Australian National Obesity Roadshow, Mudgee N.S.W. February 2023
As I was driving to Mudgee today to deliver an educational in-service to GPs and their primary healthcare team, I had 4.5hr to reflect on many things:
- with the smoke I could see and smell from the bushfires in nearby Tambarooba and Cranbrook,
- and the creeks I could see were full as a result of the recent floods
It got me thinking about the "Aussie Battler", which is an Australian colloquialism for the ordinary working-class people who persevere through their commitments despite adversity. Typically, this adversity comprises low pay, family problems, environmental hardships (bushfires, floods, droughts), and personal recognition woes.
Having spoken to local GPs and primary healthcare teams, where it can take up to a month to get an appointment to see an HCP, it was eye-opening to hear from fellow GPs about the challenges they face trying to manage people living with obesity, given the local community prevalence rate of 41.4%.
Together we can drive change. So let's talk about obesity...
Australian National Obesity Roadshow, Bathurst N.S.W. February 2023
During my obesity roadshow in regional Australia, I also spent time in Bathurst.
I have spent time as a medical student here in Bathurst, and also post-grad time in Bathurst and the nearby town of Orange.
Bathurst was a well-known mining town during the Australian Gold Rush circa 1850s.
In recent years we have had a mining boom in various states and it got me thinking about the high prevalence of pre-obesity and obesity in miners.
Mining companies need to be part of the discussions, along with healthcare providers and government policymakers.
Together we can drive change and improve the health and safety of our miners and their families.
Australian National Obesity Roadshow, Tamworth N.S.W. February 2023
I was fortunate to be invited to speak to GPs and primary care teams in Tamworth last night about the challenges of managing obesity in regional areas.
In addition to the well-known/often cited GP challenges eg lack of time, and fear of offending patients, they come with a “shopping list” of health issues to deal with too. The recurring theme was access.
Many people living with obesity simply can’t afford eg gap payment to see a dietitian despite a GPMP plan to subsidize it, they often can’t afford private health insurance, they’d like to try anti-obesity medication or undergo bariatric surgery (where applicable), but simply can’t afford it.
That seems to be the rate-limiting step.
The Results of the ACTION-AU study
The ACTION- AU study showed a mean delay of 9 years from when a person with obesity starts to struggle with their weight and when they had an initial consultation with a healthcare professional about their weight.
Furthermore, the study revealed that people living with obesity had tried a mean of 4 serious weight loss attempts (some up to 12) in the preceding 5 years.
I can’t think of any other health condition where the patient feels that they need to do it on their own and take so long before they ask for some help from the healthcare professional.
As doctors, we know that the majority during this period will likely develop metabolic, mechanical +/-mental health complications of obesity, some of which are irreversible.
To my fellow GPS do not hesitate to raise the issue of weight and it’s impact on their health and wellness, with your patients, as long as this is done in a sensitive and non-judgemental manner. The majority of people living with obesity want their GP to raise it, with only 3% indicating they would be offended.
Australian National Obesity Roadshow, Perth W.A. March 2023
Those in Perth’s southern fringes have the worst health outcomes.
Once again speaks to the inequity of access to -healthcare services and effective adjunct anti-obesity therapies.
Australian National Obesity Roadshow
I was honored to be invited to give a lunchtime presentation as part of a primary care in-service, to a group of dedicated HCPs in a regional town outside of Perth. These GPs and their fellow nurses, like many others, struggle to access integrated health support and effective anti-obesity treatments for their patients.
Australian National Obesity Roadshow, Adelaide S.A. March 2023
As part of the national obesity roadshow I recently found myself in Adelaide-dubbed “the city of churches” and also the capital city of South Australia- the Festive State.
However, I believe with the recent stats continuing to creep up above the national average, prevalence of overweight/obesity in south Australian males( 75% ) & females (65%) I’m concerned that the state may be remembered for something other than the festivals and vineyards.
Australian Obesity Roadshow, Toowoomba Qld April 2023
I was both privileged and humbled to spend a couple of days in Toowoomba this week.
Dubbed in recent years as “one of the most fattest towns in Queensland”, this agricultural regional town is a true example of the “haves” and “have nots”.
Speaking to local GPs there are a significant number of PwO from lower SES, with some “unable to afford to buy paracetamol for their children”.
These individuals are unlikely to have private health insurance and so unlikely to be afford adjunct anti-obesity therapies.
This highlights the inequity of access to therapies and support services for PwO.
I acknowledge that we have the Australian National Obesity Strategy, launched in March 2022. However, it appears dissemination hasn’t been as great as it could be.
We are still waiting for adequate resource allocation to implement the key initiatives.
Australian National Obesity Roadshow, Canberra A.C.T. , April 2023
It wouldn’t be a genuine Australian national obesity roadshow, without a visit to our national capital city Canberra, and surrounding areas which constitute the Australian Capital Territory (ACT).
The link to this fairly recent report underscores some of the inequities that I have been highlighting these past 6 months during this self-initiated roadshow I am undertaking.
