social agents are increasingly preoccupied with their bodies, and with the pursuit of bodily perfection through diet, exercise etc. The obesity trend suggests a rather different picture. I aim to reconcile these partial pictures of the body in late modern societies. Finally, I use obesity as a way of exploring relations between biology and society. Involuntary weight gain, I suggest, provides an excellent case study for thinking about the interaction of biological and social processes.Social Theory & Health (2004) 2, 222–253. doi:10.1057/palgrave.sth.8700030

Figures - uploaded by Nick Crossley

Author content

All figure content in this area was uploaded by Nick Crossley

Content may be subject to copyright.

# data[].attributes.attachment_link.title
(PDF) Fat is a Sociological Issue: Obesity Rates in Late Modern, 'Body-Conscious' Societies

# data[].attributes.attachment_link.description
This paper seeks to explore the sociological dynamics of the current escalation in rates of obesity in late modern societies, focusing both upon the causes of this escalation and its consequences. The paper has three aims. Firstly, I aim to open up a sociological debate on obesity and to show that this is an issue we can both contribute to and learn from.

# data[].attributes.body
Fat Teen Trouble: A Sociological Perspective of Obesity in Adolescents

# data[].attributes.attachment_link.readable_text
The body mass index (BMI) is a measure that uses your height and weight to work out if your weight is healthy.

Who can use the calculator

The BMI calculator is suitable for adults and children aged 2 years old and over.

The BMI calculator may not be suitable if you think you have an eating disorder or are being treated for one. Ask a GP for advice.

If you are pregnant, use your pre-pregnancy weight when calculating your BMI.

BMI weight ranges

Adults

A BMI calculation in the healthy weight range is between 18.5 to 24.9.

For Black, Asian and some other minority ethnic groups, the healthy weight range is 18.5 to 23.

For people of White heritage, a BMI:

below 18.5 is underweight

between 18.5 and 24.9 is healthy

between 25 and 29.9 is overweight

of 30 or over is obese

Black, Asian and some other minority ethnic groups have a higher risk of developing some long-term conditions such as type 2 diabetes with a lower BMI. People from these groups with a BMI of:

23 or more are at increased risk (overweight)

27.5 or more are at high risk (obese)

Children's BMI

For children and young people aged between 2 to 18 years old, the BMI calculator takes into account age and gender as well as height and weight.

A child's BMI is given as a "centile". The centile number shows how their BMI compares with other children of the same age and sex as a percentage.

For example, a girl on the 75th centile is heavier than 75 out of 100 other girls her age.

The BMI calculator works out if a child or young person is:

underweight - on the 2nd centile or below

a healthy weight - between the 2nd and 91st centiles

overweight - 91st centile or above

very overweight - 98th centile or above

See a GP if you're concerned about your child's weight. They may be able to refer you to your local healthy lifestyle programme for children, young people and families.

Limitations of the BMI

Muscle mass

The BMI calculation does not include muscle mass, which weighs more than fat.

This means muscular adults and athletes may be classed as overweight or obese even though their body fat is low.

BMI results

Underweight

Being underweight could be a sign you're not eating enough or you may be ill. If you're underweight, a GP can help.
Find out more in underweight adults
If you have an eating disorder, the BMI calculation results do not apply. Please get further advice from a GP.

Healthy weight

Find out more about having a balanced diet and find fitness videos you can try at home to maintain a healthy weight.

Overweight

If you want to lose weight, you can find more information at NHS Better Health.

Obese

Read more information about obesity. You may want to see a GP for help and advice.

Waist to height ratio

Measuring your waist to height ratio can tell you if you have excess tummy fat, even if you have a healthy BMI.

To calculate your waist to height ratio, measure your waist and divide it by your height. Use measurements in the same units (for example, centimetres or inches).

A waist to height ratio of 0.5 or higher means you may have increased health risks such as heart disease, type 2 diabetes and stroke.

To measure your waist:

1. Find the bottom of your ribs and the top of your hips (just above your belly button).

2. Wrap a tape measure around your waist midway between these points.

3. Breathe out naturally before taking the measurement.

How the BMI is calculated

The BMI calculation divides an adult's weight in kilograms (kg) by their height in metres (m) squared.

For example, if you weigh 70kg (around 11 stone) and are 1.73m (around 5 feet 8 inches) tall, you work out your BMI by:

1. squaring your height: 1.73x1.73 = 2.99

2. dividing 70 by 2.99 = 23.41

Your result will be displayed to 1 decimal place, for example 23.4.

A child's BMI is expressed as a "centile" to show how their BMI compares with other children of the same age and sex as a percentage.

For example, a girl on the 75th centile is heavier than 75 out of 100 other girls her age.

Next steps

You can use your BMI result as a starting point for further discussion with a GP about your weight and general health.

A BMI above the healthy weight range or too much fat around your waist can increase your risk of serious health problems like:

# data[].attributes.attachment_link.description
Check your BMI and understand your result

# data[].attributes.attachment_link.readable_text
Many people enjoy drinking in moderation but problems can occur if you drink a large amount of alcohol in a short period of time, if you drink to get drunk or if you find it difficult to control your alcohol use. The current UK low risk drinking guidelines recommend that adults should not regularly drink more than 14 units a week. Further information relating to the UK Chief Medical Officers' low risk guidelines can be found here.

What is a unit of alcohol?

1 unit is 10ml of pure alcohol. Alcohol content depends on the size and strength of the drink and can vary greatly. Further information about alcohol units and what they look like can be found here

Is your drinking putting your health at risk? Drinkaware have produced a quick and easy self-assessment quiz to help individuals assess whether their drinking levels pose a potential risk to their health. The Alcohol Self Assessment can be found here

Alcohol poisoning

Your liver can only process 1 unit of alcohol an hour. If you drink more than this, the alcohol in your bloodstream increases. The more you drink the greater the chance that vital functions such as breathing, blood circulation, temperature, heart rate and the gag reflex will be suppressed. If the gag reflex is impaired and you vomit, you are at risk of choking. Warning signs such as unsteadiness and slurred speech are your body's way of telling you that you need to stop drinking. The following link details the signs and symptoms of alcohol poisoning and explains what to do if you suspect someone is showing signs of alcohol poisoning.
Alcohol poisoning - signs and symptoms and how to respond
Safer drinking tips

The following steps may help to reduce the risks and potential harm caused by alcohol:

Eat a meal before you drink

Alternate with non-alcoholic drinks

Drink smaller measures

Spread out your drinks over the night

Drink lower strength drinks

Don't leave your drinks unattended

Further information and advice on how to stay safe while drinking can be found in the following links:

Staying safe while drinking
How to stay safe at University
Support

If you feel that your alcohol use is becoming problematic, or if your alcohol use is starting to affect your relationships, wellbeing and/or your ability function, then please seek help. The NHS Live Well https://www.nhs.uk/live-well/alcohol-support/ guide provides useful information on where you can get help for alcohol use and explains the different treatment options available.

Open Door Team

The University's Open Door Team provide support to students experiencing psychological and mental health difficulties. You can contact Open Door by telephone 01904 322 140 or email [email protected] . Initial appointments can be made via the online referral form.

York Drug & Alcohol Service

The York Drug & Alcohol Service is delivered in partnership between Changing Lives and Spectrum Community Health CiC. The service provides a range of clinical and psychological interventions for individuals affected by drug and/or alcohol issues.

Email: [email protected]

Telephone: 01904 464 680

Website: www.spectrumhealth.org.uk/substance-misuse/york-drug-and-alcohol-service/

On campus, you can also get in touch with YUSU's Advice & Support Centre (or the GSA Advice Service for postgraduate students) for independent and confidential guidance on support options, or speak with a member of your college wellbeing team.

Addaction

The drug and alcohol charity Addaction provide professional advice and information through their webchat service. Their opening times can vary but they are usually available Monday-Friday. Their twitter feed details their operational times.

Website: www.addaction.org.uk/webchat

Alcoholics Anonymous

Alcoholics Anonymous is a self-help fellowship of people who wish to stop using alcohol. Their regular self-help meetings are based on a twelve step programme.

Helpline: 0800 9177 650

Website: https://www.alcoholics-anonymous.org.uk/

Email: [email protected]

Drinkline

Helpline 0300 123 1110

Provide information and advice for anyone concerned about their own alcohol use, or someone else's.

Helpline available weekdays 9am-8pm and weekends 11am-4pm.

Help for carers/family members affected by alcohol use

Please see the below sources of support if you have been affected by a family member's drug and alcohol use.

York Carers Centre

York Carers Centre provide support to anyone who affected by someone else's drinking or drug use. This includes parents, partners, children, siblings, grandparents and friends. Carers can access their carer support services and their substance misuse carer support group. This support group is held on on the third Wednesday of the month, 1.30 to 3.30pm at Tesco Community Room, Askham Bar, York.

Telephone: 01904 715 490

Email [email protected]

Website: www.yorkcarerscentre.co.uk/

Al-Anon

Al-Anon provide support to anyone affected by someone else's drinking regardless of whether the individual continues to drink alcohol.
https://www.al-anonuk.org.uk/
Adfam

Adfam provide information and support for the families of drug and alcohol users.

They provide information on local support groups and helplines.

Website: www.adfam.org.uk

# data[].attributes.attachment_link.description
Many people enjoy drinking in moderation but problems can occur if you drink a large amount of alcohol in a short period of time, if you drink to get drunk or if you find it difficult to control your alcohol use.

# data[].attributes.attachment_link.description
Alcoholism is a disease that does not discriminate and can impact anyone – regardless of age, gender, ethnicity, body type or personal beliefs.

# data[].attributes.attachment_link.provider_name
Detox Plus UK | Drug & Alcohol Treatment UK

# data[].attributes.attachment_link.readable_text
What is it like living with a fully functioning alcoholic? When people think of an alcoholic, they often have an image of a homeless person on a street corner drinking wine from a bottle in a brown paper bag, but you should never judge a book by its cover.

What is a functioning alcoholic?

There are, in fact, many people with drinking problems in the UK who seem to be able to carry on, hold down a job and have a happy home life, despite drinking heavily. They may be drinking in secret and, in effect, living a double life. A functioning alcoholic may have concealed their alcohol abuse from family, friends and colleagues for a long time, possibly even years, without any significant mishaps.
For example:
But it may only be a matter of time before it all comes out.

They may maintain the illusion everything is under control. At one time they may have enjoyed a glass of wine and a drink or two but didn't have an issue with alcohol. But alcohol addiction can cause considerable physical and psychological damage to someone, as well as their friends and loved ones. It is said functioning alcoholics may vary from other people with dependency as they believe they can live a normal life while still drinking and can overcome alcoholism alone. They think even those they live and work with may be unaware they are battling alcoholism.

Functional alcoholics and relationships

If you are living with an alcoholic partner, you may wonder what you can do to assist them or where to take an alcoholic for help. They are often in denial and insist they don't need any help. However, there are certain signs of a functioning alcoholic you can look out for if you suspect a friend, loved one or colleague may have a drinking problem.

For instance, do they consume alcohol instead of having something to eat? Does your family member become angry or defensive at the suggestion they have an issue, or do they make a joke about it? Do they drink in secret, early in the morning and throughout the day until they blackout? They may place restrictions on themselves, such as only drinking at the weekend, but not stick to it.

If a person has a problem with alcohol, they may ask folk to cover for them, from loaning them money to calling in sick. But, at the same time, they often shut themselves off from the world. Where, when not at work, they may spend time alone in bars and not invite friends and family to their home, so they cannot watch them drink. They may also fail to show up at get-togethers or family gatherings, missing birthday parties, weddings or christenings because they were drunk or hungover. An example of how concealing a drinking problem can affect a person's social life.

However, in many cases, people who suffer from alcoholism drink to deal with emotional or psychiatric disorders, stress or depression to anxiety, alongside other conditions.

They want to show the world everything's ok, but if they stop drinking, they could display symptoms of alcohol withdrawal, along with experiencing changes in mood, irritability or even suicidal thoughts.

Famous High Functioning Alcoholics

Bradley Cooper is known for his comedic film roles. But like most of us, Cooper's life has had its ups and downs. He is recovering from alcoholism and has been sober for over a decade.

The beloved star of the "Harry Potter" movies has struggled, like many other child actors, growing up in show business. While his character Harry was innocent and heroic, for Daniel Radcliffe, real-life challenges started affecting him, namely his addiction to alcohol.

Famous pop/rock musician Billy Joel has admitted to struggling with alcohol abuse in his adult life. Drinking has, apparently, gotten in the way of his career and personal relationships.

What is an alcoholic in denial?

Why is it that people can so blatantly contradict themselves, yet not be able to recognise it even if it is pointed out? In one word, the answer is DENIAL.

Denial is the universal factor found in most - if not all, addicted people.

It is an active "rejection of reality.

This does not have to be "total rejection" it can be partial avoidance or evasion of reality.
Definitions of Denial:-

An evasion of reality.

An active process of avoiding the truth of a situation

A refusal to acknowledge the "obvious."

Unwillingness to recognise a problem

A headstrong amount of avoidance emotions

Types of denial:- Denial of fact, responsibility, impact, awareness, cycle.
Some alcoholics will downplay any negative consequences caused by their drinking and will often say that concerned loved ones are exaggerating. This means they will continue to drink and put their health at risk.

Signs of a functioning alcoholic

CAGE questionnaire used in routine health care

C: Have you ever felt you ought to cut down on drinking

A: Have people annoyed you by criticising your drinking?

G: Have you ever felt bad or guilty about your drinking?

E: Have you ever been drinking in the morning to steady your nerves or get rid of a hangover (eye-opener)?

