Why Weight Matters with Felicity Cohen

Hello, I’m Felicity Cohen. I’m so excited to introduce you to my wellness warriors podcast. For over 20 years, I’ve been a passionate advocate for helping thousands of Australians. Find solutions to treating obesity and health related complications through surgical intervention and holistic managed care.

My podcast is dedicated to all the people past, present, and future who have helped shape my journey and continue to inspire me to work consistently to achieve a healthier Australia in both adults and future generations. I hope you enjoy it.

Welcome to the wellness warriors podcast. Today we are going to discuss a subject that is really so important for all of us to focus on, understand and to raise a conversation around why weight matters. Thank you so much for joining me today.

Over two decades ago, right at the beginning of the year, 2000 is when I first launched my business around managing all patients with weight related problem. Bariatric surgery in those days was a one size fits all and at that time we were really only able to offer patients the laparoscopic adjustable gastric band. And that’s where my first entry into this whole industry of bariatric surgical intervention commenced.

But personally, my connection to weight and problems associated with weight came from my mom. And if I had had the opportunity to work, supported my mom through a weight loss surgical procedure, I just wish I’d had that opportunity to have helped her and supported her at a much younger age.

I had really contrasting personal experiences within my family. I had a grandmother who really typified survival of the fittest. She was absolutely incredible and was an incredible icon for me personally and one of my most favourite mentors. The image of her becoming a yachts woman, a pacer for the Olympic swim team, going to university in Sydney at a time when women actually didn’t even attend further education was quite exceptional. And she remained healthy, fit and well, living in her own home until the age of 95. In fact, in her early nineties, she would complain when she went for a walk if she had to stop and have a break.

So for me, she typified what I would want for every single patient who comes through WeightLoss Solutions Australia. And that is living in your own home until you reach the age of 95 and never ending up in a nursing home.

So for me, that’s become my, I guess, part of my mantra around my delivery, my passion and what I’m looking for for each and every patient when they come through WeightLoss Solutions Australia, is having that vision of not just how much weight you’re going to lose, but what does that mean for your life long term?

Not just in 12 months, but 5, 10 and 30 years beyond your weight loss journey. And if we can help patients live healthy and well and never end up in nursing homes, that’s the absolute goal for me. That they’re not going to be doctor shopping, that they’re never going to need to attend an endocrinologist, a cardiologist or anything else with the ending in “-ist” at the end of it, you know, stay away from doctors, keep patients healthy and fit and away from the health system and really alleviate the burden on our Medicare system.

That would be amazing. So I guess in my quest to really support patients in ending everything that goes hand in hand with obesity, it’s that vision for me that is so powerful.

Unfortunately, conversely, with my own mother, she had a horse riding accident when she was quite young, she had a terrible injury and she was quite idle. She didn’t lead an active lifestyle as a result of that.

She was an incredible person, the most beautiful person ever, an amazing philanthropist. She was an avid reader. She was involved in so many different sectors of charity and a very giving person, but physically she was really impaired through being overweight.

And I think I was first aware of that as a young girl going to school, I was embarrassed. I felt uncomfortable. And I so relate when I’m talking to women who feel that now and have through the last two decades of my career. I talk to so many people who talk about that experience of being uncomfortable when they’re taking their kids to school or taking their kids to their sporting events or any other associated school program. They tend not to socialise. They prefer to hide. They feel uncomfortable.

And I think I lived that on the other side of the fence as a child, feeling so uncomfortable, but also so concerned and wanting to make a difference and do something for my own mother. And her end of life was really quite sad to observe. She ended up with type two diabetes. She went through that whole stage of vascular dementia and all those associated illnesses. And I think that these are preventable diseases. Well, in fact, they are preventable diseases.

So watching my own mother go through that journey of living through absolute living hell, really, to observe in a nursing home, I’m just on a mission to make sure that that never happens to anyone else.

Let’s think visually for a moment around what does obesity look like and how has that changed over the past few decades? Really interesting. If you look at photographs of Australians on the beach in the 1970’s, there’s this image of health, wellbeing, fit – really not overweight. We just did not see overweight people.

And I think if we think right back to post-war families, you know, they’d lived through an era where rations were the norm. And so many people were raised in that environment where you have to eat everything on your plate. And that actually became a problem for many people. We can see this evolution of portion sizes increasing and what many dietitians refer to as portion distortion plates over time even got bigger.

