Is It Time to Rename Obesity Management as Secondary Prevention?

Abstract

As the prevalence of obesity increases, we may need to expect that the associated medical problems will also increase. There are very many different factors involved. We are obese and getting bigger; therefore, unless we tackle all of these different factors, we will not solve this problem. In the meantime, obesity remains associated with over 50 common and often life-threatening medical conditions. Rather than treat the consequences of these conditions, we should focus our attention on dealing with the cause. Common sense would suggest a need to focus on prevention; however, the evidence base for effective preventative measures just does not exist. Many different proposals have been made to help manage obesity by prevention, but will they work and are they the most cost-effective way to manage the obesity epidemic? At present, considerably more money is invested in the prevention of obesity than in its management, despite the fact that there is good evidence for effective weight management interventions. This management should be done in the primary care setting, and barriers to effective obesity management should be addressed. Furthermore, it should be considered as secondary prevention, as we do with cardiovascular disease. In this sense, the management of the obese prevents further obesity, morbid obesity, the super-obese, and so on. With examples of “best practice” available, we should not hesitate in rolling out effective weight management programs nationwide.