Professor Naveed Sattar, Chair of the Obesity Healthcare Goals set the scene explaining how the current prevalence of obesity is environmentally driven. While prevention needs to be a priority, diet & activity will not go back to what they were in the 70s; which is why GLP1 medications are needed to help treat obesity. And living with obesity increases the likelihood of experiencing other health conditions, which is why targeted treatment and better prevention is key.
From then on, speakers spoke to a range of themes over the day:
- Obesity as a disease – and the need to treat it as such.
- The need for system change, first highlighted by Ken Clare and later exemplified by Sally Hogg, talking about the Why Weight Pledge: a systems approach to tackling obesity in Bristol, North Somerset and South Gloucestershire. Bai Li extended this theme to a global scale, talking about the need for system change to address systemic injustices. Medications won’t solve the issue; prevention is needed too.
- Difficulties & differences in defining & measuring obesity; the (144 known) causes of it were highlighted by Nic Timpson. Nic and Emma Hazelwood raised the inadequacy of BMI as a measure, as proportion & distribution of fat aren’t taken into account; and where fat is stored matters in terms of risk for some cancers.
- Obesity is a disease with stark inequalities, with people from lower socioeconomic backgrounds more likely to live with obesity, from a young age. Clinician Hassan Kahal spoke about inequalities in accessing medication and other treatments, explaining the gradual process NHS England is taking to prescribing medication over time. Karen Coulman discussed the demand from communities for conversations & support about weight.
- Bariatric surgeon Dimitri Pournaras asserted there is no role for shame in obesity. He spoke about the detrimental impact of weight stigma on mental health and accessing treatment, arguing that stigma causes obesity. Researcher Amanda Hughes picked up the theme, focusing on the long term impacts of weight-related bullying & need for acknowledgement of weight in schools’ bullying policies (currently less than 7% reference weight specifically, despite it being a widespread issue). Stigma & its impact is under-recognised in policy.
- Julian Hamilton-Shield raised the importance of intervening in childhood to prevent later complications from obesity. PPI contributor Louise Lacey spoke about her own experience of living with obesity, and advocated for better education in schools about food and mood.
There was discussion around:
- The need for policy to recognise obesity as a chronic condition with complex drivers;
- The need for clinicians to treat the physical and the social aspects of obesity at the same time and for medical education to highlight obesity and the physical and mental health consequences of it;
- The need for the education system to recognise bullying connected with obesity;
- The importance of continued cross sector conversations, and the need to centre lived experience in conversations about the implications of, and important evidence gaps around, GLP1 medications;
- The (im)balance of funding for prevention & treatment;
- The risk that new medications will be seen as a panacea and take all the focus of obesity prevention, research and funding.
We’re excited to see where conversations go in this fast-moving policy area – thanks to all who attended and contributed enthusiasm and differing perspectives. We’ve got a list of areas ripe for future research and we’re sure the Bristol Health Partners Healthy Weight HIT, which many of the event’s speakers were part of, will be busy for some time to come.