As our politicians meet next week to discuss the Federal Budget, I hope that they will allocate sufficient resources to implement the National Obesity Strategy.
As I have been traveling around the country, my fellow GPs concur that 2022/3 saw the first time in our recollection that people living with obesity have been coming forward and demanding access to effective anti-obesity therapies.
The NOS wants us as clinicians to be proactive when a PwO gains weight and offer adjunct therapies which lead to (I)clinically significant and sustained weight loss, and (ii) subsequent health improvements; rather than reactive ie when the complications of obesity (some of which are irreversible) have already set in.
Australian Obesity Roadshow, Mittagong N.S.W. April 2023
Having spent a few days in Mittagong - a small regional town in the Southern highlands of New South Wales 🇦🇺 and surrounding towns, the visible difference between the “haves” and “have nots” was glaringly obvious.
Whilst it is encouraging to see in the locally commissioned report (see link) that obesity is the second health priority for the region, people living with obesity and Healthcare professionals alike, are still echoing the same sentiments:
Inequity of access to effective evidence-based anti-obesity medications and bariatric surgery.
We have undergone the national senate enquiry into obesity in 2018/19.
This culminated in the release of the National Obesity Strategy March 2022.
We now demand adequate resource provision so we can implement these local and national initiatives, and address this critically important health condition.
Not only for those with the lived experience, but also for future generations.
The time has arrived.
I implore you to listen to clinicians such as myself who are in the front line of patient care in the community.
However most importantly, I invite you to listen to individuals who are living with obesity.
New Zealand Obesity Roadshow, April 2023
Whilst Aotearoa (New Zealand) is well known for
- more sheep living in 🇳🇿than there are humans
- the haka before rugby games in particular, to demonstrate strength and unity and pride…
Sadly we are seeing NZ steadily moving its way up in the “prevalence of obesity” national leagues tables.
In preparation for the recent meetings with my fellow GPs in NZ, I did some research to better understand the lay of the land here concerning obesity prevalence and was concerned to see the alarming prevalence rates of obesity in Maori and Pacifica peoples in particular (up to 70%). This is associated with significant morbidity, mortality and poorer quality of life.
Having spoken with numerous GPs and other HCPs working in diverse cultural and social primary care clinics in and around Auckland these past few days, has highlighted the inequity of access to evidence-based effective anti-obesity healthcare services/ treatments.
I encourage and invite cross-Tasman collaboration and shared learnings with regards to advocacy, education and management of people living with obesity.
HealthEd Presentation: "Combination therapy for the management of obesity" April, 2023
IFSO Conference Naples, Italy August 2023
Australian National Obesity Roadshow: Griffith N.S.W.
I was fortunate and humbled to speak with front-line GPs in rural NSW yet again.
Griffith is part of the Murrumbidgee healthcare district, with approximately 5.3% of the population identifying as of Aboriginal and/or Torres Strait Islander ancestry. Griffith is located on the traditional land of the Wiradjuri people.
Of concern is that Griffith has higher rates of premature mortality in both males & females including circulatory disease, ischaemic heart disease etc.
Griffith also had a higher proportion of people living with obesity for both genders.
One of the striking features of Griffith is its “Italian” influence, with apparently 60% of the population claiming Italian heritage.
Italian settlers who came to Griffith were farmers from the Veneto region and continue to do so today.
World Diabetes Day, November 2023
Today is “World Diabetes Day”
Fortuitously this morning I was privileged to present at the St George Public Hospital Cardiology Grand Rounds on a very hot topic at the moment “role of GLP1 -RA in the management of people living with concurrent T2DM and CVD”.
We have robust medical scientific data on cardiovascular safetu outcomes for people taking GLP1a medications.
To people living with T2DM, obesity or both aka "diabesity" who wish to find out more AND to find out whether this is relevant and/or applicable to you, please seek the advice of an experienced healthcare professional.
To my fellow healthcare professional colleagues: we have an ethical and medico-legal responsibility to inform patients of effective evidence-based treatments, without assuming/ presuming to know if they can afford therapy/ have a preference for method of administration etc.
Let's work together to assist patients in making an informed decision.
An evening of clinical discussion on the CVOT and heart failure data for GLP1-RA
As founder of the RACGP obesity management network in 2014, it was both a pleasure and privilege to attend this me
7NEWS Toowoomba: Friday Evening News
A nutritionist who fell into the trap of overdieting and exercising is speaking out to others with obesity on a mission to stop the stigma.
