The Media

Media Articles in which Neil Peace is quoted:

Sun Herald
13th February 2005
Alert on infertility risk for women
Author: MIRANDA WOOD
Date: 13/02/2005
Publication: Sun Herald
Section: News

RESEARCH has revealed the most common hormonal disorder in Australian women, and one of the leading causes of infertility, is more prevalent than health experts have believed.

The incidence rate of polycystic ovary syndrome (PCOS) is normally quoted at between 5 and 10 per cent, but results from the study show at least 12 per cent of women are affected.

The findings, published in this month's Australian And New Zealand Journal Of Obstetrics And Gynaecology, correspond with anecdotal evidence from specialists.

The exact cause of PCOS, an incurable and often misdiagnosed condition, is not fully understood, but its symptoms can be devastating.

The disorder can lead to infertility, weight gain (even to obesity), diabetes, heart disease, excessive facial hair and acne.

It affects women of reproductive age, and sufferers normally have high levels of male hormones and an irregular or absent menstrual cycle. Many have small cysts in their ovaries.

Dr Neil Peace, of the Sydney Medical Weight Loss Centre, said more overweight patients with PCOS were being referred to him.

Dietitian Kate Marsh, from the University of Sydney's Human Nutrition Unit, has seen similar increases. She said more women were altering their diets to lose weight and better manage PCOS.

Women with the disorder are usually, but not always, overweight.

This has led to many studies examining the relationship between PCOS and a woman's ability to make the hormone insulin. Insulin regulates the change of some foods into energy for the body's use or for storage.

Some women with PCOS produce too much insulin, which stimulates the ovaries to generate large amounts of male hormones (androgens) that can cause weight gain and ovulation problems, thus causing infertility.

To help more overweight women, including those with PCOS, become pregnant, Peace is starting a new weight-loss program this week.

The weekly, two-hour program is based on an Adelaide study that found women had a high rate of conception after they lost weight in a group setting.

"Even the process of weight loss itself rather than the total amount lost is beneficial to these women, because as soon as a woman starts the process of weight loss they reduce insulin resistance," he said.

"This in turn improves their chance of ovulation."

Sydney event manager Emily Jackson, 28, said she had lost 15 kilograms since she was diagnosed with PCOS three years ago. She is on a diet that includes no sugar, and exercises regularly.

Her goal is to be fit and healthy so when the time comes for her to start a family, she will be ready.

"Basically it's my aim to try and get my body the best that it can possibly be," she said.

Ms Jackson said she visited "every specialist possible" before she was diagnosed with PCOS.

"Nobody knew what was going on," she said. Ms Jackson said she was putting on 11/2 kilograms every month and was very emotional.

Experts believe diet plays an important role in helping women with PCOS, and Ms Marsh is recruiting overweight women for a study looking at the benefits of a low glycaemic index diet in reducing insulin levels.

For more information on the study, email pcosdietstudy@nnd.com.au.

Financial Review Magazine
29th July 2005
Forget the ticker, have you got the stomach?
Author: Story by Jill Margo
Date: 29/07/2005
Publication: The Financial Review
Section: Australian Financial Review Magazine

Next time you're in front of a mirror, turn sideways and look at your body in profile instead of full-on. If you see a pronounced central bulge, there is something you should do for yourself: measure it. Put a tape measure around the broadest part of your abdomen - it can tell you much more than you imagine. If you're male and measure over 94 centimetres, it's highly likely you've got a cocktail of potentially fatal conditions. The same applies if you are female and you measure 80 centimetres or more.

This seems ridiculously simplistic, but these numbers are the result of international consensus, conducted at the highest level and based on millions of hours of research. They represent the base measurement of what is now being called metabolic syndrome. Without being dramatic, this is the time bomb syndrome. It is a blend of conditions linked to an enlarged girth that triples your risk of heart attack or stroke and potentially marks you for an early death.

You can safely assume that if your waist has expanded, your blood vessels have narrowed. And all the evidence shows that if you can reduce your girth, you can make a striking difference to your chances of survival. Even if you keep exercising and your girth doesn't go down by much, you can still reduce the impact of the cocktail. A visit to your family doctor will tell you if you have metabolic syndrome. The diagnosis depends on three things - abdominal obesity, blood pressure and laboratory findings.

The notion of metabolic syndrome is not new. It grew out of what an American endocrinologist once called syndrome X, which was comprised of high blood pressure, high abdominal fat and high blood fats. People with syndrome X had a condition known as insulin resistance, which means they responded inadequately to their own insulin production. This meant they were in the waiting room for diabetes.

In the late nineties, syndrome X evolved into the more complex metabolic syndrome but there was no single agreed definition of it. This meant a lot of competition between researchers producing work on the syndrome that couldn't usefully be pooled. In April this year, this problem was overcome when the International Diabetes Federation met in Berlin and issued a global consensus statement presenting the worldwide definition of metabolic syndrome.

