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Medicine 2021: Recognising obesity as a disease

On day 2 of the RCP’s annual conference Medicine 2021, Professor Rachel Batterham, professor of obesity, diabetes and endocrinology at University College London, gave a talk outlining our current scientific understanding of obesity and calling for its wider recognition as a serious and complex disease.

The impact of obesity on mortality and wellbeing has long been recognised, and the issue has taken on a new urgency in the past year given the effect of obesity on COVID-19 outcomes. In 1997 the WHO formally identified it as a serious, complex, incompletely understood chronic disease, and our understanding of its role in a large number of comorbidities continues to develop. Yet policymakers and the general public still often take a simplistic view of the solution to the problem, centring on individual responsibility and the need to ‘eat less and move more’.

Professor Batterham’s talk set out a clear case for the complexity of the issue, outlining the scientific mechanisms underpinning obesity’s impact on morbidity and mortality and going on to explore the importance of physiological, psychological, genetic and societal factors in regulating appetite and weight.

She then went on to review the NICE-recommended, evidence-based therapies currently available, setting out a stepwise treatment strategy working up from education and supported lifestyle change to pharmacotherapy and surgery. With these options available (and others on the horizon), failure to refer and stigma are often the barriers to realising the minimum 15% sustained weight loss necessary to significantly impact conditions such as type 2 diabetes. Professor Batterham concluded with a call to clinicians to truly support their patients with obesity and to play their role in communicating the science of weight management and ending stigma in the clinic and in society.

Professor Batterham’s responses to follow-up questions from the audience focused on the usefulness of the BMI measure, whether intermittent fasting should be recommended to patients as a weight loss strategy, the role of metformin and the outlook for obesity management as ‘game changing’ new therapies targeting the gut hormones are likely become available over the next 1–2 years.

Inspired to find out more? Our annual conference is virtual this year and you can sign up to Medicine 2021 to watch the full presentation. We’ve extended on-demand access to all conference content until 30 April 2021.

You can gain up to 16 CPD points until 7 February 2021. Thereafter you will be able to self-accredit as independent learning