A VIRTUAL HSE event today is seeking to encourage open discussion on obesity and reduce the stigma attached to talking about weight.

The HSE and the Royal College of Physicians Ireland are hosting a series of seminars on obesity for the public and healthcare professionals. They will feature experts on the subject and will tackle the stigma of obesity and offer advice on how to talk about weight with a GP or family.

They will also discuss childhood obesity and advocating for people living with obesity.

The HSE Obesity Management Clinical Programme, which is leading the “summer school”, will present on the HSE’s newly developed model of care for the management of overweight and obesity in Ireland.

The model of care guides how obesity care is delivered for children, young adults and adults by the HSE.

Speaking to TheJournal.ie, Dr Michael Crotty, a specialist in Bariatric Medicine, said that the new model of care sets out a structure for how obesity should be treated in Ireland, from “being brought up in primary care with your GP to assess the situation to having more subspecialised practitioners in a community setting”.

“There’s a big push to increase awareness of obesity,” Dr Crotty said.

“A lot of GPs might be reluctant to bring up the topic to someone for fear of offending people, whereas scientific evidence suggests that if you bring up weight in a sensitive and non-judgemental way, it is very acceptable with patients when it’s done appropriately,” he said.

Dr Crotty, who will deliver a talk today on how to discuss obesity with a healthcare professional, patient, or family member, said that it was important to “increase awareness in primary care and trying to maybe encourage people to bring it up with their doctor to start the conversation going and looking at what the options are as far as treatment and further options that are available”.

The event will focus on obesity as a chronic disease and how to treat it as such, rather than considering it as a lifestyle issue.

“The focus is on gaining health rather than losing weight,” Dr Crotty said. 

It’s not about numbers on the scales. It’s about people’s health, and weight is not necessarily an indicator of health.”

Dr Crotty said that the idea that someone’s weight is a lifestyle issue or entirely the individual’s responsibility is not backed up by scientific evidence.

“This is a complex, chronic medical condition. It’s a genetically-conferred, neurological and hormonal disease. There’s a strong environmental influence; differences in social inequality, education – lots of different things affect weight,” he said.

“We probably have a lot less control over our weight than we think we do, but people wh living with obesity sometimes feel that it’s their responsibility that they have to control their weight, whereas we don’t say the same thing about depression or hypertension.

“They’re medical conditions that need medical treatment and obesity is the same. By bringing up the topic of weight in general practice, it opens the door to these treatments.

“It’s not the cause of all health problems and we shouldn’t assume anything about people because of their weight. It doesn’t necessarily tell us anything about their health or diet or lifestyle. It doesn’t define people.”

One of the seminars at the event will consider the impact of Covid-19 on living with obesity.

Some of the limited evidence available indicates that those living with obesity may face a “more severe” experience of Covid-19 if they are infected.

“Some people living with obesity have other medical conditions like diabetes or hypertension which are risk factors for more severe Covid-19,” Dr Crotty said. 

“But certainly, [obesity] is emerging as a risk factor for a more severe disease..”

Dr Crotty said that conditions living during lockdown had caused difficulties for some patients living with obesity, while others found it gave them more time to focus on their health.

It’s a very complicated and individual disease. Different people struggle with different things.”

“Patients of mine, some of them would find that the lack of routine, disturbed sleeping patterns, easier access to the kitchens and foods, increased stress, uncertainty, financial problems, maybe less secure access to healthy foods during the lockdown and being more reliant on processed foods – there’s a lot of different things that can influence people having trouble with their weight.”

Other patients reported finding it easier to manage their health during lockdown.

“Maybe they weren’t eating out as much, or had more time to focus on healthy eating patterns,” Dr Crotty said.

He cautioned, however, that obesity is not a question of lifestyle choices.

“The hormonal regulation of appetite is different in people living with obesity. They have a dysregulation of appetite and don’t feel appetite and fullness the same as people who don’t struggle with weight,” he said.

“Neurologically, there’s differences in the signalling in the brain. For people who are living with obesity, the response to certain foods is different, and lack of sleep can increase susceptibility and cause poorer food choices.”

The HSE event has been booked out, with 1,000 registrations signed up for the summer school.

Overweight and obesity are considered to mean an abnormal or excessive accumulation of fat that presents a risk to health.

Currently, 60% of adults and 20% of children are living with obesity or overweight in Ireland.