Moving obesity care into the community

With over 250,000 obese people in the region, there is no way that specialists or tertiary care centres like the Adult Weight Management Clinic at the Royal Alexandra Hospital can even begin having an impact on reducing the burden of obesity in the region - there is no question that much of obesity treatment has to happen in the primary care networks and community classes and take full advantage of whatever resources there are for this in the community.

As with all chronic diseases, empowering patients to help themselves requires teaching them the insights and skills to deal with their condition. They also need to be aware of the realistic treatment options in order to make informed choices on what treatments work and how to distinguish weight-loss scams from professional help. This is a huge challenge!

Not only will we need to educate our patients but we also have to educate our health professionals to better understand obesity and teach them how to approach it with the same knowledge base, understanding, compassion and attention that they pay to other chronic conditions. Without a concerted effort at all levels of care, we are not going to provide obesity treatments to a meaningful proportion of the population struggling with excess body weight.

In the end, whether or not we can provide effective obesity treatments in the community will make or break the WW program. Not only do I not see an alternative, but fortunately, I am also confident that it can be done - the sooner we move on this the better.

Obviously, while we think about how to provide better obesity treatments, we should by no means ignore the very urgent task of preventing further spread of this epidemic. This will require both changes in individual behaviours but also massive and profound changes in the current "obesogenic" environment.

Using the analogy of water-borne communicable diseases: yes, we need to get more people washing their hands but we also need to ensure a clean water supply and a functional sewage system.

AMS