Health
Doctors treating obesity shouldn't focus on weight loss, researchers say
Professor Karel Leroux, spokesman for the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), said the paper showed that obesity should be measured in “improved health and quality of life” rather than kilograms.
Professor Leroux was a co-author of the paper published in 2010. Lancet This week the institute recommended achieving a 15% weight loss as a starting point, saying “most obesity-related complications will be effectively reversed.”
Weight loss is an indicator of treatment effectiveness, but “most chronic diseases are treated to a target value,” he said.
Professor Leroux stressed that the various complications associated with obesity “make it difficult to identify a single, realistic weight target that is appropriate for all patients”.
Dr Weld Al Najim, a nutritionist and spokesman for IrSPEN, said managing obesity required “long-term goals”.
“Lifestyle changes aimed at optimizing nutritional quality and physical activity will have health benefits regardless of weight loss, but the overall goal of a treatment program should be to achieve sustainable health gains over the patient's lifetime,” she said.
Professor Helen Heneghan, a bariatric surgeon and spokesperson for IrSPEN, said many treatments for obesity work differently for different patients and at different times, so they all should be studied to deliver “lifelong benefits”.
“Individual responses to medications are highly variable, so if medications don't achieve treatment goals, bariatric surgery should be considered,” she said.
She also said people who respond poorly to bariatric surgery or who experience a recurrence of obesity-related illnesses should consider using obesity medication.
“Obesity drugs only work as long as the patient is taking them.
“Long-term use is therefore necessary to maintain the health benefits,” Professor Heneghan said.
“However, long-term adherence to obesity medications is low, influenced by high costs to patients, lack of supply chains for newer drugs, and patient dissatisfaction with side effects.”
The diabetes drug Ozempic has been in short supply worldwide since it gained popularity as an effective weight loss treatment for obese people.
Dr Mick Crotty, head of obesity at the Irish College of General Practitioners, said the problem stemmed from a common misconception that obesity was a “self-inflicted condition” that could be treated by “eating less and moving more”.
“The HSE should plan to keep access to and coverage of effective treatment for obesity at the same level as other chronic diseases,” he added.
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