More than one positive response to the CAGE questionnaire suggests an alcohol problem.

In the UK in 2018 there were 7,551 alcohol-specific deaths.

Excessive Alcohol Increases Risk of...

Brain damage

Colorectal and breast cancer

Inflammation of the stomach lining

Sleep disturbances

Hypoglycemia

High blood triglycerides

Cirrhosis of Liver

Heart rhythm disturbances

Hypertension & hemorrhagic stroke

Osteoporosis

Consider Carrying out an intervention

If the consequences have become overwhelming, and your loved one refuses to seek help for alcohol abuse, it could be time to plan an intervention. An intervention is a planned meeting in which the concerned parties confront the addict about his or her behaviour. The goals of intervention include:

Getting them to see how drinking has harmed him or her and their loved ones

Presenting the individual with a plan for recovery

Laying on the line ramifications if they refuse to consider treatment

Assisting them in taking the right steps to seek treatment

Do you believe someone in your life may have an alcohol problem? You can get help for both yourself and the person close to you by speaking to a counsellor who could arrange an intervention for you or arrange for them to enter rehab. It could be the first step to helping your friend and loved one turn their life around and break free of alcohol. Contact us now for further advice and information.

# data[].attributes.attachment_link.title
Living With a Fully Functioning Alcoholic - Detox Plus UK

# data[].attributes.attachment_link.description
What is it like living with a fully functioning alcoholic? When people think of an alcoholic, they often have an image of a homeless person on a street corner drinking wine from a bottle in a brown paper bag, but you should never judge a book by its cover.

# data[].attributes.attachment_link.readable_text
If you're living with obesity, your GP can offer you for advice about improving your lifestyle and losing and managing your weight safely.
Your GP can advise you about losing weight safely by eating a healthy, balanced diet and regular physical activity.

They can also let you know about other useful services, such as:

local weight loss groups - these could be provided by your local authority, the NHS, or commercial services you may have to pay for

exercise on prescription - where you're referred to a local active health team for a number of sessions under the supervision of a qualified trainer

If you have underlying problems associated with obesity, such as polycystic ovary syndrome (PCOS), high blood pressure, diabetes or sleep apnoea, your GP may recommend further tests or specific treatment. In some cases, they may refer you to a specialist.

Diet

There's no single rule that applies to everyone, but to lose weight at a safe and sustainable rate of 0.5 to 1kg a week, most people are advised to reduce their energy intake by 600 calories a day.

For most men, this will mean consuming no more than 1,900 calories a day, and for most women, no more than 1,400 calories a day.

The best way to achieve this is to swap unhealthy and high-energy food choices - such as fast food, processed food and sugary drinks (including alcohol) - for healthier choices.

A healthy diet should consist of:

plenty of fruit and vegetables

meals based on potatoes, bread, rice, pasta and other starchy foods (ideally you should choose high fibre and wholegrain varieties)

some milk and dairy foods or dairy alternatives

some meat, fish, eggs, beans and other non-dairy sources of protein

just small amounts of food and drinks that are high in fat and sugar

Try to avoid foods containing high levels of salt because they can raise your blood pressure, which can be dangerous for people who are already living with obesity. Read some tips for a lower-salt diet.

You'll also need to check calorie information for each type of food and drink you consume to make sure you don't go over your daily limit.

Some restaurants, cafés and fast food outlets provide calorie information per portion, although providing this information isn't compulsory. Be careful when eating out because some foods can quickly take you over the limit, such as burgers, fried chicken, and some curries or Chinese dishes.

Read more about calorie counting.

Diet programmes and fad diets

Avoid fad diets that recommend unsafe practices, such as fasting (going without food for long periods of time) or cutting out entire food groups. These types of diets do not work, can make you feel ill, and are not sustainable because they do not teach you long-term healthy eating habits.

This is not to say that all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well for some people.

A responsible diet programme should:

educate you about issues such as portion size, making behavioural changes and healthy eating

not be overly restrictive in terms of the type of foods you can eat

be based on achieving gradual, sustainable weight loss rather than short-term rapid weight loss, which is unlikely to last

Very low calorie diets

A very low calorie diet (VLCD) is where you consume less than 800 calories a day.

These diets can lead to rapid weight loss, but they are not a suitable or safe method for everyone, and they are not routinely recommended for managing obesity.

VLCDs are usually only recommended if you have an obesity-related complication that would benefit from rapid weight loss.

VLCDs should not usually be followed for longer than 12 weeks at a time, and they should only be used under the supervision of a suitably qualified healthcare professional.

Speak to your GP first if you're considering this type of diet.

Further information

For more information about diet and weight loss, read:

Exercise

Reducing the amount of calories in your diet will help you lose weight, but maintaining a healthy weight requires physical activity to burn energy.

As well as helping you maintain a healthy weight, physical activity also has wider health benefits. For example, it can help prevent and manage more than 20 conditions, such as reducing the risk of type 2 diabetes by 40%.

The Chief Medical Officers recommend that adults should do a minimum of 150 minutes moderate-intensity activity a week - for example, 5 sessions of 30-minute exercise a week. Something is better than nothing, and doing just 10 minutes of exercise at a time is beneficial.

Moderate-intensity activity is any activity that increases your heart and breathing rate, such as:

brisk walking

cycling

recreational swimming

dancing

Alternatively, you could do 75 minutes of vigorous-intensity activity a week, or a combination of moderate and vigorous activity.

During vigorous activity, breathing is very hard, your heart beats rapidly and you may be unable to hold a conversation. Examples include:

running

most competitive sports

circuit training

You should also do strength exercises and balance training 2 days a week. This could be in the form of a gym workout, carrying shopping bags, or doing an activity such as tai chi. It's also critical that you break up sitting (sedentary) time by getting up and moving around.

Your GP, weight loss adviser or staff at your local sports centre can help you create a plan suited to your own personal needs and circumstances, with achievable and motivating goals. Start small and build up gradually.

It's also important to find activities you enjoy and want to keep doing. Activities with a social element or exercising with friends or family can help keep you motivated. Make a start today - it's never too late.

Read more about the physical activity guidelines for adults and the physical activity guidelines for older adults.

You may need to exercise for longer each day to prevent obesity or to avoid regaining weight if you've been obese. To prevent obesity, 45 to 60 minutes of moderate-intensity activity a day is recommended. To avoid regaining weight after being obese, you may need to do 60 to 90 minutes of activity each day.

Your GP or weight loss adviser will be able to advise you further about the type of exercise you should do and for how long taking into account your current fitness level and individual circumstances.

Further information

For more information about exercise, see:

Other useful strategies

Evidence has shown that weight loss can be more successful if it involves other strategies, alongside diet and lifestyle changes. This could include things like:

setting realistic weight loss goals - if you're living with obesity, losing just 3% of your original body weight can significantly reduce your risk of developing obesity-related complications

eating more slowly and being mindful of what and when you're eating - for example, not being distracted by watching TV

avoiding situations where you know you may be tempted to overeat

involving your family and friends with your weight loss efforts - they can help to motivate you

monitoring your progress - for example, weigh yourself regularly and make a note of your weight in a diary

Getting psychological support from a trained healthcare professional may also help you change the way you think about food and eating. Techniques such as cognitive behavioural therapy (CBT) can be useful.

Avoiding weight regain

It's important to remember that as you lose weight your body needs less food (calories), so after a few months, weight loss slows and levels off, even if you continue to follow a diet.

If you go back to your previous calorie intake once you've lost weight, it's very likely you'll put the weight back on. Increasing physical activity to up to 60 minutes a day and continuing to watch what you eat may help you keep the weight off.

Medicine

Many different types of anti-obesity medicines have been tested in clinical trials, but the only ones that have proved to be safe and effective for use on the NHS for weight management are orlistat, liraglutide and semaglutide.

Orlistat

You can only use orlistat if a doctor or pharmacist thinks it's the right medicine for you. Orlistat is available on prescription from your doctor, or you can buy it at a lower dose from a pharmacy. Products available directly from pharmacies are Alli and Orlos, which must be taken under the supervision of a pharmacist.

Orlistat works by preventing around a third of the fat from the food you eat being absorbed. The undigested fat is not absorbed into your body and is passed out with your poo. This will help you avoid gaining weight, and may help you to lose weight.

You'll need to start eating a balanced diet and exercising regularly before beginning treatment with orlistat, and continue this during treatment and after you stop taking orlistat.

When orlistat should be used

Orlistat will usually only be recommended if you've made a significant effort to lose weight through diet, exercise or changing your lifestyle.

Even then, orlistat is only prescribed if you have either:

a body mass index (BMI) of 28 or more, and other weight-related conditions, such as high blood pressure or type 2 diabetes

a BMI of 30 or more

Orlistat is not usually recommended for pregnant or breastfeeding women.

Before prescribing orlistat, your doctor will discuss the benefits and potential limitations with you, including any potential side effects.

Follow your doctor's advice about how to take it, and the instructions that come with your medicine.

How long to take it for

Treatment with orlistat should only continue beyond 3 months if you've lost 5% of your body weight. It usually starts to affect how you digest fat within 1 to 2 days.

If you have not lost weight after taking orlistat for 3 months, it's unlikely to be an effective treatment for you. Ask your doctor or pharmacist, as you may need to stop your treatment.

Orlistat and other health conditions

If you're taking medicine for another serious health condition, such as type 2 diabetes, high blood pressure or kidney disease, it may be necessary to change the dose of your medicine. Speak to your GP before starting treatment with orlistat.

If you have type 2 diabetes, it may take you longer to lose weight using orlistat, so your target weight loss after 3 months may be slightly lower.

Side effects of orlistat

Common side effects of orlistat include:

fatty or oily poo

needing the toilet to poo urgently

pooing more frequently

an oily discharge from your rectum (you may have oily spots on your underwear)

farting (flatulence)

You're much less likely to get these side effects if you stick to a low-fat diet.

If you're taking the oral contraceptive pill and you have severe diarrhoea while taking orlistat, use an additional method of contraception, such as a condom. This is because your body may not absorb the contraceptive pill if you have diarrhoea, so it may not be effective. Check the pill packet for advice.

Liraglutide and semaglutide

Liraglutide (also called Saxenda) and semaglutide (also called Wegovy) are weight loss medicines that work by making you feel fuller and less hungry. They're taken as an injection. Your doctor or nurse will show you how to take it.

Liraglutide is taken once a day, and semaglutide is taken once a week.

You can only take liraglutide or semaglutide if they're prescribed for you by a specialist weight management service. A doctor might recommend that you take one of these medicines if diet and exercise changes have not worked on their own.

You'll need to eat a balanced, reduced-calorie diet and exercise regularly while taking liraglutide or semaglutide.

Before prescribing liraglutide or semaglutide, your doctor will talk you through the benefits and limitations, including any side effects you might get.

When liraglutide should be used

Liraglutide is suitable for adults aged up to 75. It is not recommended if you're pregnant or breastfeeding or have certain health conditions, such as liver or kidney problems.

You'll only be prescribed liraglutide if all of these apply:

When semaglutide should be used

You'll only be prescribed semaglutide if you have health problems due to your weight and you have a BMI of either:

35 or more, or 32.5 or more if you're of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin

30 to 35, or 27.5 to 32.5 if you're of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin, and you meet other criteria to be treated by a specialist weight management service

It's not recommended if you're pregnant or breastfeeding or have certain health conditions.

How long to take liraglutide or semaglutide for

You'll have a review after taking liraglutide for 3 months, or after taking semaglutide for 6 months. You'll then usually only carry on taking the medicine if you've lost at least 5% of your body weight.

You can take semaglutide for a maximum of 2 years.

Surgery

Weight loss surgery, also called bariatric surgery, is sometimes used to treat people who are severely obese.

Bariatric surgery is usually only available on the NHS to treat people with severe obesity who fulfil all of the following criteria:

they have a BMI of 40 or more, or between 35 and 40 and another serious health condition that could be improved with weight loss, such as type 2 diabetes or high blood pressure

all appropriate non-surgical measures have been tried, but the person hasn't achieved or maintained adequate, clinically beneficial weight loss

the person is fit enough to have anaesthesia and surgery

the person has been receiving, or will receive, intensive management as part of their treatment

the person commits to the need for long-term follow-up

Bariatric surgery may also be considered as a possible treatment option for people with a BMI of 30 to 35 who have recently (in the last 10 years) been diagnosed with type 2 diabetes.

In rare cases, surgery may be recommended as the first treatment (instead of lifestyle treatments and medication) if a person's BMI is 50 or above.

Treating obesity in children

Treating children living with obesity usually involves improvements to diet and increasing physical activity using behaviour change strategies.

The amount of calories your child should eat each day will depend on their age and height. Your GP should be able to advise you about a recommended daily limit, and they may also be able to refer you to your local family healthy lifestyle programme.

Children over the age of 5 should ideally get at least 60 minutes of vigorous-intensity exercise a day, such as running or playing football or netball. Sedentary activities, such as watching television and playing computer games, should be restricted.

Read more about the physical activity guidelines for children and young people.

Referral to a specialist in treating childhood obesity may be recommended if your child develops an obesity-related complication, or there's thought to be an underlying medical condition causing obesity.

The use of orlistat in children is only recommended in exceptional circumstances, such as if a child is severely obese and has an obesity-related complication.

Bariatric surgery isn't generally recommended for children, but may be considered for young people in exceptional circumstances, and if they've achieved, or nearly achieved, physiological maturity.

Further information

For more information about diet and exercise in children, read:

# data[].attributes.attachment_link.description
Information and advice about losing weight safely using diet and exercise. Other useful strategies include setting weight loss goals and asking for the support of family and friends.

