Saturday, August 08, 2020

Saturday Story: Just One This Week. A Must Read If You Haven't Yet

Ed Yong, in the Atlantic, with the sadly all too believable (yet still unbelievable) story of how SARS-CoV2 defeated America

Tuesday, August 04, 2020

Canada's Obesity In Adults: A Clinical Practice Guideline, Released Today, A Huge Step Forward

I'm proud to have played a small part in the release of today's Obesity In Adults: A Clinical Practice Guideline as it is the first (I think, though I'm biased) to truly take a patient-centred approach while simultaneously treating obesity like a chronic disease

Not a small endeavour, this years long effort includes chapters never before seen in any other obesity treatment guideline including those on weight bias and stigma, virtual medicine, commercial weight loss programs, living with obesity, as well as issues specific to indigenous peoples.

It explicitly steers away from diet culture (but does speak to the need for individualized medical nutrition therapy), teaches readers that neither BMI nor weight measures the presence or absence of health and introduces them to the concept that obesity should be considered a chronic disease only when excess adiposity impairs health, and it recognizes that obesity is anything but a choice.

While going through the entirety of the guideline isn't doable in a short blog post, here are the guideline's overarching summary points:
  • Obesity is a prevalent, complex, progressive and relapsing chronic disease, characterized by abnormal or excessive body fat (adiposity), that impairs health.
  • People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of weight or body mass index.
  • This guideline update reflects substantial advances in the epidemiology, determinants, pathophysiology, assessment, prevention and treatment of obesity, and shifts the focus of obesity management toward improving patient-centred health outcomes, rather than weight loss alone.
  • Obesity care should be based on evidence-based principles of chronic disease management, must validate patients’ lived experiences, move beyond simplistic approaches of “eat less, move more,” and address the root drivers of obesity.
  • People living with obesity should have access to evidence-informed interventions, including medical nutrition therapy, physical activity, psychological interventions, pharmacotherapy and surgery.
Kudos to all of my fellow authors and especially to Dr. Sean Wharton the project's chief cat wrangler.

To have a peek at the CMAJ's published guideline summary, click here.

To access the guideline in its 19 chapter entirety, click here.

Saturday, August 01, 2020