Australian public hospitals cannot meet the rising demand for obesity care

Despite our national waistline being touted as a major public health concern – new research, led by Western Sydney University, has found that public hospitals are not adequately resourced to treat the one million adults who currently live with clinically severe obesity in Australia.

Dr Evan Atlantis from the University’s School of Nursing and Midwifery led the study for the Clinical Obesity Services in Public Hospitals (COSiPH) Working Group, which also involved expert representatives from 15 public hospitals in New South Wales, Queensland, Victoria, South Australia and the ACT.

The results of the study, published in Clinical Obesity, indicate that:

• Only a small fraction of Australians who are eligible to access specialist healthcare services for obesity would have access to such services in Australian public hospitals.
• The services for clinically obese patients vary substantially between hospitals.
• The small number of specialist obesity services that are available, are under-resourced and only located in a few major cities.
• Patient access to services and treatments is limited by strict entry criteria, prolonged wait times, geographical location, as well as out-of-pocket costs.

The Clinical Obesity paper calls for significant improvements in:

• staff and physical infrastructure resources;
• access to services, weight loss medications and surgery; and
• research funding for improving services.

Dr Atlantis says patients with severe obesity often have multiple health conditions, and consequently, complex health needs that cannot be met within the constraints of most primary care settings.

“The results of this study indicate that thousands of people, who may benefit from specialist health care, are currently not having their needs addressed by the public health system,” says Dr Atlantis.

“The experts that responded to this study reached a consensus on the need for significant improvements in obesity medicine – this includes education and training for staff; improved physical infrastructure and access to services; and more targeted research funding.”

Chair of the COSiPH Working Group, Professor John Dixon from the Baker Heart and Diabetes Institute, says the vast majority of Australians with clinically severe obesity cannot access the specialist evidence based treatments needed.

“Despite the one million adults with clinically severe obesity in Australia, very limited services are available and there is substantial variability in the structure, resourcing and capacity of current specialist obesity services in public hospitals,” says Professor Dixon.

“The current national approach to assessing and managing clinically severe obesity would surely be unacceptable if it were applied to other complex chronic health conditions such as cancer, diabetes, and heart disease.”

Organisational level data was sought for the study from specialist obesity services across Australia in 2017, and hospital clinicians responded to two surveys to share their views on any gaps in resources in public hospitals.

Other stakeholders in the COSiPH Working Group include current Presidents of the Australian and New Zealand Obesity Society (ANZOS), the Australian and New Zealand Metabolic and Obesity Surgery Society (ANZMOSS), and the World Obesity Federation.

(Source: Western Sydney University, Clinical Obesity)