The treatment of obesity should focus on lifelong health gain rather than weight loss, according to research published in The Lancet.
Irish Society for Clinical Nutrition and Metabolism (IrSPEN) spokesperson Professor Carel le Roux said the success of treating obesity should not be measured in kilograms, but improvements in health and quality of life.
He said that while the recommendation is to achieve 15% weight loss as a starting point to effectively improve most obesity-related issues, the different complications of obesity make it "difficult to identify a single realistic weight goal suitable for all patients".
Speaking on RTÉ's Morning Ireland, Prof le Roux, who is a co-author of the paper, said researchers now understand that obesity cannot be cured but can be controlled if treatments are continued lifelong.
He said that if obesity treatment is stopped once weight loss is achieved, the disease of obesity relapses and all of the benefits are lost.
"We want people to live longer, but also to live better, if we control the disease lifelong," he said.
He added: "We're not saying that it's not about weight loss on its own, but it's about the combination of health gain and actually living longer because of reduction of heart attacks.
"It doesn't matter what the treatment is, provided it works for you and you can maintain it in the long term. Please don't start a treatment if you're not prepared to take it for the rest of your life."
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Prof le Roux, who is an obesity specialist at St Vincent's University Hospital, said most people who are obese "have been blamed" for it since a young age.
He said that while it is not their fault, it is their responsibility to treat the disease.
"The same way it would be your responsibility to treat the disease of asthma or epilepsy," he added.
He said once people understand it is a disease they can be connected with the right treatment.
"It becomes plain sailing and it's incredible how it transforms peoples' lives because they feel healthier, they feel more functional, they can do more things and their quality of life improves dramatically," he said.
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Bariatric Surgeon Professor Helen Heneghan noted that obesity medications only work while patients take them and that long-term use is required to maintain the health benefits.
"A current issue with obesity treatment is that long-term adherence is low which is affected by many factors such as high costs to patients, supply chain shortages for the newer medications, and patients’ dissatisfaction with side effects," she said.
She said if obesity treatment goals are not reached with medications, bariatric surgery should be considered.
However, people with a suboptimal response to bariatric surgery, or a recurrence of obesity-related diseases, may then benefit from moving to an obesity medication, she said.
Irish College of GPs Obesity Lead Dr Mick Crotty said that many problems partly result from the common misconception that obesity is a self-imposed condition that can be treated by asking people to eat less and move more.
He said this creates a discrepancy in the care provided to people with obesity compared with patients with other chronic diseases both at an individual and systemic levels.
"The HSE should plan to maintain the same level of access or coverage for effective treatments for obesity as for other chronic diseases," he said.
