ECPO Patient Lounge – 5 May 2021

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You’re very welcome along. My name is Vicky Mooney and I will be your host along with a fantastic panel of ladies. Now, what we’re speaking about tonight is the European Congress on Obesity.

For people who don’t know, this takes place every year. Unfortunately, this year it is virtual. We should be heading to Malaga, Spain.

However, for four days, we will see a number of scientists, clinicians come together with a lot of advocates and patient community so they can understand more about obesity, learn from each other, share research and findings. So this is why I’m so excited, because we have a stellar panel for you. And we also have fantastic interviews coming up.

You can see that we have Professor Rebecca Poole on white stigma. We have the found WDOSI and wonderful Tommy Fisher in his funky shirts from Netherlands who will be joining us. And obviously, as well on childhood obesity, we have Dr. Louisa Els and Peter Huliusen.

Now, I have to make sure I pronounce it correctly from Norway. We have our guest panel, as you can see there. We have Solveig Sigridortier, our president from ECPO.

We have Petra Nella-Jurgensen from Belgium and Miss Cherie Bryant from the UK and IAZO. Now, if you want to ask us any questions, if you want to get in touch with us, you can indeed go on to any of your social media channels. Just use hashtag ECPO patient lounge.

Our comms team will pick it up and they’ll make sure that, of course, we get it here on the studio. So what I want to delve into is our very first interview. Now, this lady is an absolute legend in her fields of research and white bias and stigma.

Professor Rebecca Poole, she is professor in Department of Human Development and Family Sciences. I have to make sure I say that correctly as well. She is deputy director of the Rudd Center in Connecticut.

Let’s have a listen to what Rebecca had to share with me when I caught up with her earlier. Hello, Rebecca, and you are so welcome to our patient lounge. I’m so excited to have you here.

It’s great to see you. How are you doing? I’m good. Thanks so much for having me.

No, you’re so welcome. So you are heavily involved with obesity stigma in so many different ways over the years. And one thing I’ve noticed, we’re coming up to ECO, the European Congress on Obesity, and at the same time on a different time zone, the Canadian Obesity Summit.

And you’re presenting a book on this, I suppose, a topic that is close to so many people and so many families on obesity stigma. But you’ve worked in this area for 18 years. And when I was listening to one of your podcasts, I went 18 years.

Where do you get that passion and drive to keep going with something that is so emotionally hard? And as a researcher, where is that passion coming from for your work? You know, I started out in this field a long time ago when I was a graduate student. I went to graduate school in 1999 and to get a degree in clinical psychology. And at that point, I thought I was going to grad school to study prevention of eating disorders.

But I was offered an opportunity as a graduate student early on to essentially do some research on weight stigma. And I really didn’t know anything about weight stigma at that point. And I did a review of the research at that time.

And wow, did I ever see, you know, a scattered literature? But I saw that this was causing a lot of harm. And even though there were lots of research questions back then, it was clear that this was happening in a lot of places and that it was really harmful at that same time. As a grad student, I was also completing my clinical training where I was working with clients and patients who had eating disorders, who were struggling with weight and obesity.

And one thing that I noticed coming up again and again was stigma and how it was really creating barriers and interfering with their lives. And I just kind of put these two things together. And I thought, you know, this is really an important issue and we’re not seeing enough attention to it.

And it really changed the trajectory of my career. And I haven’t looked back since. And, you know, if there’s we’ve done a lot of work and I there’s a lot more that we need to do as well.

Do you know, I was going to say, I think before kind of the likes of yourself and I know Mary Foran as well up in Canada, before you guys kind of came on the scene, there wasn’t a lot of research in the weight stigma area. Right. And now we have research everywhere.

And it is just in the last 20 years. When I look back over some of the work that you guys have done, it shows that it is actually shifting. It’s making a change.

Can you see that change when you look back over all that time? Absolutely. I mean, even 10 years ago, the kinds of conversations that we now see happening with weight stigma weren’t happening at all. There was much less public awareness of this issue and much less awareness of how harmful it is.

People weren’t taking it seriously. You know, it was something that people thought, well, that’s not a big issue. You know, people deserve to be treated that way.

And granted, those those opinions still exist. Really, there’s been a much bigger movement occurring, I would say, especially in the last decade where people are recognizing that this is a legitimate problem and that we need to be. So it has been it’s been really helpful to see that change over time, coming from a place where, as you said at the beginning, when I started out, there really just wasn’t much attention to this at all.

Yeah. And I think like if I think back to 1999, you know, I was kind of in my first relationship preparing to get married. I was carrying a lot of weight.

I was, you know, quite what they would have said, a big boned girl, you know, and looking for a wedding dress. I couldn’t try anything on because I was, you know, too overweight. But it was always kind of like left to it was my fault.

You know, when I think back to that time and how challenging it must have been to actually set out with this, you know, goal to to make that change. So we’re coming into like these congresses and summits and that. And and you present so beautifully.

I’m becoming a bit of a fan. There’s a bit of a girl crush going on after watching you on all these podcasts. Because I was preparing, I was like, this woman is Sassatown.

What do you intend to present and bring to, you know, all of these clinical scientific guys and girls that are going to turn up and rock up and say, hey, Rebecca, what’s going on? Yeah. Thank you very much for those kind comments. You know, there are a couple of key things that I plan to talk about, both at the Canadian Obesity Summit as well as ECO.

And, you know, one is some recent multinational research that we’ve just completed on weight stigma. And something that I’ve noticed in the field is even though we’re seeing weight stigma research pop up in a number of different countries, there has been very little collective multinational research happening. And I think that’s a real gap that we need to address and do more of.

So I’m going to present some recent findings looking at people’s experiences and internalization of weight stigma and how it’s related to their health across six different countries. And, you know, not to give too much away, but one of the things that is really interesting about this work is just in some ways how universal and remarkably consistent this problem and experience is for people. So I think that really tells us that we need to collectively work together much more than we are right now to try to find solutions and remedies and ways to really address this.

And then a couple of other things I’m going to talk about is some of our recent work looking at weight stigma during the pandemic and also how weight stigma affects both emotional well-being and eating behaviours. And this is something that we all need to be more aware of as clinicians and researchers and people working with people of diverse body sizes is how this is affecting their health and health behaviours. So those are some of the key things that I’m going to talk about this year.

I love this because we recently had the MEP and Trust Group Alliance kind of launch here over in Europe, which is so exciting for us. And one thing that we really need built into that framework is weight stigma awareness and that some of the policies and strategies out there, they actually have kind of pushed that narrative of, well, if you blame the person, they might do something about it rather than realising the emotional damage. And in particular, I think of in the pandemic, as you said, mental health has just been incredibly damaged.

