Physicians, who are part of the nonprofit Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, believe that doctors are not treating patients with obesity the way they should be. In his view, weight discrimination impedes treatment and medicine has created little room for body positivity.
Obesity, they argue, should be defined by a person’s health and not just by their weight.
Guidelines published this week in the Canadian Medical Association Journal believe obesity should be classified as a chronic disease requiring treatment and long-term care.
The authors also encourage doctors to stop relying on BMI (or body mass index) when it comes to diagnosing their patients.
According to that definition, people will be identified as obese only if their body weight affects their physical health or mental well-being, Drs. Arya Sharma, Scientific Director of the University of Alberta, Edmonton, and Obesity Canada, who is a scientist at co. Write directions
“This is a huge departure from the notion that you can massively grow and diagnose obesity,” Sharma said. “It has nothing to do with shape or size or anything else. It’s simply the question, is your body spoiling your health?”
Five steps to better treat obesity
The new guidelines provide a five-step road map for doctors to treat patients with obesity.
The first step – an approach that Sharma said was “very Canadian” – encourages doctors to ask their patients if they feel comfortable discussing their weight. If they are, and they want treatment, doctors can proceed.
At this stage, doctors should also learn to rethink obesity, not as a personal failure, but as a chronic disease that is not cured even by a large procedure such as temporary diet or bariatric surgery. As a result, it requires long-term care from a physician.
Sharma told CNN, “Obesity management needs to be based on principles or chronic disease management, which means that any quick solution … that won’t have any long-term effects.”
Obesity is considered a serious condition that occurs when a patient has an alarming amount of excess weight. Nearly 30% of Canadian adults are obese, according to Obesity Canada, while the number is more than 42% among Americans.
It is associated with serious conditions such as heart disease, cancer and sleep disorders, according to the National Institute of Health. Sharma said obesity is a complex condition in itself, which can be caused by genetic, psychological or environmental factors.
It is the duty of a physician to identify those causal factors in their patient, chart a course for tailored treatment and cooperate with the patient, he said – two steps through four of the recommendations.
Not all treatment options for obese patients include weight loss, Sharma said – if a patient eats healthy foods, exercises frequently and is showing overall signs of better health without losing weight, then they succeed Are happening
“I don’t care what’s happening on the scale,” he said. “The real question is, does my patient feel better? Problems associated with obesity – can those conditions now be better controlled? It may or may not cause weight loss.”
The fifth step involves assisting patients with obstacles to meet their goals, whatever they may be. It is the job of a doctor to be helpful and to identify those obstacles before they come so that they do not prevent a patient’s success according to the new guidelines.
Easy treatment of weight loss medicine
Weight has become a subject of polarization and knotting in medicine.
The stigma of obesity has disrupted current treatment, the team of Canadian doctors writes in its guidelines. Sharma said doctors may prescribe obese patients due to a lack of will or being irresponsible, or may gain weight when it is not appropriate. He said that biased treatment is enough to get obese people away from the drug.
These guidelines are an “excellent upgrade” from a prior approach to obesity, said Sylvia Ley, an assistant professor in the Department of Epidemiology at the University of Tulon, who was not involved in the study.
Lei wrote to CNN in an email, “The new guideline attempts to use a combinatorial approach to overcome obesity as a complex disease …”. “It also acknowledges the importance of a patient-centered, personally tailored approach.”
But the guidelines have not fully aligned with the fat acceptance movement, although Sharma said the guidelines were created with the cooperation and input of people with obesity. Many fat-positive activists reject the notion that obesity is a disease or defect.
A writer, YouTuber and fat activist, Ali Thompson, told CNN that characterizing obesity as a disease “turns a normal human variation into a problem that has to be solved.”
Thompson said the guidelines may still leave room for discrimination between doctors.
“Any standard of care for obese people that does not begin and end with ‘behaving like thin people’ is inadequate” she said.
He also disagrees with calling obesity an “epidemic”, as the US Center for Disease Control and Prevention and the National Institutes of Health have it.
“It is highly inhumane to talk about the same way as a virus,” she said.
Public health researchers and fat acceptance advocates may disagree about when obesity comes, how to describe it, and whether it requires medical intervention. But Sharma said the guidelines were not designed to force people to accept treatment. If someone is not interested in changing anything about themselves, they should not be made unless their health is in danger.
Sharma said, “Earlier, we had a recommendation: eat less, and move on.” But this was just a narrow view of a complex situation that has no root cause.
Sharma and his colleagues hoped, open a window for a more sympathetic view of obesity, which centers around patients.