Weight Management

Understanding obesity

Obesity is a chronic health condition. According to the Australian Bureau of Statistics 2022–24 National Health Measures Survey, more than two-thirds of Australian adults were living with overweight or obesity (approximately 13.2 million adults), including one in three living with obesity.

 Obesity and excess weight can increase the risk of serious health problems, including:

• heart and blood vessel disease
• some cancers
• type 2 diabetes
• metabolic-associated fatty liver disease (MAFLD)

Weight gain and obesity can have many causes. These causes are often complex and differ from person to person.

Genetics and body physiology can affect how the body controls weight and body composition. This includes differences in metabolism, appetite, feelings of fullness and how the body stores fat. These factors may cause some people to gain weight more easily or make it harder for them to lose weight and maintain weight loss.

Our modern environment can also affect body weight. Easy access to high-energy foods and drinks, together with less physical activity and sedentary lifestyle, can influence the balance between the energy we consume and the energy we use. Age, lifestyle and other environmental factors can also affect how a person’s genetic risk is expressed.

Changes in hormone levels, including those that occur during perimenopause and menopause, may contribute to weight gain. Some endocrine, or hormone-related, conditions can also affect weight.

It is important to look for symptoms or signs of these conditions when discussing weight management. Your Endocrinologist will make a throughout assessment during your consultation and may recommend further tests if needed.

Approaches to weight management

Weight management usually involves a combination of lifestyle changes, medical support and, in some cases, medication or surgery.

Lifestyle changes may include:

• improving food quality and eating patterns
• increasing physical activity
• reducing long periods of sitting
• improving sleep
• managing stress
• receiving behavioural or psychological support

Lifestyle changes are important for health, even when weight loss is small. However, lifestyle changes alone usually result in modest weight loss, and weight regain is common.

Weight-management medications

Weight-management medication may be used with lifestyle changes for people who have a BMI of 30 kg/m² or higher, or a BMI of 27 kg/m² or higher with at least one weight-related health condition.⁴ These may include type 2 diabetes, high blood pressure, cardiovascular risk, metabolic-associated fatty liver disease (MAFLD), obstructive sleep apnoea, polycystic ovary syndrome (PCOS) or osteoarthritis.

These medications may reduce hunger, improve feelings of fullness and help with portion control. They do not replace healthy eating, physical activity, good sleep or other lifestyle changes, but can make these changes easier to maintain.

Before starting treatment, your endocrinologist will review your medical history, current medications, previous weight-management treatments, eating patterns and any history of disordered eating. Blood pressure and blood tests may also be checked.

People respond differently to treatment. Regular follow-up is important to monitor progress, manage side effects and adjust the dose if needed. Treatment may need to continue long term. Stopping medication can increase hunger and lead to weight regain.

Appointments are generally recommended:

• every month while the medication dose is being increased, to assess side effects and tolerance; and
• every one to three months after this, to monitor progress and support ongoing treatment.

Specialist Endocrinologist care should be considered for people who have:

• significant obesity-related health conditions
• complex medical or psychological needs
• a BMI above 40 kg/m²
• difficulty achieving their treatment goals in primary care.

Cost and access

Weight-management medications are not currently subsidised through the Pharmaceutical Benefits Scheme for the treatment of obesity. This means patients usually need to pay the full cost of treatment.

This can make it difficult for some people to access these medications. Your endocrinologist can discuss available treatment options, possible alternatives and whether you may be eligible for a clinical trial.

Key messages

• Obesity is a chronic health condition, not simply a result of personal choices or lack of willpower.
• Weight is affected by genetics, hormones, health conditions, medications, lifestyle and the surrounding environment.
• Lifestyle changes remain an important part of treatment, even when medication is used.
• Weight-management medications may help some people achieve and maintain greater weight loss.
• Stopping weight-management medication commonly leads to weight regain.
• Long-term treatment and regular follow-up may be needed to support lasting health improvements.

Reference

1. AIHW. Overweight and obesity. 2026. Accessed 4 August 2026. https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity
2. Bonnefond A, Bruner WS, Grant SFA, Morandi A, Froguel P. The genetics of obesity: aetiology, prevention and therapy. Nature Metabolism. 2026/04/01 2026;8(4):778-794. doi:10.1038/s42255-026-01497-w
3. Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. Mar 7 2019;4(5)doi:10.1172/jci.insight.124865
4. Apovian CM, Aronne LJ, Bessesen DH, et al. Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2015;100(2):342-362. doi:10.1210/jc.2014-3415