Recently, I caught up with Dr John Searle who has joined the UK Fitness Industry Association as their Chief Medical Officer. John is a ‘committed’ and enthusiastic exerciser himself who has ‘discovered’ that regular exercise can control the symptoms of his rheumatoid arthritis.
I limited myself to just five questions; so here they are:
The position of Chief Medical Officer at the Fitness Industry Association in the UK is a new one. Why has it been created, and what is its core purpose?
“The FIA is a major partner with the UK Government in promoting health and well-being in the population. As a nation we are becoming sicker, fatter and older. Many of the conditions, such as coronary heart disease, which account for the greater percentage of NHS expenditure, are the result of our sedentary life styles and unhealthy eating habits. Exercise and healthy eating are the two most important factors in preventing these diseases. The fitness industry is an enormous resource of both facilities and expertise and is therefore a key element in getting the nation more active.
My role has to be seen in the context of the fitness sector being a credible partner in promoting health and well-being and involves several areas of work:
Promoting cooperation between the fitness sector and the medical and other health professions.
Advising the fitness sector on exercise not only in the prevention of disease but also in the use of exercise as part of the management of many chronic conditions such as arthritis, heart disease and many others.
Working with the industry to establish standards of best practice.
Encouraging the industry to base its exercise practice on sound scientific evidence. This is essential if we are to establish our credibility with health professionals, the Department of Health and other stakeholders”.
You want to see the fitness and health-care sectors working more closely together; can you describe to me a scenario where this is perfectly synchronised?”
“The gatekeepers in health care are general practitioners and practice nurses. In a perfect world, exercise would always be at the forefront of their minds when they are thinking about how to manage a patient’s condition. For example we know that exercise is actually more effective in the treatment of mild to moderate depression than drugs but only 4% of GP’s use it as their first line treatment. So the recommendation to exercise should be normal. But with many chronic diseases planned, structured supervised exercise is necessary. So ideally there should be a close partnership between GPs and local gyms and fitness instructors with appropriately qualified instructors being seen as part of the primary healthcare team in the same way that a physiotherapist or counselor is”.
Imagine you are now three years into your role as CMO, how would you summarise your main achievements to date?
“I would want four things to have happened:
Doctors and other health care professionals seeing exercise as the key part of maintaining good health. Incidentally, sadly these professions need to get their own house in order. Many NHS staff have unhealthy life styles, are overweight and do little or no exercise.
High standards of best practice in using exercise in the management of disease which have been agreed between the fitness sector and the health professions. We are in the early stages of doing this work with the medical profession and also with physiotherapists.
The fitness industry seeing itself not just as an industry which enables people to ‘look good and feel great’ important thought that is) but also as an industry which promotes health and well-being for all ages. Only 5% of gym members are retired but exercise is essential for the maintenance of health and independence, as we get older. There is actually a huge market of older people out there for the industry.
Gyms and clubs becoming health and fitness hubs for their local communities. Our clubs are an amazing resource of expertise and enthusiasm which is currently largely confined within the clubs. Why not take that expertise and enthusiasm out into the local community to schools, youth clubs, Mum’s groups, older people’s homes and so on?
Everywhere the debate rages about ‘fighting’ the obesity epidemic, but what if we reach a future tipping point where to be of normal weight, is ‘abnormal’ Should we not be discussing, and preparing for this scenario?
“Being overweight is bad for health. Yes, at the moment there is a lot of research being done on the ‘’fat fit’ – that is it is possible to be overweight and still be aerobically fit. But the fact remains that the single most reliable indicator of future ill health is the waist circumference. Let me put it another way. When I was a medical student 50 years ago smoking was normal. During the 1960s more and more evidence appeared about the terrible effects of smoking on health and therefore on the economy. The medical profession could have said ‘Ah well, it is normal. It is what people do so why bother? We did not do that but waged a 50 year campaign against smoking and the nation is healthier as a result. Of course people have a choice – if they want to abuse their bodies that is their privilege, but should they then expect the public purse to pick up the bill for the treatment which they will surely need at some time? There can be little or no scientific or ethical case for accepting that being fat is a good idea.”
We read a lot about medical advancements adding ‘years to life’, but less about adding fun and enjoyable life to those extra years. Many of us do not seem to be looking forward to getting ‘old’. Should we be more optimistic that living well in later life is a realistic goal?
“Let me speak personally here. I have rheumatoid arthritis which in my mid-fifties threatened drastically to reduce what I could do. Some years ago my wife had cancer. We both draw the old age pension. Neither of us knows how much longer we have on this earth but the reality is that we are not going to be here forever. So our philosophy is ‘carpe diem’ – seize the day because today is all we have. So we walk, cycle, I go to a gym four times a week and my wife runs. Life is full. Yes of course we are hugely fortunate in having an adequate income, fabulous kids and grandchildren and lots of friends. And some of those friends (and many of my personal training clients) are not so well off and have had hard times, but they have a great zest for life. Why? Because they are positive, content and don’t grumble. The choice is ours. Of course there are people for whom choice is, in reality, not an option because of social deprivation. But actually, that is another opportunity for our industry which some within it have already begun to explore. An excellent example of this is TAG – Transform a Generation which works with unemployed young people. It is impossible to over emphasise the importance of exercise. Sir Liam Donaldson, the former Chief Medical Officer of the Department of Health in England put it like this:
“Being physically active is crucial to good health. If a medication existed that had a similar effect on preventing disease, it would be hailed as a miracle cure.”