# data[].attributes.attachment_link.readable_text
THE USE OF illegal drugs is a class issue, but whilst it is essential to develop a Marxist response to the problems of drug abuse, this has not been the case with many sections of the far left. Militant, in the days before it became the Socialist Party, and Workers Power serve as two useful examples of some of the pitfalls that need to be avoided.

Militant's past attitude to drugs can be summed up as puritan at best, and reactionary at worst. Like being gay, drugs were something "real workers" had nothing to do with, an alien culture imported by trendy middle class students, or a capitalist plot to distract workers from the path of enlightenment. The practical outcome of this outlook came in a little known about (outside of Liverpool) policy initiated when Militant had hegemony within Liverpool City Council in the 1980s. During this time the Drugs Liaison Office (DLO) was set up, staffed by a number of Militant supporters, and whose basic policy was encapsulated in their slogan, and alternate name, of "Drug Free". The ideology behind this policy may have been well intentioned, but it led to some very dangerous positions which differed little from the contemporary campaigns of Nancy Reagan and her "just say no" publicity stunts.

The inevitable outcome of a blanket "drug free" approach was to put all drugs in the same category, even to the extent that the reactionary myth that cannabis use leads to heroin addiction was peddled shamelessly. To this end various leaflets were issued by the DLO which purported to show the dangerous consequences of smoking dope. These hazards included lung damage, reduction of the body's ability to fight infections, and birth defects - all of which were described as medical facts.

However, whilst it is possible that, like tobacco, cannabis can cause lung damage and reduce the effectiveness of the immune system (not enough extensive, and genuinely objective, medical research has been carried out on the effects of cannabis to be conclusive), the source given by the DLO in other literature that they circulated to the local labour movement on matters such as birth defects was from a Sir William Paton. However, Paton's "experiments" had been discredited many years previously. He had reported that if mice were injected with THC, the active constituent of cannabis, it accumulated in their body fat, foetuses were born deformed, and mice were killed by larger doses. This seemed impressive until the relationship of dose to body weight was analysed. It then turned out that while the normal, social use of THC is about 2 microgrammes per gramme of body weight, the mice died from injected doses of 1,000 mcg. to 5,000 mcg. per gramme. It was as if a adult male had been injected with nearly a pint of pure THC - death would not in these circumstances be surprising! (A pint of caffeine would have the same result.) As the Guardian commented at the time: "it was unclear whether mice shouldn't use cannabis, or professors shouldn't use mice."

This use of dubious "scientific" research, which has a long history within the US and is linked to racist and reactionary far right organisations, was vigorously defended by Militant (other publications of dubious organisations, such as the US group "Pride" - the National Parents' Resource Institute for Drug Education, Inc. - were also used as "support" for the policy).

In no way could these methods be supported by Marxists who had any sense. Apart from the medical inaccuracies and the dubious allies Militant lined up with, the campaign against cannabis was counter-productive to the aim of keeping kids off "hard" drugs such as heroin. By not distinguishing between different drugs in the medical effects and dangers of addiction that they had - and in the social setting in which they were used - these policies actually made drugs like heroin seem safer, because anyone who had tried cannabis, and therefore knew it was non-addictive, would see the DLO and Militant as talking crap; and if they were discredited here, then they would not be believed when they spoke of the very real dangers of heroin addiction.

Where Militant, and the DLO, did find a hearing, however, was amongst non-drug-takers, such as the parents of those youth that were on drugs, and it was here that Militant's attitude makes sense if we see it as part of their tail-ending of various aspects of workers' existing ideology, and linking up with a kind of "working class morality". Rather than attempting to fight for progressive attitudes to the problems of drug addiction, and launching socialist campaigns that would show the causes of drug taking in the alienation produced by capitalist society, Militant were happy to adapt themselves to various backward ideas on these issues. This adaptation culminated in Militant supporters, together with the DLO, arguing against clean needle exchange schemes on the grounds that it might encourage heroin use! Given the well known risks of HIV infection from shared needles, this reactionary - and highly dangerous - position is clearly not the way to proceed.

Of course in recent years, largely as a result of internal pressure from some of the more realistic youth members, these attitudes have changed, to the extent that the Socialist Party now is in favour of legalising cannabis. But if we can sum up the previous ideas of Militant as conservative, and similar in style to a moralistic temperance society, what are we to make of those of Workers Power?

On the face of it, Workers Power seem to put forward some very progressive views on the issues surrounding drug use, and by the simple fact that they are one of the few left groups that have even attempted to get to grips with this social problem that effects working class communities this should mean that they are in a good position. However, a closer look at some of the concepts of Workers Power, and the method that lies behind them, actually shows the opposite to be true.

Their basic position on drugs is set out in a number of passages in the The Trotskyist Manifesto, published by Workers Power's international tendency. In it we find the following: "The rapacious search for profit degrades and destroys individuals well beyond the factory or office. Under capitalism the use of drugs drives hundreds of thousands beyond the limits of enjoyment and stimulation to the wastelands of dependency and enslavement: alcoholism and narcotic addiction wrecks the lives of many potential class fighters against the system which breeds such dependencies. We demand the decriminalisation of drug use and the confiscation of the massive profits that the narcotic barons make from illegal import and export of drugs. We are for a state monopoly, overseen by the workers' and peasants' price committees, of the sale of drugs for pharmaceutical and non-pharmaceutical use. We demand scientifically based education and information on the dangers of the use of particular narcotics for non-medical purposes." ¹

Further on, under the section entitled "Agrarian revolution in the semi-colonies", it states: "Many peasants find that the only way to make a living is to cultivate crops related to the narcotics industry. They are ruthlessly exploited by the narcotic barons and persecuted by the imperialist "anti-narcotic" agencies. We demand the right of the peasants to cultivate narcotic related crops on a free and legal basis. We demand the purchase of such crops by the state at prices fixed by workers' and peasants' price committees." ²

These views were deepened in a 1993 article in Workers Power's monthly paper, ³ which discussed the issues surrounding the debate on legalising drugs. After making some valid points - correctly arguing that illegality does not prevent drug use, but rather increases violence in areas like dealing - the article reached the following conclusions: "All drugs should be legalised and available under a state monopoly. If drugs are legalised but they are sold by private companies then they would happily push all the most addictive drugs to boost profits. That is why we need workers' control of production, selling and distribution of all drugs. There should be a licensing system that enables workers and youth to take distribution out of the control of the current dealers and to make sure it is not in the hands of the government. Local venues should be licensed for drug distribution. Who is licensed should be decided by local organisations of youth, the labour movement and community. That way there will be democratic control over the distribution and sale of drugs that allows neither the state nor drug dealers to abuse it, or if it is legalised, pharmaceutical companies to make profits out of their use."

Although the article finished with a claim that it is against youth taking drugs, the statements outlined above, and the sentence towards the end that says "Workers Power is not against the recreational use of drugs any more than we are against the recreational use of alcohol", leaves a confusing picture of just what Workers Power really believes on this matter, apart from the general view that drug taking can be both condoned and encouraged by workers' organisations, as if intervention by the labour movement in the supply of addictive drugs would somehow make it alright.

The basis for Workers Power's confused, and ultimately reactionary, position lies in the misunderstanding of how revolutionaries relate to anti-social behaviour within the working class (behaviour that has its roots in the class system, and the poverty and alienation that this produces), and also of how we fight the terrible effects of drug addiction that have destroyed so many lives in our communities. Whilst it is true that drugs such as cannabis have few harmful effects, and are physically non-addictive, this cannot be said for many of the other, addictive, drugs that are available. Simply because we realise that illegality does not stop the use of dangerous addictive drugs, does that mean we should call for legalising all drugs? No! This position would be the greatest folly we could commit on this issue. Instead we should demand that drug users, as victims of the trade in drugs, should not be criminalised by the state. This is entirely different from calling for legalisation, in the same way that whilst we, as socialists, demand the end to police and state harassment of prostitutes, and for prostitutes not to be criminalised for being the victims of a rotten society, we do not call for prostitution or pimping to be legalised, as we are against the whole practice. If Workers Power used the same method for analysing prostitution as they use for drugs, they would, presumably, call for nationalised prostitution under workers control! This should be enough to show what a reactionary, and plain stupid, method they have used in attempting to formulate their position on the drugs problem in Britain. If Militant were guilty of adapting to certain backward working class views on morality, then Workers Power have, by comparison, adapted to a certain type of liberal middle class morality, and have sought to dress this up with various bits and pieces of Marxist phraseology.

Even their views on the exploitation of peasants who grow drug crops is faulty, for whilst it is true that these peasants are also victims of the drug trade, does that mean that we should advocate that they expropriate the landlords and drug barons in order to take charge of the trade themselves? The fact that Workers Power use the revolutionary phraseology of control of this trade by "workers' and peasants' price committees" should not blind us to the underlying reactionary position that exists here. Of course, Marxists should agree one hundred per cent that peasants should expropriate their landlords, but do we then think that they should carry on producing drug crops? Apart from the fact that this position reveals a very wooden and metaphysical conception of what expropriation would entail (as it would presumably be part of a revolutionary process if such things as workers' committees were in the position of fixing prices), it also suggests that a future workers' state (which would be the only basis for any real expropriation and the continued existence of pricing committees) would carry on supplying workers in other countries with the harmful substances that degenerate capitalism first created the demand for, and such a muddled position is clearly anti-Marxist claptrap.

When Marx analysed the opium trade in the nineteenth century, a trade in which Britain went to war against China in order to guarantee the continued monopoly to supply Indian produced and British controlled opium to China (to maintain the addicts that it deliberately created to massively increase colonial profits), he condemned it as a particularly nasty example of colonialism and the search for capitalist profit. However, he did not then put forward the position that Indian peasants should expropriate the British colonialists in order to continue the trade themselves, and thereby continue the misery of Chinese opium addicts, but this is precisely the non-Marxist position of Workers Power on today's drug trade!

So how should Marxists respond? Perhaps a historical perspective would prove useful here.

All revolutionary events are marked by the emergence of a strict code of revolutionary morality that acts as the basis for discipline and unity in action. Witness this contemporary (and hostile) report of the English Peasants' Revolt of 1381, when the rebels attacked and destroyed the Savoy palace, home of one of the King's ministers, the hated John of Gaunt:

"One of the criminals chose a fine piece of silver [from the palace] and hid it in his lap; when his fellows saw him carrying it, they threw him, together with his prize, into the fire, saying that they were lovers of truth and justice, not robbers and thieves. It is said that some of the rebels entered the wine cellar at the Savoy, and several drank so much sweet wine that they were incapable of leaving. They sang, joked and amused themselves in a tipsy fashion until the door was blocked by fire and stones. And so they died, for even if they had been sober they would have found themselves deprived of any exit. For the following seven days the trapped men were heard shouting and lamenting the enormity of their wickedness by the many people who visited the spot; but no one helped or consoled them in their trouble. And so those drunken men who came to consume wine perished in wine - to the number (so it was said later) of thirty-two or thereabouts." ⁴

This description of events, the concern to be seen as fighting for justice rather than personal gain, and the opposition to undisciplined elements who could destroy this revolutionary morality, will be uncannily familiar to us when compared to descriptions of very similar events in the capture of the Winter Palace, and its wine cellar, in October 1917. In both cases, and in countless others around the world, drugs, in the form of alcohol, were rightly seen as an enemy of the revolution.

Trotsky later set out his views on the subject: "In both the city and village the opinion is held that 'a member of the Communist League of Youth may not drink'. This is an achievement that must be strengthened and developed. You will frequently encounter a windbag who with a look of profundity will start explaining that the struggle against alcoholism is Tolstoyanism. It is hard to imagine anything more stupid or banal. For the working masses the struggle against alcoholism is a struggle for physical, spiritual, and most of all, revolutionary survival. We have barely began to raise ourselves up. We barely have enough to make do. We can raise our wages only very, very slowly. And indeed wages are the basis of everyday life and the basis of cultural progress. Forcing its way into the daily life of the worker, alcohol snatches a large share of wage earnings and in this way undercuts the advance of culture. It is necessary to clearly understand the full extent of the dangers of alcohol under our conditions, in which the country's economic organs have hardly begun to recover after a dangerous illness and everywhere still carry traces of chronic disease. The worker correspondent must be able to intimately relate the struggle against alcoholism to all the conditions of life of a given group of workers, to all their factory, cultural, and domestic circumstances. And any worker correspondent who takes alcoholism lightly, when it is the most malicious enemy of the revolution and of the cultural advance of the masses, is not a real worker correspondent." ⁵

In another article he writes: "But, Comrades, in this struggle [the abolition of illiteracy] we have another fierce adversary whom we must overcome if we are able to advance. I speak of alcoholism, of drunkenness. Various forms and methods of struggle against drunkenness have been tried and will be tried in the future. But the basic method is to bring about the cultural progress of the masses themselves, to develop in them a stubborn fighting vanguard in the battle against alcoholism.

"In this connection, the first place must be taken by the women, and of course the worker correspondents must make their contribution to this movement. The period that lies ahead must be a period of heroic struggle against alcoholism. The working masses still live very poorly, but nevertheless not so poorly as in past years. We can observe a weariness of the nerves, both from the revolutionary upsurge of the recent past and from the present revolutionary lull, which demands stubborn everyday work. People's nerves are badly worn. There is a great demand for different sorts of stimulants or, conversely, sedatives. The demand for alcohol, for intoxicating, artificially stimulating drink, is very strong among the workers in the towns.

