New clinical practice guidelines for the treatment of obesity for adults are being launched today, which will mean obesity will no longer be solely defined by weight in recognising that it is a disease defined by many factors.
Supported by the HSE and Department of Health, the guidelines move away from obesity being a lifestyle illness, to recognising that obesity is a disease defined by health impairment and driven by complex biological, environmental and psychosocial factors.
The guidelines have been developed by the Association for the Study of Obesity on the Island of Ireland, and are the first of their kind in Europe, adapted from a Canadian model seen as the international benchmark.
The Association is working together with the Irish Coalition for People Living with Obesity (ICPO) and the HSE Obesity National Clinical Programme and the guidelines will be available to GPs in a drive to reduce bias and stigma around the disease both among the public and healthcare professionals.
Adapting the material for an Irish healthcare system involved over 70 specialists from a range of academic and health backgrounds and they looked at the experience of patients to date.
The aim is to address existing gaps and the root drivers of the chronic disease which has been too simply defined to date.
HSE Clinical Lead for Obesity and Consultant Endocrinologist Prof Donal O'Shea said that the guidelines were a turning point, and that patients would now have access to therapies such as medical nutrition, physical activity and physical rehabilitation, psychological interventions, pharmacotherapy and bariatric surgery.
"To address health inequalities, we are calling for obesity to be put on the same footing as diabetes, heart disease and chronic lung disease within general practices. It is also essential that access to treatments for obesity, both medication and bariatric surgery, is funded in the same way as for other chronic diseases and available based on need not means."
Speaking on RTÉ's Today with Claire Byrne, he said that today healthcare professionals are saying "prevention of a disease and treatment of a disease are different things".
He said the food and drinks industry are "the drivers of obesity" and that due to the stigma attached with obesity, patients tend to "self-blame".
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He said that you cannot treat obesity by eating less and exercising more, and that people put on the most weight over the decade of their 20s to 30s due to lifestyle factors as they get a car, stop competitive sport and have children.
"The couch potato narrative drains the energy out of people living with obesity and people who are treating obesity. You need to treat it in a holistic way".
Chairperson of the ICPO Susie Birney said that before now, obesity has incorrectly been seen as the result of poor personal decisions, including among health professionals.
"We need a programme of education among healthcare professionals, and the public, to eliminate bias and stigma about obesity."
Speaking on the same programme, she said into a multi-disciplinary approach was important, but that people living with obesity also had to speak up about any stigma they were experiencing.
"Unless more people living with obesity and the challenges that brings every day share their stories, people don't really understand what they're going through".
Dr Michael Crotty, a GP specialising in obesity, said that for many people their weight is not in their control as much as they would like to think.
Speaking on RTÉ’s Morning Ireland he said obesity is not based on size or body mass index (BMI).
"We're talking about excess or a typical fatty tissue that's impairing health. It's based on the effect that weight is having on somebody's health and if somebody's health is being affected, then this is a medical issue and there are treatments available".
Dr Crotty said there should always be a focus on healthy eating and activity, but "telling somebody who's got an issue to simply eat less and move more for the rest of their life is like telling somebody with depression to cheer up".
He said that it was a complex issue but the new guidelines will give people as much help as possible to improve their quality of life and their risk of developing medical conditions in the future.
