Whose body is it anyway?

As a practising clinician, I saw all kinds of interesting people popping into my consulting room every day.

From the enthusiastic, "I'm so sick but I managed to consult Dr Google so give me my meds" type, to the openly disinterested, "I'd really rather be out drinking with friends but my wife threatened to deal with me tonight if I didn't come see you" type.

However, there is one group that continues to intrigue me. They're sick, want help, but couldn't care to follow through on any of your generously dished out medical advice.

This special group of patients is genuinely concerned about their wellbeing, educated in all manner of sickness and disease, oversubscribed to health and fitness clubs, never misses a doctor's appointment, but the more you see them, the more things stay the same.

Behavioural economists have failed to unravel this habitual abdication of personal wellbeing to helpless and often bewildered health professionals. Their bewilderment stems from these patients' willingness to freely ferry massive uninvited non-love handles around their torsos, while their joints give off piercing yelps, or their accommodation of this invasion by potholes termed dimples where their quads are meant to be.

My people call it beautiful. My colleagues call it dangerous and life-limiting. Some celebrities and BBBEE proponents have interlaced it with their branding, defending it at all cost, often to their detriment or eventual demise.

Obesity and being overweight are but a fraction of various displays of a compromised state of wellbeing, though not always perceived as such.

People in this position fail to appreciate the stark similarity between these and excessive drinking, smoking, risky sex behaviour, poor eating habits and a lack of physical activity.

Public health specialists have observed a shift in disease patterns. Communicable diseases, such as TB and HIV, were a leading cause of death in years gone by, particularly in third world countries, Now, however, non-communicable diseases such as cancer and diabetes are claiming more lives in more recent times.

This heralds the onset of a season of provider-patient joint responsibility and mutual accountability, with the patient's role finding pre-eminence beyond the doctor's rooms.

Responding to why there were so few youngsters among the hordes of cyclists on a Saturday morning at the Maropeng Cycling Precinct, my cycling coach and his 40-something-year-old friends asserted that, at their age, they no longer have a choice but to exercise.

So, remember, my colleagues spent some six years in medical school consuming volumes of text for your wellbeing. Don't make them do it again. Get with the programme.

*Phalatse is MMC for health and social development in the Joburg City Council.