"And, Comrades, the worker correspondent who sets a bad example in this matter is not worthy of the name of worker correspondent. A worker correspondent must be a fighter against drunkenness. This is no laughing matter. History will subject us to a hard test in this matter. If we do not give a rebuff to drunkenness, starting in the towns, then we shall drink away socialism and the October Revolution." ⁶

What can we learn from this? Firstly, we should remember that all drug taking is defined by its historical and cultural setting; in Britain today although alcoholism is widespread, it is not really comparable to the extent of its existence in Russia when Trotsky wrote the above passages. Nevertheless, his general arguments, whether applied to alcohol, or any other potentially dangerous drug, remain valid. Marxists should be in the front line against drug abuse, but without at the same time placing themselves, like Militant in the recent past, in a reactionary position. Our positions today will be dependant on the situations that face us, and the social conditions that lead to drug use (many drug addicts are created quite legally in the prescribing of tranquillizers for depression that often has its roots in the unbearable conditions poverty creates, and are then left without properly structured or funded help).

Whilst it would be reactionary nonsense to believe that it is possible to "invent" a communist morality, what is essential is to develop progressive aspects of workers' ideology from where it stands now. It is necessary to fight against drug abuse in a progressive manner, and connect this with the desire of workers to end the horror that drug addiction wreaks on their communities.

We can identify this attitude in the work of Jim Larkin. Larkin is well known today for his political activities, but rather less known is the tireless campaigns he made during his life against drunkenness, the scourge of ports in Britain and Ireland. It was the practice of Larkin when he was a foreman never to pay the workers under him in the local pubs, as was the custom at the time, and where it gave the men ample opportunity to drink away their wages before they thought about their wives and children. Larkin undoubtedly made an error when he lined up organisationally with the various religious bigots in the temperance movement, but his basic attitude was progressive for the contemporary situation he faced, as Emmet Larkin describes in his biography of Jim Larkin:

"His devotion to the cause of temperance won him the loyalty of the workers' wives. Many of the Dublin workers were heavy drinkers, and alcohol was the greatest drain on the weekly earnings of the family. The women would often come to Larkin and complain about their husbands' drinking. Larkin would see to it that the wives and children received first consideration, and after that the men could do what they liked. More than one drunken docker went head first down the steps of Liberty Hall with Larkin the propelling force. He was usually looked upon by those he chastised, when they sobered up, as 'only talking right' and 'being for their own good'. Larkin became their moral policeman." ⁷

What the Bolsheviks, and Larkin, represented in their campaigns against the abuse of alcohol, was a legitimate socialist approach that was organically connected to the working class. Jim Larkin may have been the dockers' "moral policeman", but he did not represent outside forces in this task, but rather the most progressive views of the workers' movement itself.

The key task in any campaign against drug abuse is workers' self-activity. We should place no trust in the police, or forces of "law and order" to stop drug dealing or drug misuse: these bodies, the police and courts, are, as part of the capitalist state and as representatives of the oppression of the proletariat by the bourgeoisie, part of the problem, and never part of the solution.

However, we must recognise that workers' self-activity will not necessarily take on a socialist perspective. It is all too frequent to have campaigns against drug dealing in various working class areas take on a right-wing perspective of the need for more policing, or harsher sentences etc. In these situations the power of the police is strengthened, and the campaigns are diverted into reactionary avenues. However, we should not necessarily abstain from intervening in campaigns such as these, for to do so on the grounds of the reactionary ideology they hold would be an act of sectarian stupidity, and an actual abstention from the vital need to counter backward ideas within the class with Marxist solutions. In situations where workers attempt to fight against drug dealers (or for that matter joy riding or other criminal activity) on their estates, it is our duty to intervene to give Marxist explanations of the causes of drug abuse and crime, and to point to socialist solutions using the method of transitional demands (the fight for jobs, housing, resources, youth facilities etc).

But how should Marxists respond to attempts to set up "vigilante" patrols? At one extreme are the activities of groups such as the Guardian Angels. Obviously the left should have nothing to do with groups like these, who represent a reactionary ideology of "law and order", and who act as police informers. However, it is possible to envisage spontaneous attempts by workers in areas that are affected by drug dealing to set up their own patrols. In this latter situation it would be necessary to look at the local situation carefully, and to gauge the outlook of the participants, and the support that they have in the community. If these groups have racist ideas ("black drug pushers in our areas" etc) then they should be vigorously opposed, as they should if they view themselves as a select band of the "moral elite" who want to attempt to impose right-wing notions of morality (attacks on gays etc). Nevertheless, it is possible to foresee the potential for groups of workers to emerge who wish to rid their areas of dealers, and who have the support of the local community; in this situation Marxists should attempt to work with these groups, arguing for a perspective based on the labour movement, and on fighting for socialist measures. We should have no hesitation in wanting to get the dealers off the streets and out of workers' areas, but we must do this only after attempting to distinguish between the main dealers, and those who are themselves addicts and therefore in need of help from the community.

The experience in Ireland in recent years of the attempts by Sinn Féin and the IRA to stop drug dealing need to be properly analysed, because they show the danger of attempts at physically confronting dealers and petty criminals if they become divorced from those in whose benefit the campaign is supposedly being waged. In this case they revolve not around workers' self-activity, but rather a moral elite of gunmen who act on behalf of workers. This leads not only to substitutionism, but also to an often reactionary moral outlook being imposed onto the working class from without (IRA beatings of homosexuals within the nationalist areas have often been conveniently ignored by their cheerleaders on the British left). Whilst it has been the case that some of the IRA actions against drug pushing have had wide support amongst nationalist workers, by themselves they have not stopped the problem, just as many of the youth who have been shamefully "kneecapped" by the IRA for joy riding have not stopped their activities either.

As Marxists, we also need to analyse the international situation. Drugs are a valuable commodity for those that control their manufacture and transportation. However, many of the couriers, and most of the producers, see little of this wealth. Few of the latter are involved in the drugs trade by choice, but rather drugs are often the only money that these people could hope to make to support themselves and their families. In Asia most of the opium poppies used to produce heroin are grown by poor peasants as a cash crop, likewise in South America the first stages in cocaine production are the growing of coca plants by poor farmers, whilst the same is also true of cannabis production in the West Indies and the Middle East. These poor farmers are victims of capitalism, of imperialism, and of the existence of the drugs markets - markets that they did not create, but have to supply in order to earn a living, in just the same way as those peasants and labourers who farm legal tobacco do.

We therefore recognise that the origins of any drug is not the cause of the drugs problem we suffer today, and that those in the underdeveloped world who grow the ingredients for the manufacture of illegal drugs are not in any way to blame for what is the product of degenerate and decaying capitalist society. In this manner we oppose their exploitation by the landowners and drug barons, and also defend them against attack from the mainly US based imperialist forces in the anti-drug agencies.

Our position must be clear: whilst we defend the peasants and labourers who are forced by the capitalist market to grow harmful drugs, we understand that the overturn of capitalist relations of production, either in the countries where the drugs are grown, or in the countries to which they are supplied, would mean the ending of production of these products, as such a situation would allow the implementation of alternative, non- dangerous, crop production that would benefit all of humanity. The historical basis of socialism centres on the fact that by raising the level of the productive forces for the benefit of all it can provide an increased standard of living for both producers and consumers, whilst at the same time ending the existence of alienation workers have towards their work and the rotten society they currently live in. Such a situation would remove the demand for the supply of dangerous drugs whose sole useful purpose is to enable a temporary escape from the nightmare conditions many workers and youth presently face.

The problem of drug abuse within working class areas, and especially amongst the youth, is a serious one. It is a problem that needs to be properly understood by revolutionary socialists if they are to make any headway in relating to workers concerned over the issue, and the interrelated problems of criminality and violence.

The abuse of drugs is caused by the degenerate capitalist society in which workers' lives are destroyed by endless fears and worries. Drug addiction increases that misery, as families are broken up, and the streets become ruled by violent dealers who survive by the rule of fear and intimidation. Drugs have become a caustic poison that eats away at the social bonds between workers in these communities. The decline of collectivist ideology within the estates, due to the restructuring of capitalism that has pushed many into lives of permanent unemployment and petty crime, is speeded up by the appearance of drugs. In many inner city areas only the dealers are seen to have money, and in this situation, where the youth can see no alternative, it is not surprising that some of them aspire to this way of life, often in the mistaken hope that it can get them out of the ghettos and their existing poverty. In these situations the horror of drugs and the menace of fascism are two sides of the same coin; both are products of the bankruptcy of capitalism.

Whilst the youth organisations of the left have dwindled to nothing - the membership of the Labour Party Young Socialists was around 10,000 in the mid-1980s - this does not mean that youth are not open to socialist ideas. History shows that when the class struggle picks up there is massive potential for a fight by them. However, without finding organisational expression, and a principled programme to fight for, this spirit has the potential to be wasted. It is essential that Marxists find ways of linking up the aspirations of working class youth with socialist ideas, and this is only possible by the use of the transitional method to produce fighting demands the youth can unite around.

We must be sensitive on this question; young workers must be allowed to make their own mistakes if they are to learn and to develop their class consciousness. The revolutionary left must give those youth it is in contact with "room to grow". We must learn from the youth themselves how to proceed in our work amongst young workers, and in our efforts to campaign against the horrors of drug addiction within our communities.

We must also recognise that for many youth experimentation with drugs is an integral part of growing up, in the same way that experimenting sexually and experiencing new emotions is in the human development from the child to the adult. Whether this experimentation involves drinking cider through straws, or taking ecstasy, it is a stage that many will pass through unscathed. Only the alienation produced by capitalism turns this natural curiosity and adventurism of the young mind into a dangerous risk - from dependency and addiction to the violence associated with dealing. We cannot in advance say what role, if any, mood altering drugs will have in a communist society, but whilst capitalism survives drugs like heroin remain a constant source of increased misery for those who have already suffered enough.

It is necessary for Marxists to work out a programme that relates to drug addiction. Whilst that cannot be done fully here, as it will only come about through a wide discussion within the left and the labour movement, a few main points can be made that will hopefully prompt some of that discussion:

1. We recognise that the problems of drug abuse within our communities are caused by the existence of the capitalist class system.

2. Only workers ultimately suffer through drug addiction: the rich have access to private clinics, or money to maintain their supply of drugs. Drug addiction is not "classless", but another example of the bankruptcy of capitalism and the class system.

3. Only workers' self-activity can provide the basis for dealing with these problems.

4. Whereas the capitalist system offers our youth no hope for their future, Marxist ideas point to a way out of this misery, and can offer hope to those who at present have none.

5. The method of transitional demands must be used to formulate a programme to meet the needs of workers and youth who are affected by drugs. These demands must included the following emergency measures: jobs and decent living conditions for all; properly funded rehabilitation centres, needle exchange schemes and support for all addicts, whether of legal or illegal drugs; decriminalisation of addicts and an end to police harassment of addicts and youth; resources to be provided for youth facilities, decided on by the youth themselves.

6. No profits can be allowed to be made from health care. We call for a genuinely free and properly funded NHS, together with the nationalisation of the drugs companies.

7. A principled, internationalist, revolutionary party must be built within the working class, and orientated to the labour movement, that takes up the demands of workers and youth, and fights against the oppression of capitalism.

1. Liaison Committee for a Revolutionary Communist International, The Trotskyist Manifesto, 1990, p.33.

2. Ibid, p.72.

3. Workers Power, June 1993.

4. From a report by Henry Knighton, quoted in R.B. Dobson, ed, The Peasants' Revolt of 1381, 1983, p.184.

5. "The Cultural Role of the Worker Correspondent" in Trotsky, Problems of Everyday Life, 1973, p.174.

6. Ibid, pp.187-8.

7. Emmet Larkin, James Larkin: Irish Labour Leader, 1876-1947, 1989, p.161.

# data[].attributes.attachment_link.description
THE USE OF illegal drugs is a class issue, but whilst it is essential to develop a Marxist response to the problems of drug abuse, this has not been the case with many sections of the far left.

# data[].attributes.headline
The health effects of alcohol consumption 

# data[].attributes.subject
The health effects of alcohol consumption 

# data[].attributes.attachment_link.readable_text
Short-term effects of alcohol consumption

The short-term effects of alcohol consumption are outlined below. This information is based on the assumption that you have a normal tolerance to alcohol.

Dependent drinkers with a higher tolerance to alcohol can often drink much more without experiencing any noticeable effects.

1 to 2 units

After drinking 1 to 2 units of alcohol, your heart rate speeds up and your blood vessels expand, giving you the warm, sociable and talkative feeling associated with moderate drinking.

4 to 6 units

After drinking 4 to 6 units of alcohol, your brain and nervous system starts to be affected. It begins to affect the part of your brain associated with judgement and decision making, causing you to be more reckless and uninhibited.

The alcohol also impairs the cells in your nervous system, making you feel lightheaded and adversely affecting your reaction time and co-ordination.

8 to 9 units

After drinking 8 to 9 units of alcohol, your reaction times will be much slower, your speech will begin to slur and your vision will begin to lose focus.

Your liver, which filters alcohol out of your body, will be unable to remove all of the alcohol overnight, so it's likely you'll wake with a hangover.

10 to 12 units

After drinking 10 to 12 units of alcohol, your co-ordination will be highly impaired, placing you at serious risk of having an accident. The high level of alcohol has a depressant effect on both your mind and body, which makes you drowsy.

This amount of alcohol will begin to reach toxic (poisonous) levels. Your body attempts to quickly pass out the alcohol in your urine. This will leave you feeling badly dehydrated in the morning, which may cause a severe headache.

The excess amount of alcohol in your system can also upset your digestion, leading to symptoms of nausea, vomiting, diarrhoea and indigestion.

