Tackling obesity needs a number of magic bullets

No one health issue has the most impact on human health, or engenders more debate about how to tackle it, than obesity.

It has become the scourge of the health agenda, especially in the west, and it is a growing problem. According to the latest figures from the World Health Organisation, almost three-quarters of British men and two-thirds of women will be overweight or obese by 2030 – a staggering 39 million adults in total. We have one of the worst obesity records in Europe, with just six of the 52 countries in the WHO’s European region with worse obesity rates for women.

We know that obesity has a highly detrimental effect on health and well-being. As a result of its consequences obesity places an enormous burden on the NHS and other social services. Take diabetes as an example – not all cases of diabetes are caused directly by obesity or an unhealthy lifestyle, but the vast majority are. According to the Impact Diabetes report, the cost of treating diabetes will rise from £9.8 billion to £16.9 billion in 25 years’ time – which will equate to 17 per cent of the total NHS budget. Treatment for cardiovascular disease, another condition exacerbated by obesity, already costs the UK health system around £9 billion. These are staggering sums of money that the UK will probably not be able to afford.

The cost implications of obesity are not just confined to health care expenditure – there are ramifications for the wider economy too. In 2013, the Office for National Statistics estimates that 131 million days were lost to UK businesses through absences due to sickness and many of those illnesses can be linked to obesity. According to the CBI, absence from work through sickness is costing the UK £14 billion a year.

While there are many possible approaches to tackling obesity and its consequences in the population, it is clear that there is no single magic bullet. Rather, an arsenal of different approaches needs to be brought to bear on the complex challenge posed by obesity. For some people, there is a need to embrace treatments that clearly work. For certain types of treatments there is still a need to understand better how these treatments can work more effectively so that more people can benefit from them. However, many fundamental questions also remain about the causes of weight gain obesity, which clearly affect only a proportion of the population – although a growing proportion.

This is why this year’s Plymouth Obesity, Diabetes and Metabolic Syndrome Symposium, our fifteenth, has brought together some of the UK’s leading experts and opinion leaders to discuss their work in this field. Entitled “New Ideas and Controversies in Obesity”, we are showing the latest thinking in a number of areas related to obesity including:

  • the potential appropriateness, for some people, of bariatric surgical solutions as a primary approach to treating diabetes.
  • the latest ideas and developments in important clinical trials.
  • whether obesity is a psychological disorder
  • new insights into the role of the gut in regulating blood glucose levels and influencing the risk of developing diabetes,
  • using groups in delivering group therapy as an approach to the treatment of obesity
  • new ideas on the importance of adipose (fat) tissue in health and disease.
  • new insights into the causes of diabetes in women with Polycystic Ovary Syndrome.
  • challenges ahead for the implementation of the latest NICE guidance on obesity.
  • latest findings and developments from the Plymouth EarlyBird study, which is now following up Plymouth children as adults

Our experts include: Professor Francesco Rubino, Chair of Metabolic and Bariatric Surgery at Kings College London; Dr. Jennifer Logue, Clinical Senior Lecturer at the Institute of Cardiovascular and Medical Sciences, Glasgow; Professor Jason Halford from Psychology Sciences at the University of Liverpool; Dr. Royce Vincent, Consultant Chemical Pathologist at King’s College Hospital; Dr. Mark Tarrant, Senior Lecturer in Psychology Applied to Health and Dr. Katarina Kos, both at the University of Exeter; Dr. Joanne Hosking, PhD Statistician at Plymouth University Peninsula Schools of Medicine and Dentistry; and Professor Jonathan Pinkney, Consultant Endocrinologist from Plymouth University Peninsula Schools of Medicine and Dentistry and Plymouth Hospitals NHS Trust.

By bringing together such a spectrum of experts we are capturing the series of challenges faced by everyone in the field of obesity care and study: from environmental and personal factors to biology, behaviour, cutting edge science, politics and public health.

It is fair to say that it is unlikely that all these august and knowledgeable individuals will be in one place at one time any time soon, so the discussions we have here in Plymouth will have ramifications for tackling obesity worldwide.

What will be the answer? There is some work to do yet before that is clear, but our conference shows that we must accept that the problem of obesity is multi-facetted, and as a consequence requires a multi-disciplinary approach.

That is why we need expert opinion and input from across the full ‘life story’ of obesity – from science in the laboratory to an investigation of social influences, surgical options, psychological factors and ultimately health policy.

As world leaders in diabetes, obesity, metabolic syndrome and endocrinology, we in Plymouth are well-placed to contribute to a round of debate and action which in time and with appropriate resource could tackle the problem of obesity once and for all.

Professor Jonathan Pinkney is Professor of Endocrinology and Diabetes at Plymouth University Peninsula Schools of Medicine and Dentistry and a Consultant Physician in Endocrinology and Diabetes at Plymouth Hospitals NHS Trust.

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