Campaigners welcome new guidelines for treating obesity

Irish Coalition for People Living with Obesity chairwoman Susie Birney said the new guidelines will help patients talk to doctors. Picture: Abbie Trayler-Smith.

New clinical guidelines for treating obesity as a disease represent a turning point in the way the condition is managed, campaigners and health professionals have said.

An estimated 1m people are obese in Ireland, with Healthy Ireland data showing that 23% of all over-15s are obese while 37% are overweight.

New guidelines launched today by the HSE and other agencies aim to tackle rising obesity levels by treating it, for the first time, as an illness needing complex support.

The Irish Coalition for People Living with Obesity (ICPO) chairperson Susie Birney said the guidelines will help patients talk to doctors.

“They are listening to what patients need, and what they need for the long term,” she said. 

It’s a chronic relapse disease, and the sooner that is recognised the better.

“One major chapter in it is the ‘stigma chapter’.” 

People living with obesity tell her that they are judged because of their weight.

“The stories are just heartbreaking,” she said. 

“We have instances of women who are pregnant on maternity wards being told they are part of the fat club. 

We have a member who was told: ‘You should have told us you are this big, you don’t fit into our MRI scan, you’ll have to book into the other one.’ That was said to him in front of others on the corridor.” 

Another woman was told repeatedly that being overweight was making her ill, but it turned out to be endometriosis.

“She was crying, she told me she was never so ashamed to be told it was her fault for being sick,” said Ms Birney.

In this case, the Coalition wrote to the doctor, who ultimately apologised and changed the treatment.

“Healthcare providers don’t get training on this, they get very little training on obesity,” she said.

They say the most horrific things about weight to people, it has a devastating effect.”

The Coalition wants to see an end to reliance on body mass index (BMI) as a measurement.

Presenting obesity as a disease allows people to talk more openly, said Ms Birney.

“Health promotions that try to prevent the onset of obesity are fantastic in raising awareness,” she said, referring to public weight-loss campaigns.

“But we also need to be mindful of any stigmatising approaches.” 

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HSE clinical lead for obesity and consultant endocrinologist Professor Donal O’Shea said: “Adapting these clinical practice guidelines in Ireland represents a turning point in the way we approach the management of obesity.” 

He said the guidelines include advice on medical nutrition therapy, physical activity, psychological interventions, pharmacotherapy, and bariatric surgery such as gastric bypasses.

“The model of care now agreed by all parties must be resourced annually and fully implemented,” he said.

To address health inequalities, we are calling for obesity to be put on the same footing as diabetes, heart disease, and chronic lung disease within general practice."

Ireland is the first country to adopt the gold-standard set out by Obesity Canada in 2020 with these guidelines, published by the Association for the Study of Obesity on the Island of Ireland today. 

This follows a World Health Organization warning in May that Europe faces an epidemic of weight problems.