Alan Payling raises the issue of the national obesity crisis and speaks to a tour driver who, having taken the advice of his doctor to address his diet, has got a weight off his mind – and his body too
In more ways than one, the obesity crisis in the UK is getting bigger by the imperial pound every second. Putting on weight has serious implications for one’s health and could have dire consequences for those who work in the bus and coach industry – and for the industry itself. The impact of weight gain is not hard to miss amongst those who drive for a living. You may know what’s going on. People are eating and drinking too much, not exercising enough and they’re becoming overweight or obese in the process. The health consequences of excess weight can be severe. There is an increased risk of diabetes and as a result, other serious and life-threatening conditions could arise. Perhaps uniquely, PSV drivers can put their licences and thereby their income at risk if their larger-than-life diets develop into serious medical conditions. [wlm_nonmember][…]
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I was prompted to raise this issue in the magazine when I watched the recent BBC TV programme Britain’s Fat Fight, starring TV chef turned healthy diet campaigner Hugh Fearnley-Whittingstall. The three part programme outlined Hugh’s attempts to get the people of Newcastle to lose weight. One of the people who appeared on the programme was Geordie Stagecoach bus driver, Jonny, who volunteered to join Hugh’s campaign because he realised he needed to lose weight. Jonny was quite upfront about his weight and fully aware of the consequences of the obesity issue. He said that it wasn’t just that he wanted to lose the pounds for health reasons, but it was his desire to still be around to see his children go to college that had prompted him to address his weight. Part way through the series though, Jonny called Hugh to tell him he’d been diagnosed with diabetes. The impact of this diagnosis hit Jonny hard, not just because of the implications for his health, but for his job. As a PSV driver, Jonny understood all too clearly that his medical condition could affect his ability to hold his licence, keep his job and as he bluntly said, to put food on the table for his children. The really good news for Jonny was that after changes to his lifestyle, his diabetes went into remission.
So, the question for me was, should I raise this issue? I think so. Given Jonny’s experience, it spurred me to try and support Hugh’s campaign to see what I could do via the pages of the magazine to raise this issue in a way that could have beneficial results. The question was, how? I’m not an expert, so I’m not going to offer medical or nutritional advice because I’m not qualified. There are plenty that are though, like your doctor. But perhaps my own awareness of the tempting issues here for bus and coach drivers might help. Plus, what better way to demonstrate that people can change their lifestyle for the healthier than to recount the experience of a tour driver who, faced with a stark diagnosis from his doctor, decided to change his own lifestyle.
One of the problems that tour drivers face is food – if you have too much of it, that is. If you do, it’s almost an occupational hazard. And there is plenty on offer. When you’re on tour, there’s a fried breakfast going. The buffet breakfast bar was a killer – perhaps in more ways than one. I can recall having four and five course breakfasts in such places. Of course, by the time of the first stop of the day at about 1030hrs, I was starving. So when offered a piece of cake with my coffee, or even a pasty; well, oh, go on then. Then there was a stop for lunch. Again, I was hungry but usually limited myself to a one course meal. When we stopped in the afternoon it was time for a light afternoon tea, wasn’t it? Having tidied up and or washed the coach to work up an appetite when we got back to the hotel, it was time for the three course evening meal. As much as you like and all you can eat. Oh, I nearly forgot.
Some people only visit a bar or pub occasionally. Bus driver Jonny said he went twice a week. If tour drivers mingle with their passengers in the evening then that’s where they probably end up – in the bar on a regular basis. At 225 calories a pint on top of all the rest, there’s only one place those calories are going to end up. Though I have outlined the worst case scenario for tour drivers, resisting delicious, tasty food is not easy, particularly when it’s all free and handed to you on a plate. Been there, done that, got the bigger t-shirt and the lager trousers – that’s a very accurate typo – with an elasticated waistband. Exeter-based tour driver Brian Smith, who drives for Kingdom’s Coaches of Tiverton, has been there too.
Brian Smith: getting a bit lighter each day
‘You’re obese, Brian.’ That was the stark diagnosis Brian received from his doctor some three years ago. His contact with the medical profession at that time had been caused by two early morning visits to A&E in an ambulance after waking with severe stomach pains. Brian was told it was probably gall stones but further tests were needed. This was followed up with an appointment with a hepatologist (or liver consultant) and after MRI and ultrasound scans, Brian was told he probably had fatty liver disease. Common causes of this condition are a poor diet with too much sugar and foods made of white flour. In addition, excess alcohol consumption is one of the biggest causes of fatty liver disease. Excess weight and being diabetic are also risk factors.
The doctor’s orders were therefore pretty clear: Brian had to lose weight, change his diet, cut back on the booze and get more exercise. If he did, then fatty liver disease is reversible. At the time, Brian was some 16.5 stone, making him technically obese with a Body Mass Index (BMI) of 32.8. A BMI of 25 is the borderline figure before you become technically overweight. Brian had gone into the next and worse category and was therefore classed as obese. The target for Brian was to lose two stone. Brian saw the consultant some four or five times and while he lost some weight it was felt he needed to lose more. The booze was the sticking point. While Brian had cut down on his three to four pints a night, every night, to a weekly total of 10 pints, he finally decided to cut out the drink completely. Had there been no changes to Brian’s medical condition, the alternative course of action that spurred him on to cut out the booze was the proposal by the specialist to carry out exploratory surgery to see what was happening with his liver. Brian didn’t really relish the prospect of ending up under the knife so he took on board the suggestions about the booze that would lead to the removal of the fat from his liver and see his health improve. In addition to giving up drinking, Brian also started to do more exercise and ate better, healthier foods including fruit and salads. He is now 14.5 stone with a target of 14 stone. There has been another benefit too: Brian’s a lot better off financially. Given the cost of some 20 to 30 pints a week, he now has an extra £100 in his pocket every week. Those pockets have also had to be replaced though, as his waist band has reduced from 44 to 40 inches with a target of getting down to a 38.
