Treating chronic diseases without tackling excess adiposity promotes multimorbidity

Few people now reach old age without taking multiple drugs, often attending various clinics, and undergoing secondary or tertiary investigations. Most chronic conditions are, to differing extents, caused or exacerbated by excess adiposity, but weight management is rarely discussed or attempted for patients. Furthermore, progressive symptoms usually attributed to ageing (eg, musculoskeletal pains, fatigue, and breathlessness), and which create considerable health-care demands, can also be attributed to the accumulation of body fat over time. For many symptoms and diseases that are more frequently reported in people with excess adiposity (such as depression), there exist potentially multidirectional, causal relationships that generate a cycle of clinical and social deterioration. There is insufficient research on the effects of effective weight management on these clinically demanding, age and weight-mediated symptoms. Based on current evidence, we suggest that policy makers need to be more proactive in obesity prevention and effective weight management should receive research funding to match the search for novel therapeutics for secondary chronic diseases.