Overweight and obesity are common and together are a major health problem, with much cost to individuals and society. In Australia currently over 70% of adult males and 56.2% of adult females have a “weight problem” and 1 in 4 of our children do as well. This means that there is a very large numbers of individuals who should be considered for, and then offered, treatment and very few of those who require treatment get the treatment they need.
What are the reasons/barriers for this inaction in the health professions?
The first is probably lack of perceived efficacy – the current attitude is that everyone regains and so why waste time treating obesity? There is increasing evidence that weight loss programs can be and are effective for longer periods and there is a range of effective treatment options. There is also increasing evidence that a serious weight loss attempt can have beneficial effects years later (despite weight increasing over years). Weight loss does reduce the health costs for an individual.
A second barrier is the time it takes to manage obesity and this can be addressed with a multidisciplinary care team.
A third barrier is the number of those who should be offered treatment this can be countered with the development of healthcare pathways and a stepped approach to care, in the community, in special clinics, with bariatric surgery.
A final major barrier is the invoking of “individual choice”; this denies the major role the current environment has in producing obesity and needs to be addressed by health professions working with policy makers to change attitudes.
Obesity treatment has been shown to be effective where there are proper healthcare interventions provided – so we should set about introducing best practice care, improving health and reducing health care costs.