Mental illnesses, people are just so dragged down at the moment. And I think mental health, children, all of these strategies, adolescents, social media. It’s like this awful cocktail that this, you know, and at the core of that is a lot of work on weight stigma.

So I’m super excited you’re presenting that. But I kind of when I notice on the the session that we’re doing as well with Humana and I notice mental health and obesity stigma and just what’s your thoughts on that overlap, just how damaging have you seen it to be? Yeah, you know, I think we really can’t underestimate how harmful this is to emotional health. And we know that when people experience stigma, whether it’s a child or an adult, that this increases risk of things like depression and anxiety and poor body image, but also things like substance use and suicidality.

So, you know, this really is important and serious and harmful. And, you know, it’s interesting because we know this about other forms of stigma as well. We’ve known for decades that stigma is an enemy to public health.

So there’s no reason to think that the same wouldn’t be true for weight stigma. But, you know, that that kind of recognition has taken a lot longer. And I think it gets to the point that you just raised, which is that there’s still this this reaction to say, yeah, but, you know, it’s their fault and, you know, maybe stigma will motivate them or provide an incentive.

And, you know, certainly what we see in our research is that the opposite is true, that in fact, stigma is impairing health, worsening well-being and quality of life, increasing weight gain over time. So it really is contributing to poor health. It’s not an appropriate or an effective motivator for behavior change.

So I think all of those things are really important as part of the message. Yeah. And I think I know like we’ve only got a few minutes, but, you know, but like when I kind of look up that that bag of mental health, adolescence, social media, obesity, stigma everywhere you go, and the fact that the science and the research and everything behind your work is not aligned with what society believes today, that is just for me, it’s hurtful.

Right. I’ve got two children who struggle so hard with their weight. And I know what it was like.

I struggled all of my life. And actually, I remember one incident where, you know, I was kind of I was the slower developer when it came to the boys. I was seen as, you know, the pretty big girl, you know, pretty face, but you could lose the weight.

And, you know, I think it was probably about 13 years old. And this boy said, I think you’d be so great if you look like this instead of like that. And I was just so hurt, so emotionally hurt.

And when I think of my children, how protective I am over them, if that was my daughter, I would be so upset and I would want to just cocoon her. Right. And I think of social media.

Right. And you’re seeing a lot of this with social media, Covid, adolescence. What’s kind of your take on what’s going on there? Yeah, I’m so glad you brought this up because youth and adolescents are so extremely vulnerable to the damage of weight stigma.

And, you know, social media is something that, you know, you and I didn’t have to deal with when we were that age. And now it’s this whole other complicating factor that I think just throws a big wrench into this. And what we’re seeing with our work is that adolescents, girls in particular, are reporting, especially during Covid, that they’re seeing these weight gain memes and fat shaming in social media.

And that cyberbullying on social media has continued throughout the pandemic. And there was some question from researchers like, what’s going to happen with weight teasing during the pandemic? Since so many kids aren’t even in school, they’re at home. Is this going to, you know, maybe get a little bit better? And what we’re seeing is no, it’s not.

And, you know, there was a lot of weight stigma before the pandemic. There’s going to be a lot of weight stigma afterwards. But I think what this kind of gets to is what you were saying before, is that a lot of what we are seeing in the research is not are not the messages that are being perpetuated in society.

And we know now in the obesity field and throughout the medical community that weight stigma is harmful, but that’s not a message that is getting out. And I think it’s critically important that we really promote messages that weight stigma is absolutely a social injustice, but it’s also a public health issue and it’s harmful to health and it’s harmful very early on in health as well. So, yeah, critically important issues, critically important age group for us to be focusing on.

So, you know, you have crammed everything and more into 10 minutes. So excellently. And this is why I know you’re going to have many other ladies and guys come on and say, I’ve got such a crush on this lady and her work that she does.

Just amazing. So thank you so much for taking the time. And I look forward to seeing you at the Congress and the summit.

And I’ll see you at both sessions and the very best of luck. Thank you for everything you do. First, Rebecca.

Thank you so much. A pleasure to talk to you. And you’re very welcome back.

I absolutely loved listening to that lady. I loved interviewing her. And I’m so excited now because I can bring on our panel and we can talk about it.

So here we have our fabulous ladies. I love that it’s an all girls panel because we’ve got some of the guys in the interviews coming up. And we have, of course, all the Sigrid Ortier, who is our president, who is a long term, lifelong dear friend of mine as well.

Fabulous mom. And she is up there in the land of fire and ice with an erupting volcano. So I’m just glad you’re safe and you’re with us in one piece of egg.

And also we have Petronella Gjersen from Belgium. Petronella, well, we will call you Ellie because that’s how we know you. And Ellie is our director of our scientific committee.

She is also in Belgium and she is a mathematician and has the most marvelous brain. And we’re just so blessed to have her with us. Cherie Brines, of course, is here with us.

Director of Communications for EASO, all round wonder woman and legend. So you’re all very, very welcome along, you guys. And now I want to open the conversation on Rebecca and Cherie as director of communications and with EASO and the Congress coming up next week.

Rebecca’s got a few sessions. And what was your take on what she said there and she shared? Yeah, Rebecca is Rebecca’s amazing, and I think that you can sum it up by saying that stigma is a public health issue. And among our clinical and scientific community, it is important to remember that it’s really only been during the past four or five years that person first language, for instance, has been widely accepted, even among medical and scientific professionals.

And we’re seeing more and more that this is becoming the rule. So in the process of getting people to submit their abstracts to the Congress this year, we had a brief presented on person first language, which people followed in order to be able to submit content to the Congress. This is a real step forward.

But in terms of the wider public health conversation, it will be exciting to see Rebecca’s her big study, her multinational study and those results. We have some some real opportunities, I think, there. Most definitely, and I think for people at home as well, when we when we look at the Congress and we think about something like a four day Congress on obesity and we talk about weight stigma and we talk about, you know, people first language, how amazing would it be to have people first language out in society as a whole, that it wasn’t just, you know, us pushing for abstracts and symposiums that come in, speakers and researchers and all of that scientific and clinical community that they speak in person first language, but that they actually understand that, you know, labeling somebody as obese or fat or judging them in any way is damaging.

And I actually want to jump back to our president Solveig, because Solveig, you were with us when we launched as an organization two years ago in Glasgow. We were there, Cherie was there, Ellie was there, we were all there. But Solveig, person first language and weight stigma.

And when we listened to Rebecca, what were you thinking? People’s first language is something that I’m new to, like everybody else. And in the beginning, I didn’t understand it because I have always been bigger than average since a young age. So I’ve always heard negative, you know, words coming into me, you know, going to the health, to my doctor, to the health clinic.

It’s just recently been a little bit changing that, but not that much over here, at least in Iceland. But I will never forget that night, that evening when we launched the patient, the ECPO, because this was such a big part of our launching this people’s first language. And it really made the difference.

