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Obesity is not a lifestyle choice but a serious chronic disease

By LAI S. REYES, The Philippine STAR Published Oct 25, 2022 5:00 am

Filipinos still have some misguided notions about obesity, a condition that the World Health Organization (WHO) considers a big threat to global health.

In a country where society values physical appearance, obesity is often thought of as “being overweight” and having the lack of will power and self-discipline to eat less and move more.

And many people who suffer from obesity are constantly shamed and blamed for their disease. This is because many people—even doctors—do not understand that obesity is a chronic disease

Obesity is caused by various factors—genetic, due to medical conditions, metabolism, psychosocial factors (e.g. stress, anxiety, eating disorders, or depression)—but definitely not by poor lifestyle choices and inadequate willpower.

Redefining obesity and its treatment

Southeast Asia is home to a huge population of people living with obesity. In fact, there were over 60 million people diagnosed with obesity in 2010.

“Now, that’s really a frightening issue,” warns Prof. Brian Oldfield, president of the Asia-Oceanic Association for the Stud of Obesity (AOASO), at the recent media roundtable on the first-of-its-kind obesity management consensus paper titled, “Obesity in South and Southeast Asia: A New Consensus on Care and Management.”

There were over 60 million people diagnosed with obesity in, as of 2010.

The consensus paper is a collaboration between Novo Nordisk and the AOASO and is driven by a number of compelling factors as discussed by resource speakers Dr .Tham Kwang Wei, secretary of the Asia-Oceania Study of Obesity (AOASO), and president of the Singapore Association for the Study of Obesity (SASO); Dr Mia Fojas, senior lecturer, UP College of Medicine Manila; Dr Tran Quang Nam of the Ho Chi Minh City University Medical Center Ho Chi Minh, Vietnam; and Dr Rohana Abdul Ghani, consultant endocrinologist, Faculty of Medicine, Universiti Teknologi MARA Selangor, Malaysia.

The medical experts shared exclusive insights from the consensus document, which was presented at the International Congress on Obesity 2022 held from Oct.18-21.

“And the figures are likely to double by the year 2030,” Prof. Oldfield adds. “Even more concerning is the fact that those numbers in adult obesity are actually being paralleled by an increase in the number of children living with obesity.”

Studies showed that there will be 45 million obese children (five years old and above) in South and Southeast Asia.

The consensus is a set of 42 clinical recommendations that were rigorously developed by a panel of medical experts from 10 countries in South and Southeast Asia. It’s intended to be used by clinicians across the region to improve the quality of care for people living with obesity.

Everybody needs to act to curb obesity.

“And so, with this huge burden of obesity, there needs to be care for people suffering from it. It calls for even more urgent action not just in the treatment of obesity, but also the support around obese patients, and even children who tend to remain overweight when they become adults,” shares Dr. Wei.

While international guidelines and protocols on the management of obesity exist, this regional consensus is an important advancement as it puts obesity management in the context of the region’s unique biological characteristics in obesity, cultural nuances and healthcare landscape.

“But these need to be updated in terms of the approach to the risk management, and the treatment options that are thankfully rapidly developing,” she adds.

Most importantly, the Consensus calls for the recognition of obesity as a chronic disease, a crucial step in acknowledging the science of obesity, and a unified approach to combat obesity with a whole-systems approach—from prevention to treatment.

‘Changing obesity’

The consensus addresses optimal approaches for identifying and staging obesity, treatment and long-term maintenance of weight, as well as issues related to weight stigma and patient engagement in the clinical setting.

It also identifies certain areas for action specific to this region such as addressing the double jeopardy of malnutrition in many parts of South and Southeast Asia, which poses increased risk for obesity, highlighting the coordinated action to increase public awareness, addressing food security, encouraging healthful habits and early life nutrition, and improving access to care for people with overweight or obesity.

“Changing Obesity is Novo Nordisk’s long-term commitment to improve the lives of people with obesity. Together with our partners, we are changing how the world sees, prevents and treats obesity,” enthuses Vinay Prusty, senior director, Clinical, Medical, Regulatory, Quality Novo Nordisk Business Area South-East Asia.

Recognizing there may be a paucity of treatments for obesity in the region, the Consensus calls for policies and healthcare resources to prioritize training of healthcare professionals and multidisciplinary teams.

“Despite the size and diversity of this region, there are sufficient cultural and social demographic similarities to justify this shared effort,” explains Prof. Oldfield. “It is our hope that with clear definitions and recommendations, we are one step closer to optimum care for people living with obesity in South and Southeast Asia.”

Obesity is a chronic disease. It’s not something that happened out of chance or bychoice. And just like other chronic diseases like Type 2 diabetes and heart disease, there is what we call pathophysiology. There’s something that has gone wrong with the patient’s body.

“By fundamentally recognizing obesity as a chronic disease, we aim to shift a variety of erroneous beliefs to acknowledging the science of obesity,” says Dr Wei.

When medical experts approach obesity as a chronic disease with a propensity for relapse and progression, “we not only enable the provision of a whole-systems approach for effective prevention and treatment for the long term, but also shift the focus on persons with obesity (PwO) and combat the stigma and discrimination associated with weight, which impedes PwO in seeking appropriate care., ” adds Dr Wei.