Obesity: the big picture

He is considered a leading authority on obesity prevention and has worked in the area of public, corporate and clinical health for over four decades. Yet Dr Garry Egger says there is still much to do to combat obesity. He talks to 6minutes.

Are we getting closer to managing obesity?

Not at all.  In fact, we are not doing well. I had a meeting with a colleague who works in smoking [prevention] and I noted she has had enormous success over 30 years but in obesity we can’t claim any success at all because at a population level it is continuing to rise.

Why?

It’s a political and environmental issue. We live in an environment that not only encourages but almost mandates over-consumption.

What is actually causing obesity?

It’s a combination of lifestyle and environmental related anthropogens associated with chronic disease including inadequate nutrition and activity, stress, techno-pathology [adverse effects of technology], inadequate sleep, environmental pollutants, occupational status, drugs, smoking and alcohol, over (and under) exposure to things like sun, smoking and toxins, the quality of interpersonal relationships and social disadvantage.

Wow! That’s some list.

The reason for that is that after 25 years in working in obesity I don’t believe obesity per se is the problem. I think you have to look at the whole package. Obesity is not really a risk factor it’s a determinant of disease.

Do you have any advice for clinicians?

Yes, at a clinical level the most important thing to know is that obese patients are not necessarily unhealthy patients. One third of obese people have no health risks at all.