New obesity guidelines focus on root causes, bias against overweight patients

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OTTAWA — New guidelines for treating obesity stress the need to focus on root causes rather than weight loss alone.

That means working with patients to understand the “context and culture” that underlie the issue, which could include genetics, trauma and mental-health issues.

The advice by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons also pushes clinicians to recognize any bias they may have against overweight patients — such as assuming they lack willpower or are non-compliant.

One of the lead authors, Dr. Sean Wharton of Hamilton’s McMaster University, says treatment depends on “showing compassion and empathy” and using evidence-based interventions that focus on patient goals.

The guide recommends a holistic approach in which doctors consult patients on goals they consider important, and then collaborating on a plan that is personalized, realistic and sustainable.

“Obesity in adults: a clinical practice guideline” was published Tuesday in the Canadian Medical Association Journal.

“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,” adds Dr. David Lau, co-lead of the guideline and professor at the University of Calgary.

The advice is an update to the 2006 guideline and targets primary health care professionals, policy-makers, people living with obesity and their families.

The experts say Canada has seen a threefold increase in obesity over the past 30 years. Severe obesity has increased even more, with more than 1.9 million Canadian adults affected.