And our little ribbons that we gave out and has been going all over the conferences nowadays, not before. And to see how when you have this little ribbons we had, we gave them to people coming into conferences and just to see their faces when you give it to them and you start to explain. This is like come first, come together.

And it made such a difference. Also with stigma, this is something that I always say stigma is something that people get has to get a better education on. And also with that, that obesity is a disease and it’s a long term chronic disease.

And I think like the means and all of that, that’s on line now. I mean, you wouldn’t make fun of a person with a disease, life threatening disease. You would never share anything like that online.

You wouldn’t even make fun of people with Parkinson’s or MS disease or stammering or anything like that. You would never do that. But why are we doing that with obesity? Yeah, see, this is what I don’t get.

Right. And I’m going to jump to Ellie now in a second. But and Sheree, you were a part of when obviously we created the People First campaign and you were on the very first call with me about that and kind of guiding us through it.

But this is what I don’t get. It is statistically impossible to not know somebody who has obesity. Right.

There is everybody knows somebody, whether it’s a colleague or a friend, because unfortunately, it’s a worldwide epidemic. And my problem is that how can you share something that would be damaging to your child or your grandparents or your friend or your colleague that would be hurtful to them? How can you share that on social media and laugh at it and think it’s OK? And for people like ourselves that put our hands up and say, this is not OK, then to call us maybe snowflakes. Oh, you’re taking it too personally.

You know, you know, it’s only a fat joke or a fat meme, but it is incredibly hurtful. Ellie, how do you feel about that kind of stigma that exists in our world? Yeah, it’s it’s maybe different for me because I was not I was was not living with obesity as a child. I wasn’t what they say, normal sized child.

Although I’ve always been short. And so they made jokes about that. And I was wearing glasses, so they made jokes about that.

But I think the reason they do it is because lots of articles are there that say that if you shame people enough, they’re going to lose weight because they don’t want to be shamed. But as Rebecca says, it doesn’t work that way. Yeah.

And because it’s a disease, it’s not something you choose. And if it would work that way, nobody would be fat because nobody would live with obesity because we don’t choose this disease. Yeah, that’s it.

We don’t choose to have adiposity, to have extra layers of fat on our midsection, as some people would call it, or have obesity. It’s not a choice. Furthermore, it’s not just the weight.

Weight is just one aspect of the disease, obesity. It’s you have a low weight of chronic inflammation. In your whole body.

And that’s, they think, it’s not quite sure because the research isn’t there yet, but I think that that low weight inflammation might actually be one of the factors that make you prone to gain weight. Yes. Yeah.

And I think it’s at least it’s one of the factors that make you that may cause many of the diseases that are connected with obesity. Yeah, absolutely. I think as well, when we look at and actually all of you ladies were in attendance, surely you were heavily involved as well in the MAPE interest group.

The Alliance that went live there and launched a few weeks ago. And when I was actually writing my own piece for it, I was thinking about all those rugby players out there who have extra weight, right, but do not have obesity. And most would qualify for bariatric surgery or pharmacotherapy or some sort of treatment because of their weight, the number on the scale and their BMI.

However, they don’t have the disease of obesity, but they’re considered as beasts, as fine, strong men, you know, and in this really positive light because they’re so healthy and fit. And I love my rugby and I’m like amazing men and what they endure is incredible. But weight is only one symptom of obesity, sleep apnea, chronic inflammation.

As you said, there is so many other symptoms of obesity, but we still focus on weight, which is just so frustrating. And I think that’s where a lot of the stigma comes from as well. Shuri, what’s your thoughts as we kind of progress in the conversation here? Absolutely, so obesity is about health, it’s about body size and it’s not about physical appearance, and I think that’s something that our medical and scientific leaders have been trying to share.

And as we move forward, you know, this is going to become a much larger conversation in public health. And now that the EU Commission has officially officially recognized, formally recognized obesity as a chronic disease, you know, there’s it’s absolutely inappropriate to stigmatize someone living with cancer, for instance, or MS. And we’re hoping that our key opinion leaders from the MEPs who are involved in the interest groups to our medical and scientific leaders who are going to be presenting at ECO next week will take this message forward, because I think stigma touches the lives of everyone.

And remember, this is about so everything we do at EASO is about patients. It’s about people. It’s and we want to make sure that the patient experience is a positive one.

Indeed, and, you know, as you were speaking there as well, it made me think and I noticed a couple of comments kind of coming in on Twitter. I’m looking around on different screens here and a lot of the comments are talking about, you know, health care and in schools and at what point should we actually be teaching about, you know, weight stigma and the damage of that to our health care professionals and even teachers and schools so they’re aware and they can kind of like put a stop to it because young children are can be so damaged and Salveg as a mom and as somebody who’s worked with a lot of health care professionals, what do you think? I think we have to start to advocate more into schools and to health care, you know, we need to advocate everywhere, actually. We need to go to the health care system.

We need to go to the school system. We need to be shouting on the top of the roof because advocating of obesity is the key point to get them to recognize that obesity is a disease, is a long term chronic disease. At the moment, we don’t have a cure for obesity.

We have management in some places. Not everybody can have the best management for obesity. We are not that lucky in the world, actually.

And over here in Iceland, it is a taboo talking about obesity. You get shamed even talking about obesity because we shouldn’t. It’s sort of like you shouldn’t talk about weight.

Because it’s fine to be in every size you want. But it’s not about that. Of course, you can be in every size.

But like we said, it’s not about the weight. It’s not about appearance. It’s about the disease.

And this has to be advocated into the system because no child would suffer in the school suffering from having a serious chronic disease. It breaks my heart. Because I will never forget.

It’s completely wrong. And I’ll never forget that days when we had to go to the nurse and being weighted in front of everybody. And it was showed that which number it came out.

I was always tall and I was proud of that. But I was always with a higher weight. And it was so much shame to carry.

And till now, in some countries, they do the same thing. They weigh children in front of everybody. And this is wrong.

It’s so damaging. It is so damaging. And we move on for a second interview now in a moment.

But I love what you just said there, Solveig, about it being lifelong. Like we don’t have a cure for obesity. We have treatments and we have and there is no one size fits all.

There is no treatment that suits one person because we are all so different. But like when I think about it, I think my grandmother would always say to me, she’s been on a diet all of her life. And you lose weight and you regain it.

You lose and regain. And that is how our biology works when you have a disease called obesity. And I think as we step into this next interview on childhood obesity, I think we can probably continue this discussion.

Nellie, I’m going to come to you straight after this interview because I’d like to get your thoughts as well. So as we move on to our second interview, I’m going to keep our panel behind the scenes and ready to go after our next interview. But this discussion is around childhood obesity.

