Introduction

Australia has one of the highest prevalences of overweight and obesity in the developed world, and this is a contributing factor, along with ageing, to the burden of chronic disease in our society. [1] The sequela to this burden is an increase in morbidity and mortality in the community.

In 2022, the National Obesity Strategy 2022 – 2032 was released. This is the Governments first ever strategy aimed at the future prevention of chronic diseases, mental health, as well as the impact on social and economic opportunities. [2]

According to Dr Michael Wright, RACGP President, “Nearly a third of Australia’s adult population is living with obesity, and its predicted to cost taxpayers and governments $87.7 billion annually by 2032. This is why it is essential that everyone in Australia has access to affordable general practice care, including for longer consults and GP mental health consults, which we know many people living with obesity may need’. [3]

Dr Wright stated that the goal for Australians is to experience gains in their overall health and that weight loss is secondary to this. The causes of obesity are multi-factorial with genetics, stress, early life experiences, disordered sleep, and the environment playing a part in this complex dynamic.[4] Additionally, the proliferation of fast-food outlets in our society which offer cheaper food choices and easy access, as well as advertising of these products, makes healthier choices harder for some.

In Australia, according to the Obesity Evidence Hub, [5] one in four Australian children and adolescents were living with overweight or obesity in 2022- 2023. This has increased from 20.1% in 1995 to 27.7% in 2022 – 2023 amongst Australians aged 5 – 17 years.

What is overweight and obesity

According to the World Health Organisation (WHO), [6] overweight is ‘a condition of excessive fat deposits’. Obesity is ‘a chronic disease defined by excessive fat deposits that can impair health’. This condition can therefore increase the risk of other chronic diseases such as type 2 diabetes, osteoporosis, arthritis, and certain cancers.

The diagnosis of overweight or obesity is made by determining a person’s body mass index or BMI. This is calculated by dividing a person’s weight in kilograms by their height in meters squared. So, if a person was 1.7m, the square of this is 2.89. If they weighed 70kg, the calculation is 70kg divided by 2.89 giving a result of 24.2.

A healthy BMI for an adult is between 20 and 25. For older Australians over the age of 74 years, their general health may be more important than being mildly overweight. Some researchers have suggested that a BMI range of 22-26 is acceptable for older Australians.

For adults, the WHO defines overweight and obesity as follows:

  • overweight is a BMI greater than or equal to 25; and
  • obesity is a BMI greater than or equal to 30.

Another useful measurement is weight circumference. A healthy waist circumference is generally considered to be less than 94cm for men and less than 80cm for women, as larger measurements are associated with an increased risk of chronic diseases. The risk increases significantly for men with a waist circumference of 102cm or more and for women with a measurement of 88cm or more. [7]

For children, age needs to be considered when defining overweight and obesity.

Management of overweight or obesity

General practitioners play a vital role in the management of overweight or obesity and are often the first healthcare provider that identifies these conditions.

Management and treatment requires a personalised approach considering the person’s mental, social, physical, cultural and environmental circumstances. GPs can establish and refer to a team of health professionals who can guide and support the person with therapeutical goals going forward in a shared care arrangement.

The team may include a dietitian, exercise physiologist, practice nurse, and psychologist.

Lifestyle Interventions

The first line of treatment for a person who is overweight or obese involves lifestyle interventions using the expertise of the health team working in partnership to achieve SMART (specific, measurable, achievable, relevant and time bound) goals. Broad socio-economic factors that may impact on achievement of goals need to be acknowledged in a supportive environment.

Dietary

A referral to an accredited dietitian can assist with an individualised, tailored plan that reduces dietary energy intake whilst encouraging healthy food choices.

A self-recorded food diary may be recommended so that the dietitian can assess and modify the plan accordingly.

According to the Obesity Evidence Hub[8], a dietary pattern that has been widely studied and has no overt focus on energy intake is the ‘Mediterranean Diet’. This recommends a high intake of vegetables, legumes, nuts and fruits, and a moderate meat intake. It also suggests replacing saturated fats with monounsaturated fats like olive oil. Research indicates that that the Mediterranean Diet reduces the risk of cardiovascular disease as well as assisting with weight management.

Physical Activity

Regular physical activity is recommended in conjunction with weight management strategies. An exercise physiologist will be able to develop a physical activity plan and support the person to stay motivated.

In 2022–23, only 24.7% of Australian adults met physical activity guidelines[9].

The guidelines state that adults aged 18–64 years should be active most days of the week, accumulate 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity (or an equivalent combination) each week, and do muscle strengthening activities on at least two days each week.

Adults aged 18–24 years were most likely to meet this recommendation (31.3%), and those aged 55–64 were the least likely (61.1%)[10]

Maintaining lifestyle changes and weight loss long-term can be challenging and management approaches should reflect this by providing ongoing monitoring and support.

Mental Health

A person living with overweight or obesity may be experiencing mental health challenges, may not have a suitable sleep pattern or be dealing with other stressful circumstances.

A psychologist is another team member who can help with health promoting behaviours and wellbeing. There may be underlying belief systems, triggers and feelings about weight issues, food or exercise for the person which a psychologist can explore through effective therapies such as cognitive behavioural therapy (CBT) as one example.

