Specialists speaking at last night’s RCPI Clinical Update on Obesity have called for a redoubling of the effort in the battle against overweight and obesity.
The call comes against a background of two recently published studies discussed at last night’s Clinical Update in RCPI. A study from Cornell University, New York found that obesity now accounts for more than 20% of the US healthcare budget – almost double the amount previously estimated. A second study from Boston has shown that diet products, outside of clinical trial settings, may actually work against people’s efforts to lose weight.
Professor Donal O’Shea, who runs an adult obesity clinic in Dublin, said, “The Cornell study suggests that we need to nearly double our estimate of how much obesity costs in Ireland, to almost 3,000 million Euros per year, which is a staggering amount of money. But when you consider how many conditions are caused by overweight and obesity it shouldn’t be a surprise. Obesity is a major contributor to cancer, diabetes, heart disease and stroke and these are all high-cost illnesses.”
Professor O’Shea repeated his call that health care professionals should not support or promote the use of diet products based on a “real world study” that shows those who rely on diet products are actually less likely to lose a significant amount of weight compared to those who rely on diet and exercise.
He said, “The fact that in real life, outside of clinical trial settings, diet products seem to work against you might come as a surprise, but I suppose you can understand it if you consider that the product takes the emphasis off what is really needed. People tend to rely on the product to do the work for them – and that isn’t sustainable. As healthcare professionals we need to make sure we promote what has been shown to work. Diet products seem to get promoted on the basis that they have not been shown not to work, which seems a bit mad. As healthcare professionals, we need to see the evidence that they actually work before we can recommend them.”
Professor O’Shea highlighted the findings of US research that shows a lack of evidence for fad diets, such as liquid diets, in losing weight and stressed that for most people, healthy eating and increasing physical activity remain the key evidence-based measures for losing weight and keeping it off.
He said, “These studies reflect what we see in practice: that people who are most successful at managing their weight are those who increase their levels of physical activity and change fundamental things in their diet. And the most effective change seems to be a reduction in fat intake.”
Dr Francis Finucane, who runs an obesity treatment service in Galway, told specialists at the Clinical Update in RCPI that compelling evidence is now emerging that bariatric surgery can save lives and reduce the burden of diabetes in carefully selected patients with severe obesity. He quoted two recent trials from the New England Journal of Medicine as well as a report from the Office for Health Economics in England.
Dr Finucane said, “Several studies have now confirmed that in the right patients, bariatric surgery can actually cause remission of conditions like type 2 diabetes and sleep apnoea, in addition to prolonging life. The benefits of this surgery go beyond simple weight loss. It isn’t just cost effective, but cost saving, even in the medium term.”
Dr Finucane highlighted the importance of developing bariatric medical and surgical services for adults affected by severe obesity in Ireland. “It makes clinical and economic sense. We’ve made significant progress in this regard in recent years, but we have to prioritise their continued development, as well as adopting evidence-based public health strategies in the wider population.”
For further information please contact
Aoife Ní Mhaitiú, Communications Executive
Royal College of Physicians of Ireland
Phone 01 8639 770, 085 850 0080