More than 12 units

If you drink more than 12 units of alcohol, you're at considerable risk of developing alcohol poisoning, particularly if you're drinking many units over a short period of time.

It usually takes the liver about an hour to remove one unit of alcohol from the body.

Alcohol poisoning occurs when excessive amounts of alcohol start to interfere with the body's automatic functions, such as:

breathing

heart rate

gag reflex, which prevents you choking

Alcohol poisoning can cause a person to fall into a coma and could lead to their death.

Other risks

Some of the other risks associated with alcohol misuse include:

accidents and injury - more than 1 in 10 visits to accident and emergency (A&E) departments are because of alcohol-related illnesses

violence and antisocial behaviour - each year in England more than 1.2 million violent incidents are linked to alcohol misuse

unsafe sex - this can lead to unplanned pregnancies and sexually transmitted infections (STIs)

loss of personal possessions - many people lose personal possessions, such as their wallet or mobile phone, when they're drunk

unplanned time off work or college - this could put your job or education at risk

Long-term effects of alcohol misuse

Drinking large amounts of alcohol for many years will take its toll on many of the body's organs and may cause organ damage. Organs known to be damaged by long-term alcohol misuse include the brain and nervous system, heart, liver and pancreas.

Heavy drinking can also increase your blood pressure and blood cholesterol levels, both of which are major risk factors for heart attacks and strokes.

Long-term alcohol misuse can weaken your immune system, making you more vulnerable to serious infections. It can also weaken your bones, placing you at greater risk of fracturing or breaking them.

There are many long-term health risks associated with alcohol misuse. They include:

As well as having a significant impact on your health, alcohol misuse can also have long-term social implications. For example, it can lead to:

family break-up and divorce

domestic abuse

unemployment

homelessness

financial problems

Kindling

Kindling is a problem that can occur following a number of episodes of withdrawal from alcohol. The severity of a person's withdrawal symptoms may get worse each time they stop drinking, and can cause symptoms such as tremors, agitation and convulsions (seizures).

Alcohol has a suppressing effect on the brain and central nervous system. Research has shown that when alcohol is removed from the body, it activates brain and nerve cells, resulting in excessive excitability (hyperexcitability). This can lead to behavioural symptoms such as seizures.

With each alcohol withdrawal episode, the brain and nervous system becomes more sensitised and the resulting side effects become more pronounced.

This kindling effect can also occur after chemical stimulus to the brain or body, such as anti-convulsant medication. This means a person's alcohol withdrawal programme needs to be carefully planned, with close monitoring of its effects.

Read more about kindling in alcohol withdrawal (PDF, 163kb).

# data[].attributes.attachment_link.description
The short-term effects of alcohol consumption are outlined below. This information is based on the assumption that you have a normal tolerance to alcohol. Dependent drinkers with a higher tolerance to alcohol can often drink much more without experiencing any noticeable effects.

# data[].attributes.attachment_link.readable_text
Obesity is a complex issue with many causes. It's caused when extra calories are stored in the body as fat.
If you consume high amounts of energy, particularly found in high fat and high sugar foods, and do not use all of the energy through physical activity, much of the extra energy will be stored in the body as fat.

Calories

The energy value of food is measured in units called calories. The average physically active man needs about 2,500 calories a day to maintain a healthy weight, and the average physically active woman needs about 2,000 calories a day.

This amount of calories may sound high, but it can be easy to reach if you eat certain types of food. For example, eating a large takeaway hamburger, fries and a milkshake can total 1,500 calories - and that's just 1 meal. For more information, read our guide to understanding calories.

As well as this, many people do not meet the recommended physical activity levels for adults, so excess calories consumed end up being stored as fat in the body.

Diet

Diet and lifestyle factors contribute to development of obesity and overweight. Some of the most common ones are:

eating large amounts of processed or fast food - this is food that's high in fat and sugar

drinking too much alcohol - alcohol contains a lot of calories

eating out a lot - food cooked in a restaurant may be higher in fat and sugar

eating larger portions than you need

drinking too many sugary drinks - including soft drinks and fruit juice

comfort eating - some people may comfort eat due to many other factors affecting their life such as low self-esteem or low mood

Changes in society have also made it more difficult to have a healthy diet. High calorie food has become cheaper and more convenient, and is heavily advertised and promoted.

Read about eating less saturated fat and how to cut down on sugar in your diet.

Physical activity

Lack of physical activity is another important factor related to obesity. Many people have jobs that involve sitting at a desk for most of the day. They also rely on their cars, rather than walking or cycling.

For relaxation, many people tend to watch TV, browse the internet or play computer games, and rarely take regular exercise.

If you are not active enough, you do not use the energy provided by the food you eat, and the extra energy you consume is stored by the body as fat.

The Department of Health and Social Care recommends that adults do at least 150 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, every week. This does not need to be done all in a single session, but can be broken down into smaller periods. For example, you could exercise for 30 minutes a day for 5 days a week.

If you're living with obesity and trying to lose weight, you may need to do more exercise than this. It may help to start off slowly and gradually increase the amount of exercise you do each week.

Read more about the physical activity guidelines for adults.

Genetics

There are some genes associated with obesity and overweight. In some people, genes can affect how their bodies change food into energy and store fat. Genes can also affect people's lifestyle choices.

There are also some rare genetic conditions that can cause obesity, such as Prader-Willi syndrome.

Certain genetic traits inherited from your parents - such as having a large appetite - may make losing weight more difficult, but they do not make it impossible.

In many cases, obesity is more to do with environmental factors, such as not having easy access to healthy food, or unhealthy eating habits learned during childhood.

Medical reasons

In some cases, underlying medical conditions may contribute to weight gain. These include:

However, if conditions such as these are properly diagnosed and treated, they should pose less of a barrier to weight loss.

Certain medicines, including some steroids, medications for epilepsy and diabetes, and some medications used to treat mental illness - including some antidepressants and medicines for schizophrenia - can contribute to weight gain.

Weight gain can sometimes be a side effect of stopping smoking.

# data[].attributes.attachment_link.description
Read about the main cause of obesity - eating too much and moving too little. Genetics, underlying health conditions and taking certain medications can also contribute to weight gain.

# data[].attributes.attachment_link.readable_text
Scale of the obesity problem

Nearly two-thirds of adults (63%) in England were classed as being overweight (a body mass index of over 25) or obese (a BMI of over 30) in 2015.

In England, the proportion who were categorised as obese increased from 13.2% of men in 1993 to 26.9% in 2015 and from 16.4% of women in 1993 to 26.8% in 2015. The rate of increase has slowed down since 2001, although the trend is still upwards.

The prevalence of obesity is similar among men and women, but men are more likely to be overweight.

In 2015 to 2016, 19.8% of children aged 10 to 11 were obese and a further 14.3% were overweight. Of children aged 4 to 5, 9.3% were obese and another 12.8% were overweight. This means a third of 10 to 11 year olds and over a fifth of 4 to 5 year olds were overweight or obese.

In summary, nearly a third of children aged 2 to 15 are overweight or obese and younger generations are becoming obese at earlier ages and staying obese for longer.

It is estimated that obesity is responsible for more than 30,000 deaths each year. On average, obesity deprives an individual of an extra 9 years of life, preventing many individuals from reaching retirement age. In the future, obesity could overtake tobacco smoking as the biggest cause of preventable death.

Obesity increases the risk of developing a whole host of diseases. Obese people are:

at increased risk of certain cancers, including being 3 times more likely to develop colon cancer

more than 2.5 times more likely to develop high blood pressure - a risk factor for heart disease

5 times more likely to develop type 2 diabetes

Reducing obesity, particularly among children, is one of the priorities of Public Health England ( PHE). PHE aims to increase the proportion of children leaving primary school with a healthy weight, as well as reductions in levels of excess weight in adults.

PHE is working to significantly reduce childhood obesity, contributing to the delivery of the government's Childhood Obesity Plan.

The costs of obesity

Failing to address the challenge posed by the obesity epidemic will place an even greater burden on NHS resources. It is estimated that the NHS spent £6.1 billion on overweight and obesity-related ill-health in 2014 to 2015.

Annual spend on the treatment of obesity and diabetes is greater than the amount spent on the police, the fire service and the judicial system combined.

Obesity can harm people's prospects in life, their self-esteem and their underlying mental health. Research published in the BMJ found that people who are obese or overweight are less likely to exercise in public as they feel discriminated against because of their weight.

More broadly, obesity has a serious impact on economic development. The overall cost of obesity to wider society is estimated at £27 billion.

The UK-wide NHS costs attributable to overweight and obesity are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year.

Obesity and health inequalities

No one is 'immune' to obesity, but some people are more likely to become overweight or obese than others. The Marmot review highlights that income, social deprivation and ethnicity have an important impact on the likelihood of becoming obese.

There is a strong relationship between deprivation and childhood obesity. Analysis of data from the National Child Measurement Programme (NCMP) shows that obesity prevalence among children in both Reception and Year 6 increases with increased socioeconomic deprivation (measured, for example, by the 2010 Index of Multiple Deprivation (IMD) score). Obesity prevalence in the most deprived 10% of children is approximately twice that of the least deprived 10%.

On average, there are more fast food outlets in deprived areas than in more affluent areas.

People from certain ethnic groups, such as south Asians, are more likely to be overweight and obese, and have a higher susceptibility to particular diseases linked to excess weight, such as type 2 diabetes.

Factors behind the rise in obesity levels

Obesity is a complex problem with many drivers, including:

The main risk factors for obesity are:

1.The food and drink environment

The PHE Eatwell Guide provides a compelling evidence base for eating a healthy diet, and ignoring this advice increases the chances of becoming obese.

But many people still find it difficult to eat healthily. This is primarily because we are living in an obesogenic environment where less than healthier choices are the default, which encourage excess weight gain and obesity.

The Foresight report states that while achieving and maintaining calorie balance is a consequence of individual decisions about diet and activity, our environment, and particularly the availability of calorie-rich food, now makes it much harder for individuals to maintain healthier lifestyles.

The increasing consumption of out-of-home meals - that are often cheap and readily available at all times of the day - has been identified as an important factors contributing to rising levels of obesity.

PHE estimated in 2014 that there were over 50,000 fast food and takeaway outlets, fast food delivery services, and fish and chip shops in England.

More than one quarter (27.1%) of adults and one fifth of children eat food from out-of-home food outlets at least once a week. These meals tend to be associated with higher energy intake; higher levels of fat, saturated fats, sugar, and salt, and lower levels of micronutrients.

This edition of Health Matters focuses specifically on what can be done to improve the food environment in which we live through the use of PHE's Strategies for encouraging healthier 'out of home' food provision toolkit.

2.Physical inactivity

Put simply, we are not burning off enough of the calories that we consume. People in the UK are around 20% less active now than in the 1960s. If current trends continue, we will be 35% less active by 2030.

We are the first generation to need to make a conscious decision to build physical activity into our daily lives. Fewer of us have manual jobs. Technology dominates at home and at work, the 2 places where we spend most of our time. Societal changes have designed physical activity out of our lives.

Figures from the Health Survey for England show that 67% of men and 55% of women aged 16 and over do at least 150 minutes of moderate physical activity per week.

Only 22% of children aged between 5 and 15 met the physical activity guidelines of being at least moderately active for at least 60 minutes every day (23% of boys, 20% of girls).

Read the Health matters edition on physical activity for more advice on embedding physical activity into everyday life.

PHE 's plan to tackle obesity includes looking at behaviour change relating to healthier eating and increasing physical activity as part of a whole systems approach.

Improving everyone's access to healthier food choices

The PHE toolkit, 'Strategies for encouraging healthier "out of home" food provision' has been developed to encourage local intervention that will further increase the opportunities for communities to access healthier food whilst out and about in their local community. It outlines opportunities both to manage new business applications and to work with existing food outlets to provide healthier food.

The toolkit has been created to help local authorities across England work with smaller food outlets such as:

takeaways

restaurants

bakers

sandwich and coffee shops

mobile traders

market stalls

corner shops

leisure centres

children's centres and private nurseries

Understanding barriers to change

Understanding the limitations to offering healthier food and drinks is vital to the development of healthier interventions. For example, food outlets in low income areas can face particular barriers to offering healthier food and drink choices, such as highly competitive, price-sensitive markets, and a real or perceived lack of demand for healthier food and drink.

Smaller outlets often struggle to be profitable and many aspects of low-income neighbourhoods make change difficult. A study by London Metropolitan University of fast food outlets in deprived areas found that barriers to change included:

limited menus with little scope for healthier changes

lack of space and the right equipment, or skills and resources to prepare or cook healthier options

a fear that fresh fruit and vegetables would be wasted and lose the outlets money

the higher cost of healthier options. (some suppliers charge more for healthier products and additional costs cannot be passed on to the customer)

the lack of availability of healthier options in appropriate sizes for small outlets, that may only need small quantities

a fear that some changes, such as reducing salt, would affect the taste and deter customers

a reluctance to change popular recipes or traditional ethnic cuisines

supporting business to offer healthier food and drink

Healthier catering can save businesses money. Strategies for encouraging outlet participation should emphasise that changes that are cost neutral may save the outlet money or attract new customers. For example, by providing smaller portions, using less oil, or promoting healthier products.

How local authorities can help businesses offer healthier food and drink

An increasing number of local councils have developed healthier catering initiatives in recent years. These are generally led and managed by staff from environmental health or trading standards teams who are able to build on their established relationships with local outlets.

The initiatives encourage outlets to switch to healthier ingredients, menus and cooking practices. They focus particularly on reductions in salt, fat and sugar, smaller portions, and inclusion of more fruit and vegetables and the provision of calorie information.

