Obesity Management In Canada - A Long (But Promising!) Road Ahead
>> Saturday, May 2, 2015
At this week's Canadian Obesity Summit meeting, I have had the great pleasure of chairing, speaking, and participating in a diverse array of educational sessions, ranging from studies of lifestyle alterations, to government policies, to medications treating obesity, to bariatric surgery.
One of the themes that rang strong is this:
Canada needs more resources dedicated to the management of obesity.
I can give you many examples of how this point came out, but I'll give you one that rings out in particular. One session which discussed bariatric surgery included a fabulous presentation by bariatric surgeon, Dr Mary-Anne Aarts, regarding barriers to post operative follow up of bariatric patients. An interesting discussion ensued with comments from bariatric care providers across the country, and most agreed that follow up appointment attendance is often not good, particularly the further a patient gets in their post op journey (after 6 months post surgery, patients are usually requested to come to appointments every 6 months until 2 years post op). One point that was made was that follow up may be perhaps too infrequent to keep patients interested and motivated to continue to come. (Studies do show that bariatric surgery patients enjoy greater success with more frequent follow up.) Dr Aarts pointed out that in the Netherlands, bariatric patients have appointments scheduled every 3 months for 2 years postoperatively, which shocked most of the audience... who in Canada has the resources for that?!
Here is our problem. Obesity is a chronic disease, just like, for example, diabetes - yet, we don't treat obesity like a chronic disease. The Canadian Diabetes Guidelines recommend that diabetics see a physician every 3 months at least, to have an A1C (diabetes report card) and other elements of their health checked as needed. Why don't we have the same resources available to treat obesity in the same long term, longitudinal way? If we asked our patients with obesity to follow up every 3 months with a health care provider on an ongoing basis to help them manage this disease, perhaps they might feel more supported and weight management success might be better.
What we need is to:
1. Break down the stigma against obesity amongst the general public and health care providers, such that obesity is accepted as a chronic disease and not a lifestyle problem.
2. Have more resources available in health care such that we are able to manage obesity with a long term, team based approach that engages multiple disciplines including dietitians, nurses, pharmacists, psychologists, exercise therapists, and doctors.
3. Teach health care providers how to best approach the discussion and treatment of obesity with their patients. (See the 5As of obesity as a great way to start!)
So what's the 'Promising' part in all of this? We (as the Canadian Obesity Network) are 11,000 members strong, and passionately dedicated to achieving these goals. Together, we continue to make a difference one step at a time, with the above goals in mind. This week's Summit has gone a long way to breaking down the obesity stigma in the public eye, and we continue to redouble our efforts as our numbers and voice grow.
PS - the Canadian Obesity Network membership is open to anyone with a professional stake in obesity - and it's totally free to join! Check it out here!
Looking forward to the last day of the Summit today.
Follow me on twitter! @drsuepedersen
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