Obesity and health--new perspectives from bioscience research suggest directions for clinical practice

This viewpoint is written from the dual perspectives of a metabolic biochemist and a nurse academic who met at the Oxford University Round Table Forum on Obesity in 2008. Forty invited participants from around the world spent a week presenting and debating research and practice in the area of obesity. A unique feature of this forum was that it was cross-disciplinary with participants ranging from those working in public health with a background in medicine, paediatrics, nutrition, nursing, education, policy analysis, behaviour and social sciences, and exercise physiology to those working in the food industry and health insurance. The link between our current affluent lifestyle and increasing obesity, cardiovascular disease, type 2 diabetes mellitus and the associated morbidity and mortality is well established. Interventions have involved individual patient clinician encounters aimed at weight loss and broader public health interventions with the goal of prevention and management of obesity. However, what is often overlooked is the need to also understand the psychosocial implications and issues for those living with a large body in a society where the prevailing culture, including that of health professionals, espouses a lean body as the ideal and excess weight as a testimony to greed, sloth and lack of will power. In this paper we share observations and learning from Round Table participation together with some of our own research interests.