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Title: Clinical Obesity Services in Public Hospitals in Australia: a position statement based on expert consensus.
Austin Authors: Atlantis, E;Kormas, N;Samaras, K;Fahey, P;Sumithran, Priya ;Glastras, S;Wittert, G;Fusco, K;Bishay, R;Markovic, T;Ding, L;Williams, K;Caterson, I;Chikani, V;Dugdale, P;Dixon, J
Affiliation: Capital Markets Cooperative Research Centre, Sydney, Australia
School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
Department of Endocrinology and Metabolism, Concord Repatriation General Hospital, Sydney, Australia
Department of Endocrinology, Campbelltown and Camden Hospitals, Sydney, Australia
Diabetes Obesity Metabolism Translational Research Unit, Campbelltown Hospital, Sydney, Australia
Department of Endocrinology, St Vincent's Hospital, Sydney, Australia
Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney, Australia
School of Science and Health, Western Sydney University, Penrith, Australia
Austin Health Weight Control Clinic, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Endocrinology, Diabetes and Metabolism, Royal North Shore Hospital, St Leonards, Australia
School of Medicine, The University of Adelaide, Adelaide, Australia
Metabolic and Weight Loss Clinic, University Clinics, Western Sydney University, Blacktown Hospital, Sydney, Australia
Boden Institute, Charles Perkins Centre, University of Sydney, Sydney, Australia
Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, Australia
Department of Chemical Pathology, Royal North Shore Hospital, NSW Health Pathology, Sydney, Australia
Sydney Medical School (Nepean), Sydney, Australia
Nepean Family Obesity Services, Nepean Blue Mountains Local Health District, Sydney, Australia
Department of Diabetes and Endocrinology, The Princess Alexandra Hospital, Brisbane, Australia
Centre for Health Stewardship, The Australian National University, Canberra, Australia
Chronic Disease Management Unit, Australian Capital Territory Health Directorate, Canberra, Australia
Baker Heart and Diabetes Institute, Melbourne, Australia
Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Australia
Issue Date: Jun-2018 2018-04-23
Publication information: Clinical obesity 2018; 8(3): 203-210
Abstract: We aimed to describe the current state of specialist obesity services for adults with clinically severe obesity in public hospitals in Australia, and to analyse the gap in resources based on expert consensus. We conducted two surveys to collect information about current and required specialist obesity services and resources using open-ended questionnaires. Organizational level data were sought from clinician expert representatives of specialist obesity services across Australia in 2017. Fifteen of 16 representatives of current services in New South Wales (n = 8), Queensland (n = 1), Victoria (n = 2), South Australia (n = 3), and the Australian Capital Territory (n = 1) provided data. The composition of services varied substantially between hospitals, and patient access to services and effective treatments were limited by strict entry criteria (e.g. body mass index 40 kg/m2 or higher with specific complication/s), prolonged wait times, geographical location (major cities only) and out-of-pocket costs. Of these services, 47% had a multidisciplinary team (MDT), 53% had an exercise physiologist/physiotherapist, 53% had a bariatric surgeon and 33% had pharmacotherapy resources. Key gaps included staffing components of the MDT (psychologist, exercise physiologist/physiotherapist) and access to publicly funded weight loss pharmacotherapy and bariatric surgery. There was consensus on the need for significant improvements in staff, physical infrastructure, access to services, education/training in obesity medicine and targeted research funding. Based on the small number of existing, often under-resourced specialist obesity services that are located only in a few major cities, the vast majority of Australians with clinically severe obesity cannot access the specialist evidence based treatments needed.
DOI: 10.1111/cob.12249
ORCID: 0000-0001-5877-6141
PubMed URL: 29683555
Type: Journal Article
Subjects: Obesity
hospital Outpatient Clinics
specialist weight management
weight loss
Appears in Collections:Journal articles

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