Ongoing care

Overweight and obesity is a complex chronic condition which requires ongoing support through the multi-disciplinary team approach.

If the lifestyle interventions do not result in sufficient weight loss, a GP may recommend medication therapy in conjunction with the continuation of health food choices and physical activity.

Medication

Advances in medical research have meant that there are now a range of medications available for the treatment of overweight and obesity in conjunction with lifestyle changes. According to the Obesity Evidence Hub[11], ‘Obesity pharmacotherapy is indicated as a treatment option for people with a BMI ≥ 27 kg/m2 and with a weight-related health problem, or people with obesity (BMI > 30 kg/m2)’.

The medications mainly act to suppress appetite by reducing hunger and/or increasing a feeling of fullness after food.

A GP needs to assess each person and their circumstances before prescribing a medication that will be best suited to that person. Such therapies need to be ongoing to prevent relapses but given that these medications have been approved by the Therapeutic Goods Administration (TGA) but are not on the Pharmaceutical Benefits Scheme (PBS), there is a significant monthly cost which has a socio-economic bias.

Education on the side-effects as well as the fact that long term safety and efficacy data is limited at this time, will need to be explained if the person who lives with overweight or obesity is able to afford the medication.

It is worth mentioning that over-the-counter weight loss supplements from supermarkets and pharmacies are often promoted in the media but show no evidence of working effectively.

Surgical Interventions

There are a number of surgical interventions available for people living with obesity who fit the criteria. These include:

  • Gastric balloon – inserted into the stomach to cause a feeling of fullness so that a person eats less
  • Gastric banding – a small ring is placed around the top part of the stomach. This gives a person a feeling of fullness so that eating a small amount will occur
  • Gastric sleeve surgery – removes removal of most of the stomach so restricts how much a person eats
  • Gastric bypass surgery – makes the stomach smaller and affects how food is digested. [12]

Whist bariatric interventions achieve weight losses of around 25 – 30%, and is generally safe, there are, as with any surgery, side effects that people need to be aware of.

A GP will need to refer a person living with obesity to a bariatric specialist clinic. The latter often involve a multi-disciplinary team to support the person in both the short term and long term. Most procedures occur in the private sector in Australia which impacts on access and equity issues for the general population.

However, the 2023 Annual Report from the Australia and New Zealand Bariatric Surgery Registry found that rates of bariatric surgery have decreased partly due to the improvements in medications now available as well as the increase in cost living pressures.[13]

Conclusion

Overweight and obesity is a multi-factorial, complex issue which requires behavioural change for the person living with the condition/s in partnership with a supportive GP and team of health professionals to guide the journey.

Societal pressure and social media is relentless in its ability to shame and negatively impact children and adults alike about their bodies. The proliferation of fast-food outlets offering cheaper but less nutritious food options in addition to their catchy marketing campaigns do not help.

However, given that the trends for Australian adults in terms of obesity and waist circumference is increasing and the prevalence of chronic diseases is increasing, people living with overweight or obesity are urged to speak to their GP and health team.

[1] Printed from Australian Family Physician https://www.racgp.org.au/afp/2013/august/obesity, Accessed November 2025

[2] Department of Health and Aged Care. The national obesity strategy 2022 – 2032. Australian Government, 2022. Available at www.health.gov.au/resources/publications/national-obesity-strategy-2022-2032. Accessed November 2025

[3] RACGP Media Release ‘It’s about gaining health, not just losing weight’: peak body’s new obesity position 4th March 2025 https://www.racgp.org.au/gp-news/media-releases/2025-media-releases/february-2025/it-s-about-gaining-health-not-just-losing-weight-p#:~:text=RACGP%20Obesity%20Management%20Specific%20Interest,an%20appointment%20with%20their%20GP.” Accessed November 2025

[4] Ibid

[5] Obesity Evidence Hub, https://www.obesityevidencehub.org.au/collections/trends/australian-children#:~:text=Last%20updated%2019%2D02%2D2025 Accessed November 2025

[6] World Health Organisation, Key Facts, https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=Overview,in%20infants%2C%20children%20and%20adolescents.

7th May 2025: Accessed November 2025

[7] Australian Institute of Health and Welfare https://www.aihw.gov.au/reports/diabetes/diabetes/contents/diabetes-risk-factors/waist-circumference 12th December 2024. Accessed November 2025

[8] Obesity Evidence Hub, https://www.obesityevidencehub.org.au/collections/treatment/behavioural-interventions-for-the-management-of-overweight-and-obesity-in-adults Accessed November 2025

[9] Australian Institute of Health and Welfare https://www.aihw.gov.au/reports/physical-activity/physical-activity Accessed November 2025

[10] Australian Bureau of Statistics. National Health Survey 2020-21: Health Conditions Prevalence. 2022 Available from: https://www.abs.gov.au/statistics/health Accessed November 2025

[11] Obesity Evidence Hub, https://www.obesityevidencehub.org.au/collections/treatment/medication-and-surgery-for-the-treatment-of-overweight-and-obesity-in-adults Accessed November 2025

[12] Health Direct https://www.healthdirect.gov.au/guide-to-bariatric-surgery Accessed November 2025

[13] The Bariatric Surgery Registry Annual Report – 2023. School of Translational Medicine, Monash University, August 2024, Report No. 11. Version 1.0.