Fascinating. If you look at some of the plates in dishwashers these days, they don’t even fit. And so we got to the point over, you know, really from the seventies all the way to where we are at now, where portions have constantly just got bigger and bigger and bigger. In fact, if we look at things like Supersize Me, the documentary around upsizing and feeling valued by bigger sizes, that has actually been part of our crisis.

So many other things have led to the increase in the rise in obesity. That is so prevalent. And if we look at the statistics in terms of where are we going to end up around even 10 years from now? It’s one-in-two Australians. We’re talking about 50% of our adult population is going to be in a situation where they’re dealing with a weight crisis.

“Globesity” is a word that we hear used. It is a genuine crisis. It is probably if we think about the word pandemic, it is our most significant modern day crisis. The real pandemic that we really need to be focusing on and thinking about is what is this doing to the health of our entire nation? So statistically, we know that the numbers are continuing to escalate, not just in adults, but in children.

And it is in a stage of, we know now that obesity is classified as a chronic disease. And that’s taken many, many years to obtain a classification where there’s an understanding around what does this look like? Many, many years ago, around 2004, I’ll never forget a patient saying to me that the last GP he went to see said to him, “you need to lose weight, you know what to do.”

And so there was this really poor understanding around what a patient should actually do to manage their weight. Our general practitioners were uncomfortable often to weigh a patient. They often didn’t have the right blood pressure cuffs. They didn’t know how to raise the conversation. Motivational interviewing was really poor and having the conversations around managing weight was really not something that all that they were raising with their patients.

It was all about treating the medical conditions that go hand in hand with weight related problems. So rather than look at the underlying cause, we see treatment for things like type two diabetes, medications increasing, giving patients more and more medication for weight loss, rather than looking at a holistic managed approach to change the nature of that obesity and prevention of so many other comorbid conditions as people age.

Weight related stigma is a big problem right throughout our community. It’s so embedded in how we’re actually trained to think that if we have a weight related problem, we should be able to solve it ourselves. And so this prevents people from actually having real conversations; they feel trapped. Often, socially isolated. They end up in a situation where they’re not even leaving their own homes.

So people don’t feel as though talking about weight is something that they can actually raise or talk about, or even seek out treatment because they’re so entrenched in this thought that society teaches us to believe that we should be able to manage and treat and look after this ourselves.

And what that does is it sets up a cycle of behaviour that is failure after failure. And so people blame themselves. So we get this kind of concept of self blame around trying another diet. Most people, when they come to WeightLoss Solutions Australia, they’ve tried every single diet under the sun. And the problem with that is that many health professionals don’t tell people that 97% of diet and exercise programs alone will fail at some point. Whether that’s at one year out or five years out.

So what that does is it sets up this cycle of yoyo dieting behaviour, which is really, really unhealthy because people will tend to gain more weight consistently over time as they stay on that whole big roller coaster of yo-yo dieting. And then they just don’t know what to do. And then all of a sudden they wake up and they turn 40, or they turn 50 and suddenly they’ve got all these medical conditions associated with excess weight. Plus they’ve got social isolation and all those other issues that they’re dealing with and just not living their best lives.

So, if we’re going to talk about how do we raise conversations, how do we actually remove the stigma? How do we get to a point in time where it’s actually okay to talk about your weight and how it impacts your health, how it impacts your family, how it impacts your day to day functioning and how you live your best life. Quality of life and the medical implications: they’re both equally as important. And it’s super important to start having these conversations and finding people who are really happy to take that on board and don’t wait until it becomes a critical situation.

Interestingly enough, over the last couple of decades, there’s been a big shift in the patients that we are treating and who is actually coming to us. So many, many years ago, I would only ever speak to people who were just turning 40 or just turning 50. They were typically the moments in life, where there was a trigger moment where they were about to be put on more blood pressure medication or they just had enough of their sleep apnea machines or whatever that trigger moment was.

Or not being able to play with grandchildren – that was always a big issue, you know – and that’s so important. That’s functional fitness and mobility. If you can’t get down on the floor and roll around with your grandchildren, you’re just missing out on enjoying that part of your life.

