Page 2131 - Week 07 - Wednesday, 6 August 2014
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Obesity is a disease. It is a disease where fat is accumulated to the point where health is impaired. It is often defined in terms of a body mass index of over 30 for adults and, for children and adolescents, there are other specific BMI thresholds. For people who are already overweight, weight loss strategies need to address modifiable causes of weight gain, such as inappropriate diet and sedentary lifestyle.
Many overweight or obese people self-manage their weight or they seek support—such as dietary advice, exercise programs, counselling and behavioural modification therapies—from private organisations, general practitioners or other primary care providers. Pharmacological therapies, which include appetite suppressants and drugs to reduce the absorption of fats, and behavioural or cognitive therapies, may be needed to maximise an individual’s capacity to benefit from healthier lifestyle choices. In some cases referral to specialist weight management clinics will need to be considered.
There are also, increasingly, surgical options, including gastric banding and gastric bypass, to address obesity. However, as is well known, as health preventions and interventions become more complex, they become more expensive, entail greater risk and use more of our precious health resources. So we need to be judicious with any public funding in these areas.
With so many health issues, we need to focus where we can on a holistic public health viewpoint. In 2010 I released a discussion paper, “The state of our health”. I opened my discussion paper with a quote from Professor Patrick McGorry, who is a specialist in mental health but his point is well made. He said:
Australia now needs radical change to the system of care with early intervention as the core feature.
It is very difficult to do, to transition from all the care at the tertiary end to a greater emphasis on primary and preventative, but it is an approach that I think we all would support.
In the discussion paper I made the following point:
Changes to the ACT’s health care system are needed to meet the growing demand on services by an increasing and ageing population that is expected to push the ACT health care system to its limits over the next … decades. The current approach to delivering health care in the ACT is failing in a number of areas, particularly within our hospitals and in primary health care. Without significant improvements in the way we deliver health care in the ACT, it will become increasingly difficult for our health care system to cope with the increased demands. The cost of delivering health care in the ACT is enormous, consuming—
at that stage—
over $1 billion of the ACT budget each year and growing at about 11 percent each year.
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