Weight management: why a whole health system approach is needed

Weight management: why a whole health system approach is needed

ACBRD

New research shows many people living in larger bodies face challenges getting the care they need

By Amy Silverwood

More than 60% of adults in Australia live with overweight or obesity. Behind these numbers are real people, who may experience weight stigma and limited access to healthcare. People living in larger bodies often struggle to get the help needed to manage weight. To find out why, a team of researchers from Deakin University’s Institute for Health Transformation, including the centre’s own Dr Elizabeth Holmes Truscott, looked at healthcare related barriers and enablers of weight management.

What did the study look at?

The researchers wanted to understand why weight management support in healthcare doesn’t happen or work well. They reviewed the findings from 216 studies from English-speaking high-income countries. The studies included views from health professionals, people in larger bodies, and researchers.

What makes care difficult?

For health professionals:

      • Not seeing weight management as important.
      • Feeling unsure or unprepared to talk about weight.
      • Having unhelpful or stigmatising views about weight.
      • Lacking clear guidelines or tools to support people with larger bodies.
      • Not seeing weight management support as part of their job.

In the healthcare system:

      • Poor communication between services about weight support.
      • Mixed or confusing advice from different health professionals.
      • Not enough support services or clear referral processes.
      • Long wait times to get help.
      • Not enough time to give ongoing, personalised care.
      • Strict eligibility criteria that excludes many people from getting support.

In policy and funding:

      • No clear policies to guide how services should be delivered.
      • Limited funding for long-term care.
      • Complex funding split between federal and state systems.

How can we improve weight management care?

      • Upskill and support health professionals to feel more confident talking about weight and reduce stigmatising attitudes
      • Coordinated team care (including GPs, dietitians and nurses), and access to specialist support
      • Set up clear referral and support pathways
      • Improve tools and policies to guide evidence-based and non-judgemental care
      • Wider eligibility and improved rebates or insurance coverage for weight management

Supporting priority populations

People from different culture backgrounds, Aboriginal and Torres Strait Islander communities, and those living in rural areas may face additional challenges when it comes to managing weight. These challenges include a lack of easy-to-understand, culturally relevant resources and local services. Experiences of discrimination and mistrust are also key barriers to care. Providing information in different languages, using interpreters, respecting local cultures, and offering local services can help people feel better supported. Researchers called for further research and support for these priorities populations.

In a related review the researchers explored weight management care for women during pregnancy. That study reported similar barriers and enablers.

What does this mean?

There’s no single fix for weight management care. Clear policies, strong guidelines, better training for health professionals, and clear roles for weight management in primary care are urgently needed. The researchers found that meeting these challenges requires a whole health system approach, so that everyone, everywhere can get the respectful, person-centred weight management care they deserve.

If you are interested in reading more about research on weight stigma, particularly for those with type 2 diabetes, see our blog posts – here and here.

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