Pioneering guidelines on obesity management in Canada are challenging doctors to consider the health problem as a complex chronic illness rather than something a little diet and exercise can cure, reports The Guardian. The guidelines – believed to be the first of their kind in the world – were developed over three and a half years by a committee of 62 professionals led by Dr Sean Wharton, a Toronto internist specialising in weight management. The document advocates for approaching obesity as a complex chronic disease, rather than an issue of weight loss.
Canadians living with obesity and the healthcare professionals who support them have a new roadmap for quality collaborative care. More than two years in the making, the Canadian Adult Obesity Clinical Practice Guidelines (CPGs) provide a much-needed evidence- and experience-based, patient-centred framework for healthcare professionals, patients and policy makers. They represent the first comprehensive update in Canadian obesity guidelines since 2007, and perhaps the most extensive review of published evidence yet conducted in obesity worldwide.
Developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, the new CPGs were authored by more than 60 Canadian health professionals, researchers and individuals living with obesity. Together, they assessed well over 500,000 published peer-reviewed articles and built consensus on a wide range of clinical and scientific issues to identify 80 key recommendations.
“Science tells us the drivers of weight gain are complicated and unique to the individual, and also that the human body is hard-wired against weight loss. Historically, we have told people whose weight affects their health merely to eat less and move more, which on its own is ineffective and even dangerously simplistic advice,” says Dr Arya M Sharma, scientific director of Obesity Canada. “The CPGs represent a turning point in the way Canada needs to approach the treatment of obesity, and that is to acknowledge obesity as a complex chronic disease requiring lifelong support, as we do for diabetes, heart disease and others – this is the best evidence to date on how to do that.”
The CPGs are rooted in patient-centred care, with patients and providers working together to identify personal drivers of obesity, set realistic goals and maintain healthy behaviours over the long term. In addition to medical nutrition and physical activity, psychological interventions, medications, and surgery can be used to support patients as needed. The CPGs also discuss key issues such as weight bias, implications for Indigenous communities and more.
“People who live with obesity have been shut out of receiving quality healthcare because of the biased, deeply flawed misconceptions about what drives obesity and how we can improve health,” explains Lisa Schaffer, chair of Obesity Canada’s Public Engagement Committee. “Obesity is widely seen as the result of poor personal decisions, but research tells us it is far more complicated than that. Our hope with the CPGs is that more healthcare professionals, health policy makers, benefits providers and people living with obesity will have a better understanding of it, so we can help more of those who need it.”
The CPGs were supported through a Canadian Institutes of Health Research Strategy for Patient-Oriented Research grant.
[link url="https://www.theguardian.com/society/2020/aug/04/obesity-chronic-illness-guidelines-canada"]Full report in The Guardian[/link]
[link url="https://obesitycanada.ca/cpg/new-canadian-adult-obesity-clinical-practice-guidelines-published-treatment-goals-are-improved-health-and-quality-of-life-not-a-number-on-a-scale/"]Guidelines[/link]