Canadian Obesity Practice Guidelines: Takeaways for HCPs

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The Canadian Adult Obesity Clinical Practice Guidelines (CPGs) provide a much-needed evidence and experience-based, patient-centered framework for healthcare professionals, patients and policy makers. They represent the first comprehensive update to Canadian obesity guidelines since 2007, and perhaps the most extensive review of published evidence conducted in obesity worldwide to date. Here’s our summary of what we think physicians will find most interesting / useful.

Key Takeaways:

-Obesity is a complex disease caused by genetic, metabolic, behavioral and environmental factors.

-Obesity is chronic, progressive and relapsing.

-Weight bias describes the negative, weight-related attitudes, beliefs, assumptions and judgments in society that are held about people living in larger bodies. It is caused by an oversimplification of obesity. It is harmful and leads to increased risk for morbidity. All healthcare professionals should assess their own biases and create a safe environment for all patients. 

-Regular monitoring can help catch early weight gain and HCPs should recognize the many life stages (including but not limited to, pregnancy, smoking cessation, cancer treatment, medication use, menopause, aging and young adulthood) that can be periods when weight gain is more common. 

-BMI should only be used as a screening factor when it comes to diagnosing obesity. It should take special populations into consideration and be interpreted with extreme caution as it does not measure body fat or cardiovascular risk and/or health. 

-HCPs should obtain an obesity-centered health history for all patients they are treating for obesity and excess weight. 

-Healthy eating is for everyone, not just those who struggle with weight, and there is no “one size fits all” pattern when it comes to diet. HCPs should use a shared-decision making approach and/or collaborate with a dietitian when helping patients choose an eating style that works for them. Similarly, everyone should exercise, as physical activity provides a wide range of health benefits across all BMI categories.

Most Useful Checklists & Charts:

   
Office Inclusivity Checklist
(See it here*)
A stigma-free environment can help patients feel more comfortable and receptive to treatment. Use the checklist to ensure your office space is inclusive for bodies of all sizes
OT Referral Checklist
(See it here*)
Occupational therapy promotes health by facilitating engagement in activities of daily living. Ask patients about daily activity and consider the chart when deciding if patients will benefit from an OT referral.
Physiotherapy Referral Checklist 
(See it here*)
Physiotherapy can help patients manage functional challenges. Ask patients about pain and functioning and consider the chart when deciding if patients will benefit from PT referral
Components of the 4Ms Framework for Assessment of Obesity
(See it here*)
A clinical tool such as the 4Ms (mental, mechanical, metabolic and monetary) can provide a practical approach for PCPs to explore major drivers, barriers and complications of obesity
Key Components of an Obesity Centered Medical History
(See it here*)
When assessing patients with obesity, include the obesity centered questions in the chart
Summary of Weight Promoting Medications and Alternative Therapies
(See it here*)
Some medications are known to promote weight gain. Consider an alternative treatment option if the patient is gaining weight or already struggling with obesity.
Medical Nutrition Therapy Quick Reference Guide
(See it here*)
Everyone can benefit from a healthy diet. Use this quick reference chart to assess patient readiness to change current eating habits and explore and collaborate care for new habits.
Summary of Nutrition Interventions Used in Obesity Management
(See it here*)
A list of nutrition interventions used in obesity management, their outcomes and impact, and their advantages and disadvantages
Micronutrient Deficiency 
(See it here*)
Many patients with obesity experience micronutrient deficiency. This list contains the most common deficiencies, how to screen and drug and nutrient interactions

  *Tables from Canadian Adult Obesity Clinical Practice Guidelines

To learn more from the Canadian Adult Obesity Clinical Practice Guidelines, click here.

If you are a physician who specializes in the medical management of obesity and would like to be included on our physician locator, click here.

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