COMMENTARY

Obesity as a Disease, More Patient Involvement: ECO 2019

Prof Jason Halford PhD. C.Psychol. (Health) AFBPsS

Disclosures

May 01, 2019

I'm Jason Halford. I am treasurer of the European Association for the Study of Obesity. And I'm also a professor at the University of Liverpool.

How would you sum up the Congress?

What's really struck me is how many people came so early to get here on Sunday morning, and how people have been really engaged with many of the sessions, including the training sessions that we put on for the dietitians and the nurses in the morning. So there's lots of educational activity going on, along with the exchange of the best top level science we have internationally on obesity.

Is the message getting through to health professionals about the need to tackle obesity in primary care and beyond?

I think one of the struggles is having obesity recognised as a disease.

But I think that's a battle that we're winning. But having obesity recognised as a disease doesn't necessarily mean that people then go on to treat it as a disease. So healthcare practitioners may not feel that patients are motivated, or may not feel that they have any effective treatments open to them. Patients may still take it upon themselves to deal with their own weight control problem and may not necessarily feel that they can approach healthcare practitioners or that their health care practitioners are able to help them in any way.

How does the treatment approach differ by calling obesity a disease?

If you recognise obesity as a disease, and if you recognise that it has biological and also environmental determinants that are outside the control of the individual, it then means that you probably recognise those, you tackle those things, as well as the individual's behaviour within that context.

So it's not blaming the individual. Individual behaviour is important in obesity. This is understanding some of the biological, environmental underpinnings of that, recognising that it's not all your fault. There are things that we can do and we can work with you in helping you with your own lifetime weight management.

UK mainstream media coverage of ECO has highlighted BMI risks. Is the message reaching the wider population?

I think yes, people recognise that obesity is a risk for health and the number of non-communicable diseases it is associated with is [not so well known], because people know about the link with diabetes, perhaps they know a bit about the link with cardiovascular health. They won't know so much of the cancer story, and the cancer story at this Congress has been very big so far as well. We've seen lots of interesting presentations on that. I think the other thing people aren't aware of is the mental health issues around obesity and having obesity, and the struggling with obesity and the stigma as well. I think that's come through quite well at this Congress, also.

Having said that, there is still a great deal of work to be done. The options for people with obesity are still very limited, access to treatment is still very, very limited. And I don't think people have really put together that if you want to do things across the entirety of non-communicable disease, it has to involve obesity and obesity has to be directly addressed.

You’ve attended these events for many years. What’s shifted over time?

I think what has shifted over time: two things have shifted over time. We now work truly interdisciplinary. It's not lots of single silos. It used to be lots of single silos. So the nutritionists would talk to the nutritionists, psychologists to psychologists, the clinicians to the clinicians. We now, we're talking to each other.

The other important thing is we're talking with the patients. And you'll notice that the Patient Council has spun off into a new organisation of their own which we're supporting. But the patients have been involved in the planning of the Congress as well, they've been involved in co-chairing, and also running their own events at the Congress. And I think actually having that dialogue with people with obesity has informed a lot of what we're doing. I think we used to be frightened of talking with patients or having patients here. But now, it's, it's acceptable. It's normal. The patients are talking to us about how we talk about obesity and how we talk about them and they're educating us, and that's a great thing.

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