So that was really interesting, but what I see now is this huge shift and transition to seeing all sorts of different patient cohorts that we are talking to and hopefully treating and managing and doing better.

And so we are seeing people, for example, in their twenties, often with fertility issues. So maybe they’ve got pre-diabetic or they could have PCOS endometriosis and other associated conditions in relation to their weight that is actually presenting as a problem, a barrier to falling pregnant. And in this group of patients, what we want to do is help them to lose weight, get healthy, fall pregnant and carry a pregnancy to full term.

So getting them to think about how does that look completely differently and hopefully preventing them from ever needing to go down that pathway of IVF. And there have been so many beautiful stories over the years of our, what I refer to as our “WLSA babies” and some of the most beautiful stories ever, you know, women who’ve lost 50 kilos after having already had three cycles of IVF treatment and sometimes spending up to $70,000 before they’re actually addressing the weight related problem. Post weight loss, then falling pregnant naturally and being able to just carry to full term and have a beautiful baby. Those are the stories that absolutely make my heart sing.

When we are talking about body positivity, we’re surrounded by a social media environment where we are absolutely bombarded with images that dictate to us how we should look and how we should feel about ourselves.

And that is across the spectrum of weight. So we need to really consider how does that impact people who are possibly underweight and dealing with eating disorders as much as we do those who are overweight and dealing with the complications of being overweight or morbidly obese. And I think, you know, it is so important when we are raising conversations around the topic of weight, that there is not one size that is the perfect size.

It’s all about your health, your wellbeing, your quality of life. And we do absolutely need to have these conversations, not just to reduce the need for this awful stigma that exists around weight related conditions, but feeling confident, feeling good in your skin is definitely so important. That message around body positivity.

There’s not a size or a number or even a number on a scale that that relates to. So I love having conversations around non-scale victories. It’s so much more valid than looking at the numbers and, you know, sometimes I think it’s really important to switch off from social media or choose who you are following.

Please, don’t all allow yourself to be dictated to by these images that are just unrealistic and unattainable. And this is really important to impress upon young people because we don’t want those people to end up either with eating disorders, which is a huge, big problem as well and really worthy of mention that these are also conditions that need dealing with when we are talking about the bigger picture around weight.

Of course, for me, in my industry sector, we are dealing with overweight and obesity, but let’s not ignore that there are also bigger problems at that other end of the spectrum that also must be addressed consistently so that we don’t have issues in a younger population. And we don’t want those people to end up with that yo-yo diet mentality, because what can happen long term is unfortunately, they’ll end up with weight gain and it can lead to other problems for them down the track as well.

Today I think it’s so important that we’re having this discussion right now. And to really impress upon all of you listening, why does weight matter? And the first thing is your health. Let’s look at “what are we treating and why?”

And what I wanna tell you is that it is not about getting you into a situation where you’re going to be the next bikini model.That’s not what we are looking for. Let’s address the concerns that surround health first of all and why being overweight is actually dangerous for your health, your wellbeing and your future.

So some of the things that we see on a daily basis, the medical concerns that are consistently getting more and more prevalent as we see more and more overweight people. Type two diabetes. It’s so significant. The numbers are astounding. The increase is absolutely overwhelming. These are things that we are not just able to say “you can have medication to treat it.” Let’s look at trying to get you off some of that medication because if you don’t the progression long-term can be really, really significant and serious.

There are so many other correlated diseases that you’ll end up with down the track. So if we can stop some of the medical comorbidities that go hand in hand with excess weight at an earlier stage, you are going to have a much healthier future. So we’ve got all of the metabolic diseases associated with things like thyroid, whether it’s under-active or overactive; Hashimoto’s, we see more and more diagnoses of Hashimoto’s.Type two diabetes, et cetera and the projection of long term complications. It’s really not a healthy picture to look at.

One of the things that I see so much of is sleep apnea. And this really, really worries me because people don’t understand the potential risk factors associated with this.

Number one: premature death. Okay. I can’t get more, I guess, serious than  representing this in that particular way. This is the risk we’re talking about: stroke, heart attack and, you know, just poor quality of life outcomes. Many patients have undiagnosed sleep apnea. And typically that might look like really poor quality sleep, low daytime energy.

