It is a whole paradigm shift that is proposed Tuesday to doctors who take care of a patient suffering from obesity.
Stop focusing only on weight loss, ask them to new guidelines published by the Journal of the Canadian Medical Association, and tackle health parameters like diabetes, blood lipid levels and hypertension.
“By following these targets, rather than simply body weight, if these parameters improve, the work is done, regardless of body weight”, summarized in an interview Dr. André Tchernof, who is a member of the board of administration of Obesity Canada.
Developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, the Canadian Clinical Practice Guidelines for Obesity in Adults replace those in effect since 2006.
Some 500,000 scientific articles have been scrutinized by researchers and gathered into nineteen chapters.
The new guidelines recognize, among other things, that sustained weight loss can be an extremely difficult goal.
“Some health professionals will approach the issue this way, saying that you need to eat better and move more,” said Dr Tchernof. It’s a bit simplistic, because the body will compensate.
” The person […] will succeed in the short term in losing weight, on the other hand the body will adapt, there will be compensatory mechanisms that will somehow defend the initial body weight, and after a few years, the weight will slowly rise again to join the initial value, and maybe even a little more. “
These physiological mechanisms are so powerful, he adds, that between 75% and 85% of those who lose weight will have regained it after three or four years, and “at that point, we don’t is not more advanced ”.
“We know that waist circumference and abdominal obesity are more closely associated with these health problems, so if a person makes changes in nutrition, physical activity, and their waistline decreases, his health parameters will improve substantially, even in the absence of significant weight loss, ”explained Dr Tchernof.
The new guidelines also demand that obesity be recognized as a chronic disease, like diabetes and hypertension, which would allow better management by the health system, particularly with regard to access. to certain services.
“In Quebec alone, we are talking about 2,000 people waiting for bariatric surgery,” said Dr Tchernof, which represents a year or two of waiting.
Finally, the guidelines address key issues, such as weight stigma and implications for Indigenous communities.
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