KEY POINTS:
Name: Robyn Toomath.
Job: Endocrinologist, physician and clinical director at Wellington Hospital and spokesperson for Fight the Obesity Epidemic.
Age: 52.
Working hours: About 55.
Salary: Standard rate for senior clinician/clinical director, FOE role is voluntary.
Qualifications: BSc, MB ChB, FRACP
Describe your hospital and FOE roles.
FOE grew out of my hospital work. I trained as a diabetologist, then worked as a consultant endocrinologist and general physician. As time went on, I felt as if there was only this tiny number of people coming to see me through the hospital's diabetes clinic, whereas there was a increasing number of people with diabetes "out there" in society.
That made me feel we had to deal with it in a different way, to stem the tide further.
I am dedicated to public hospital medicine and I still work as an endocrinologist, looking after people on the acute medical roster. I also work as a clinical director, as a manager keen to solve hard problems like how to keep a hospital afloat with not enough staff and not enough money and an increasing number of patients.
Around 2000, I was president of the NZ Society for the Study of Diabetes and decided to use my term to advance the cause with regards to preventing obesity.
I was at a World Health Organisation and International Diabetes Federation meeting in Kuala Lumpur with Diabetes NZ CEO Sarah Thomson and I was telling her about my desire to do something about obesity.
Also at the conference was Boyd Swinburn, who had trained as a diabetes specialist and became involved in diabetes prevention with his work for the National Heart Foundation. By that time, he was working in Melbourne, so we asked his advice and he said to form an advocacy group. So Sarah and I formed FOE. I realised that if you wanted to make a difference, you had to get out in the public arena and grab people's attention.
What skills and qualities are required?
I think what I bought across to FOE from my hospital work was credibility and the ability to make overweight people realise that I am an ally campaigning on their behalf.
I hope I have managed to convey empathy for people with obesity and type 2 diabetes.
The characteristics you need to be a spokesperson for an advocacy group are to be thick-skinned and prepared to do things on the hoof a lot, quick and responsive.
You have been with FOE since 2001. What have you achieved?
At the beginning, our goal was to raise public awareness of the health risks associated with obesity, with a view to bringing about changes that would reduce child obesity and child diabetes.
We had a petition and asked for advertising of junk food on TV to be restricted, for sale of junk food in schools to be restricted and for a health select committee inquiry into obesity. Before we had wrapped up the petition, the inquiry was announced.
If you look on our website, you will see a Slane cartoon.
It does reflect a possible sea change, there are the food Nazis and the food producers just trying to make a buck. There is some understanding that we do need to protect the community from these rapacious marketing influences.
What is the main barrier in the "fight against obesity"? There has to be a tipping point where there is a general community understanding that personal responsibility is not the answer.
The idea that you can be a fat person and turn into a thin person is insane because whether we are at the thin or the fat end of the spectrum is determined genetically. But, during the past 20 years, obesity rates have been blown out of the water because there has been intensive marketing of energy dense food and a complete change in the way the majority of people eat.
Everybody who is fat is desperate to be thin.
What people don't understand is that if you are hard-wired to seek out food, then you have to have it. We have to make sure that if people make the effort to walk to work, they don't pass giant billboards advertising junk food, see ads plastered across buses ... that food isn't gigantic in size and energy dense.
If you wanted, you could legislate against it.
You could say you're not going to have gigantic billboards promoting food that nobody in their right minds wants to eat - energy-dense, nutrient-poor, which junk foods are. Especially for parents of overweight and obese children, it can all be too hard.
What do you want to be doing in five years?
I still love clinical medicine in hospitals. It is tremendously rewarding.
And I would like to still be in my hospital management function, trying to keep the ship afloat.
I would love to think FOE had sufficient momentum to leave it to other people.
