Catherine Smith’s relationship with obesity runs deep.

There’s a strong family history – one of her parents underwent bariatric surgery. While a close relative died from obesity-related conditions.

Her own experience emerged in her mid-to-late 30s, triggered by having an early hysterectomy to help prevent ovarian cancer, which her mother passed away from, that caused surgically induced menopause. She was also diagnosed with thyroid issues.

Coincidentally, at the time one of her parents underwent bariatric surgery, Catherine was studying to become a nurse practitioner, and learning about obesity. Ultimately, it inspired her to become a Bariatrics NP and open up her own nurse-led weight loss clinic, Weight Health You, to help others impacted by the condition.

“Back then, you were just told to diet and exercise, and nobody could tell you do anything different,” recalls Catherine.

“We didn’t understand that menopausal people should exercise differently, and that cardio doesn’t do anything, for example. I was rowing and I was doing all these things to try and keep my weight managed, but I also lived on night-shift permanently, which didn’t make my situation good.”

Earlier this year, a new report released by the Obesity Collective, the national peak body for obesity aiming to reduce its health and wellbeing impacts, found that 6.3 millions Australians are now living with obesity, up from 3.9 million in 2012. The national umbrella coalition said the results showed that the health system is failing people with the most severe weight issues, prompting calls for greater government investment and leadership to support prevention, treatment, and tackling stigma.

Now in her mid-50s, Catherine has lived with obesity for almost two decades. As a result, she has experienced a raft of health issues like high-cholesterol and sleep apnoea, as well as widespread stigma, including from the health profession itself.

“Some of the most scarring comments that are made are things like people going into pharmacies to purchase weight loss medication and being told that they can’t have it because they’re not diabetic, and they’re shamed in front of the whole pharmacy,” reveals Catherine.

In a positive sense, Catherine says her own lived experience with obesity has enabled her to acutely understand what her clients are going through, including how they’ve previously been treated by health professionals. She established her clinic to help fill a gap in patients being able to access appropriate services to help them lose weight.

The clinic has six nurse practitioners who specialise in bariatrics and has about 2,000 clients on its books across Australia. The nurse-led model of care includes lifestyle and dietary modifications, managing stress, and balancing chronic pain and musculoskeletal conditions that may be impacting the inability to lose weight. Some clients are pre or post bariatric surgery, meaning they need tailored support.

“We practice a very reducing stigma, patient-centred approach,” says Catherine.

“We obviously spend a lot of time helping people to lose weight, but we work very much on trying to ensure that it’s a full-life improvement process that they go through so that it’s not just about trying to lose weight. They’re looking at how they can improve their stress levels, their sleep, and other obesity-related co-morbidities.”

Interestingly, Catherine says that almost third of clients that the clinic sees are nurses, just like her.

It fills her with satisfaction that so many nurses are seeking help on ways to improve their health.

“My classic patient group, it’s pre-menopause to menopause,” she says.

“A lot of nurses are experiencing that as we know that the percentage of nurses who are in that mid-40s to 50 age group is quite significant. Then, of course, there’s night shift that impacts them, and, obviously, stress has a lot to do with it [obesity].

“Also, nurses have seen what can happen if you don’t do something about improving your health. A lot of them are quite engaged in trying to improve their health so that they are able to enjoy the life that they want. I think it’s fantastic that they feel empowered to want to do that [seek help].”

As well as her clinic, Catherine is also involved with the Obesity Collective, sharing her lived experience and knowledge on the peak body’s recent free e-learning module for health professionals to help them better understand the science and reality of obesity in order to provide improved patient care. 

One of her biggest messages is that obesity is a disease, and it’s okay to ask for help to treat it.

“We don’t ask our patients to treat any other disease by themselves but for years we have felt it was okay to do that with obesity,” she says.

“When a lot of people ask me why bariatric healthcare is in the space it is, and not respected, I think at the moment, we are probably where mental health was 10 years ago. It was pull your socks up, get your act together, you’ll be alright. But we’ve got better at that and I think we can get better at this too.”

The Obesity Collective’s recent budget submission focused on three action areas – prevention, treatment, and tackling stigma. Recommendations included comprehensive government regulation to protect children from unhealthy food marketing, including a 20% health levy on manufacturers of sugary drinks, investing in more options for healthcare professionals to provide quality and equitable healthcare to manage obesity and prevent further chronic conditions, and addressing weight stigma across society. 

Catherine agrees with the actions, especially addressing weight stigma, and says that nurses have a big role to play in championing the change.

“We are incredible change agents when it comes to healthcare,” she says.

“You can go from hand washing, right through to World Health Safety checklists, we were the people that changes those things in healthcare. We could be the process to change this.

“All it requires is the nursing workforce to become more educated in this space and to do things like the free e-learning module, which is a good starting point.