They frequently draw on behavioural economics, encouraging consumers to make healthier choices through, for example, promoting the sale of food in smaller containers or the placing of healthier drinks at eye level.

Schemes can be classified depending on:

the types of outlet targeted, for example by food type or outlet type or single/small chain

whether or not an award is offered

whether the scheme is targeted at a specific geographical area or across the whole local authority

PHE's healthier catering guidance for different types of businesses supports the toolkit and provides tips on providing and promoting healthier food and drink for children and families.

Using planning policies to tackle obesity

Planning policies can be used by councils to help promote healthier food and drink choices. The PHE toolkit outlines a number of suggestions for planning teams to create a healthier food environment such as:

ensuring shops and markets that sell a diverse food offer are easy to reach by walking, cycling or public transport

requiring leisure centres, workplaces, schools and hospitals with catering facilities and/or vending machines to have a healthier food offer for staff, students, and/or customers

ensuring development avoids over-concentration of hot food takeaways in existing town centres or high streets, and restricts their proximity to schools or other facilities for children and young people and families

Restricting the opening of new hot food takeaway outlets

Planning documents and policies to control the over-concentration and proliferation of hot food takeaways should form part of an overall plan for tackling obesity and should involve a range of different local authority departments and stakeholders.

Once appropriate planning policies are in place, supported by local evidence, local councils can refuse planning permission for a new food outlet if they can demonstrate that:

it will have an adverse impact on the health and wellbeing of the local population

will undermine the local authority's strategy to tackle obesity

NICE's pathway on tackling obesity through working with local communities calls for empowering local authorities to influence planning permission for food retail outlets in relation to preventing and reducing obesity.

To achieve this, the following are among the measures that should be considered:

encourage local planning authorities to restrict planning permission for takeaways and other food retail outlets in specific areas, such as within walking distance of schools

review and amend 'classes of use' orders for England to address disease prevention via the concentration of outlets in a given area

An increasing number of local councils have developed Supplementary Planning Documents (SPDs) to restrict the opening of new hot food takeaways close to schools, leisure centres, or other places frequented by children. It is up to each local council to develop an approach that, according to existing evidence, is likely to be appropriate and effective.

For planning decisions to be successfully upheld they need to be able to demonstrate a link to sound evidence and clear local policy. In particular there needs to be good linkage between any SPDs or neighbourhood planning policies, health strategies (Health and Wellbeing strategy and the Joint Strategic Needs Assessment) and, most importantly, the Local Plan. Local plans need to refer to these health strategies and vice versa.

Restricting the proliferation of new fast food outlets benefits the whole community by:

reducing the amount of litter in the area

cutting down on discarded food waste and litter, which can stop foraging animals and pests

improving the visual appeal of the local environment and reducing night-time noise

reducing traffic congestion caused by short-term car parking outside takeaways

improving access to healthier food in deprived communities, which may contribute to reducing health inequalities

Working with schools

Children need a healthy balanced diet to support growth and development, and the school environment can have a powerful influence on their eating habits. Children eat at least 1 and sometimes more meals there each day. For some, a school lunch is their main meal, providing a critical nutritional safety net.

With a significant proportion of secondary, and even some primary age pupils, choosing to purchase food from nearby outlets, the food environment around schools has an important role to play in encouraging children and young people to eat a healthy diet.

The PHE toolkit outlines the role schools can play in encouraging healthier eating. Schools can adopt a number of policies to encourage pupils to purchase their lunch from the school canteen. These include:

consulting with children on the food offer and school canteen via school nutrition action groups

making the canteen environment more attractive by use of, for example, shorter lunch queues, music and improved décor

adopting cashless systems to speed up food service and remove the need for pupils to be given cash that might be spent outside school on less healthy alternatives

closed gate or onsite policies

offering meal deals, subsidised or free school meals

getting pupils, as part of the curriculum, to analyse local food outlet offers and develop and trial healthier, tastier food options, which can encourage change in choices

National policies to tackle obesity

A soft drinks industry levy

The government's childhood obesity plan outlined plans for a soft drinks industry levy across the UK. Sugary soft drinks provide 26% of the total sugar intakes for 11 to 18 year olds in England, according to the National Diet and Nutrition Survey. The Scientific Advisory Committee on Nutrition (SACN) recently concluded that sugar consumption increases the risk of consuming too many calories. A single 330ml can of a soft drink with added sugar (which can contain as much as 35g of sugar), may instantly take a child over their maximum recommended daily intake of sugar.

In England, the revenue from the levy will be invested in programmes to reduce obesity and encourage physical activity and balanced diets for school age children.

Sugar reduction

Evidence shows that slowly changing the balance of ingredients in everyday products, or making changes to product size, is a successful way of improving diets. This is because the changes are universal and do not rely on individual behaviour change.

A broad, structured sugar reduction programme is being led by PHE to remove sugar from the products children eat most. All sectors of the food and drinks industry will be challenged to reduce overall sugar, across a range of products that contribute to children's sugar intakes, by at least 20% by 2020, including a 5% reduction in year 1.

This programme will apply to all sectors of industry (retailers, manufacturers and the out-of -home sector) and to all foods and drinks that contribute to children's sugar intakes, including those aimed at very young children.

The programme will initially focus on the nine categories of family everyday foods that make the largest contributions to children's sugar intakes:

1. breakfast cereals

2. yoghurts

3. biscuits

4. cakes

5. confectionery

6. morning goods eg croissants, muffins, crumpets, pastries

7. puddings

8. ice cream

9. sweet spreads, toppings, sauces

PHE's marketing campaigns

PHE has a number of national marketing campaigns that can be used at a local level to encourage people to improve their lifestyle behaviours. Downloadable content is available from the PHE campaign centre.

Change4Life has advice on how to reduce the amount of sugar that children consume, as well as the free Be Food Smart app which can be used to find out how much sugar, saturated fat and salt is in food and drink.

PHE's One You campaign is aimed at adults, aged 40 to 60, and contains advice on healthy eating including recipes, an alcohol checker to monitor alcohol consumption, and tips for encouraging physical activity.

Call to action

Influencing the food environment so that healthier options are accessible, available and affordable can only be accomplished through a collaborative approach, with effective partnerships and co-ordinated action at a local level across the public, private and voluntary sectors, with councils taking this forward through their leadership.

Local authorities

Establish strategic partnerships across relevant local council departments (for example, planning, economic development and public health), and work with local partners such as schools, the community and the supply chain as part of a whole systems approach.

Identify local needs (for example, through mapping levels of obesity, deprivation and location or density of fast food outlets) to support targeting. PHE has data on obesity and tools to help support this.

Encourage a cost neutral approach for small food business with small gradual changes less likely to be noticed by customers. Offer incentives such as free training on food hygiene or nutrition.

Involve local communities, working with practitioners, in initiatives designed to help local outlets create a healthier food offer to raise awareness of the importance of healthier eating habits, and help increase the pressure on outlets to make changes.

Small food businesses

Should work with the supply chain to encourage healthier procurement, which could be through LA Healthier Catering Schemes or Awards.

Look at structural changes to achieve sustained behavioural change. These could include reducing the price of healthier foods, increasing the availability of healthier options, reducing pack size, portion control and calorie labelling on menus.

Businesses should signpost customers to healthier options with less salt, saturated fat, sugar and calories on menus.

Schools

Schools can focus initiatives, through a whole school approach, to improve pupils' eating habits on both the 'in-school' and 'out of school' food environment.

They should look at policies to encourage pupils to purchase their lunch from the school canteen, including via consulting with children on the food offer and the school canteen.

Town planners

Supported by local evidence, and working alongside public health teams, town planners can develop planning documents and policies to support the creation of healthy environments promoting opportunities for the production and consumption of healthier food, and restricting the proliferation of hot food takeaways.

Look for the win wins such as limiting takeaways may help with reducing the amount of litter in improve the visual appeal of the local environment.

The local council, using its leasing and licensing powers, can influence the provision of healthier food in outlets operating from sites it owns or controls.

Health professionals

Health professionals, including pharmacists, nurses and GPs, should feel confident discussing nutrition and weight issues with children, their families and adults. They can advise on the importance of following a healthy, balanced diet in line with recommendations outlined in the PHE Eatwell Guide.

Health Education England (HEE) and PHE have launched a suite of resources aimed at supporting the health care and wider workforce in 'Making Every Contact Count'.

Where appropriate, health professionals should refer people to local weight management services, clubs and websites, if they ask for more advice.

Resources
Download infographics Case study: Box Chicken - providing healthy competition to fast food outlets Case study: planning document to limit the proliferation of takeaways Health matters blog Health matters videos

# data[].attributes.attachment_link.title
Health matters: obesity and the food environment

# data[].attributes.attachment_link.description
Nearly two-thirds of adults (63%) in England were classed as being overweight (a body mass index of over 25) or obese (a BMI of over 30) in 2015. In England, the proportion who were categorised as obese increased from 13.2% of men in 1993 to 26.9% in 2015 and from 16.4% of women in 1993 to 26.8% in 2015.

# data[].attributes.attachment_link.readable_text
Latest Events & News

Here are our opening times over the Christmas period! Read more

The 50+ Crowd has been awarded a grant to help improve digital skills and access for members of the group. Read more

Introducing a huge collaborative effort between BDP, Terrence Higgins Trust and Unity Sexual Health to target blood-borne viruses in Bristol. Read more

# data[].attributes.attachment_link.description
Latest Events & News Here are our opening times over the Christmas period! Read more The 50+ Crowd has been awarded a grant to help improve digital skills and access for members of the group. Read more Introducing a huge collaborative effort between BDP, Terrence Higgins Trust and Unity Sexual Health to target blood-borne viruses in Bristol.

# data[].attributes.body
Effect of COVID-19 lockdown on alcohol consumption in patients with pre-existing alcohol use disorder

# data[].attributes.attachment_link.provider_name
The Lancet Gastroenterology & Hepatology

# data[].attributes.attachment_link.readable_text
We agree with the Editorial in the July, 2020, issue of The Lancet Gastroenterology & Hepatology, which emphasised the concerning long-term implications of lockdowns implemented to flatten the epidemic curve of COVID-19 on the health behaviour of individuals with alcohol-use disorder.

A complex interplay of heightened financial difficulties, social isolation, uncertainty about the future, and the redistribution of the health workforce and the disruption to clinical services could contribute to increased alcohol intake and relapse under lockdown conditions, and, subsequently, contribute to further liver-associated complications via direct injury or through late presentations to the appropriate services.

Lockdown is a complex social phenomenon that provokes different behavioural responses: a population survey of 1555 active drinkers in the UK identified that 21% increased alcohol consumption during the lockdown, while 35% reduced their alcohol intake.

The true effect of the lockdown on alcohol intake remains unknown because of a paucity of qualitative data.

2 months after lockdown was declared in the UK (March 23, 2020), we did a cross-sectional telephone survey of patients with pre-existing alcohol disorders registered since 2017 in the alcohol clinic of St Mary's Hospital, London. From May 21 to June 10, 2020, 322 (70%) of 462 patients from the database were contacted and 182 (57%) agreed to participate ( appendix). The survey was done in English using a standardised questionnaire by two trained clinicians (JUK, AM).

Participants were mainly male (133 [73%] men, 49 [27%] women) and of white ethnicity (141 [78%]), with a median age of 57 years (IQR 49-66). 42 (23%) of the 182 participants were hazardous drinkers and 71 (39%) were moderate-severe alcohol users before lockdown, as assessed by AUDIT score. Of the 182 participants, 43 (24%) reported an increase in their alcohol intake, with a mean increase in the AUDIT score of 57·6%, and a mean weekly consumption of 82·5 units (SD 78). 34 (19%) reported a decrease in their alcohol intake. Although some parameters such as age, mood, and some social conditions differed between those who had increased, decreased, or had an unchanged consumption of alcohol during the lockdown ( appendix), a multivariate analysis identified only the pre-lockdown AUDIT score and percentage change of AUDIT score from before to during lockdown as factors associated with increased alcohol intake during lockdown.

69 (38%) patients were classified as abstinent before lockdown, with a mean abstinence period of 19·5 months (SD 22). Of this subgroup, 12 (17%) relapsed during lockdown. Mean AUDIT score within the relapse group at the time of our survey was 15·7 (SD 9·6), representing a 226% mean increase from before lockdown, with a mean weekly consumption of 48·8 units (SD 63) during lockdown. Of the 113 individuals who were previously drinking before the lockdown, 14 (12%) became newly abstinent since the beginning of lockdown.

Among all participants, 55 (30%) had either a virtual or face-to-face contact with the clinic during lockdown; 19 (44%) of the 43 individuals who had increased alcohol consumption had a clinic appointment, compared with 36 (26%) of the 139 individuals with decreased alcohol consumption or for whom consumption remained the same (p=0·035; odds ratio [OR] 0·586, 95% CI 0·378-0·908). Of the subgroup of patients who had a virtual or face-to-face consultation during the lockdown, 13 (24%) had contact specifically with an alcohol specialist nurse. Univariate analysis revealed that those who had contact with a specialist nurse were more likely to become newly abstinent, compared with those who did not have contact (two [100%] of two vs two [12%] of 17; p=0·035; OR 1·118, 95% CI 0·032-0·432); a positive trend was observed for reduced relapse during lockdown, occurring after alcohol nurse contact (six [18%] of 33 vs three [60%] of five; p=0·075; OR 0·303, 95% CI 0·110-0·839).