And at the Congress next week, we have and I called her doctor earlier and I realise now, Professor Louisa Elves, who is just one of the most inspiring people that I’ve ever met as a professor. She works in obesity fields in Leeds Beckett University. She also works as a specialist or sits as a specialist on public health England.

So she’s a super duper spy for us as well. And we have Dr. Peter Huliusen and I said his name right. So I’m very, very proud.

And Ken Clare actually joined me on this interview as we interviewed Dr. Huliusen and he’s a paediatric endocrinologist in Norway. So I’m kind of excited to hear what they have to say and have a listen for the next 10 minutes. We’ll come back to our panel.

Let’s go. Hi and welcome, everybody. I am so delighted to have you on our lounge, Louisa, Peter and Ken back with us.

And let’s jump straight into it. We’ve been talking about the Congress. We’re really excited about bringing some of the science and research and what you phenomenal guys are doing.

And so, Louisa, I want to come to you first as a lady. You are chairing sessions. You are doing sessions.

But first of all, childhood obesity and adolescence is one of the sessions yourself and Peter are co-hosting there or co-chairing. And do you want to give me a little bit of insight into what you do? And, you know, childhood obesity, adolescence. You know, what are we looking at when we talk about these sessions at the Congress? So, thanks, Vicky.

Yes, I’m a professor of obesity at Leeds Beckett University, and I’m also a specialist academic advisor to Public Health England. And I’m really passionate about obesity within childhood and in young people. And I’ve done various work over the years on this area.

So one of the relatively recent pieces of work I undertook was a large systematic review, looking at the evidence for the effectiveness of treatment for different age groups. And I’m really interested in working with families, working in co-production with families and really conscious of the individual needs of our young people and their families. Really thinking about tackling inequalities, working with them to find innovative new approaches.

So I’m very interested in the development of digital technology and how that can be incorporated to support our young people. But really just to try and think outside of the box to really help to best support our young people going forward. When you say that, you can hear the excitement in you and the passion.

And I love it because this is what we are all about as patients. It’s how can we help other people? How can we help families? So I’m incredibly grateful for all the work that you’re doing there. And Peter, what about yourself? Because you’re up in Norway and it’s snowing up there as well.

Indeed. Thank you so much. Well, my name is Peter Uliusson and I am a paediatric endocrinologist and been working for over 20 years in the clinic.

And I’m also attached to the university, a professor at the University of Bergen. And my actually main position is the National Institute of Public Health now. So I’m working in three places, but really contributing or focusing on growth and development of children in all those places.

So, well, I’ve been conducting two growth studies in Bergen and, you know, making growth charts of Norwegian children. That was the Bergen growth study one. And more recently, we did a puberty study documenting the pubertal development of Norwegian children.

And but while doing the first growth study and working in the clinic, it was way back in 2004, we discovered that the number of obese children was not to be ignored in the clinic. So then we started to, you know, to to make something, you know, to provide some treatment. And so I’ve been attached and responsible for the treatment of children with severe obesity in Bergen from 2004, actually.

And from 2012, we established this outpatient clinic and where we have been treating rather many children. We have about 100 new children each and their families each year and about three to four hundred children attached to the clinic on every time. So we have this treatment as usual, lifestyle treatment.

But we also have, you know, randomized studies on the cognitive behavior approach. And we are now planning a nationwide study in Norway on adolescents. We are trying to bring up the treatment of adolescents up to a new level using e-health, e-CBT, low calorie diets and medications.

Same with the randomized study. So we’re trying to improve our ability to help. That’s, you know, it’s quite exciting.

And when I when I was listening to you speak there, when you said e-health and various treatments, Louisa, you got really excited there, too. I can see you were like, yes. Why did you actually get so excited about that? Like, I know for me, because I have two children who have obesity and they struggle so hard.

I know what that means for me. But for yourself, you know, in the work that you do, just listening to Peter, what do you think? Oh, well, I mean, it’s just it’s just it’s always lovely to find people that, you know, are so passionate and really sort of care within this area. But when Peter mentioned about severe obesity, one of the tasks I undertook a few years ago with colleagues at Public Health England was to look at the English National Child Measurement Program and to actually look at the number of children that were living with severe obesity.

So obviously, the National Child Measurement Program only measures children in reception, which is ages four to five and then year six, which is 10 to 11. And just in those two sort of measurement years, looking at one year only, we identified over 4000 children that were living with severe obesity. And, you know, lots of people look at these numbers and just think of them as numbers.

But that’s that’s over 4000 real children. And that level of obesity is likely to be impacting on their lives. And you just really want to do something about it, something to support.

And we know our kids now, you know, do live their worlds through, you know, electronic media. And I just think, you know, I’m a bit of a technophobe myself. I just think we’ve got to get with the program and we’ve got to work with families to find out how they’re living their lives and how can we provide that tailored support that is delivered in a way that our children and young people are going to want to engage with and to develop those programs with them.

So it’s just lovely to hear of the work that Peter’s doing. Just to know it’s not just the UK, it’s happening across the world. It’s just lovely.

I’d like to thank you both, Louisa and Peter, for just setting me on fire and thinking of the possibilities. And just to describe ECPR, we’re in over 25 countries now across Europe. And we’ve got two countries that are doing very well with children and young people, and that would be Portugal and Sweden.

And there’s others as well. But I’d like you to each sort of, if you could, to think about and to tell us what we could do better to reach out and involve children and young people and their organisations. Either what you’ve done in your own country or what you think we could do to involve them in the broader movement.

Over to you, Louisa, please. Well, I’m going to go back to my hobby horse and it’s co-production and public and patient engagement. I really want us to be working more with families.

So for families to, you know, for us to work with families and say, you know, what are the problems that they perceive? You know, what are the barriers that they’re facing? What are the challenges to everyday life? And how can we use the tools in our toolbox to work together to develop really new, innovative programmes that are tailored to the individual needs of families? Because, you know, as people and as families, we lead such complex lives. And this one size fits all approach is never going to work. So to me, I just feel passionate about co-developing with families, but also being really important that we reach out to families that are perhaps from some of our least heard communities as well.

And so I’m particularly passionate about working with families that have children, perhaps who are living with either an intellectual or physical disability. And from families who are really rich, broad and diverse communities that, you know, might not perhaps engage or even know that some of our current services are available. How can we work with them to make sure services are tailored to need, but also they’re accessible to everybody? So everybody that needs support gets the support that they need.

Thank you, Louise. And Peter, would you like to add anything to that? Yes. Well, I must say that I feel this is a very complex area.

And at my obesity clinic, I feel that there’s no two families that are alike. And the heterogeneity of this whole is so extreme. So it’s, yeah, I think it’s quite fascinating, actually.