And in this cycle of behaviour of reaching for that next quick burst of energy, whether that’s high-calorie, energy-dense foods or drinks, it could be coffee, it could be energy drinks, it could be chocolate- whatever that looks like, so many people are in this cycle of behaviour. And it’s just so hard to break that cycle.

Yet, if we treat the weight and start to look at some other mechanisms for a much healthier lifestyle and get them off CPAP machines and reduce the sleep apnea, then things change drastically and the projection for the future is so much better

And then there’s all these other things that I want you to think about.

You know, not just all the medical conditions that are potential risks, things like high cholesterol, high blood pressure – the list is vast. There are 13 known cancers associated with being morbidly obese. Let’s not forget what that looks like. So, you have the ability to reduce your weight and protect yourself from being exposed to all of these vast medical conditions that are going to hold you back in life.

And then let’s think about quality of life outcomes, mental health. Mental health is one of the biggest issues that we are facing in our society today. And I can tell you that pretty much every single patient that we see without fail would’ve been experiencing some form of anxiety or depression or PTSD or a combination of those conditions.

So really, really important in our environment that we’ve got psychologists to deal with all the underlying self-esteem issues, psychological issues and those kinds of conditions. Mental health is really important. How you feel about yourself every single day is going to dictate every day of your life.

And I think most of you listening will agree with me that these are things that we really do need to think about, that we need to address in association with our weight and how we want to live our lives. Especially if you’re living in social isolation. If you’re not enjoying your life, if you’re not getting out and going and socialising, we really need to think about this.

It upsets me so much when I talk to people who tell me that they actually won’t go to social engagements at all because of how they feel about themselves. So having the opportunity to transform someone’s life and to see them living their best life and enjoy it, that’s the ultimate satisfaction for me. 

At WeightLoss Solutions Australia, our signature, I guess, key point of difference and something that is so important to us is having a multidisciplinary team. What does that mean and why is it important? So, we have nurses, dietitians, psychologists, we have an exercise innovator.

All of these people combined are so valuable to managing someone’s expectations, their education information and the support that they gain from being engaged with the team is a really critical factor. And one of the things that we know at WeightLoss Solutions Australia is that when we have this model of care that patients are able to engage with, we achieve 30% greater excess weight loss at 12 months.

But not only that, our patients actually maintain that weight loss at five years and beyond. So they’re less likely to need something at that five year point in time, which is so often in other environments, a really defining point where weight regain can happen. So we want to make sure that we’re selecting the best procedure for each individual or intervention or opportunity to support them no matter what that looks like. Whether it’s a non-surgical procedure or even a non-interventional approach in terms of having a 12 Weeks to Wellness program that doesn’t involve anything that’s interventional or surgical, and then all of the surgical options. And this is fascinating because the evolution of where we are at now in the world of bariatrics means that there’s been such an incredible innovation around device technology that allows us to better assess, evaluate and offer the right procedure for each patient.

So we’ve got that real vision of where you’re going to be in 30 years time. Are we giving you the right solution to address your medical needs, your personal needs, your geographic location? So many different things that come into play when we are evaluating a patient, it has to be from a holistic managed approach and that engagement is so important.

What are we here for? We’re here to give you the best results you can possibly achieve, and they need to be durable, sustainable and for the rest of your life. 

How do we reduce the stigma around having conversations with family, with loved ones, with our friends and with our colleagues at work around weight?

It’s really interesting that the more and more people who have bariatric surgery, they’re more open now to having the conversation and sharing with others. So I’m hearing more consistently when I’m talking to people “oh, I’ve just seen the results in my colleague at work, or my neighbour” and people are more open to share once upon a time.

It was so taboo that no one would share that they’d actually had bariatric surgical procedures or intervention because it was considered to be such a taboo. And we need to kind of really improve how we’re having conversations overall around weight. And it’s like anything else: admitting that you’ve got a concern or a problem? That’s step one.

We know from our own research that many people take up to two years of thinking before they even reach out. Don’t let that be you. I think it’s really important to start also around the dining table, talk to your kids, let them know that being healthy, fit and well is important and that they can talk to you from a really young age about the things that concern them.