The weight creeps on
So how did Brian come to need to change his lifestyle so drastically? He is now 67 and hails from the Rhonda Valley in Wales. He’s worked in most forms of road transport throughout his career, having experienced, for example, the fatty delights of the salmonella burger bars that infect lay-bys throughout the UK when he was an HGV driver. He’s spent the last 25 years working exclusively as a tour driver. In that respect, he’s lived off the fat of hotel and motorway service land to the eventual detriment of his health. He readily admits that when he’s been on tour his diet has been terrible, made up of too many pies, kebabs, burgers and portions of fish and chips. He invariably started the day with a fried breakfast, ended it with a three course meal in the evening with cakes and cream teas in between. So, the pounds crept on. In 1993 Brian was a svelte 13 stone, and had been an active sportsman with no weight or health problems. But slowly the weight crept on from his mid thirties due to the job and drink. When I asked Brian whether he noticed the changes in his weight, he says he didn’t. He said that all the people he was working with were also getting bigger, were all buying larger clothes and because they were all sat on their backsides all day he felt that this was a normal, inevitable acceptable fact of life that you couldn’t do much about. So, it didn’t bother him. In fact, Brian recalls that he was the slimmest of a big bunch. When I also asked him about his awareness of the publicity around health issues like excess weight gain, given that he doesn’t watch a lot of television or read a newspaper regularly, that source of information passed him by.
Even when questions were raised by his doctor at a PSV medical, Brian didn’t start to worry about his health and that he could and should do something about it. In 2011, when Brian was 60, his doctor was not impressed with his health and was of the view that he should switch to local bus work rather than undertaking tour work. So his doctor’s report to the DVLA was not good, largely because of concerns about Brian’s alcohol consumption. Brian lobbied the DVLA, pointing out in a letter that he wasn’t an alcoholic and that he didn’t binge drink. After an appointment with the DVLA’s own doctor in Taunton, Brian’s licence was finally renewed, but that took some seven months. What worried Brian most of all was the prospect of not being able to carry on doing tour work. Even when Brian saw his doctor complaining of tiredness in the morning and was diagnosed with type 2 diabetes in 2013, he didn’t worry too much. Again he saw this as part of growing older, and that the medication he was prescribed, Metamorphine, would cure all his ills. Brian says that he simply didn’t have the time to worry. After all, he didn’t really feel any symptoms of his diabetes. The DVLA said that if he was diagnosed with type 1 diabetes and he had to take insulin he should let them know. He was working 65 to 70 hours a week so didn’t have the time to think about his situation or consider that he could and should do something about it, including the advice to lose weight and cut down on the booze.
Feeling better
Three factors have made Brian think about and change his lifestyle now. One was the diagnosis of fatty liver disease. The second was the awareness that too many of the drivers that he’d worked alongside over the years were dying an early death, including his best friend, Ian Law. The third was his wife Ellie, who has been very supportive of the changes in Brian’s lifestyle. And things are looking up. His diet is on track. His GP is pleased with his progress and he hopes to be discharged by his specialist this year. This should make his next annual medical a formality. His abstinence hasn’t caused him any grief. Brian used to think that if he had to give up the booze he would be suicidal. Importantly, it could be that the changes to his lifestyle could see his diabetes go into remission as well as the fatty liver disease.
He now feels a lot better being the fittest he’s been for for a long time. He walks more and engages in work that requires physical effort when he’s in the yard at work. His garden looks better and his cars are a lot cleaner. He also keeps fairly active, enjoying the occasional round of golf and if his hotel has a swimming pool, he’ll have a dip. When I spoke to him, he was enjoying a bit of post holiday lethargy having spent the savings he’s made on booze on 11 nights in Crete. Overall he is of the view that it hasn’t been that hard to make the changes that have seen his health improve and he would not go back to his old lifestyle.
So now that Brian feels good about himself and what he’s achieved, he admits to telling other drivers about the changes he’s gone through and that making a positive difference to one’s health is possible and desirable. In Brian’s case, it has been down to the individual. He did ponder on the thought that the industry and the Government should do more to raise awareness of health issues for drivers, but he recognises that at all levels of the industry, people have similar problems with their weight, their diet and their health. So, what can you do generally to improve drivers’ health? Brian did have one suggestion here. Now that he has to have annual medicals, he feels this gives him greater peace of mind about his health.
A five year gap between medicals, in Brian’s mind, is far too long though. He is of the view that a driver can become seriously unfit in five years. Given the value of the cargo that PSV drivers carry, Brian believes that the gap for medicals should be reduced to two to three years and that it should not just be a medical, but a health check and medical advice session where drivers can receive specialist advice about their lifestyles and the long term consequences of poor diet for example. Just a quick thought of my own: perhaps health issues should be included in the DCPC training.
Perhaps the most surprising revelation when speaking to Brian was that the public health message about poor diet, lack of exercise and drinking had completely passed him by. While Brian has now taken it on board, my feeling is that people like Hugh Fearnley-Whittingstall and Jamie Oliver still have their work cut out to get the healthy lifestyle message across. But hopefully, Brian’s experience will help someone.
CBW would like to thank Brian for being willing to discuss such a personal subject in such an open, and we trust, helpful manner. We all wish him very good health.
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