And so designing, you know, treatment, it should be obviously very tailored, but it also should be designed in very close collaboration with the users or with the group, with the patients. So we are now in the phase of planning this randomized study in Norway. And then we will, the ECBT, for instance, will be, you know, planned and structured, organized in close collaboration with the adolescents that will be receiving this.

Thank you, Peter. Vicky, over to you. Yeah.

Do you know, actually your words came when you said you’ve set me on fire. That’s exactly how I feel when I’m listening to both of you. And I’m just I’m so delighted that the Congress on Obesity has people like yourselves doing this work and bringing this information to people like ourselves who are the patient community.

So thank you both so much for that. But just before you go, Louisa, you do have an extra few sessions going on at the Congress. Can you give us just a little kind of sneak peek at what you’re doing? Yeah, sure.

So I’m involved and I’m very privileged to be involved in two further sessions. So the first session is I’m going to be chairing with Maria a session looking at the development of dietary or guidelines around the dietary management of obesity, which will be really exciting. And I’ve also been invited to actually deliver a session looking at different dietary approaches to weight management, where I’m going to give a little insight into a systematic review.

I wrote a couple of years ago looking at the effectiveness of intermittent fasting interventions. And Ken and I are going to give an overview of a project that we’ve literally just started and we’ve been working on together, which is the evaluation of the new NHS low calorie diet pilot here in England. So it will be absolutely fantastic to to to present to that session as well.

That just sounds absolutely amazing. I’m going to be at all of these sessions, cheering you along and thanking you for the work that you can. Seeing as your session is with Louisa, do you want to share a little bit on PPI as well? And what does PPI mean, actually? Well, it’s it’s three little letters, but it’s not always the same three little letters.

So it’s usually about patients or public or involvement or engagement or anything. And it’s about putting the person living with obesity at the centre of everything that’s done. So that’s about research.

It’s about clinical practice. It’s about commissioning. It’s even about government policy.

And just making sure that that voice is heard, because over the years, I mean, you and I have been around some years now. And what we do is not always have the name. And now it’s called advocacy, I think.

But people have not always listened to our voices. And it’s so fantastic to be people don’t know I’m working with Louisa on this project. And I was involved before it even got off the blocks.

And that’s what’s really important to be involved, not from day one, but from before day one to even the conception of the project. And we’re running now. And it’s a fantastic team.

And look forward to more inputs and outputs in the next year or two, because we’re going places. And PPE and PPI and whatever you want to call it, we’re doing really good work there. I just think it’s it’s marvellous.

And I know I got to let you go back to your incredibly busy jobs, but I just want to thank you from myself, from Ken, from the whole ECPO for all of your work, for sharing your time with us and sharing it with the audience at home. So have wonderful sessions at the Congress. We’ll be there cheering you on in the background.

Oh, thank you. Thank you so much. Thanks.

Welcome back. How absolutely infectious is Louisa Elves? And it was an honour to talk to Peter Julius. And now I’m going to bring our panel back in because we want to chat about not only what they told us and what they will be presenting at the Congress.

But we were talking before we actually went into this interview about people first language and people first language in a nutshell is about treating people and speaking about people as a person before their disease. So therefore, you wouldn’t say a cancerous person. You would say somebody who has cancer.

You wouldn’t say an obese person. You would say somebody who has obesity, because I’m Vicky and I have obesity and various other chronic diseases. Now, Ellie, one thing that I find a challenge and I think we’ve seen this right across Europe is that the word obese doesn’t translate in all languages.

And for somebody who has English as a second language, it can be very hard to actually to rephrase it. And Peter himself said obese children and then went dope people first language. And how have you found that? Because English obviously is your second language as well or third or fourth because you’re bilingual.

It’s well, it’s my second language. Dutch is my mother tongue. I’m from the Netherlands originally.

And their obesity or obesity or alternatively adiposity, which is adiposity, which were both used in. The 1990s, when I started studying obesity in a more scientific way. There were both really scientific terms and never used in normal language.

People were. Well, there was this word dick. Which is in English translated as fat, but in English fat has is both for people and for.

Food and in Dutch, there are two different words for that. There’s dick for people, there’s fat, fat for food. So.

That that gives it a real different. Value, I mean, if you use the same word for people as you use for food and you don’t like the component in food. Then that gives a negative connotation to the people automatically.

Yes, but if in the language that’s different, it’s. Yeah, so it doesn’t get that negative connotation automatically. And then there’s a number of proverbs which use the word dick in a positive way.

Yeah, so. Isn’t so negative. Yeah.

Do you know for ourselves, actually, and I know Solveig will chuckle away here when I say this. We had our wonderful German colleagues on for World Obesity Day and in the background, they had their banners, which had dick, which is fat. But in English, dick is something quite different.

So it was it was quite challenging for me because I was looking at it, kind of trying not to laugh and chuckle, because obviously with the translation, it’s so different. But actually just thinking about what you were saying there, Ellie, and we’re talking about the various different languages and people first and how how hard it can actually be to change that wording. But for children, it is so important.

Like I remember when I was probably about my mum will correct me on this, but I was about 14 years old and I was washing plates in a kitchen in the middle of town in Dublin. My friend Lynn had got me the job and I went in one Saturday on a trial and it was this tiny kitchen, really small. And you were literally just scrubbing plates, you know, for a few pounds.

And when I asked, could I come back the following week, Lynn told me that the manager said I was too fat for the kitchen. And I remember that at the time thinking, oh, my God, it was so negative. And when that word fat is used for people, probably more Westerners that are English speakers, it is very damaging and hurtful.

And we think of childhood obesity and all of the work that Louisa and Peter are doing there. And so we’ve seen this with Mario in Portugal and the tremendous work that he does. And is there anywhere else that we’re seeing that? Or, you know, as a mum, what are you thinking when you listen to them? When I was listening to them, I just they made me smile.

They made me like I want to just go and hug them to the computer. I love how things are changing. Actually, here in Iceland, we don’t have that much change.

We have first of all, we don’t have obesity as a word. So it’s here. No, obesity doesn’t exist in our vocabulary.

So it’s all the fat or too much fat. Nothing else. So I have been trying and a few of us up here in Iceland, we are trying.

We are trying to advocate on new things. And this is among that. And with children here in Iceland, there is a quite a good hospital actually here in Iceland University Hospital.

They have a fantastic program called the Health School. And it’s the team. Their team is absolutely brilliant.

And as I always say that they should spread, they should go, they should be everywhere. And the thing is, though, and this is something that I listen from Luisa and Peter, is that how important it is to have family involved when you are treating a child with obesity. Because this can’t be treated alone.

The child cannot take the burden off himself to be taught to do something different. You have to have the family involved. And I can say that from when I was young, we were two children raised up in the same household.

