New Guidelines in the Treatment of Obesity

Jennifer Morzier September 7, 2020 Eat Well, Health, Weight Loss

The issue of obesity raises a lot of debate and discussion, particularly in the health field. This debate is all the more active now since the new guidelines for its treatment were released on August 4, 2020. Published in the Canadian Medical Association Journal, the new guidelines have been updated, replacing their previous publication in 2006.

This document is intended to be a reference guide for healthcare professionals to better help them support patients suffering from obesity.

The Obesity Canada organization also hopes that these new guidelines will lead to better management by the health care system and a better understanding by health care professionals, policy makers and individuals.

Essentially the idea is to include the patient as a partner in their health care. To focus not only on losing the weight but to also aim for an improvement in the state of health and well-being of the individual.

Obesity, is it a disease?

A new perspective in this document proposes that we consider obesity as a complex chronic disease that requires long-term, even lifelong, support.

In effect, excessive adiposity (weight) is harmful for one’s health, increasing the risk of long-term medical complications, impacting quality of life and reducing longevity. As we know, obesity increases the risk of several chronic diseases, certain cancers and makes the individual more fragile in the face of certain viruses.

Weight is often measured using the BMI (body mass index) which is the ratio of weight in kg to height in meters squared. A person is considered obese when their BMI is “over 30 kg / m2”. But BMI is not the ideal tool for detecting health complications related to excess adiposity. Waist circumference must also be added to the measurement which makes it possible to assess visceral adiposity and therefore the risks of developing chronic diseases such as type 2 diabetes and cardiovascular diseases. In addition, it is important to take into consideration the metabolic, physical and psychological parameters of the person.

Do individuals who are obese simply need to eat less and exercise more?

You hear this often, and maybe even think it’s true. Unfortunately, things are not that simple.

Obesity is often the result of several factors:

• biological factors: genetic, hormonal imbalance …
• behavioral factors: sedentary lifestyle, bad eating habits …
• psychological factors: stress, anxiety, low self-esteem, eating disorders …
• others: medication, disturbed sleep, socio-cultural practices, individual experiences

It is important not to just focus on the weight. You have to understand the person and support them well enough to ensure their physical as well as mental health. “Treating the root causes of weight gain is the foundation of obesity management.” This is why, in the treatment of obesity, it is important to work with a team made up of different professionals (doctor, dietitian, psychotherapist …).

This we know: the body sets up various mechanisms in order to return to the original starting weight, which is why weight loss and maintenance is not easy, hence the need for long-term monitoring.

Obesity and prejudice

In the new guidelines we can read that “Biased beliefs about obesity also affect the level and quality of health care that patients with obesity receive. The dominant cultural narrative regarding obesity fuels assumptions about personal irresponsibility and lack of willpower and casts blame and shame upon people living with obesity.” It is therefore essential to educate healthcare professionals as well as possible about the complexity of obesity, so that they can provide the best possible care to patients.

In conclusion, talking about obesity as a chronic disease is meant to make governments and health professionals reflect on the importance of caring for these individuals. This disease is not just caused by poor individual decisions, but rather the result of multiple factors, thus justifying the need for a multidisciplinary approach. Among the healthcare professionals that need to be involved are dietitians who can implement nutritional therapy by giving personalized advice and goals, while helping the individual to adopt healthy eating habits.

With this important aspect our team of dietitians are here to help you.

References

• Wharton, S. MD et al. (2020). Obesity in adults: a clinical practice guideline – CMAJ Cmaj. https://www.cmaj.ca/content/cmaj/192/31/E875.full.pdf
• Calle, E. E., & Thun, M. J. (2004). Obesity and cancer. Oncogene, 23(38), 6365-6378.

Author

Jennifer Morzier

Jennifer is a Registered Dietitian graduated from the University of Montreal in December 2018 and is a member of the Ordre professionnel des diététistes du Québec (OPDQ). She believes that the quality of our food choices has a direct impact on our health and energy level. Her goal? To help people improve the quality of what they put in their plates, for their better well-being and greater pleasure.