Foreword - Focus on Obesity

World Obesity Day is held to draw global attention to a condition that can no longer be ignored. More than one billion people worldwide are now living with obesity and current projections suggest this number could rise to four billion by 2035. This number is close to half of the global population. Obesity is a current and accelerating public health challenge with profound implications for individuals, health systems, our communities and future generations.
One of the alarming trends is the rapid rise in childhood obesity. Prevalence of obesity in those younger than 18 years has increased from around 4% in the mid-1970s to more than 20% today. Many children and adolescents are showing early markers of conditions once considered diseases of adulthood, especially type 2 diabetes and cardiovascular disease. Without intervention, this growing prevalence of obesity will entrench illness across the life course.

Obesity is a global issue, affecting people of all ages and in every region. The steepest increases are now occurring in low- and middle-income countries, reflecting widening global inequities in food systems, environments, access to care, the priorities of health systems and the lack of preventive strategies. These patterns highlight that obesity is not simply a matter of individual choice but a complex condition shaped by genetic, biological, social and economic factors.

Obesity is now recognised as a complex, chronic, relapsing disease and growing evidence shows that timely, appropriate intervention can really improve health outcomes. These interventions for communities and individuals require collective action in healthcare, policy, clinical practice and community settings. Starting such initiatives and interventions now is more important than ever.

This collection of six articles has been curated to reflect these realities. Together, they provide clinicians with contemporary, evidence-based guidance on the assessment and management of obesity and its associated complications. They offer practical approaches for general practice and highlight advances in managing obesity-related conditions such as obstructive sleep apnoea and cardiovascular disease, and review the new pharmacotherapies.

It is important to realise that many of our current attitudes and approaches contribute to obesity stigma (often felt by those struggling with obesity). We must prioritise prevention from the earliest years, understand the lived experience of our patients and then ensure equitable access to effective care. By approaching obesity in this way, we can change the outcomes for individuals and populations. GPs are central to this effort, and it is hoped that this collection will support informed, compassionate and effective care for people living with obesity.  MT