And I was always taken to a doctor because I constantly was putting on weight. But my brother, he was taken to the doctor because he was underweight all the time until late 20s. Me too.

My brother was so thin. Yeah. My mother, she cooked the same food.

We ate the same food. We drank water and milk, the same thing. But we were completely on the other end.

Isn’t it amazing? Yeah. Do you know, for me, I kind of think about it and I think like it’s right there in front of us. And, you know, health is what we should be focusing on.

We need to move away from weight, the word weight. Like, yes, that’s for the clinical community to actually work on. But for ourselves, it is about our health and about a disease and not the number on the scale or the size of your your your blouse or your pants.

Cherie, this is like a conversation that we’ve had over and over. But what’s your thoughts after listening to Peter and Louisa? First of all, I loved their sort of positive and proactive work. They’re both doing very important work.

But it is also important to realize that the EASO Childhood Obesity Task Force has taken a position on childhood obesity as a chronic disease requiring treatment and care. So the positive aspects of the conversation that both of them had. And actually, I would I would add Denmark is doing a fantastic job as well, as is Switzerland.

But the the co-creation with families, the identity, the recognition that families are diverse and, you know, that there are huge health inequalities and there are underserved populations that need more support and more tailored interventions. And the fact that every family unit is unique is very exciting and creates huge opportunities. I see this as early intervention.

So if you can prevent severe obesity by engaging with children and families when children are young, let’s just it’s a fantastic opportunity. And it improves public health in general. It improves health for everyone.

Yeah, I think what you said there just nails it, really. And, you know, for us in ECPO, the best thing about being a part of the scientific community in a way of a patient team is that we have all of this evidence based research that you guys do and you bring to the forefront to support everything that we advocate for and we speak about. Well, I just noticed a couple of questions that have come in around, you know, has the childhood obesity rates gotten better or worse over the last few years? But I know with Covid, it’s probably incredibly challenging to to like nail that down.

Right. But as well as that, I’ve seen that Katherine’s there, Maura’s there, some of our colleagues are tweeting and sharing. But Dr. Savita actually made a statement there and said about the inequalities in when it comes to getting a job and employment because you carry excess weight.

Right. And whether or not you have obesity, you know, there’s nothing on the form that says, you know, do you have the disease of obesity? It’s, you know, have you, you know, are you are you fat? You know, yeah, it’s the number on the scale or it’s when you walk in and they look at your body before they meet your eyes. And it’s that inequality, it’s that judgment.

And Ellie, I just want to say, exactly, it’s it comes back to weight stigma, exactly as we said with Rebecca, right? It’s at the core of absolutely everything. And it’s something that I think we’ve been nearly around knocking around about a decade now with yourself, Shree. We’re coming up to a decade, I think, in a year or so.

And it’s always there, this conversation. And Ellie, I just want to ask you from your point of view, right, because I know myself, I have a number of chronic illnesses and diseases and yourself as a as a patient with your patient had on. Have you seen that kind of inequality across the patient community as yourself? For me personally, not quite when I was looking for a job.

But I have the advantage of academic titles and I am very good at speaking. So most of the times when I went into an interview, I could get it, get the job. But on the other hand, I have been in situations where a manager, when I’ve had, when I have been in a situation where I’ve had long term illness, which was not related, by the way, to my obesity.

That he was sort of dismissing me and then trying to get me declared unable to work, so for medical retirement. Because I think because of my weight, I’m not 100 percent sure because, well, they never say that. But, well, in that situation, a particular situation, in the end, we decided to part ways with a shorter than normal time.

Because also, well, what I wanted from a job changed and what they wanted from me for the job changed and not in the same direction. So they supported me in getting, in that case, a teacher certificate and leaving for teaching. I think for many of the people that I’ve spoke with that have obesity and myself, many people would say it’s almost like that unspoken word.

It’s there. It’s like right in front of us that, you know, they’re clearly discriminating about your weight. However, they’re actually not going to say it.

Right. And apologies. A helicopter just flew over actually when you were speaking there, so I hope it didn’t sound you out.

But I’m just looking at the time and we only have one interview left and then we can come back. And I’m quite excited because Professor Tommy Bisher has been with ECPO as a patient counsel going back to the early days when we were in Sofia and Bulgaria. He’s a marvellous man.

He’s a public health expert. He’s done fantastic work with IAZO as well, and Sheree, and he’s an epidemiologist. Tommy and myself and Ken had a great chat earlier, and I was delighted I could have our Chairman Ken come and join me on this conversation.

Let’s have a listen to what Tommy had to share with us. Welcome, Tommy. Hey, Ken, it’s good to see you, my friend.

And Ken, I’m going to come to you in a second because you’re going to help me with more of the technical stuff Tommy’s going to talk about here. But Tommy, you have been from when we go back to the very beginning of the patient council, myself and Ken floating around in Sofia, Bulgaria and various other countries, trying to be a support to that scientific community. You have been there from the beginning.

And for me, I would love people at home to understand what it is that you do and what you bring to that obesity community in the science. Thank you very much, Vicky, and it is so good, Vicky and Ken, to see you again. And I remember those days very well.

It was the highlight of a symposium. And I remember, well, 35, if not more, patients sitting in a large circle telling their story. And top scientists said afterwards, well, we always learn a lot from the obesity conferences.

But in the last 20 years, since the beginning of IAZO and EGOS, we have not learned so much as we have learned in this meeting. And I think they were completely right. And it made me aware that it is so important to speak to patients or persons with obesity if you want to improve the quality of lives of persons living with obesity by your science.

So, well, it’s right. You need to know patients, persons with obesity, also persons without obesity, if your field is prevention. You need to know why it is so hard to change your lifestyle.

And, yeah, so. And your role in this whole area, because you walk up to these conferences, as you have here in the funkiest of shirts, and you’re like this so chilled out dude. What is it that you actually do in this in this field? Yeah, with our research, we try to understand the environment of populations and how unhealthy is the environment.

How easy is it to make the wrong choices or to be to adopt unhealthy behaviors? And how easy is it to make mistakes as a clinician, as a prevention expert? And I always like to add some plea to really involve patients in your research. You cannot do any proper research with impact without patients. And in the past, of course, we’ve had researchers who shared their results afterwards with patients.

But that’s the wrong order. We should start talking to patients, realizing what the important questions are to be answered by science, then start doing the research, only then start doing the research. Because only then you know that somebody is waiting for the answer.

And if you do not involve patients, then you have a chance that you have beautiful science, but your answers are not going to lead to any solution. And well, well, that’s that’s what I try to do. Try to make my colleagues and my friends aware of the absolute needs and joy, I have to say.

To speak to people as you are, there is so much to learn from you that we cannot learn in our lectures and in our textbooks. We have to learn it from you. So and I say this joy because I’m really serious.