Allow yourself to talk to your friends. Maybe go for a walk and talk about it without feeling as though it’s a prejudicial type of conversation. It’s not, it’s showing empathy, concern, compassion for anyone who might be in your inner network or circle, whether it’s a friend, family member, colleague, think of it as being important for their health. It’s not judgemental. It’s not a criticism, but it’s showing concern for someone’s future.

So many amazing stories to share success over the years, and success is different in each and every patient. What they’re looking for, what they want to achieve, their goals, their personal achievements are all so varied.

Something that’s so fascinating to think about, especially when we are looking at cost. So for many people, when they’re inquiring about weight loss surgery, the top question will be around can they afford it? My first thing is, can you afford not to? Look at where you’re going to be in five years from now, if you don’t. And it’s fascinating to see that people transform their financial health and wellbeing.

It took me about 10 years working in this industry to actually understand what that looked like. And I never actually thought that that was a byproduct of successful weight loss. And I had this beautiful patient many, many years ago. Her name’s Melinda and her story just sticks with me forever because I remember when she first walked up the hill to attend an information session with her parents and her parents were really fearful for her life.

She was severely morbidly obese. In fact, I remember that she was over 200 kilos when I met her. And at that stage, we were only offering the gastric band. And that’s the procedure that she had. She was a seamstress and she actually has a claim to having been a seamstress for lady Di at one point, and I remember her telling me that her range of motion extended from sitting in front of a sewing machine, standing up and turning around to an ironing board.That was it. She literally was pretty much not just sedentary, but pretty immobile. And she struggled to walk up the hill to come to that information night. She lost well over a hundred kilos and she set goals all the time. She was consistent. She was dedicated and she knew that she wanted to achieve a better quality of life for herself.

So not only was she able to go and bungee jump because she had to be at a certain weight to be able to do that in New Zealand, and achieved these incredible physical goals that she had set for herself, but she changed her job situation. She changed her financial health and wellbeing. She went and worked in the mining sector.

She was managing camps and she told me that she was starting to invest in property and do all of these things. It was that whole self confidence that changed in her that gave her the ability to live an active fit, healthy and more secure lifestyle. So the financial benefit was really fascinating to me and she really taught me that, “wow, that’s something that patients can achieve.”

And then I started to hear more and more stories about people throughout their first 12 months who would come in and say, “I’ve gone for a job promotion and I’ve done that because my self confidence is so much better.” And previously they felt really inhibited or they felt judged or they felt uncomfortable.

They’ve been exposed to that stigma that is really still quite prevalent in the workplace and they were not getting the jobs that they felt that they were deserving of. They had the qualifications, but they were poorly evaluated and all of a sudden through weight loss, through that image and perception from others, but also image and perception of themselves, it gave them that push, that drive and self confidence to just go after anything.

So seeing people achieve better health and wellbeing, but also financial health and wellbeing as part of that whole big picture is just such a great story and I love it. Other success stories, so different, you know, people who join us on our Gold Coast marathon team, which is one of my most favourite events on our lifestyle modification program on our annual calendar, something that I’m really passionate about and achieving getting a team together of a hundred entrants this year was just a dream come true. 

And I hope I can continue to double that as we move through the next decade. I can’t wait to see that continue because what does that bring to me? Watching people achieve their goals, step outside of their comfort zones, doing things with their families, whether it’s walking five kilometres, running 10 kilometres, setting those goals all the time.

Watching people just smile at the end, that sense of achievement and personal satisfaction is just phenomenal.

My wish for all people on their wellness journeys is all around achieving their own personal success, their personal goals, no matter what that looks like. If it’s been a situation of not being able to tie up your shoelaces, not being able to walk to your letterbox or not having the self confidence to actually get out and go for that job that you want.

Or if it’s about playing with your grandchildren, if it’s about running 10 kilometres, it doesn’t matter what that looks like. But as long as our patients are becoming healthier and achieving their own personal goals and living their best lives, if they can sit comfortably in an economy aircraft seat and travel the world and go and walk the great wall of China, it really doesn’t matter what that looks like, but at the end of the day that their obesity and their weight is not preventing them from living their best lives. That’s what we are looking for.

And ultimately that we are reducing the burden on our health system and that no one needs to end up in a nursing home. That would be my ultimate wish. Really, if we can achieve that in more and more people, then I feel like that’s the legacy I’d like to leave behind me.