The President’s Conference confronts obesity

Morning Sessions 

The meeting opened and closed with the Chief Scientist for Health in Scotland, Professor Dame Anna Dominicziak, serving initially as the session chair. The overview from Johanna Ralston of the World Obesity Federation showed that projections for obesity prevalence around the world are looking grim - doubling, with an additional 1 billion people living with obesity in 2035 compared with today. This doubling will affect children and adults alike. The United Nations is due to hold one of its rare High-Level meetings specifically over this crisis in September 2025. In an entertaining and informative talk from Professor Giles Yeo from Wolfson College, University of Cambridge, we learnt that there are single and multiple gene variants that make obesity more likely for a given set of circumstances. But genes do not determine how much weight the population carries – Professor Yeo talked of ‘fighting your biology’ in responding to weight gain. The whole population now needs to fight, as the environment makes accumulating weight easy for everyone, and especially if genes predispose you to excessive weight gain. Adam Bradshaw from the Tony Blair Institute summarised the economics of the issue and reported even higher estimates of the costs - £98bn or 4% of GDP based on calculations that account for economic inactivity (1). He introduced work now available to tackle this scalable challenge.  

In the following session, Frances Bain of NESTA Scotland described their work on diet and weight initiatives from across the world, outlining several examples, including Korea and Japan. She then introduced NESTA’s most recent Blueprint for Halving Obesity which sets out a blend of approaches, primarily focused on prevention and treatment through regulation, promotion, advertising restrictions, and investment in treatment capacity (2). Laurie Eyles, a dietician advising the Scottish Government and service lead in NHS Lothian, covered the current ambitions of country-wide initiatives to tackle – even reverse – type 2 diabetes, primarily through weight loss programmes. 

Professor Naveed Sattar of the University of Glasgow, who chairs the UK Government’s Obesity Mission, addressed the topic that had already featured in conversations across the conference – the place of ‘weight loss drugs – are they the answer?’ His overview of the entire field yielded an answer – yes, they have potential, and we are learning more - but it depends on the question asked. The field is complex and far greater than a problem that drugs alone can fix. Simon Dexter, a Leeds-based surgeon who has worked as a leader in bariatric surgery, brought the conference up to date on surgical techniques and their place in tackling weight loss, securing major improvements for many patients but showing also that weight gain after surgery can still be a problem unless other measures to reduce calorie intake are in place.  

This array of contributions completed the morning. Throughout, speakers recognised the scale of the challenge, that medicine and surgery could play a part, but the way we are influenced by the food industry and the environment in which we buy and consume food and drink is crucial to prevent the doubling of the major global problem that we already have. As the House of Lords committee report Recipe for health: a plan to fix our broken food system states: ‘The food industry bears major responsibility for the obesity public health emergency’ (3). 

Afternoon Sessions 

In the afternoon, there was a varied and insightful session of contributions on clinical consequences, chaired by Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, closing with Andrew Healing, providing eloquently the voice of lived experience. Talks from Vice Presidents of the Royal Colleges of Obstetricians (Hassan Shehata), and Anaesthetists (Helgi Johannsson), and a senior paediatrician in Sheffield (Dita Aswani) outlined their evidence-informed way of coping with patients’ problems complicated by obesity, adding that prolonged waiting times for planned interventions offered an opportunity to encourage greater fitness for surgery. Mental Health conditions, treatment and practice are intimately tied with issues of overweight, and they were covered by Professor Fiona Gaughran from King’s College London.  

Two thought provoking talks on stigma (Stuart Flint, Leeds) and lived experience (Andrew Healing, European Coalition for People Living with Obesity (ECPO)) presented a challenge to all of the conference. In Mike McKirdy, the President’s, words, ‘Andrew’s account had perhaps the most important lesson. He asked us to stop and consider that our potentially negative language, when used with patients living with obesity, can have a significant impact on their access to care and health outcomes. To best support our patients, we must start by involving them, approaching language with the same care and consideration we would when treating any other illness’.  

The closing session, chaired by the incoming RCPSG President Hany Eteiba (from December 2024), tied strands from the conference together. The first integrated the three themes of the President’s recent conferences – climate, sustainability and inequalities – which was encouraging as there is much in common in what needs to be done, although there is widespread resistance to change. One key area for action is the food system, the focus of Anna Taylor’s contribution from the Food Foundation. Her appeal was for the Government to implement what it stated it would do. This involves confronting the scale of the issue of what we already know we have to do: with better Government across its functions, clear signs to investors about the right thing to do, better business practice and stronger city leadership – we could read that as all cities as well as the City of London. On theme with the power of the food system, a petition set up by Obesity Action Scotland was highlighted throughout the day’s events and returned a high volume of clinician support. With the 2026 Commonwealth Games in Glasgow fast approaching, the petition’s focus is to restrict high fat sugar salt food sponsorship of Scottish sporting events, due to partnerships such as these being recognised as undermining efforts to achieve a healthy weight nation. To close, we returned to Professor Dominicziak who proposed the merits of a triple helix – health services, academia and business – specifically data science and drug discovery – to solve the challenges of treatment and tertiary prevention. She added food as a fourth factor, which would broaden the options for all types of prevention. 

Confronting Obesity: Challenges, Prevention and Treatment 

The conference set of the challenge of obesity. That scale is great and could double worldwide in the next 11 years, unless we act. We have a great deal of understanding about that challenge, the systems that need to change and grow to achieve effective prevention (primary, secondary and tertiary), and the possibilities for treatment. Whilst focus on treatment in the conference was in specific areas – type 2 diabetes, new medicines and surgery, obstetrics, psychiatry, anaesthetics and children – it was emblematic of a system that is coping with much wider ill-effects, addressing a preventable crisis. The NHS and clinicians cope and adjust, as they always do, but the organised efforts of society need to come to its aid, aligning with difficult things we need to do in climate sustainability and inequalities, on transforming our food system, and on collaborations between clinicians, scientists and other health-promoting actors. Above all we need to act in the interests and support of those who have the condition – systematically, collaboratively, individually, with humanity. 

Blog written by Dr Andrew Fraser, Steering Group Chair. 

Support the Petition

As highlighted at the President's conference, Obesity Action Scotland is heading a petition calling for several actions to make Scottish sporting events healthier for all. We outline urgent steps to keep HFSS food availability and sponsorship out of sports, please review the full actions here.

Please sign on to our petition and support the cause here.

Recommended Reading

Johanna Ralston – World Obesity Federation 

Professor Giles Yeo – selection of videos themed on ‘Is Obesity a Choice?’ 

Anna Taylor – The Food Foundation 

NCD Alliance - NCD Prevention: A Commercial Determinants of Health Approach A 10-Year Vision for a Healthier Scotland 

European Coalition for People living with Obesity 

References

1. Bradshaw A, Dace H. Unhealthy Numbers: The Rising Cost of Obesity in the UK. Institute for Global Change; 2023 Nov 21. Available from: https://institute.global/insights/public-services/unhealthy-numbers-the-rising-cost-of-obesity-in-the-uk 
2. Nesta’s blueprint for halving obesity, 2024. Available from: https://blueprint.nesta.org.uk/ 
3. House of Lords Food, Diet and Obesity Committee. Recipe for health: a plan to fix our broken food system. Report of Session 2024–25, 2024 Oct 24. Available from: https://publications.parliament.uk/pa/ld5901/ldselect/ldmfdo/19/19.pdf