Poster Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Clinical Obesity Services in Public Hospitals (COSiPH) in Australia: a position statement based on expert consensus (#302)

Evan Atlantis 1 2 3 4 , Nic Kormas 4 5 6 , Katherine Samaras 7 8 , Paul Fahey 1 , Priya Sumithran 1 9 10 , Sarah Glastras 11 , Gary Wittert 2 , Kellie Fusco 2 , Ramy Bishay 12 , Tania Markovic 13 14 , Lucy Ding 11 15 , Kathryn Williams 16 17 , Ian Caterson 13 14 , Viral Chikani 18 , Paul Dugdale 19 20 , John Dixon 21 22
  1. Western Sydney University, Penrith, NSW, Australia
  2. Medicine, University of Adelaide, Adelaide
  3. Capital Markets Cooperative Research Centre, Sydney, New South Wales, Australia
  4. Diabetes Obesity Metabolism Translational Research Unit, Campbelltown Hospital, Campbelltown, New South Wales, Australia
  5. Endocrinology, Campbelltown and Camden Hospitals, Campbelltown and Camden, NSW
  6. Department of Endocrinology & Metabolism, Concord Repatriation General Hospital, Concord, New South Wales, Australia
  7. Department of Endocrinology, St Vincent’s Hospital, Darlinghurst, New South Wales, Australia
  8. Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
  9. Austin Health Weight Control Clinic, Heidelberg, Victoria, Australia
  10. Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia
  11. Department of Endocrinology, Diabetes & Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  12. Metabolic & Weight Loss Clinic, University Clinics, Western Sydney University, Blacktown Hospital, Blacktown, New South Wales, Australia
  13. Boden Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
  14. Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  15. Department of Chemical Pathology, Royal North Shore Hospital, NSW Health Pathology, St Leonards, New South Wales, Australia
  16. Sydney Medical School (Nepean), Kingswood, New South Wales, Australia
  17. Nepean Family Obesity Services, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
  18. Department of Diabetes and Endocrinology, The Princess Alexandra Hospital, Brisbane, Queensland, Australia
  19. Centre for Health Stewardship, The Australian National University, Canberra, Australian Capital Territory, Australia
  20. Chronic Disease Management Unit, Australian Capital Territory Health Directorate, Canberra, Australian Capital Territory, Australia
  21. Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
  22. Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia

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. Organisational level data was 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. BMI 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.