We emphasise several points. First, lockdown causes different behavioural changes on alcohol intake, with about 20% of individuals increasing or decreasing their normal alcohol consumption. Although psychosocial distress has been well recognised as a risk of relapse and increased alcohol consumption,

the reduction might be associated with decreased financial ability and the decreased availability of on-site alcohol areas (eg, pubs or bars).

Second, we found no distinct protective factors for relapse, suggesting that pre-lockdown abstinence status is not protective against lockdown-related relapse. The mean duration of abstinence before relapse was long, which has been previously identified as a strong predictor of continuous abstinence.

Lockdown might overshadow this paradigm. Third, those who relapsed had a clinically significant average level of alcohol consumption of nearly 49 units weekly post-relapse, which is concordant with previous studies of a high risk of harmful drinking after relapse.

Finally, in a subgroup of patients who had clinical contact during lockdown, contact with an alcohol nurse specialist was a positive predictor for reducing relapse and improving new abstinence. Nonetheless, these findings should be interpreted with caution because of the small sample size of this subgroup. Our data represent a cross-sectional perspective of alcohol disorders during COVID-19 lockdown; any further changes that might present if lockdown conditions change remain to be elucidated.

In summary, lockdown represents a risk factor for increasing alcohol consumption in people with alcohol use disorders and relapse for those who were previously abstinent. Those who do relapse are at a high risk of harmful drinking and require a tailored approach for follow-up and intervention. Support from alcohol liaison services could prevent relapse during lockdown.

We declare no competing interests.

References

1. 1.
The Lancet Gastroenterology & Hepatology

Drinking alone: COVID-19, lockdown, and alcohol-related harm.

: 625

2. 2.

Alcohol use in times of the COVID 19: implications for monitoring and policy.

: 301-304

3. 3.

Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis?.

: e259

4. 4.

COVID-19 hangover: a rising tide of alcohol use disorder and alcohol-associated liver disease.

5. 5.

Covid-19 and alcohol-a dangerous cocktail.

m1987

6. 6.

Drinking during lockdown: headline findings.

7. 9.

Assessment of the risk of alcohol relapse following liver transplantation for alcoholic hepatitis using a meta-analysis approach.

: 1322-1323

Article Info

Publication History

Identification

DOI: https://doi.org/10.1016/S2468-1253(20)30251-X

ScienceDirect
Access this article on ScienceDirect

# data[].attributes.attachment_link.title
Effect of COVID-19 lockdown on alcohol consumption in patients with pre-existing alcohol use disorder

# data[].attributes.attachment_link.description
We agree with the Editorial in the July, 2020, issue of The Lancet Gastroenterology & Hepatology, which emphasised the concerning long-term implications of lockdowns implemented to flatten the epidemic curve of COVID-19 on the health behaviour of individuals with alcohol-use disorder.1 A complex interplay of heightened financial difficulties, social isolation, uncertainty about the future, and the redistribution of the health workforce and the disruption to clinical services could contribute to increased alcohol intake and relapse under lockdown conditions, and, subsequently, contribute to further liver-associated complications via direct injury or through late presentations to the appropriate services.

# data[].attributes.attachment_link.readable_text
FREE Advice including NHS & Private Options

Bespoke Treatment Options For All Addictions

Access to Hundreds of Drug & Alcohol Rehab Centres

Direct Access To Treatment Counsellors

Help & Support for Families

We offer a free callback service 24/7. Simply enter your number below and our addiction counsellors will call you back in a few minutes.

Welcome to UK Rehab - your source of drug and alcohol rehab information. We find you the most appropriate addiction treatment in London, across the UK and worldwide. If you or someone you know has a problem with drug or alcohol dependence, or any form of substance abuse, contact us today.
Our addiction service is completely confidential.

Find local addiction Help

Detox Rehab

The most effective addiction treatment is in a drug & alcohol rehab clinic. Our network includes the most successful rehab centers for alcoholics and drug addicts in London, the UK and overseas.

Finding the right rehab clinic can seem daunting and you may feel you can't do it alone. You don't have to - we're here to help. Contact us today and we'll find you the best place in which to recover from your drug or alcohol problem.

Rehabilitation

If you, or someone you know, suffer from alcoholism, drug addiction or any other form of addiction or dependency, rehabilitation is the most dependable way of fighting the disease. At UK Rehab we help people with dependencies find the best treatment for their addictions at the right treatment centres - which might be residential private rehab clinics or a community-based treatment such as cognitive behavioural therapy or specialist support group. It's a fully devoted addiction service, so contact us now to seek immediate help and start living life the way it should be lived.

Effective rehabilitation restores confidence, strength and motivation, and is the safest route back to a more normal way of life. It's a process that varies from person to person, depending on attitude, personal circumstances, and the nature of the dependency. Whatever the addiction, the first step will always be to deprive the addict of the substance or access to the habit to which they're addicted. For drug and alcohol addictions, this entails detoxification. Understandably, addicts worry about the difficulty of detox. But detoxifying in private treatment centres makes the detox process as safe, controlled and quick as it can be, managing withdrawal symptoms, and providing access to the right medical and therapeutic support.

After detoxification, the next step in rehabilitation will be counselling. Rehab counselling looks to pinpoint the root of the addiction and the reasons that the dependency developed and took hold. By spending time with a trained addiction counsellor, addicts learn how to avoid relapse, manage the psychological withdrawal symptoms that may linger after the physical withdrawal symptoms have been vanquished, and how to bypass the situations and individuals that may have been contributing to or aiding the continued addiction. Addiction therapy is a critical part of rehabilitation treatments, not only demonstrating to addicts the causes and effects of their dependency, but treating the underlying psychological issues which create an addiction cycle. It's often said that there's no cure for addiction, but with expert therapy and counselling, addicts stand the best chance of beating their addiction for good.

If you know that you're suffering an addiction which is detrimental to your health, lifestyle, work, family, friends or finances, get in touch with us now, and we can help you start repairing the damage. If you're concerned about a friend, family member or co-worker who you fear may be an addict, call us for some advice, or read up on family interventions to find out how to begin the process of rehabilitation.

Drug rehab help

It's estimated that as many as a third of the UK adult population has taken illegal drugs in their lifetimes. There's a difference of course between recreational drug use, drug abuse and drug addiction, but with cannabis, illegal pharmaceuticals, and Class A drugs all arguably more accessible than ever before, the risk of more casual drug users developing psychological and physiological addictions increases. Of course not all people seeking drug rehab help have developed dependencies through using recreational drugs; certain painkillers, tranquilisers, and antidepressants such as Prozac, for example, are prescription pharmaceuticals which can prove extremely addictive and ultimately dangerous and harmful for the user. The reality is that drug rehabilitation can rarely be achieved by the individual without help and support. If you are worried that you may have crossed the lines between drug use and drug abuse, or drug abuse and drug addiction, contact us now for immediate advice and support. If you fear that you've seen signs of drug abuse in someone you care about, contact us now to find out how to arrange family interventions and arrange fast and effective drug rehab help at the right treatment centres.

There are a large number of drugs available which can prove addictive to varying degrees: cocaine, ecstasy, heroin, LSD, methamphetamine, PCP, marijuana and more. For many drug abusers - particularly those using powerfully drugs which cause a physical dependency, such as heroin, crack cocaine and certain prescription medications, the first stage of drug rehabilitation - detoxification - should happen at a private drug treatment clinic. As with alcohol rehabilitation, drug rehabilitation can require close monitoring and supervision in a clinical environment because of the damaging side effects of detox, the management of withdrawal symptoms and the need to administer medication. Different treatment centres take different approaches to detoxifying drug addicts, depending on the drug and the individual's personal circumstances. So a residential detox programme may be advocated at a private drug treatment clinic, or recovery may be possible on an outpatient basis at a local treatment centre.

After detox, drug rehabilitation may include one or a combination of psychotherapy, counselling, group therapy, CBT or pharmaceutical maintenance therapies, depending on the chemical, mental, emotional and physical effects of the particular addiction.

We work with an extensive network of private rehab clinics to ensure the most appropriate drug rehabilitation programme for the individual and their personal, professional and family needs. Contact us now to arrange a clinical intervention if you know someone who you think is abusing drugs or has become a drug addict, and if you're worried about your own drug use, get in touch for immediate advice, support, and treatment.

Get Confidential Help Now

Our trained addiction counsellors are
on hand 24 hours a day

We'll help you find help near you.

If you are experiencing problems as a result of your alcohol or drug use, or if you are drinking or using drugs to cope with existing problems, our National Addiction Treatment & Rehabilitation Directory contains over 700 addiction treatment services that may be able to help you when you decide to do something about them.

# data[].attributes.attachment_link.title
Drug Rehab | Alcohol Rehab | Addiction - Rehab Information

# data[].attributes.attachment_link.description
FREE Advice including NHS & Private Options Bespoke Treatment Options For All Addictions Access to Hundreds of Drug & Alcohol Rehab Centres Direct Access To Treatment Counsellors Help & Support for Families We offer a free callback service 24/7. Simply enter your number below and our addiction counsellors will call you back in a few minutes.

# data[].attributes.attachment_link.readable_text
Information about Covid19:
Please read our information on how we are supporting residents and businesses, as well as information on affected services.

Community and health based profiles provide a snapshot overview of the population across Cornwall. They help build an understanding of our population and are used to help inform plans, strategies and funding bids.

Community Profiles allow you to find, explore and use a wide range of facts and figures at different geographic levels for Cornwall, highlighting variations and how areas compare against others across Cornwall.

Community Network Health Profiles provide summary health indicators for each of the 19 Community Network Areas across Cornwall.

Health Profiles provide summary health indicators showing how the latest Cornwall Health Profile compares to the national average.

Kernow CCG Pack provides information covering a wide range of areas

Context - population, births, socio-economic data, risk factors - data on smoking, alcohol, exercise, diet and obesity, alcohol - risky behaviours and hospital admissions, conditions managed in primary care - information on condition specific emergency admissions by practice; and service user views - opinions on GP practices based on the patient survey.

General Practice (GP) Profiles provide access to individual practice profiles where each practice can be compared with the CCG and England, and also with the practice deprivation decile.

Mental Health

Children and young people mental health and wellbeing profile collates and analyses a range of data on risk, prevalence and detail (including cost data) on those services that support children with, or vulnerable to, mental illness.

Neurology profile illustrates health statistics around emergency hospital admissions for twelve common neurological conditions and a more detailed analysis of an epilepsy care pathway.

Co-existing substance misuse and mental health issue profile provides data around tobacco smoking, alcohol use and drug use, including data on prevalence, risk factors, treatment demand and treatment response for Cornwall and enables benchmarking against other areas.

Common mental health disorders profile contains key indicators which help assess and benchmark indicators linked to this condition.

Severe mental illness profile presents collated risk, prevalence, early intervention, assessment and treatment, outcomes and service costs data relating to people with severe mental illness. It also provides a set of high level indicators that relate to the psychosis care pathway.

Public Health Programmes

The NHS Health Check programme is for those aged 40 to 74 and aims to help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia. This profile provides a set of indicators to help understand how Cornwall performs against the national average.

The National Child Measurement Programme (NCMP) shows the prevalence of underweight, healthy weight, overweight, and obesity for children in Reception (age 4-5 years) and Year 6 (age 10-11 years).

Disease and Long Term Conditions

The Cancer profile gives a 'snapshot' overview of cancer within Cornwall and how this relates to the national average.

The Liver disease profile gives a 'snapshot' overview of liver disease and associated risk factors within Cornwall and how this relates to the national average.

The Cardiovascular profile is made up of five chapters which look at risk factors, coronary heart disease (CHD), diabetes, kidney disease and stroke. Each profile compares Cornwall with data for England, a group of similar CCGs and its strategic clinical network (SCN).

The Learning disability profile provides a range of data about people with learning disabilities comparing Cornwall to the SW Region, and England.

The Diabetes profile gives a 'snapshot' overview of diabetes and associated risk factors. Each profile compares Cornwall with data for England, a group of similar CCGs and its strategic clinical network (SCN).

The Hypertension profile compares how Cornwall is detecting and treating high blood pressure in comparison to the SW Region and England.

Children and Young Peoples Health

Breastfeeding - reports on women seen by a healthcare professional within 12 weeks and 6 days of their maternity, those mothers' breastfeeding and the number of infants breastfed at 6-8 weeks.

Early Years - health profile of public health outcomes relating to early years (children aged 0-5 years).

Infant Mortality and Stillbirths - show performance at both local authority and clinical commissioning group (CCG) level so they can be compared locally and nationally.

School Age Children - show how your local area is performing and compares the data with other local authorities and nationally.

Young People - shows performance against the national average and local areas.

Children and Young Peoples Mental Health Profile - data comparing local area against other local authorities and nationally, presented under Risk and Related Factors, Prevalence, Health, Social Care and Education.

Community and health based profiles provide a snapshot overview of the population across Cornwall. They help build an understanding of our population and are used to help inform plans, strategies and funding bids.

Community Profiles allow you to find, explore and use a wide range of facts and figures at different geographic levels for Cornwall, highlighting variations and how areas compare against others across Cornwall.

Continue reading

Community Network Health Profiles provide summary health indicators for each of the 19 Community Network Areas across Cornwall.

Health Profiles provide summary health indicators showing how the latest Cornwall Health Profile compares to the national average.

Kernow CCG Pack provides information covering a wide range of areas

Context - population, births, socio-economic data, risk factors - data on smoking, alcohol, exercise, diet and obesity, alcohol - risky behaviours and hospital admissions, conditions managed in primary care - information on condition specific emergency admissions by practice; and service user views - opinions on GP practices based on the patient survey.

General Practice (GP) Profiles provide access to individual practice profiles where each practice can be compared with the CCG and England, and also with the practice deprivation decile.

