What is Obesity?

What is Obesity?

1 in 3 Australians are currently living with obesity, and the prevalence of obesity is increasing.1 Obesity is a multifactorial disease that often requires lifelong medical treatment and/or support—it is not simply the result of poor choices or a lack of will power.2-4 Obesity affects most organ systems, increasing the risk of developing serious health problems and a broad range of complications.4-6 Download information to discuss with your patient.

A quote from Rubino et al discussing stigma around obesity in society

Why is Obesity So Hard to Treat?

There is a theory that weight is regulated by complex hormonal signalling that controls appetite and metabolism to maintain a steady-state metabolic set point.3,7 Causes of weight gain and obesity are multifactorial, and weight loss itself can trigger metabolic adaptation that drives weight regain (after an energy-controlled diet and physical exercise have been unsuccessful).4,7-9 Despite some of these factors which can be out of a patient’s control, unconscious bias still surrounds people living with obesity and their treatment choices.10 Download information to discuss with your patient.

Treatments for People Living with Obesity

Diagram of three arrows comparing weight loss between lifstyle changes, medication and weight loss surgery

Treatment Options

Effective treatment options are available for people living with obesity. Guidelines recommend lifestyle modifications (diet change and exercise), pharmacotherapy, and bariatric surgery based on a patient’s body mass index, the presence of obesity-related complications, and target weight loss.11,12

Flow chat diagram that depicts the cycle of weight gain

Why Diet and Exercise Don’t Always Work

Lifestyle modification underpins all successful weight loss.11 For many people, lifestyle modification alone is unsuccessful because of genetics, environment, or normal compensatory physiologic drivers of weight regain after weight loss that increase appetite, reduce satiety, and slow down metabolism.7-9  Why is Weight Loss so Hard to Maintain? Download this information sheet to discuss with your patients or visit our Bariatric and Metabolic Surgery page to learn how surgery could help your patients.

References

1.    Australian Institute of Health and Welfare. Overweight and obesity: an interactive insight. Cat. no. PHE 251. Canberra: AIHW. 2020. Available: https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity-an-interactive-insight (accessed May 2021). 

2.    Royal Australian College of General Practitioners. Obesity prevention and management position statement. February 2019. Available: https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf (accessed May 2021).

3.    Das B, Khan OA. The myths of obesity. Int J Surg. 2019;68:114-116.

4.    Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation Obes Rev. 2017;18(7):715-723. 

5.    Bray GA, Heisel WE, Afshin A, Jensen MD, Dietz WH, Long M, Kushner RF, Daniels SR, Wadden TA, Tsai AG, Hu FB, Jakicic JM, Ryan DH, Wolfe BM, Inge TH. The Science of Obesity Management: An Endocrine Society Scientific Statement. Endocr Rev. 2018;39(2):79-132. doi: 10.1210/er.2017-00253.

6.    Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients With Obesity. Endocr Pract. 2016;22 Suppl 3:1-203. 

7.    Pucci A, Batterham RL. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. J Endocrinol Invest. 2019;42(2):117-128. 

8.    Papamargaritis D, le Roux CW. Do Gut Hormones Contribute to Weight Loss and Glycaemic Outcomes after Bariatric Surgery? Nutrients. 2021;13(3):762.

9.    Busetto L, Bettini S, Makaronidis J, Roberts CA, Halford JCG, Batterham RL. Mechanisms of weight regain. [published online ahead of print, 2021 Jan 16]. Eur J Intern Med. 2021;S0953-6205(21)00002-9. DOI:10.1016/j.ejim.2021.01.002

10.    Rubino F, Puhl RM, Cummings DE, Eckel RH, Ryan DH, Mechanick JI, Nadglowski J, Salas XR, Schauer PR, Twenefour D, Apovian CM, Aronne LJ, Batterham RL, Berthoud HR, Boza C, Busetto L, Dicker D, De Groot M, Eisenberg D, Flint SW, Huang TT, Kaplan LM, Kirwan JP, Korner J, Kyle TK, Laferrère B, le Roux CW, McIver L, Mingrone G, Nece P, Reid TJ, Rogers AM, Rosenbaum M, Seeley RJ, Torres AJ, Dixon JB. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020;26(4):485-497.

11.    Australian & New Zealand Obesity Society. The Australian Obesity Management Algorithm. 2020. Available:  https://www.anzos.com/publications (accessed May 2021).

12.    National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. 2013. Melbourne: National Health and Medical Research Council. 

Disclaimer: There are risks with any surgery, such as adverse reactions to medications, problems with anaesthesia, problems breathing, bleeding, blood clots, inadvertent injury to nearby organs and blood vessels, even death. Bariatric surgery has its own risks, including failure to lose weight, nutritional or vitamin deficiencies and weight regain. Patients should consult their doctor to determine whether this procedure is appropriate for their condition. Alternative options to surgery include a healthy energy-controlled diet and physical activity.

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