Are You Addicted to Your Doctor?, a Channel 4 Dispatches documentary, due to be aired next week, features one woman who has called 999 for an emergency ambulance 20 times in the past year to deal with anxiety attacks, and others for whom a GP or A&E appointment is a monthly or even weekly event.
Dr Laurence Buckman, a former chairman of the British Medical Association's GPs committee, who practices in London, says: "There has been an extraordinary rise in the worried well. I don't mind patients who do their own research and are trying to inform themselves, but it's interesting that most people wouldn't dream of going to their accountant or lawyer and telling them how to do their job, and yet they feel fine about doing it to their doctor.
"My heart does sink when someone comes in with a sheaf of papers with the Google logo at the top, absolutely convinced they know what is wrong with them before you've even discussed their symptoms. And often there is nothing wrong with them at all."
And it seems that nowhere are the worried well more prevalent – and more confused – than when it comes to food.
The market for food products marketed as "free from" gluten, sugar, lactose and other ingredients has more than doubled in the last five years, according to research released last week. More than half of shoppers now buy "free from" products, according to market experts Kantar Worldpanel, making the industry worth £355 million and one of the fastest-growing sectors in the food world.
Much of this huge growth centres on gluten-free foods – Marks & Spencer says sales of its products have risen by 100 per cent in the past year alone. M&S is expanding its gluten-free range to more than 150 products, while the other big supermarkets are giving ever more shelf space to "free from" brands. Yet only 1 per cent of the population is believed to have coeliac disease, an autoimmune condition triggered by gluten that means sufferers must avoid the ingredient completely. And there is scant evidence that the disease is becoming more widespread.
So why do so many people think gluten is to be avoided at all costs? Gluten is a protein found in wheat, rye, barley and oats. Its elasticity is an essential component in bread, pasta and cakes. Gluten-free products have to use other ingredients, such as rice and tapioca flour to create the same effect, which means higher costs for manufacturers – which are, inevitably, passed on to consumers.
The gluten-free trend, led by celebrities such as Gwyneth Paltrow, Victoria Beckham and Stella McCartney, has fuelled the market. Tennis champion Novak Djokovic says he believes his form improved massively after adopting a gluten-free diet.
Tesco buyer Lauren Tredgett says demand is soaring because consumers are becoming "more aware of their intolerance to wheat and gluten intolerance" – but medical experts are more sceptical.
"Anyone who hasn't got a double First from Oxford and isn't managing director of their own multi-million pound company by the age of 30 wants to blame it on a food intolerance," says Dr Buckman. "I get people coming in, saying they've self-diagnosed with a dairy or wheat allergy. When you look at their diet, they're eating 10 Mars bars a day but they don't want to talk about that – they want to label themselves with an allergy and these products are helping them to indulge that."
Doctors are also concerned that unregulated and underqualified nutritionists are offering testing and diagnosis for food allergies and intolerances without any scientific basis. Australian research has found that most people who say they are avoiding wheat because of their "intolerance" to it are doing so on the basis of self-diagnosis.
Another controversial area is a new term called NCGS – Non Coeliac Gluten Sensitivity – a condition many patients are now finding on Google. But experts are divided over how prevalent the disorder is – or even whether it exists at all.
NCGS, first reported in 2011, was the first indication that non-coeliacs could suffer from the same symptoms. But in a study at Monash University in Australia last year, patients claiming to have NCGS followed diets that contained different levels of gluten. In the double-blind study, the patients did not know which diet they were on. Even the people on the totally "free" diet claimed they could feel gluten sensitivity, leading some doctors to conclude that the problem was "all in the mind".
And it's not just gluten. Melanie Leech, chief executive of the Food and Drink Federation, has warned that some lobby groups are making extreme claims against certain ingredients, such as sugar, without the science to back them up, and are confusing consumers in the process.
Margarine versus butter, the benefits of red wine, whether we should be eating meat – the advice seems to change on a daily basis. Last month, Time magazine's cover story was The Truth About Fat, which cited research showing that the removal of fats from our diets has led to a rise in carbohydrates, fuelling the increase in obesity.
"There are incredibly mixed messages around food and food promotion," says Dr Sue Bailey, senior lecturer in human nutrition at London Metropolitan University. "People may think they are adopting a healthier diet by cutting out things like gluten, but that is not necessarily the case."
She points to research published in the Journal of the Academy of Nutrition and Dietetics that found that some gluten-free products had more calories than traditional products, and that gluten-free diets can lead to fibre deficiency.
Frank Furedi, emeritus professor of sociology at the University of Kent, believes the modern obsession with "well-being" has distorted our ideas about food and health. "Well-being has as its assumption that being 'not well' is a default position," he says. "In the past, being healthy was the norm.
"Historically we have fetishised food. Look at religions and food rules – gluttony being one of the Seven Deadly Sins. For a while, we seemed to move away from that, but in the past 20 years, we've gone back to it. We see certain foods as 'evil'; you go to a dinner party in London and people will say that McDonald's burgers are evil; people who buy organic see themselves as morally superior."
For some people, worrying about being well can actually lead to health problems. Health anxiety – the new term for hypochondria – is also on the increase. The charity Anxiety UK estimates that a third of calls to its helpline are from people obsessed with their own health.
Dr Paul McClaren, a psychiatrist and medical director of the Priory Hospital Hayes Grove, says patients can benefit from cognitive behavioural therapy to help their health anxiety, but says GPs need to spot the problem rather than indulge the demands of someone they may see as "worried well".
"Doctors may think that sending someone for tests will reassure them they are not ill, but the patient can actually get hooked on needing that reassurance," he says.
And, ironically, research has suggested that people who complain about their health are more likely to die earlier – even when they are in the same medical condition as non-worriers.
Just another thing for the worried well to fret about.
Source : http://telegraph.feedsportal.com/c/32726/f/568612/s/3cacb8ef/sc/14/l/0L0Stelegraph0O0Chealth0Cdietandfitness0C10A9778770CAre0Eyou0Eone0Eof0Ethe0Erising0Enumbers0Eof0Ethe0Eworried0Ewell0Bhtml/story01.htm