It’s very interesting, but also very nice to be able to talk to you and to realize, hey, wow, these people really want to share their stories. They want they are open and they trust you because you have some heavy stories to tell and you realize, OK, these are stories that you do not tell to anybody. And there is a matter of trust and respect that you experience as a researcher if you get a chance to be involved.

And I have always enjoyed it. So I try if you ask, what is your role? I try to infect my colleagues and my friends with this energy from the from the patient’s area. That’s pretty amazing, actually.

And if I’m right, because we were chatting before this interview, Ken, you and Tommy actually met at a congress many years ago. Ken. Yeah, that’s right, Vicky.

Thank you. I was invited to speak at a European conference. I was super excited.

And then I found out it was five miles from my home in Liverpool by the river. And it was I ended up speaking in a session on maternal health, which was completely inappropriate. So I just told a story that would seem to go down well.

And ever since that day, I think Tommy’s always been a good friend. He’s been a unique supporter and has been on the front line of encouraging the development of the patient voice and later the patient council across Europe. And it’s a joy to speak, Tommy, as ever.

I’m just wondering, it’s a very different congress this year. What are you hoping to bring to it and what are you hoping to take away from it? Yes. Yeah, very good.

And I remember your presentation very well, Ken. There was no award for best presenter, but I had to speak after you and we didn’t know. And when I was impressed, I really was impressed.

So I suggested to the audience, well, if there would be an award for the best presenter, then it would be for Ken. And you received a standing ovation from the whole room. So the whole room approved the beauty and the importance of your talk.

So I remember that very well. And yes, the word friend is completely, completely right. And to your question, what would you like to bring to this ECO meeting in May? Well, I’ve been asked to tell a bit about our COVID crisis last year.

And I think that’s a very brilliant idea. I’ve been asked by the youth health community experts and we are building a network of European and international healthy networks. And I think there is an important similarity in the COVID crisis and the obesity, well, crisis, obesity pandemic.

And the similarity is that, again, over the last year, more than 12 months now, governments have been blaming people to be infected. If you don’t keep distance, if you don’t follow the rules, then you will be punished either by the virus or by legislations that you cannot go out. And all those, so that’s one.

If you do not this, then you will have a problem yourself and it’s your own fault. That reminds me of how we have dealt with the obesity crisis. And governments have realized obesity is a chronic disease.

Governments have realized we should do something about it. But the first thing many governments do, or did, I have to say, did, was to do something about it. It’s your own fault.

You are responsible yourself. So that is one similarity. Another similarity is that all measures have been taken without consulting the public.

So we have not asked our adolescents, how are you going to suffer from all these measurements? What do you really need? And the result is that we have very bad quality of life in our adolescents and other age categories. Our elderly have not been able to visit their friends while dying. We did not understand that those personal, individual needs were totally ignored.

And that is another similarity I see with treating patients with obesity, as we did in the past. We made programs, we offered our programs before without asking you, what do you really need? What do we have to do and what should we not do? So that’s what I try to bring in the conference to make people aware that we may be improving on preventing and treating obesity. But at the same time, our biggest leaders are making the same mistakes as we have made five or 10 years ago in the obesity field.

Yeah. And yeah, so that is the topic of our contribution to the conference. Thank you, Tommy.

And you, Vicky, and myself have been around for quite some years now. But what do you think is the next steps, next generation of the interaction between people living with obesity and researchers and clinicians? Yeah, I think the next step is realize that you, if your goal is to improve people’s life or you call it improve people’s health or well-being. If that is your goal, then you can’t reach your goal without the people you try to serve.

So you need to help them. And how can you help them? You need to understand their lives, their way of thinking, their way of living, their context, their environment. And it seems to be very easy.

If we treat a drug addict or an alcohol abuser, if we treat them, then it’s very logic that we do not send that patient to a pub afterwards. Not in the first year. When we treated patients with obesity, and we still do, we sent them back to very unhealthy environments.

And again, the similarity with the COVID crisis, we have a vaccine, we treat people, but we send them back to an unhealthy environment. So we are waiting for the next crisis. So one lesson is, whatever you do, involve the people you are trying to improve the qualities of life and have an absolute attention for their environment, for their context.

Which makes it logic that unhealth is coming into their lives. So that’s the two lessons I think we really need. And we have learned those lessons and we really have to bring them into practice now.

And in the obesity area within the EASO and with the patient council, we are very optimistic and we have seen very good examples. But I think we have to realize we are sitting on the top of a very positive iceberg. And from this similarity I made with the COVID crisis, there are a lot of professionals and people working on the problem that can learn from us.

And of whom we can learn from, of course. Thank you, Tommy. I’m going to hand back over to Vicky now.

Thanks, Ken. You actually ask the perfect questions and I love how you make that analogy of somebody who has an addiction to alcohol. You don’t send them back into the environment of the pub, but governments expect people who live with obesity to just manage this by themselves.

Tommy, thank you so much. I want to give Ken the last word because you’ve just been amazing as always. Good luck at the Congress.

From myself, Ken, do you want to say a few words before we leave you? I love you all. Yeah, I just really, it’s great to see an old friend, Tommy, and it’s, you know, we’re all works in progress and we can all get better. And it’s nice to see you out there on the front line and that you are bringing things and giving us some of your time today, which is so very precious.

So I’d like to thank you on behalf of ECPO for that. Well, it’s been a great pleasure seeing you and it will always be a pleasure seeing you. And let’s hope that we can meet in person next year.

I can’t wait seeing you again. And what a wonderful man he is. Welcome back.

I’m going to bring back our panel in here because I’m smiling near to ear when I listen to Tommy. He’s just got such a gorgeous way about him and he is a genius in the area and the field that he works in. So really, I suppose when I listen to Tommy and as he said about you do not send an alcoholic back into somebody who has that treatment and had that challenge.

You don’t send them home to where the pub is on their doorstep. You know, you don’t bring them into a pub and offer them a pint or a gin and tonic or a glass of wine. But yet we expect people who live with obesity to just manage the environment we’re in.

Cherie, this is like such a such a huge conversation. What was your thoughts when you were listening to Tommy? Yeah, absolutely. First of all, I loved his focus on co-creation and how important it is for everyone in the patient community and in the medical scientific community to understand the importance of co-creation.

But when thinking about obesity and the overall environment at a medical and scientific meeting as ECO 2021 is, people often focus on their specialty. But we have to think about how important it is not to look at things in silos. And even if you’re a medical endocrinologist, it’s important to think about the obesogenic environment that we all live in and the impact that it has on people living with obesity.

And it also makes me think about the Foresight Report, which was, do you remember that incredible diagram over a decade ago that was developed to show the tremendous influences from every sector and every part of the environment on obesity? And we haven’t we haven’t solved the problem yet. Right. Because there is no one there is no one solution.

