New Canadian obesity guidelines focus on root causes instead of BMI, diet

Published On August 4, 2020 | By Abigael Ruto | News
New Canadian clinical guidelines recommend that doctors focus on root causes of obesity instead of calories, BMI and weight loss (Courtesy Obesity Canada).
Abigael Ruto

Canada has released a new guideline aiming to shift how doctors and physicians treat people living with obesity.

New guidelines published on Aug. 4 recommends that obesity is recognized as a chronic disease by health care providers.

It also suggests that clinicians give an individual assessment of patients living with obesity and identify the root cause before beginning treatment.

“We are trying to shift the discussion from simply size, weight and Body Mass Index (BMI),” co-author of the guideline and director of advocacy and public engagement for obesity Canada, Ian Patton said.

New guidelines are meant to change the negative mindset society has towards people living with obesity. (Photo Courtesy Ian Patton)

Society keeps discriminating against people who look bigger therefore Canadian Medical Association Journal (CMAJ) wants people to focus on a new definition, he said.

“Obesity is when excess or abnormal adiposity and fat mass impairs health,” Patton said. “There could be individuals living in a larger body but are perfectly healthy.”

A previous guideline published in 2006 encouraged clinicians to measure BMI for all individuals and recommend nutritionally balanced diet designed to reduce energy intake and cause weight loss.

“We suggest high-protein or low-fat diet as a short-term treatment option for obese adults as part of a weight-loss program,” the older CMAJ guidelines said.

This method is now outdated and more engaging procedures should be approached, Patton said.

Research by the World Health Organisation (WHO) shows that worldwide obesity has tripled over the last four decades.

Out of 1.9 billion overweight adults in 2016, 650 million were obese, WHO said in an article.

“Most world’s population live in countries where overweight and obesity kills more people than underweight,” it said.

In Canada, the rate of obesity has tripled in the past three decades. People living with severe obesity now stands at 1.9 million.

Canada is looking to decrease these numbers by incorporating medical nutrition therapy and physical activity. The guidelines include psychological and surgical interventions.

After reading the report, the recommendations have been met by criticism and praise. Matt Miller who is diagnosed with obesity and has been on a weight loss journey for more than a year commends the changes.

“I think these are great, it seems they are trying to understand the reasons behind someone’s weight,” Miller said.

He, however, feels that mental health should be key in any recommendations.

“I think the best thing doctors can do is dive into the mental health side while incorporating sound medical advice for improving physical health,” Matt Miller said.

The publication also wants society to have a clearer understanding of obesity.

Traditionally people have seen weight gain as a condition of personal failure and that some individuals eat too much and do not exercise and it is a lifestyle problem, Patton said.

“Science tells us that is not the case. There is way more involved than that,” he said.

While coming with guidelines for existing doctors, Canadian medical practitioners are urged to undergo obesity training.

Canada has a scarcity of doctors who are trained in obesity management.  The field is not covered quite well in medical school, so it is tough to ask them to treat and manage something that they do not know about, Patton said.

Research by Obesity Canada released early last year shows that there are 67 abom-certified physicians in Canada. They were 41 in 2017.

“Patients who are struggling should start raising conversation and demand better so that more doctors, physicians, and health care practitioners seek essential training,” Patton said.

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