International Conference on Obesity 2022, Melbourne
ICO, 2022: National Obesity Strategy and what it means for GPs
speaker at ANZMOSS Conference, October 2022 Cairns
Primary Care Global Diabetes Expert Meeting November 2021
Treating obesity as a chronic disease-2021 with Professor Arya Sharma
- March 2022: The role of primary care in the management of patients living with ObesityWagga Wagga
- November 2021: Treating obesity in primary care: why, who and how? World Organisation of Family Doctors [WONCA] International Congress[virtual]
- November 2021: ASCEND small group learning tutorial in obesity case management[virtual]
- November 2021: Medscape Obesity Week 21 in review: with Arya Sharma[virtual]
- November 2021: NovoNordisk: Global Obesity Clinics Academy[virtual]
- November 2021: Primary Care Global Diabetes Expert Meeting 2[virtual]
- October 2021: Primary Care Global Diabetes Expert Meeting 1[virtual]
- October 2021: "Medical management of the bariatric surgical patien" masterclass Australian & New Zealand Metabolic Obesity Surgery Society annual Scientific meeting[virtual]
- July 2021: iNova Pharmaceuticals: Development of content for “Weighingit Up” medical education program[virtual]
- July 2021: Treating obesity in primary care: why, who and how? World Organisation of Family Doctors [WONCA] European Congress[virtual]
Re-Think Obesity, Obesity & Anti-Obesity Medications
Dr Rigas talks about Australia's Obesity Epidemic
Dr Georgia Rigas for World Obesity Day
Dr Georgia Rigas appeared on Studio 10 (pictured) in addition to other platforms per below as part of World Obesity Day 2021
- 2GB – live
- Ticker TV – live
- Hope 1032 – live
- Studio 10 Facebook: The Woman Who Lost Half Her Size!
- Nine.com.au: 'I felt judged': Overweight Aussies too embarrassed to see GP
- Health Industry Hub – Novo Nordisk launches new clinician podcast to mark World Obesity Day
- 5CC Online – Obesity on the Rise as People Feel Reluctant to Talk About Weight Management
- Vision Christian Radio – Australians Struggling With Obesity Encouraged to Talk to GP
- BioPharmaDispatch – New research reveals uncomfortable conversations about weight loss
- Health Dispatch – New research reveals uncomfortable conversations about weight loss
Are you Getting the Most Out of Your Lap-Band?
Re-Think Obesity 4Forums
COVID-19 and people with obesity; what does the evidence say?
The COVID-19 pandemic has led to worldwide research efforts to identify risk factors for morbidity and mortality in order to identify high-risk populations and assist in the development of effective preventive strategies.
Diabetes Obesity Dialogue
With over 500 delegates from close to 50 countries, it was a testament to the fact that many health care professionals (HCPs) have an interest in these two synergistically entwined chronic diseases.
Melbourne Obesity Masterclass
Riddle: what does a cardiologist, renal physician, endocrinologist, psychiatrist, neurologist, oncologist, rheumatologist, respiratory physician, gastroenterologist/hepatologist and gynaecologist share in common?
Answer: Patients living with obesity.
Recent ANZOS conference at Sydney ICC
A couple of weeks ago, the Australian and New Zealand Obesity Society (ANZOS) held it's annual scientific conference. I was asked to Chair the GP Symposium dinner which was well attended. The GPs who participated were very engaged and enthusiastic to learn more about how to help manage their patients living with obesity and to share experiences, ideas,strategies. (this is the best way for adults to learn).
Overcoming the Challenges in the Management of Obesity
Featured in the photograph, left to right:
Assoc. Prof Michael Talbot, President of the Australian & New Zealand Metabolic Obesity Surgery Society (ANZMOSS)
Prof Arya Sharma, Chair for Obesity Research & Management, University of Alberta Canada
Dr Georgia Rigas, Chair: Royal Australian College of General Practitioners (RACGP) Obesity Management Network
Assoc. Prof Sof Andrikopoulos, Chief Executive Officer, Australian Diabetes Society
Dr. Georgia Rigas Appeared on Michael Mosley's Reset
Obese patients have the will, but can’t find the way
“Obesity is not due to lack of willpower or moral fibre,” Dr Georgia Rigas, the chair of the RACGP Obesity Network and a co-author of the study, said. “No one chooses to have obesity.”
Measuring the BMI and waist circumference of all patients every two years should be the norm in general practice, she said.
“This study highlights the need to take affirmative action to stop fat shaming and weight stigma which is rife in the community and among healthcare professionals.”
Obesity Australia Summit 2018: A new approach to a growing problem
Dr. Rigas is a well-known public speaker on issues related to obesity. She delivered a talk on behalf of the RACGP, to the Obesity Summit in Canberra ACT. In the past, she has participated in public-speaking events around the globe including Sweden, Athens, Vienna, and London.
Dr. Georgia Rigas talks about the effects of obesity & what you can do
Dr. Rigas talks about the growing obesity problem on 10 News First
Dr. Rigas talks about the obesity epidemic
We can call this an epidemic’: Obesity rates double in 10 years
According to Dr Rigas, children with obesity are predisposed to type 2 diabetes, premature arthritis of the knees, fatty liver, infertility and other physical health concerns. There are also the emotional effects of obesity, which include bullying, depression, anxiety, and a higher rate of leaving school early, which then negatively impacts their future job prospects.