A right to be fat? A survey of weight management in medium secure units

Abstract

Obesity is a significant problem among patients in mental health services, with implications for morbidity and mortality. This is particularly challenging in forensic services where patients often remain in hospital for prolonged periods, may be on higher doses of medication and often have less access to exercise opportunities. This survey was conducted to investigate weight management strategies in medium secure units (MSUs) and to identify potential barriers to effective prevention and management of obesity. More than half of the MSUs do not currently have an effective strategy for managing obesity, although most have a reasonable range of weight management options available. There is dissonance among clinicians about the ethics of restricting patients’ access to food in order to reduce obesity. Whilst more coercive strategies may prove challenging in terms of maintaining the balance with human rights, it is clear that hospitals need to rigorously pursue education and health promotion.