GPs call for digital, cultural obesity care in rural NZ

General practitioners are calling for a new, culturally appropriate digital healthcare model in New Zealand as obesity rates climb in rural communities and existing services struggle to meet demand.

Doctors say many rural patients cannot access specialist obesity treatment or long-term support under the current system. They say new models that use telehealth and integrate cultural and social factors are now necessary.

New Zealand is the third most obese nation in the OECD. More than one in three adults is classified as obese. Among Maori, the rate exceeds 50%.

New analysis indicates that the economic impact of obesity in New Zealand is set to rise sharply. Researchers expect the cost burden to increase 471% and reach USD $46.3 billion by 2060.

Global studies show that rural populations have driven more than half of the increase in obesity since 1985. Rural New Zealanders and Maori experience higher rates of obesity than urban residents.

Those living in the most deprived rural areas are 1.6 times more likely to be obese than people in cities. Doctors say that many of these communities face additional social and economic pressures.

Recent research into the experiences of rural New Zealanders with obesity suggests that GPs see weight management as one of their most significant community challenges. The same research found that many GPs do not believe the current health system supports them in this work.

Dr Kieran Dang is Chief Medical Officer at Moshy, a trans-Tasman network of GPs that focuses on obesity management via telehealth. He says the existing approach does not match rural realities.

“Too often, people in regional areas struggle to even see a GP, let alone receive specialist weight-management care. Without new approaches designed for rural realities, residents are left at greater risk of serious conditions down the track,” said Dr Kieran Dang, Chief Medical Officer, Moshy.

Dang says key barriers in rural areas include difficulties in communication between doctors and patients and structural constraints within the health system. He says wider social and cultural environments also shape outcomes.

He points to a University of Waikato study that examined the views of rural GPs in Waikato. The study found that many GPs were hesitant to raise weight concerns.

“The GPs surveyed also reported a lack of rurally tailored interventions, limited funding and few specialist services as ongoing obstacles. Many of them also stressed that the realities of rural life, such as long working hours, poor transport options, scarce access to gyms or fresh produce, and the dominance of fast-food outlets are not recognised at a policy level but strongly influence patient outcomes,” said Dang.

Dang says a shift in how obesity is framed is needed within health services and society. He says obesity should be treated as a systemic health issue rather than a failing of individual patients.

“Helping patients lose weight doesn't just change the number on the scale. It reduces their chances of heart attacks, diabetes, arthritis and mental health decline. The benefits are immense, but only if people can actually access the care they need.

“New digital care models such as telehealth allow us to meet patients where they are, regardless of postcode, and provide wraparound programmes that combine medical support, dietary advice and patient coaching. For rural communities, this is often the only practical way to access consistent, high-quality care,” said Dang.

He says any new model must reflect cultural and social context as well as medical needs. He says this is particularly important for Maori and for diverse rural populations.

Dang says integration of medical, social and cultural support within one pathway would reduce inequity. He says this approach would also ease pressure on an already stretched health system.

Dr Anasuya Vishvanath is Moshy New Zealand Clinical Lead. She says access delays are a daily reality for many rural patients.

Vishvanath says some rural patients wait up to six weeks for a GP appointment. She says these delays mean many patients cannot start obesity treatment promptly or maintain motivation over time.

She says digital care should sit alongside traditional general practice. She says this model can manage straightforward cases remotely.

“Digital models like Moshy help bridge that gap so patients can start care sooner and stay engaged in their health journey.

“When patients finally get support that works they become more confident and committed, making lasting lifestyle changes.

“The current system was never designed for the scale of obesity we're seeing. A new digitally enabled model that combines medical, social and cultural care is essential to close those gaps,” said Vishvanath.

Doctors now expect debate over how digital and culturally grounded models can be incorporated into national strategies for obesity and rural health in the coming years.