Intouch Public Health

Adjunct Professor Terry Slevin, Clare Hughes, Anita Dessaix, Associate Professor Kate McBride, Jasmine Lykissas

There is an urgent need for public health action on obesity, and a current window of policy opportunity for nationally coordinated advocacy.

This urgent need for action reflects the persistently high levels of obesity among Australian adults and rising rates of obesity-related cancers particularly among younger adult populations.

Key Australian policy documents such as the National Obesity Strategy, the National Preventive Health Strategy, and the Report on the State of Diabetes Mellitus in Australia outline current evidence-based solutions for addressing rising rates of obesity through prevention as well as obesity treatment and management.

Two weeks ago, an Obesity Policy Roundtable, jointly hosted by Cancer Council, Public Health Association of Australia (PHAA), and the Translational Health Research Institute (THRI) at Western Sydney University, brought together public health representatives, obesity prevention experts, health professionals, researchers, and people with lived experience of obesity, to work towards a comprehensive and consistent approach to obesity policy, research and advocacy priorities.

Megan Varlow, Acting CEO of Cancer Council Australia and PHAA CEO, Adj Prof Terry Slevin opened the day by providing context to the Obesity Policy Roundtable, emphasising the importance of treating obesity as a public health issue.

There was also a strong focus on ensuring those seeking action on obesity reinforced to policymakers that a collective range of actions is necessary, avoiding “competing” for which single initiative is most important.

Dr Mike Freelander MP, and Chair of the House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into Diabetes in Australia, spoke about his recently released report and experience working as a GP in Western Sydney.

He noted that many of the report recommendations spanning prevention, treatment, and management of diabetes would also help to prevent obesity and treat those with associated clinical conditions.

Dr Freelander spoke of his commitment to work with the Federal Health Minister and the government to see recommendations implemented and encouraged participants to bring the personal experiences of people living with obesity to the forefront of advocacy.

Attendees heard from Mr Andrew Wilson from the Weight Issues Network, who presented his personal perspective as someone living with obesity. Mr Wilson spoke about the impacts of living with obesity on his mental and physical health, as well as his experience accessing treatment and support services, including at the Nepean Family Metabolic Clinic.

Attendees also heard from researchers and clinicians working at The Daffodil Centre, THRI, the Nepean Family Metabolic Clinic, and The Obesity Collective, on topics such as obesity-related cancers, effectiveness of obesity treatments, barriers to accessing obesity treatment and management services, and the need to address weight stigma.

Priorities for action, research, and advocacy

Key themes arose from the presentations and subsequent roundtable discussions, which centred around priorities for action on obesity prevention, treatment and management, and weight stigma.

Accelerating the implementation of actions already identified in key policy documents, such as the National Obesity Strategy, National Preventive Health Strategy and Report of the State of Diabetes Mellitus in Australia in 2024, was deemed as urgent.

In addition, attendees agreed on the necessity of taking the following actions:

• A clear and comprehensive package of obesity-impacting activity – taking a systems approach to prevention, treatment, and management that addresses food and activity environments.
• Develop the primary care workforce – by ensuring adequate training and capacity for the general practitioner and broader workforce to deliver community-based care, including reducing stigma and fostering clear care pathways and links with mental health services.
• Embolden community initiatives and voice – through co-designed research and increasing support for the Weight Issues Network as the voice of people with lived experience of obesity.
• Reduce the established risk of obesity and support aftercare for long-term health outcomes, prioritising people with the highest need.
• Regulate food marketing, labelling, and pricing – to provide a supportive environment to prevent obesity, such as by enacting a sugar sweetened beverages levy on manufacturers.
• Nationally coordinated approach across Australian Governments to improving access to treatment and management – including enabling a mix of interventions, addressing multi-morbidities, and scaling support services.
• Understand the costs of action and inaction – beyond health and economic returns on investment, including the costs of interventions in the short and long term, and social costs.
• Fund Government and hospital systems – including scaling up what works to provide better value care, improving workforce capability, and committing to long-term funding.
• Address social inequities that drive obesity and obesity complications – and reduce weight stigma.

Priorities for research included the economic and social impact of treatment; enhancing advocacy success, including through improving public support for public health initiatives like a sugar tax; building consumer and clinician narratives to understand service barriers and experiences; involving people with lived experience in research; and addressing evidence gaps such as severe obesity.

Advocacy on prevention, treatment and management and weight stigma must take a comprehensive, systemic approach.

Identifying the most effective advocates, and determining how to better support and involve them, can bolster efforts. Leveraging the advocacy expertise of larger organisations to support and build the capacity of those with lived experience representatives was considered vital, including supporting those with lived experience to participate in research. Clinicians advocating for patients is powerful, and clinician-researcher connections can support transforming findings into advocacy and implementation.

Understanding the political context is crucial in shifting the dial on obesity. Advocacy must work at all levels of government, considering Commonwealth versus state responsibilities and drivers, and understanding the interconnections between prevention, treatment and management activities.

Advocates must consider political realities such as election timing and the interests of key decision makers – including conflicting interests and the need for these industries not to be at the policymaking table – and be prepared to develop a shorter list of priorities. It’s also important to involve the community and highlight the power of public policy in driving change.

Addressing weight stigma was also recognised as vitally important, through reframing advocacy positions and language to avoid blame and shame of individuals and focus on the socioeconomic determinants of obesity. This necessitates appropriate use of language by and in the media.

What next?

The case for investing in obesity prevention is clear, and consensus on obesity prevention priorities among public health experts has largely been achieved.

The convening organisations of the roundtable; PHAA, Cancer Council and the Western Sydney University Translational Health Research Institute, will write to the Federal Health Minister expressing need and support for a National Roundtable for Urgent Action on Obesity.

A comprehensive approach is needed to ensure people living with obesity have access to treatment and support that is accessible, evidence-based, and that works.

The time for united action on obesity prevention, management, and treatment is now.

Image: sourced from the Weight Issues Network Respectful Image Library and supplied by Obesity Canada.