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Overweight and obese persons' bodies are programmed to regain any weight that is lost and authorities are wasting money on campaigns urging people to exercise and eat healthy food, according to obesity expert Joseph Proietto.

In an opinion piece in The Medical Journal of Australia, University of Melbourne Professor of Medicine Joseph Proietto states that the high failure rate of weight-loss programs could be explained by growing evidence that obesity was "physiologically defended".

Professor Proietto opined that weight loss in obese people only led to changes in energy expenditure and hunger-controlling hormones that encouraged weight gain.

"It is likely that it is these physiological adaptations that make it so difficult to maintain weight loss,"

"Importantly … in those who are already obese, public health messages encouraging people to eat healthy food and exercise are unlikely to have a long-term impact on their weight."

Professor Proietto said the weight-control clinic he runs at Melbourne's Austin Hospital was overwhelmed with demand, with a two-year waiting period. But the hospital was funded to do no more than 20 gastric banding operations a year.

In an interview with The Age, Professor Proietto said political leaders were ignoring the biological reasons for obesity by focusing on lifestyle messages and providing only limited funding for bariatric surgery, which had been shown to achieve long-term weight loss.

"All the money is put into giving messages on television, but actually that doesn't work - you can't convince someone not to eat who's hungry.

"If a good tablet came along it would not make it on the PBS [Pharmaceutical Benefits Scheme] because everybody says obesity is a lifestyle disorder only and all you have to do is change your habits.

"We don't need tablets to lose weight, but we do need them to keep it off."

Professor Proietto said it was important to focus on preventing obesity, particularly in children, but more resources were needed for people who were already obese.

He believes gastric banding surgery could reverse obesity-related conditions such as type 2 diabetes and obstructive sleep apnoea.

In his journal article, Professor Proietto wrote "we must help the long-suffering obese in their struggle to maintain a reduced weight.

"In the absence of safe, effective pharmacological agents that can be used long-term, bariatric surgery is the most successful intervention for sustained weight loss.

"Why is it not more often conducted in public hospitals?"

Professor Proietto's focus on bariatric surgery has been questioned by other medical experts, who say it is a last-resort measure that does not address the complex causes of obesity.

Obesity Policy Coalition Senior Policy Adviser Jane Martin said the surgery was not feasible as a population-wide solution to obesity because it was expensive, risky and not always appropriate.

Martin explained "it's time for the Government to implement policies that tackle the key drivers of obesity, including protecting children from pervasive junk-food marketing, implementing traffic-light labelling on processed foods, and taxing unhealthy foods together with subsidising healthy foods for those on low incomes."

For more information go to www.mja.com.au/public/issues/195_03_010811/contents_010811.html

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