A new book produced by the University of Sydney's Charles Perkins Centre has challenged existing approaches to diabetes and obesity treatments and presented a strategy with the potential to revolutionise the way our society approaches weight management.
Researchers and clinicians from across the University and elsewhere have joined forces to tackle these major health challenges from a more holistic perspective, offering expert strategies to help address the high social and economic costs to the community.
Charles Perkins Centre Academic Director, Professor Stephen Simpson said diabetes, obesity and their related diseases together made up one of the greatest challenges to human health in the 21st century.
"Obesity and diabetes are not just problems for the individual, they pose risks to the environmental, psychological and economic stability of the entire community," he said.
"The estimated financial cost of type 2 diabetes alone in Australia is A$10.3 billion per annum. Innovation of health and service delivery is critical to address the burgeoning problems of diabetes, obesity and related diseases as the population ages.
"The solutions, therefore, need to be equally wide-ranging, and accessible to all. Acknowledging this, our authors have written in an engaging and easy-to-read style about the causes and consequences of obesity and diabetes, as well as prevention and treatment: how to identify and mitigate the risk factors, deliver targeted and effective health care, and formulate global strategies to ultimately turn the tide on this century's most devastating diseases."
Contributors to the book are diverse and include endocrinologists, pharmacists, haematologists, biologists, paediatricians, psychologists, health policy experts, lawyers, nutritional scientists, nurses, health promotion experts, exercise and sports scientists, and dietitians.
Summary of key findings:
We don't need to count kilojoules or weigh portion sizes in order to reduce weight just eat only if you feel comfortably and physically hungry, and stop when you feel genuinely satisfied, not over satisfied.
Constant overconsumption of a high fat-high sugar diet triggers similar changes in the brain to those seen in drug addiction. These changes can override the biological weight-control systems, driving the development of compulsive overeating and excessive weight gain.
Community pharmacists as a valuable resource of trained healthcare professionals can be utilised to provide prevention and care services as part of an integrated primary care sector approach.
Obesity is linked to changes in the nutritional balance of our diet, with a primary role for protein appetite driving excess energy intake. Small changes in the percentage of protein in the diet can potentially yield big effects on intake, with consequences - both good and bad - for weight management.
The link between epigenetic changes and obesity and the troubling possibility that obesogenic diets not only render individuals incapable of losing excess weight, but they may also affect ensuing generations with residual weight problems.
Weight-loss approaches that recognise the individual struggle with gender and the influence of other social structures may be an alternative to current, largely unsuccessful treatments of obesity.
There are a range of psychological problems associated with obesity, such as low self-esteem, body dissatisfaction, depression and eating disorders. In fact the most prevalent recognised obesity-related complications in childhood and adolescent are psychosocial issues.
Obstructive sleep apnoea (OSA), where the child has pauses in their breathing during sleep that may be severe enough to result in reduced oxygen to the brain, is up to 30 times more common in obese children and adolescents than in normal weight youngsters. Difficulties with concentration secondary to sleep deprivation from obstructive sleep apnoea may contribute to poor academic performance.
The stigma associated with obesity is considerable and comparable to racial discrimination. Discrimination against obese individuals is evident in all areas of life including social life, parenting practices, education, employment and healthcare. Furthermore the stress which obese individuals are exposed to as a result of negative societal attitudes and behaviours can lead to further weight gain, and worse health outcomes.
Promising societal and environmental responses to overweight and obesity include redesigning the built environment, providing active transport options, promoting the availability and accessibility of healthy food choices, restricting promotion of unhealthy foods, and implementing ongoing social marketing strategies to influence sustained healthy eating and physical activity behaviours. Government leadership, social planning and urban renewal that engage communities, businesses and other relevant stakeholders are fundamental to the process.