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Time to rethink how we prevent and treat obesity

28 May, 2018

In a new position statement on obesity, the Royal Australasian College of Physicians (RACP) calls for strong, positive preventative action to reduce the impact of obesity, and better health systems to support treatment, like reducing weight stigmatisation.

Doctors say people with obesity frequently encounter weight stigmatisation and bias in their everyday lives. Bullying at school and discrimination in employment and education causes harm to people’s mental, emotional and social wellbeing.

“Obesity is a societal and systemic problem, but society has a pervasive prejudice against people with obesity. We as a society need to actively work to stop stigmatisation of people with obesity, especially within the health system,” said Professor Boyd Swinburn, who led the position statement.  

“People with obesity deserve to be treated with dignity and respect in all aspects of their lives, including their experiences with the health system.

“Obesity is accelerated by people’s exposure to the obesogenic environment – kids and adults are bombarded by the advertising and marketing of unhealthy foods and beverages, which are available everywhere we turn. Right now, the environment is stacked against us. The easy choice is definitely not the healthy choice.”

The RACP’s recommendations call on the health system to:

  • Advocate for action to Government for much stronger prevention measures:
    • a tax on sugary drinks
    • limiting junk food marketing
    • healthy food policies in schools
  • End weight bias and stigmatisation and support patients to optimise health at any weight
  • Enable equitable access to bariatric surgery

People with obesity also experience weight bias in their interactions with the health system. As well as causing mental and emotional distress, bias can lead to people being disinclined to access healthcare in the future, ultimately leading to inequalities in health and care outcomes.

The RACP says doctors who listen to their patients and work with them to optimise their health, regardless of their weight, will get the best results for their patients.

“We are calling for a rethink on obesity treatment,” Prof Swinburn said. “The first goal is for people to be as healthy as possible at any weight, because maintaining weight loss long term is difficult. Second, discuss the pros and cons of weight loss diets.”

“Many people will go on a diet to lose weight, but will end up weight cycling or yo-yo dieting.  They lose weight and then put it back on and sometimes more than what they lost in the first place. This repeated cycle can often lead to a sense of failure.

“Advice for patients should be specific, actionable and achievable – in line with the patient’s own health goals,” said Professor Swinburn.

“Treatment goals should focus on encouraging healthy, nutritious diets, regular physical activity and adequate sleep to optimise health, including their mental health. These goals are valid at any weight.”  

Read the RACP’s position statement and evidence review supporting the recommendations here.

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