The consensus group, which was co-chaired by Professor Paul Zimmet, director of Melbourne's International Diabetes Institute, based much of its definition on Australian research. If you have a bit of a tummy and you have two or more of the following conditions - diabetes, diabetes risk factors, high blood pressure or an unfavourable lipid profile - you have metabolic syndrome. At least one in four Australians suffer from the condition. Professor Zimmet says many Australians who regard themselves as only slightly overweight could be at equal - or even higher - risk as those who are plainly obese.

Before the consensus, the American definition held the most sway, but it was set at levels unrealistic for the rest of the world. It used a waist circumference of 102 centimetres for men and 88 centimetres for women. This was too high for Australians, Asians and Europeans. Professor Zimmet says that focusing on waist size speeds diagnosis. Instead of doing a body mass index calculation using weight and height, a doctor can simply put a tape measure around the patient's waist and go from there.

While metabolic syndrome increases with age, it is now also being seen in reasonably high rates in children and adolescents. In Australia, it has now become more important than type 2 diabetes.

Dr Neil Peace, who specialises in treating overweight and obese patients, likens a large tummy to a land-mine which yields "a predictable result at an unpredictable time". At his Medical Weight Loss Centre in Sydney, men often point to their tummies and say that compared to their friends' guts, they don't feel they have a real problem. Dr Peace answers frankly: "Well, if your beer gut is smaller than your mate's, then you won't mind having a slightly smaller stroke than him." You can have metabolic syndrome even though you may have the correct body mass index.

In your body you have two kinds of fat: that which occurs under your skin and that which collects around the major organs in your abdomen. This latter internal fat is dangerous because it is dynamic, highly mobile and can get into the bloodstream twice as fast. It takes a much shorter route and goes almost directly to the liver. Dr Peace says metabolic syndrome refers to the way the liver is influenced by this visceral fat; to the way it impacts on blood fats, insulin, glucose and blood pressure.

Often, this visceral fat can't be seen. A man with pretzel legs and skinny arms can have a tight little drum of an abdomen, packed with visceral fat. In the past decade the understanding of fat has changed radically. It's no longer viewed as a static entity but regarded almost as an organ, producing hormones and liberating free fatty acids. One of the hormones it produces is leptin, which binds to a centre in the brain that has a bearing on food-seeking behaviour.

Dr Peace says leptin essentially dampens food-seeking behaviour through binding. But when a person loses weight, leptin levels drop leaving less to bind to the brain.

This then liberates the brain to express its full food-seeking drive and so you regain the fat you lost.

He says a whole orchestra of hormones is involved in weight gain and people who lose and then fail to maintain the loss are not spineless or undisciplined. They are just at the mercy of these powerful hormonal drivers. It is possible to outsmart these drivers but it takes technique and a degree of cunning.

Dr Peace likens them to the male sexual drive. "It's a powerful drive but, having expressed itself, it doesn't go away. Although it's basically reproductive and a man may have three children and there may be enough people in the world, the drive continues to express itself. So too with food-seeking behaviour. The fact that a person has lost weight doesn't change the drive; it's there all the time. But if you do have metabolic syndrome, you've got work to do. You need to lose weight and to exercise. Otherwise, stay near a hospital."

Professor Zimmet says that in the past 30 years, mechanisation and modernisation have engineered physical activity out of the workplace and out of our leisure time. He believes that to get Australians moving again, we may require public health legislation akin to that used to control smoking.

Australian Doctor
15th September 2004
by Bianca Nogrady

FOR most of us, that New Year's resolution to lose weight lasts as long as the first opened box of chocolates. However, Dr Neil Peace has built a career on helping patients stick to their resolution.

From his practice at the Sydney Medical Weight-Loss Centre, Dr Peace employs every trick in the book.

"It's a very, very difficult area," he says. "There's no format. You can't apply a routine diet or routine exercise [because] it's absolutely individual.

"Motivation does not work long term - people come in motivated but in the end it's finding a trick to overcoming this problem."

Often this can be something as simple as leaving healthy prepared snacks lying around the house to distract grazers from less healthy options lurking in the cupboard.

"It's often something they haven't thought of, but I've got the advantage of having worked in the area for so long I've accumulated a whole slew of tricks."

Dr Peace has been specialising in weight loss for more than 20 years, and is often the last resort for overweight patients.

"Most of my patients come by referral from GPs or specialists," he says. "They're usually patients who have tried this, that and the other. They often come through the door and say, 'You're my last chance.'"

Despite the overwhelming challenges, Dr Peace says it is an exciting and rewarding area to work in.

"When somebody loses weight - and it's almost like seeing a girl blossom in adolescence - it really is a wonderful way to work."

Sunday Times
21st November 2004

"This backs previous research which revealed obese Australians needed to be morbidly obese before they recognised their condition," Sydney GP Dr Neil Peace said ...

Manning River Times
4 February 2005
GPs to lighten epidemic
Friday, 4 February 2005

OVERWEIGHT Taree residents 'ready' to battle the bulge are being urged to seek help from their doctor as part of a new initiative involving more than 2700 GPs who have signed up in the fight against Australia's growing obesity epidemic.

The initiative has been launched on the back of a new survey that reveals many obese people are reluctant to admit they have a weight problem or to seek medical assistance for the condition which can lead to life threatening medical conditions such as heart disease and diabetes.

