Today, Europe is facing an obesity epidemic, with a staggering 60 percent of adults suffering from pre-obesity and obesity, according to the European Association for the Study of Obesity (EASO). The deteriorating situation has not gone unnoticed by policymakers. This year, on World Obesity Day (4 March), the European Commission recognised obesity as a chronic illness, and MEPs, concerned by the EU’s failure to address this public health crisis, formed a special interest group in the European Parliament in April, calling for renewed action. Now more than ever there is an urgent need for multi-disciplinary specialist expertise to come together and support those dealing with obesity so that they can manage and control it.
This was one of the key messages from an event organised by global nutrition company Herbalife Nutrition, according to Euromonitor - the world’s number one weight management and wellbeing brand - on 12 May, as part of this year’s European Congress on Obesity. Host Julian Cacchioli, Herbalife Nutrition’s Vice-President for Corporate Affairs, EMEA and India, opened the event saying, “An enhanced understanding of the science of obesity, as well as effective interventions, will accelerate not only prevention but also treatment”. The session focused on the latest thinking on the role of weight management models, such as medication and dieting, and the need for ‘community’ approaches to successfully change behaviours and lifestyles and improve public health.
How the gut talks to the brain
The event heard that understanding and treatment for obesity still too often focuses on the external aspects, such as being overweight, which leads to treatment of further health complications such as diabetes and many others. Instead, according to Professor Carel Le Roux, medical practitioners should focus on the symptoms, such as not feeling full after eating (a lack of satiety) and always feeling hungry - which is brought about by a deficiency in certain hormones in the gut which communicate these feelings to the brain. He explained, “Obesity is a very complex chronic disease of the subcortical areas of the brain; it’s characterised by excess adipose tissue causing disease and, even if the body mass index is reduced, the patient still has the disease of obesity, they just have a treated disease that we need to continue to control”.
“An enhanced understanding of the science of obesity, as well as effective interventions, will accelerate not only prevention but also treatment”
Julian Cacchioli, Herbalife Nutrition’s vice-president for corporate affairs, EMEA and India
Le Roux, who chairs the Experimental Pathology department at University College Dublin, believes that by stimulating certain hormones - whether through dieting, drug therapy or exercise - some patients with obesity can more easily manage their eating habits, although not all. "What we are learning from using the gut as a generator of signals through the brain is that there are people who respond to these treatments and those who do not. It’s linked to people’s biology”.
Although a number of drugs are now available which stimulate these hormonal responses, drugs aimed at treating obesity have had a chequered history, with several retracted following safety concerns surrounding their side effects, such as increased incidence of cardiovascular events. However, a lot has since changed, said Professor Bart Van der Schueren, who explained, “The drugs that are currently on the market are quite well tolerated; their safety profile is excellent, and they are quite advantageous. So, drugs are no longer a ‘requiem for a dream’. We should be more open-minded to using them”.
The drugs in question, including Liraglutide, Saxenda, and Mysimba, have shown in studies that they can help patients achieve “approximately a five percent weight loss after 12 weeks”, said Van der Schueren. But, he added, they are most effective when combined with low-calorie diets, including the use of meal replacements, to maintain and achieve additional weight loss.
Community health and wellbeing
Herbalife Nutrition's Dr Kent Bradley presents the company's unique approach to support people with their diets.
Lifestyle intervention, such as exercise, diet, and counselling, is another valuable tool for treating obesity, explained Herbalife Nutrition’s Dr Kent Bradley. According to a 2002 study by the US Diabetes Prevention Program Research Group, which compared the effectiveness of the drug Metformin in treating diabetes against lifestyle intervention and a placebo, over a 16-week period, patients lost more weight from lifestyle intervention than anything else. “This was a big wakeup call for the scientific community”, said Bradley, “It was this wakeup call that lifestyle intervention can in fact be very effective in supporting the prevention of a particular condition”. The study has since been replicated globally over a 15-year period, with a consensus on the same conclusion. “So, we’ve established that our understanding of the role of weight management can, in fact, be significantly affected by an effective lifestyle intervention programme”, he added.
“Celebrating small wins and having positive social support is a critical aspect of how to enhance the journey that we all have in life towards better health”
Dr Kent Bradley, Herbalife Nutrition’s chief health and nutrition officer
Other studies such as the 2008 DEPLOY pilot study, which looked at preventing diabetes, highlighted that laypersons were just as capable of coaching patients in reducing their weight as healthcare practitioners. Bradley explained, “We recognised that we could begin to scale impact through lifestyle intervention through lay individuals”. It is through this ‘community approach’ that Herbalife Nutrition supports those wanting to lose or manage their weight around the world, with the distributors working as peer coaches and supporters, says Bradley, Herbalife’s Chief Health and Nutrition Officer. “Celebration of small wins and positive social support is a critical aspect of how to enhance the journey that we all have in life towards better health.”
Bringing it all together
A common theme raised by all speakers was the fact that no single treatment is a ’silver bullet’; instead, a range of tools, in varying combinations and depending on the patient, can be used to treat obesity. And if the first treatment doesn’t work, others should be pursued, and always framed in a way that motivates the patient. But more importantly, a change in perspective of obesity is needed. “You are not thinking about the weight loss, you are thinking about how to achieve your health goals,” added Bradley.
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