As a clinic in Sydney that offers weight loss surgery options for our patients, we are only too aware of the current obesity epidemic that Australia is facing. In 2014-2015 a staggering 64% of Australian adults were overweight or obese. That’s more than half of the population. That’s almost two in three adults. What’s worse, is that we are only getting larger as a nation; this is an increase from 1995 when 56% of the nation were overweight or obese.
How do we distinguish if somebody is overweight, obese or morbidly obese?
One of the tools that we use to calculate this is a person’s body mass index (BMI). Overweight is generally defined as a person being 10 – 20 percent higher than ‘normal’ (with a BMI of 25 to 30). ‘Obesity’ is defined as a condition in which a person’s weight is 20 percent or more above ‘normal’ weight (they have a BMI of 30 or higher), and ‘morbid or severe’ obesity if their BMI is over 40.
What is our health system doing, or not doing, in order to address these issues? Why do we think that the health system is failing to address this quite serious issue?
Your Doctor
Australia is blessed by having one of the best medical systems in the world, and one of the main reasons for this is our General Practitioners who are responsible for many of the great gains in our healthcare system. GP’s and specialists have become experts in managing diabetes, high cholesterol, hypertension, sleep apnoea and arthritis but are not doing so well with managing the Obesity that causes these conditions in many patients.
For both adults and children alike being overweight or obese is becoming more common, and unfortunately it is only being managed by GP’s on an uncommon basis despite the fact that overweight and obese patients have far more GP appointments than normal weight patients. This isn’t necessarily their fault; as this is a relatively new issue that has been steadily growing over the past 20-30 years and most doctors have received minimal training in obesity management. Added to this, medicare does not subsidise medical therapies for obesity and the medications and therapies available, while effective, are very expensive due to a government decision not to support their use.
At Upper GI Surgery our most senior Doctors – Associate Professor Michael Talbot and Dr Georgia Rigas play an important part in educating doctors on how this subject can and should be discussed with patients. They attend talks around the country and provide materials that help doctors understand the issue and how they can contribute towards tackling it. Dr Georgia Rigas has had an important and increasing role in the College of General Practitioners (the body that trains GP’s) as a founding member of their Obesity training program that is being developed and rolled out across the country to educate junior and senior GP’s.
Until Medicare and public hospitals change their approach and start allowing patients to seek obesity treatments, GP’s will still have still have their “hands tied” because many cannot afford effective therapies.
Inequality of weight loss surgery treatment
Statistics from the Bariatric Surgery Registry (Monash University) shows that only 13% of weight loss surgery is performed in the public hospital system in Australia. In New South Wales the numbers are even less. Given that socially disadvantaged people are more likely to be overweight or obese, this creates another failing of the health system that they are unable to seek surgical help when their situation calls for it, often requiring private health insurance that they simply may not be able to afford.
With obesity on the rise, along with other associated medical conditions such as Type 2 Diabetes, cardiovascular disease, arthritis, obesity related cancers….the list really does go on. How long can our health system sustain its current approach to obesity before it becomes a national crisis? With soaring costs of healthcare and weight being a contributing factor, we think it’s time that the system addresses the issue and helps provide more direct care – starting with our GP’s treating patients with early obesity those needing specialist medical therapy and all the way through to surgery for those with severe problems.
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