The survey, conducted by pollster Galaxy Research, 'Weight Loss Study July 2004', found more than half of obese adult Australians have not consulted a doctor about weight loss in the past two years, with 50 per cent believing they were not sufficiently overweight and 56 per cent stating a doctor was there to treat people with an illness - something they did not have.

Up to 67 per cent of adult males and 52 per cent of females in Australia are overweight, indicating that over 50 per cent of the 78,531 people living in Manning-Forster area could be obese.

"This backs previous research which revealed obese Australians needed to be morbidly obese before they recognised their condition," Sydney GP, Dr Neil Peace said.

Based on self-motivation and the premise that those 'ready' to lose weight are more likely to succeed, the new campaign called 'iDecide', which uses the words 'Today, I decided to stop being fat', takes a direct and honest approach to reflect the moment an individual makes the decision to lose weight and highlights the importance of overweight people in Taree speaking to a doctor.

"GPs are perfectly placed to give overweight Australians living in Taree unbiased advice on weight management. Unlike some weight management options, GPs are not trying to sell a particular program or product and are able to deal with other issues of overall health which may be related to their weight," Dr Peace said.

Dr Peace is one of the GPs listed on the iDecide website which also provides information to help people determine whether they are overweight or obese and assess their readiness to lose weight. The website encourages people to discuss the subject of weight management with a doctor and provides them with the tools that will help them prepare for this important consultation.

Dr Peace urged Taree residents who felt they were ready to lose weight with their GP to visit the 'iDecide' website: www.idecide.com.au or call 1800 069 043 to find the local GPs taking part in the program.

Sydney Morning Herald
18th November 2004

Thousands of doctors across Australia have signed up to an online initiative to help fat patients shed kilos.

On the back of a national survey which found many obese and overweight Australians fail to recognise they have a problem, doctors are urging them to take action.

The survey, conducted by Galaxy Research, found more than half of the obese adults had not consulted a doctor about weight loss in the past two years.

And 50 per cent believed they were not sufficiently overweight to seek help.

Around 2,700 GPs nationwide have now formed an online database to encourage obese and overweight people to take action and seek help.

"It's a website which is designed to take a patient who has a feeling of being ready into action on their weight," said Sydney GP Neil Peace, who is among the doctors involved.

"There's a database of doctors who are interested in treating patients with weight problems so you have a ready patient and an interested doctor waiting to be matched."

The website would encourage people to begin a food or exercise diary as a starting point to losing weight.

"About 50 per cent of people who were obese didn't recognise they had a problem," Dr Peace said.

Obesity had to be tackled step by step and patients could not be made to overhaul their lifestyle.

"You can't take a person and say we're going to do an overhaul and change everything; it just doesn't work," he said.

"It takes a lifetime because these problems are not curable because if patients are overweight, they will always have a propensity to gain weight because we live in an obesogenic society.

"There are so many factors which are contributing to get you to gain weight so, really, it's a lifelong thing."

Patients who might not lose weight in the first two weeks were still better off if they had improved their fitness through exercise.

"If they haven't lost any weight... but have done a little bit of exercise, they already say I feel so much better and, indeed, the research shows that even if the patient doesn't lose weight but improves fitness, their risk of disease goes down straight away," Dr Peace said.

The website - http://www.idecide.com.au - is being funded by a pharmaceutical company.

Radio with Neil Peace Quoted:
ABC Radio Illawarra
2 February 2005
"Are you an overweight bloke? Try the Fat Test"
Wednesday, 2 February 2005 

If you're a man, go to the nearest mirror and be brutally honest with yourself.

What do you see?

No. Do it again.

Now, what do you see?

Do you think people have noticed those extra seven kilos?

And if you happen to run into a mate, it's likely for him to tactfully joke over a beer, "Gee mate, you've put it away over the holidays." And you both proceed to laugh. But if this happened between two females the earth should dutifully open and swallow up the padded one. If that fails, the friendship could come to an abrupt end.

So could it be a simple lack of vanity that explains a major increase in the rates of male obesity levels? According to the Australian Institute of Health and Welfare, 67% of Australian men are either overweight or obese, compared to 52% of women.

Sydney GP Doctor Neil Peace says that an attitude change is needed among Australian men to slow down a growing incidence of obesity. Dr Peace doesn't pull any punches with his message.

"If you want to spend the last 10 years of your life in a dependant state with things like heart attacks, stroke, diabetes, kidney failure, impotence then go ahead, but if you want to do something about it, just do something about it," he said.

Dr Peace recommends the first step is acknowledging your size.

"Grab a tap measure, place it around your midline and if you're a man and the circumference is more than 94 centimetres you are overweight. If it's more than 102 you are obese. And for women, 80 centimetres and above is overweight, while 88 and above is obese."

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Listen to Afternoon Show Presenter Bonita Brown interview Sydney GP Doctor Neil Peace

TV with Neil Peace Quoted:
Dr Neil Peace has appeared on news and current affairs programs on Channel 7 and SBS