Obesity Treatment Is Changing, But Access to Care Still Matters
New medications, advances in bariatric surgery and a greater understanding of obesity have significantly changed the treatment landscape in recent years.
But having more treatment options does not necessarily mean every Australian can access the care they need.
This issue has recently been highlighted in The Australian, which has examined some of the challenges facing Australians living with obesity, including access to specialist care and the ongoing cost of medical weight management.
Dr Jason Free, Specialist Bariatric and General Surgeon at Surgery Gold Coast and President of the Australian & New Zealand Metabolic Obesity Surgical Society (ANZMOSS), was invited to contribute to the discussion.
For Dr Free, the conversation highlights a bigger issue: obesity is a complex, chronic health condition and, particularly for people with severe or complex obesity, treatment may require much more than a single medication or appointment.
More options, but not necessarily more access
The introduction of GLP-1 and related medications has provided another treatment option for obesity and changed the way weight management is being discussed in Australia.
However, cost, tolerance, individual response and the potential need for ongoing treatment can influence whether medication is appropriate or sustainable for an individual.
Bariatric and metabolic surgery also remains an established treatment option for appropriately selected patients, while nutrition, psychological support, physical activity and management of obesity-related health conditions can all form part of care.
The challenge is bringing these different elements together.
As Dr Free told The Australian, greater investment in multidisciplinary obesity services is needed, particularly for people with complex health needs.
“We recognise this as a disease with a lot of medical comorbidities which are life threatening,” he said.
Obesity care is rarely one-dimensional
One of the central themes of Dr Free’s commentary is the importance of moving away from viewing obesity treatment as simply a choice between medication and surgery.
For some people, medical weight management may be appropriate. For others, bariatric surgery may be considered. Some patients may use medical therapies before or after surgery, while others may require input from several health professionals to address different aspects of their health.
This is where multidisciplinary care becomes particularly important.
An obesity management team can involve physicians, surgeons, nurses, dietitians, psychologists and exercise or allied health professionals, depending on an individual’s needs.
It is an approach Dr Free believes needs greater recognition within Australia’s healthcare system.
When patients struggle to find somewhere to go
The two Australian articles also highlight another important problem: navigating the health system can be difficult for people requiring longer-term or more specialised obesity care.
One of the patients featured, Geelong man Matt Bright, has complex healthcare needs and described difficulties finding appropriate ongoing services.
His experience raises a broader question: what happens when a person needs more support than can realistically be provided through short-term programs or individual appointments?
Dr Free believes specialist obesity and metabolic services have an important role to play, particularly where patients require coordinated input from multiple health professionals.
GPs are also an important part of that pathway. Greater awareness of available specialist medical and surgical obesity services can help patients access assessment and determine what options are appropriate for their individual circumstances.
Moving beyond the medication-versus-surgery debate
As obesity treatments continue to evolve, it can be tempting to ask which option is “better”.
In reality, that question often oversimplifies a complex condition.
Medication and bariatric surgery work differently, carry different considerations and will not be appropriate for every patient. Treatment decisions should take into account an individual’s health, medical history, previous treatments, preferences and longer-term needs.
The aim should be to provide patients and their referring doctors with balanced, evidence-based information about the available options rather than positioning one treatment as the answer for everyone.
This is also a key focus for Dr Free in his role as President of ANZMOSS: improving understanding of obesity, supporting education and collaboration among health professionals, and advocating for appropriate access to evidence-based obesity care.
A multidisciplinary approach at Surgery Gold Coast
At Surgery Gold Coast, obesity care extends beyond the operating theatre.
Dr Free works alongside Nurse Practitioner Virginia Moore, dietitians, psychology support and nursing staff across medical and surgical weight management pathways.
For some patients, the first step is exploring medical weight management. For others, it can involve discussing bariatric surgery or revisional surgery. In some circumstances, different approaches may be used at different stages of a patient’s care.
Importantly, an initial consultation is an opportunity to understand the available options, not a commitment to a particular treatment.
As the range of obesity treatments continues to grow, access to appropriate assessment, evidence-based information and ongoing multidisciplinary support remains an important part of the conversation.
Read the original reporting
Dr Free’s comments formed part of recent reporting by The Australian examining access to obesity treatment and GLP-1 medications in Australia.
The stark reality facing people needing GLP-1 drugs to lose weight
The Australian
Australia’s severe obesity crisis deepens as people like Matt struggle to find care
The Australian
Exploring your weight management options?
To discuss medical or surgical weight management options with the Surgery Gold Coast team, contact us on (07) 5564 6501.
All surgical procedures carry risks. A second opinion from a qualified health practitioner is recommended. Individual results vary. Medical and surgical treatments are not suitable for everyone. This information is general and does not replace personalised medical advice.