Obesity is becoming increasingly prevalent worldwide, and Canada is no different. Based on a report published in the Canadian Medical Association Journal Open, about 27% of the Canadian adult population is considered obese, a significant increase from 22.2% in 2005. There was also a gradual rise in obesity across genders from 2005 to 2018, as the obesity rate for men increased from 24% to 28.9%, while the prevalence for women went from 20.4% to 25.4%.
With more than 1 in 4 Canadian adults living with obesity, the findings call for urgent actions for obesity prevention and management in all Canadian territories and provinces. In this light, a group of physicians in Canada has released new clinical practice guidelines that take into account the latest developments in diagnosing and treating obesity. Read on to learn more about these guidelines and how they impact patients with obesity.
How the new guidelines approach obesity
In recognition of how weight-related stigma affects how people living with obesity access healthcare systems, physicians affiliated with Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons call for a new clinical approach to obesity diagnosis and treatment. On top of classifying obesity as a complex, chronic condition, the Canadian Adult Obesity Clinical Practice Guidelines (CPGs) encourage healthcare providers not to rely solely on weight or body mass index (BMI) as diagnostic criteria.
Instead, doctors should reconsider the clinical limitations of these metrics and focus more on how weight impairs the patient’s overall physical health and mental well-being. As this also departs from the traditional notion that obesity is simply a lifestyle failure, obesity must be addressed using principles of chronic disease management — emphasizing long-term care and treatment as opposed to quick fixes and temporary diets.
What this means for patients with obesity
The new guidelines also provide a five-step plan for doctors regarding obesity treatment, starting with asking for the patient’s permission to discuss their weight. This allows providers to build trust, compassion, and empathy with their patients before moving forward with diagnosis and treatment. Next, the doctor has to assess the patient’s story to properly identify the causal factors of obesity and its severity.
Establishing the complex factors affecting obesity then informs how doctors give medical advice in the third step. Individually tailored approaches include psychological and behavioural interventions, medications, and bariatric surgery. However, the guidelines still do not completely disregard standard weight loss advice like medical nutrition therapy, where doctors recommend a weight loss program supervised by a registered dietitian and customized to a patient’s nutritional needs, eating habits, and weight goals. Based on nutritional and behavioural science, personalized meal plans provide patients with healthy, lifelong habits by helping them track their food intake and guiding them toward healthier choices and portion sizes.
Regular exercise is also considered an adjunctive therapy alongside nutrition, with the specific recommendation of 30 to 60 minutes of moderate to vigorous activity on most days. This is in line with the World Health Organization’s recommended levels of physical activity for all adults, including those with chronic conditions like obesity, which is to have at least 150 to 300 minutes of moderate to intense aerobic exercise per week.
Through steps four and five, doctors collaborate with their patients to determine specific health goals, provide support, and assist them with systemic barriers, like weight stigma from healthcare professionals and systems. Obesity Canada has since rolled out specific projects that provide a safe and accessible environment for obesity care, such as the Bariatric Friendly Health Care resources for patients and family members with bariatric needs and weight bias and safety equipment training for healthcare professionals and staff. Ultimately, the updated CPGs for obesity advocate for a more sympathetic, patient-centred view of obesity diagnosis, treatment, and management.