New obesity guideline: Address root causes as foundation of obesity management

August 04, 2020

Obesity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal).

"People with obesity experience weight bias and stigma, which contribute to increased complications and mortality, independent of weight or BMI," says Dr. Sean Wharton, co-lead of the guideline and adjunct professor at McMaster University, Hamilton, Ontario. "The first step to obesity management is to recognize your own bias. If you see people living with obesity as lacking willpower, or as noncompliant, then you likely have weight bias. Obesity needs to be managed with a focus on giving unbiased care to patients, showing compassion and empathy and using evidence-based interventions with an emphasis on patient-centred outcomes."

The comprehensive guideline, developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, is based on the latest evidence, which reflects substantial advances in the epidemiology, determinants, assessment, treatment and prevention of obesity. An update to the 2006 guideline, the new guidance incorporates the perspectives of people with lived experience of obesity as well as experts in the management of obesity.

Over the past 30 years, the prevalence of obesity has increased substantially around the globe, with a threefold increase in Canada. The prevalence of severe obesity has increased even further, with more than 1.9 million Canadian adults affected.

The new guideline targets primary health care professionals, policy-makers, people living with obesity and their families.

Key recommendations: "Working with people to understand their context and culture, integrating their root causes, which include biology, genetics, social determinants of health, trauma and mental health issues, are essential to developing personalized plans," says Dr. David Lau, co-lead of the guideline and professor at the University of Calgary. "These plans can become part of a long-term therapeutic relationship with follow-up of obesity-related chronic diseases."
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The recommendations are meant to be a guide for health care professionals, who should use clinical discretion when adopting them.

Podcast: https://soundcloud.com/cmajpodcasts/191707-guide

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Canadian Medical Association Journal

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New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.

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