Prevention and Harm Reduction of Obesity (Clinical Prevention

Prevention and Harm Reduction of Obesity (Clinical Prevention)

  • Obesity is a complex chronic disease, characterised by dysfunctional or excess body fat (adiposity), that impairs health.
  • It is a heterogeneous disease that can develop via slow and steady weight gain over an extended period, or from rapid bursts of weight gain. Not all individuals who have a higher body weight will develop the disease of obesity due to differences in genetic predisposition and exposure to environmental factors.
  • Obesity prevention takes place in a range of settings that access whole populations or high-risk groups. The individual-based approach to prevention is primarily used by healthcare professionals and targets those with the highest level of risk of obesity. The population-based approach addresses the behavioural, socio-cultural, and environmental factors that contribute to noncommunicable diseases in populations, including obesity.
  • There is a critical and urgent need for crossgovernmental and cross-sectoral policies and initiatives to address the effects of the unhealthy environment on non-communicable diseases through meaningful legislative change and societal factors.
  • Common population-level primary-prevention strategies for chronic disease include unhealthy food and drink taxation, calories on menus, limiting food and beverage advertisement, affordable physical activity options, improving the built environment and addressing social determinants of health.
  • Primary care clinicians have an important role in early identification of obesity through regular screening. Using the Edmonton Obesity Staging System is recommended to determine if an individual who has a higher weight has adiposity-related health impairments and has developed the disease of obesity.
  • In healthcare settings, clinicians should initiate discussion around weight early, consider the individual’s life circumstances in the development of obesity and contemplate interventions that consider its complex causes, providing guidance beyond “eat less and move more.”
  • Many medications are associated with weight gain side effects that can contribute to long-term weight gain. The risks and benefits of such medications should be weighed up for each specific patient before prescribing. Excess pregnancy weight gain and post-pregnancy weight retention are significantly reduced with behavioural interventions. Clinicians should counsel women attending prenatal care regarding pregnancy weight gain guidelines, and also give pregnant women the necessary counselling, as well as dietary, physical activity and psychological interventions to support achievement and maintenance of a healthy weight at prenatal and antenatal visits.
  • Health benefits of smoking cessation outweigh the cardiovascular consequences associated with smoking cessation-related weight gain.
  • Short-term behavioural interventions (generally six months or less) aimed at preventing weight gain in young adulthood, menopause, smoking cessation, and breast cancer treatment have not yet been shown to be effective.
  • Studies with interventions of longer duration are needed to identify effective strategies for preventing weight gain for many of these high-risk groups and for the general population.
  • Secondary prevention aims to reduce the impact of obesity on individuals’ health and quality of life. It includes early identification and management to prevent progression to more severe obesity with additional complications.
  • Tertiary prevention aims to support people to manage long-term, complex health problems to improve their ability to function, their quality of life and their life expectancy.
  • Obesity rates increase with age. Reducing weight gain and preventing obesity as you get older is preferable to trying to lose significant weight, considering the difficulty in sustaining weight loss, especially as we age.
  • Causes of, and risk factors for, weight gain are wide ranging, extending beyond personal lifestyle choices, such as food intake and exercise, and include factors that you may or may not be able to control.
  • Obesity develops when excess or dysfunctional body fat impacts a person’s health. Not all individuals who have a higher body weight have obesity. However, research indicates that obesity can develop with small gains in weight over a long period of time, or from rapid bursts of weight gain that impair an individual’s health.
  • The estimated annual average weight gain for an adult in a high-income country such as Ireland ranges from 0.2 kg to 1.0 kg per year.
  • People are prone to greater weight gain during certain life stages, including adolescence, young adulthood, and pregnancy.
  • Raise any concerns that you may have with a healthcare professional (HCP) as soon as you feel weight is affecting your health.
  • Regular screening and conversation with HCPs can help to identify patterns and factors contributing to obesity earlier.

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