[vc_row css=”%7B%22default%22%3A%7B%22margin-left%22%3A%220%22%2C%22margin-top%22%3A%220%22%2C%22margin-bottom%22%3A%220%22%2C%22margin-right%22%3A%220%22%2C%22padding-left%22%3A%220%22%2C%22padding-top%22%3A%220%22%2C%22padding-bottom%22%3A%220%22%2C%22padding-right%22%3A%220%22%7D%7D”][vc_column][vc_column_text]by Melinda Maryniuk, MEd, RDN, CDCES
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 from the Guidelines:
–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:
See it here*
See it here*
*Tables from Canadian Adult Obesity Clinical Practice Guidelines
The 15 Most Relevant Recommendations – Selected for the Busy Family Physician
– Achieve small amounts of body weight and fat loss
– Achieve reduction in abdominal visceral fat and ectopic fat, such as liver and heart fat (level 1a, grade A), even in the absence of weight loss
– Favour weight maintenance after weight loss
– Favour the maintenance of fat-free mass during weight loss
– Increase cardiorespiratory fitness (level 2a, grade B) and mobility
Bariatric surgery can be considered for people with BMI ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 with at least 1 adiposity-related disease to:
- Reduce long-term overall mortality
- Induce significantly better long-term weight loss compared with medical management alone
- Induce control and remission of type 2 diabetes, in combination with best medical management, over best medical management alone
- Significantly improve quality of life Induce long-term remission of most adiposity-related diseases, including dyslipidemia, hypertension, liver steatosis and nonalcoholic steatohepatitis.
For adults living with overweight or obesity, the following commercial programs should achieve mild to moderate weight loss in the short or medium term, compared with usual care or education:
- WW (formerly Weight Watchers)
- Jenny Craig
*All Recommendations from Canadian Adult Obesity Clinical Practice Guidelines
To learn more from the Canadian Adult Obesity Clinical Practice Guidelines, click here.
We help people living with obesity in Canada find a physician who specializes in obesity management near them… click here to see our physician locator tool.
Melinda Maryniuk is a registered dietitian, certified diabetes care and education specialist and serves as the Lead Clinical Consultant with My Weight What to Know. For over thirty years Melinda worked at Joslin Diabetes Center and served as Director of Clinical Education Programs in Joslin’s Innovation Division. She has authored over 100 publications and has lectured extensively on topics related to nutrition and diabetes around the world. Melinda has served on the Board of Directors of the American Diabetes Association (ADA) and the Association of Diabetes Care and Education Specialists and has received numerous national awards including the Outstanding Diabetes Educator Award from ADA and the Medallion Award from the Academy of Nutrition and Dietetics. [/vc_column_text][/vc_column][/vc_row]