Expert Guest: Dr Wayne May
MBChB (UCT) 1994, FCP (SA) 2002, Endocrinology and Metabolism (Cert) 2004
Across the spectrum of diabetes care, obesity remains one of the most complex and consequential clinical drivers we encounter. It is at once a biological condition, a lived experience, as well as a systems challenge that shapes risk and long-term outcomes. This journal club invites us to pause from protocol-driven practice and re-engage with the evolving evidence base that informs how we understand and manage obesity within the multidisciplinary diabetes team.
Recent scholarship increasingly reframes obesity not as a simple imbalance of energy but as a chronic, relapsing disease influenced by genetics, environment, neurohormonal regulation, social context and healthcare structures. For healthcare professionals this shift carries practical implications: how we set goals, how we measure success, how we select therapies and how we speak with patients about weight without reinforcing stigma. It also challenges traditional hierarchies of intervention, as pharmacotherapy, behavioural strategies, metabolic surgery and digital support models intersect in new ways.
Within diabetes care, the relationship between adiposity and cardiometabolic risk is both familiar and evolving. Questions of timing, intensity, equity of access and sustainability now sit alongside efficacy data. Importantly, the MDT perspective becomes central by recognising that meaningful change rarely occurs within a single consultation or discipline, but through coordinated, longitudinal care that integrates clinical science with human realities.
Our live session aims not only to review data, but to explore interpretation: what the evidence suggests, what remains uncertain and how context shapes implementation in everyday practice.
