The emergence and development of new medication and treatments for obesity are changing the field of care, the IMO AGM heard.
Prof Donal O’Shea, Consultant Endocrinologist and HSE National Clinical Lead for Obesity, spoke during a session on obesity at the meeting. Addressing the issue of prevention and treatment of obesity, Prof O’Shea struck a positive note when looking at the future of the field.
He said the message that doctors needed to bring back to their practice is that obesity “is complex”.
“It’s the environment interacting with your genes and now we have treatments that are emerging, based on this new understanding. It’s an incredibly exciting time to be in the field of obesity.”
Prof O’Shea told attendees that advising patients to ‘eat less and move more’ is not the treatment for obesity.
“Weight gain is 90 per cent irreversible for 90 per cent of people,” he added. “You do not tell people who have melanoma to put on sunscreen and wear a hat as their treatment. Is it important to tell someone who has melanoma to put on sunscreen and wear a hat? Of course it is. Is it important that when you are treating for obesity, that you look at lifestyle? Of course it is. But it is not the treatment.”
Prof O’Shea said while obesity within the population had increased in recent decades, new research and emerging treatments are beginning to have a positive impact. However, he noted that new obesity medicines remain expensive.
The endocrinologist also said that the obesity programme is now within a new division of the HSE.
“[It has moved] from the healthy eating, active living prevention programme to the chronic disease management programme.”
He said it is “highly relevant” that obesity is “beside diabetes, COPD, and heart disease” as the move would allow services to apply for funding on the same basis as these other chronic diseases.
Prof O’Shea outlined the importance of the model of care for obesity and its impact on services. The Model of Care for the Management of Overweight and Obesity was approved by the HSE clinical forum in December 2020. According to the HSE, the model takes a population health approach to managing obesity, “recognising the wider drivers of obesity such as genetics, environment, and socioeconomic status.”
During the discussion following Prof O’Shea’s presentation, a number of IMO doctors raised concerns over the
high costs of some obesity medication and treatment and the impact this will have on patients from lower socio-economic backgrounds.
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