So I think Tommy’s challenge and it really was a challenge to everyone to the medical and scientific community to take that broader view is really important. And is, yeah, it’s really important. And that, you know, going back again to the blame and shame conversation as well.

That’s not that’s not going to work. It’s we’ve got to we’ve got to help everyone to understand that this is a you know, it’s a big environmental problem. And the public health element of the work Tommy and his colleagues do is vitally important to the work of better understanding and learning to treat, prevent and manage obesity.

Yeah. Yeah, I think when when you put it like that, it makes it seem almost overwhelming, right? The challenges that are out there, we think of, you know, when people say, you know, obesity is genetic, it’s environmental, it’s socio-economic, there’s psychological elements, there’s just such a complexity surrounding us. So it’s no wonder that we actually have four days of the Congress with EASO this year for full on packed days and tracks back to back sessions, symposiums, abstracts back to back where people can learn more and share.

But I want to jump over to Ellie now. Ellie, as somebody who has a love for this kind of information, you are a mathematician. You are the most smart person I probably know.

What is your thoughts when you’re listening to Tommy there when he was speaking? Yeah, I totally agree with him. I mean, it’s the research is very important. But research for the research might be fun, but isn’t good for us.

I mean, if you want to do applied research, you need to be sure that the question you’re answering is a question that someone is asking. So that’s why the contact with the patients is so important, so that you know that the question you are going to research is a question that’s asked by patients and not something that you. Yeah, that’s something that you think is interesting and it’s fun to research.

Well, yeah, you can do that, but don’t call it applied research, don’t call it medical research. Yeah, I remember actually on a session you and I did together, Ellie. And one thing that I always find very interesting is when you speak to somebody and you say, oh, I’m a patient, you know, and I advocate for people living with obesity.

And some of our, you know, I suppose the clinicians and the scientific community that don’t know us probably kind of go, oh, it’s just a patient, you know, they’ll, you know, leave them to do their stuff. And we did a session together. And I remember so well how blown away all of the other chairs and co-chairs and speakers were on that session when you spoke about, you know, the importance of co-creation and the patient there.

From the beginning. And when you said you were a mathematician, all the ears perked up. Everybody was like, oh, OK, what can we learn from this lady? You know, so we’re hugely grateful because you are our director of scientific committee and you have actually just started the incorporation of your organisation in Belgium for patients.

So a huge congratulations from us to yourself and to Jacqueline Bowman for the huge work that you’re doing there. And I know we only have a couple of minutes left. I just want to go to Solveig now, because Solveig, this is kind of your area, right? You know, healthy environments, you know, looking after your mind, your body, your soul.

You know, when I was over in Iceland with you, we’d have fabulous bowls of granola and fruits and go to the most gorgeous stores. And sometimes it was incredibly cheaper than buying in, you know, the huge supermarkets. And what’s your thoughts on the environment and how challenging it is for some people? It actually is challenging.

And like Tommy said about lifestyle change, how, why is it so hard to keep up a new lifestyle? I always say that I did change my lifestyle, what you can say, around eight, nine years ago, but every day I’m changing my lifestyle because you cannot change the lifestyle. Like, for example, on Monday I’m going to change my lifestyle and after that everything will be the same. It doesn’t work like that.

It takes time. First of all, it takes an education. We have to understand about obesity, how it works.

And we have to understand that food is never going to cure or fix your obesity. It doesn’t matter how little you’re going to eat or what kind of food or if you’re going to eat the freshest and the best food on earth. It’s not going to be a cure, but it can help.

And it does really help. For example, I have MS disease as well, and I treat MS and obesity nearly the same. It has to be, my lifestyle has to change because otherwise I was going to lose my health completely.

But like I said, it takes time. And this is when we come to that we need help. We cannot do it alone.

And especially now with the pandemic, it’s just too hard. You cannot even go and visit your doctor or the clinics that you are getting your help from. So I always say that I am so like the tickle therapeutic.

This is something new. This is something new to the world. This is what Peter and Peter and Louis was talking about when we were changing lives that we can use new apps or children.

They are more into technology than maybe we are. And even I use quite a lot of apps. And I think tickle therapeutic is something that we should focus more on, because from there we can get as much help as we can at the moment, because we are not able to do much meeting people face to face, even support groups.

And, you know, exactly. So, yeah, you’re spot on there. And I think when when I think about it, I think that so I’ve had bariatric surgery 15 years ago and my body has my own biology has fought against me.

Without me actually realising, thinking I was cured and I’ve regained some of the weight. And that is so unbelievably frustrating as a patient. And I think back again to what I said earlier about my my grandmother saying, you know, she spent her life on diets.

You know, she was always trying different diets and always trying to cut down and but not realising that it wasn’t only the food. It’s that’s not what it’s you know, the focus is on. And really, the food is just for our health.

So the importance is getting good nutrition and healthy food into us. But I know we have to go and wrap up, but I want to give the last word to Cherie, because the Congress is next week. And lady, you have been working like crazy hours.

Can I just ask you for two minutes of what you’re looking forward to and what you’re hoping to kind of get out of this year’s Congress on obesity? Well, thank you so much, Vicki. We are very excited. We have a fantastic Congress ahead for you.

We’ve we have multiple tracks from basic science to clinical practice. We have ECPO featured and co-chairing sessions and so on. We have a new session on communicating science, which I’m really excited about.

So please join us for that. There was a question earlier in Twitter, actually, about childhood obesity rates and how they look. Well, we have W.H.O. presenting on the latest COSI data.

We have lots of sort of breaking science and everyone’s curious about the latest in semaglutide. We have just, you know, three thousand people plus registered now. Seventy plus sessions for you over four days.

So we’re really excited about ECO 2021. So follow us, you know, share your content with us. Use the hashtag ECO 2021 and we’ll share your science.

We’ve got lots of posters. I’m hoping a lot of poster presenters will share snippets of their posters, too. Thanks, Vicki.

Thank you for that. No, you’re so welcome. And I think just the three interviews that we had are fantastic.

And really, it just shows the tremendous level of content and speakers that will actually be delivering at the Congress. So I know Ellie’s super excited. Solveig’s excited.

I’m excited. I want to thank you all. I want to thank our interviewees.

I want to thank the three of you for being here and taking the time to join us tonight. It is time for us to wrap up. However, if you want to keep having the conversation, pop on to Twitter or social media.

Use hashtag ECPO Patient Lounge. We’ll kind of follow up if there’s any questions that we’ve missed. As well as that, I would like to thank our sponsors who made this happen, Nova Nordisk and EASO.

Humongous, humongous thank you to Holly and Phil, our producers and our comms team behind the scenes. Stay safe and stay well. And we will see you on the next episode.