Children and young people mental health and wellbeing profile collates and analyses a range of data on risk, prevalence and detail (including cost data) on those services that support children with, or vulnerable to, mental illness.

Neurology profile illustrates health statistics around emergency hospital admissions for twelve common neurological conditions and a more detailed analysis of an epilepsy care pathway.

Co-existing substance misuse and mental health issue profile provides data around tobacco smoking, alcohol use and drug use, including data on prevalence, risk factors, treatment demand and treatment response for Cornwall and enables benchmarking against other areas.

Common mental health disorders profile contains key indicators which help assess and benchmark indicators linked to this condition.

Severe mental illness profile presents collated risk, prevalence, early intervention, assessment and treatment, outcomes and service costs data relating to people with severe mental illness. It also provides a set of high level indicators that relate to the psychosis care pathway.

The NHS Health Check programme is for those aged 40 to 74 and aims to help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia. This profile provides a set of indicators to help understand how Cornwall performs against the national average.

The National Child Measurement Programme (NCMP) shows the prevalence of underweight, healthy weight, overweight, and obesity for children in Reception (age 4-5 years) and Year 6 (age 10-11 years).

The Cancer profile gives a 'snapshot' overview of cancer within Cornwall and how this relates to the national average.

The Liver disease profile gives a 'snapshot' overview of liver disease and associated risk factors within Cornwall and how this relates to the national average.

The Cardiovascular profile is made up of five chapters which look at risk factors, coronary heart disease (CHD), diabetes, kidney disease and stroke. Each profile compares Cornwall with data for England, a group of similar CCGs and its strategic clinical network (SCN).

The Learning disability profile provides a range of data about people with learning disabilities comparing Cornwall to the SW Region, and England.

The Diabetes profile gives a 'snapshot' overview of diabetes and associated risk factors. Each profile compares Cornwall with data for England, a group of similar CCGs and its strategic clinical network (SCN).

The Hypertension profile compares how Cornwall is detecting and treating high blood pressure in comparison to the SW Region and England.

Breastfeeding - reports on women seen by a healthcare professional within 12 weeks and 6 days of their maternity, those mothers' breastfeeding and the number of infants breastfed at 6-8 weeks.

Early Years - health profile of public health outcomes relating to early years (children aged 0-5 years).

Infant Mortality and Stillbirths - show performance at both local authority and clinical commissioning group (CCG) level so they can be compared locally and nationally.

School Age Children - show how your local area is performing and compares the data with other local authorities and nationally.

Young People - shows performance against the national average and local areas.

Children and Young Peoples Mental Health Profile - data comparing local area against other local authorities and nationally, presented under Risk and Related Factors, Prevalence, Health, Social Care and Education.

# data[].attributes.attachment_link.description
Information about Covid19: Please read our information on how we are supporting residents and businesses, as well as information on affected services. Community and health based profiles provide a snapshot overview of the population across Cornwall. They help build an understanding of our population and are used to help inform plans, strategies and funding bids.

# data[].attributes.attachment_link.readable_text
The Definition Of Alcoholism

Alcoholism is the most severe form of alcohol abuse and involves the inability to manage drinking habits. It is also commonly referred to as alcohol use disorder. Alcohol use disorder is organized into three categories: mild, moderate and severe. Each category has various symptoms and can cause harmful side effects. If left untreated, any type of alcohol abuse can spiral out of control.

Individuals struggling with alcoholism often feel as though they cannot function normally without alcohol. This can lead to a wide range of issues and impact professional goals, personal matters, relationships and overall health. Over time, the serious side effects of consistent alcohol abuse can worsen and produce damaging complications.

You don't have to suffer from alcohol addiction in silence. There are many treatment options available to help you overcome alcohol abuse and achieve long-term sobriety.

The biggest struggle in my life was the constant feeling of emptiness and being alone. Substances turned on me and they were no longer fun nor a solution. My addiction put me in risky situations... Quitting was out of question, I was powerless.

Paid Advertising. We may receive advertising fees if you follow links to promoted websites.

Warning Signs Of Alcoholism

Sometimes the warning signs of alcohol abuse are very noticeable. Other times, they can take longer to surface. When alcohol addiction is discovered in its early stages, the chance for a successful recovery increases significantly.

Common signs of alcoholism include:

Being unable to control alcohol consumption

Craving alcohol when you're not drinking

Putting alcohol above personal responsibilities

Feeling the need to keep drinking more

Spending a substantial amount of money on alcohol

Behaving differently after drinking

If you feel as though your alcohol consumption is taking a toll on your life, it's important to find treatment options that will help you kick your alcohol addiction to the curb. Your doctor will be able to offer professional medical assistance if you are concerned about your drinking. Seeking help for alcoholism sooner rather than later gets you back on track to living a healthy, fulfilling life.

Reasons Why People Drink

Many factors can increase the risk of alcohol abuse. People may turn to alcohol for one reason and gradually develop a dependency on drinking. For example, drinking during difficult times - a death in the family or job loss - can potentially trigger long-term alcohol abuse.

While there are various reasons as to why people start drinking, some of the most common are to:

Relieve Stress

Relying on alcohol to reduce daily life stressors can impact the likelihood of developing alcoholism. Since alcohol is a depressant and a sedative, drinking produces feelings of pleasure. However, frequent drinking builds tolerance, requiring you to consume more alcohol in order to achieve the same effects.

Feel Good

Consuming alcohol can provide some people a break from reality. It offers a sense of relief from underlying issues your mind may be trying to escape from. However, continual alcohol use to get through the day or week can turn into a serious drinking problem.

Cope With Loss

Losing a family member or friend can take a toll on you emotionally, physically and mentally. Alcohol can ease the grief you are feeling and is used to get through difficult times. Depending on alcohol, even temporarily, can spiral into a drinking problem.

Overcome Anxiety

Some people are naturally anxious, causing them to perpetually worry. Drinking lowers an individual's inhibitions and makes them more comfortable in social situations. Over time though, this can lead to addictive behaviors.

Lack Of Connection

Many people drink because they don't feel adequately connected to others. They believe that alcohol will either fill the void or possibly make it easier for them to forge new bonds. However, the opposite typically ends up being true.

Shame

Shame is one of the most difficult emotions for many to cope with, and it is also one of the most traumatic. While alcohol can temporarily mask shame with false feelings, it also causes many individuals to engage in reckless or foolish behaviors that can later cause them to feel even greater shame, which can cause a downward spiral.

Trauma

Treatment professionals see some type of trauma in virtually every patient that they treat. There are many forms of trauma, but they are all painful events that take a toll on the mental health of the person struggling with addiction. For many, treating unresolved trauma is the key to their recovery.

Health Complications From Alcohol Abuse

Drinking too much - on a single occasion or long-term - can take a serious toll on your health. Some effects of alcohol may have a minor effect on your health, while others can be severe or life-threatening.

Short-term effects of alcohol abuse can be just as dangerous as long-term effects. For instance, drinking can impact your reaction time, causing you to have slow reflexes and coordination. That's why drinking and driving is extremely dangerous. Getting behind the wheel of a car can alter your perception of speed and distance, putting yourself and others at risk.

Several short-term effects of alcohol abuse may produce:

Slow reaction time

Poor reflexes

Reduce brain activity

Lowered inhibitions

Blurry vision

Difficulty breathing

Restlessness

Additionally, consuming too much alcohol can affect your long-term health. Some side effects may lay dormant for years before they surface. Because of this, professional medical care is required for proper diagnosis and treatment.

Here are some of the long-term health conditions caused by alcohol:

Brain defects

Wernicke-Korsakoff syndrome ( a neurobiological disease)

Liver disease

Diabetes complications

Heart problems

Increased risk of cancer

Vision damage

Bone loss

In 2013, 45.8% of liver disease deaths among Americans ages 12 and older involved alcohol. Alcohol abuse increases the risk of developing cancers of the mouth, esophagus, liver and breast. Excessive drinking negatively impacts heart health. Heart disease is currently one of the leading causes of death for alcoholics. An estimated 88,000 people die each year from alcohol-related causes. It is the fourth leading preventable cause of death in America. Alcohol abuse is treatable. An increasing number of rehab facilities are specializing in alcohol addiction programs and therapies.

Treatment For Alcoholism

Choosing to seek help for an alcohol addiction is one of the biggest decisions you will face. There are different forms of treatment available based on frequency of alcohol consumption and severity of alcohol abuse. Recovering from alcohol addiction is a process that continues long after rehab. It takes commitment to practice and applying the techniques you learn in rehab, counseling, support groups, and other types of therapy.

Although treatment plans are typically individualized for each patient, treatment generally follows a structure. Alcohol treatment can be broken into 3 sections, consisting of:

Detoxification

The first stage in alcohol addiction recovery is detoxification. This phase should be completed with the help of medical professionals due to the potential for serious, uncomfortable withdrawal symptoms. Many times, individuals are given a medication to help alleviate the painful side effects of a withdrawal.

Rehabilitation

There are two types of rehabilitation that help treat alcoholism: inpatient rehab and outpatient rehab. Inpatient rehabs are intensive treatment programs that require you to check into a facility for a certain period of time, usually 30, 60, or 90 days. Outpatient rehab allows individuals to participate in a recovery program while continuing with their daily life. Talk with your doctor about treatment options to choose the best form of recovery for you.

Maintenance

The recovery process doesn't end with the completion of rehab. Long-term sobriety requires ongoing therapy and may entail support groups, counseling and other recovery resources. These will make sure you maintain sobriety and continue on a happy, healthy path for months and years to come.

Paid Advertising. We may receive advertising fees if you follow links to promoted online therapy websites.

Overcome Alcoholism

If you or a loved one is ready to overcome an alcohol addiction, it's time to seek help. Take the first step to recovery by contacting a treatment provider for more information today.

# data[].attributes.attachment_link.description
Alcoholism is an addiction to drinking alcohol. Learn more about warning signs and health complications of alcoholism and how to get treatment.

# data[].attributes.attachment_link.readable_text
If you're carrying a few extra pounds losing weight could have wide ranging benefits for your health and wellbeing. Watch the video below to see the effect alcohol could be having on your weight.

The key to losing weight is to burn more calories than you consume, and reducing the amount you drink can help you lower your calorie intake. And it's not just the calories you'll cut out that could help you get in shape; cutting back on alcohol will mean you'll get a better night's sleep¹ so you'll feel refreshed and perhaps have a little more motivation to go for that morning run or swim.

It's important to remember that you should only try to lose weight if your BMI (Body Mass Index) is above the healthy range for your age, height and gender. You can find out your BMI using the BMI calculator on the NHS choices website.

How alcohol affects your weight

Alcohol is higher in calories than most people realise, containing seven calories per gram ², compared to protein and carbohydrate which have around four calories per gram and fat which has nine. The calorific nature of alcoholic drinks can be deceptive, as while you may know treating yourself to a pizza is a bit of an indulgence, but a few drinks after work every so often might not seem anything out of the ordinary. However, a pint of beer can have as many calories as a large slice of pizza, and a large glass of white wine could be the same as an ice cream and cone, so the calories in those few drinks can quickly add up. What's more, calories in alcohol are considered 'empty' calories, as they don't provide any nutrients.
Find out more alcohol and food equivalents

Other ways drinking less can help you lose weight

It's not just the calories in alcohol that can contribute to weight gain, it's also the greasy takeaway food that seems so appealing on the way home from the pub, or the chocolate at the back of the fridge after a couple of glasses of wine at home. Drinking less makes it easier to stick to your healthier meal choices, which in time will have a positive impact on your waistline.

The ways in which drinking less can make it easier to lose weight don't end there. Whether you workout, jog or play sport exercise is one of the best ways to lose weight, and there's no question that drinking less will make exercising that bit easier. If you've ever tried to drag yourself to the gym with a hangover, you'll know what we mean. As alcohol is a diuretic, your body is dehydrated after a night of drinking, affecting the flow of blood through your body during exercise ³. Being dehydrated also means your body can't control its temperature as effectively, making you more likely to overheat ⁴. Combining this with the other symptoms of a hangover such as a pounding head and sensitivity to light means exercising the morning after can be a real struggle.

Making a change for the better requires motivation and dedication, and that motivation will come much more easily if you wake up clear headed and well rested.
Find out how to beat a beer belly

Are you ready to cut down on alcohol and feel better?

Drinking less to lose weight is a great idea if combined with a balanced diet and regular exercise. If you'd like to reduce your alcohol intake on a night out, why not try alternating every alcoholic drink you have with a glass of water or low-calorie soft drink? This will slow down the rate of your drinking and keep you hydrated. Drinking plenty of water is also recommended for people trying to lose weight, as it can keep you from mistaking thirst for hunger and snacking more ⁵.

You could also try switching your regular pint for a low alcohol beer. Low alcohol beers tend to be lower calorie as well, so you'll be consuming fewer calories as well as being more likely to wake up well rested.

If you drink wine, you could try adding soda to a small glass of wine to make a spritzer that lasts just as long as a large glass, to help you cut back the calories.

Finally, try keeping track of your drinking using the MyDrinkaware Online Drinks Tracker or our free Track and Calculate Units mobile app. You'll be able to set yourself goals for reducing your drinking, and get even more tips and advice for cutting down.

References

Was this information helpful?

Also in this section

Alcohol and calories

# data[].attributes.attachment_link.description
If you're carrying a few extra pounds losing weight could have wide ranging benefits for your health and wellbeing. Watch the video below to see the effect alcohol could be having on your weight. The key to losing weight is to burn more calories than you consume, and reducing the amount you drink can help you lower your calorie intake.