Obese? Canadian Docs Say It’s About Health, Not The Scale

I’ve worked with so many overweight and obese adults and children whose weight was seriously impacting their health: diabetes, hypertension, back and joint pain, the works.  But not all overweight people experience these problems.   Some overweight patients have told me they’re happy with their weight and don’t feel hindered by it.   

As a health professional, I know and see the risks of having too much weight.  But what about the overweight person who has normal blood pressure and lab values, a good quality of life, generally feels good.  They ask, “do I still need to lose weight?”

Not necessarily, say the doctors of Obesity Canada.  The Canadian Adult Obesity Clinical Practice Guidelines (CPGs), a two-year effort by the Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, was authored by over 60 physicians.  They reviewed over 500 published studies and a formed a consensus of both clinical and scientific issues related to weight gain.

These guidelines focus on health & quality of life,                      not “ideal weight”, as goals.

Why I Like These Guidelines

They state the facts:  Obesity is a complex chronic disease that predisposes a person to many disease conditions, including:

  • Hypertension
  • Type 2 diabetes
  • Gout
  • Non-alcoholic fatty liver disease
  • Numerous cancers: colon, kidney, post-menopausal breast, esophagus

They also admit that the causes of obesity are multi-faceted, and can include genetics, individual behavior, metabolic factors, and the person’s living environment impact a person’s weight.  I’d add social factors to this as well.

BUT – and this is just as important – they emphasized that managing it is not all about the number on the scale!  It’s just as much about overall health, quality of life, and lifespan.  Bravo!

One Size Fits ONE!

These guidelines push personalized treatment.  It’s the INDIVIDUAL’s journey, not the physician’s.  Yes, the medical pieces are important.  You can’t advise which road to take if you don’t know where you are.  After that however, being effective takes more: meeting each person where they are at that point in time, how they live, and what their own goals are.  That may include not wanting intervention right then. 

All hands on deck!

These docs admit they can’t do it alone.  Obesity has many causes and therefore needs many components of treatment and a multidisciplinary approach: 

  • Medical nutrition therapy (MNT): Eureka! The physicians of Canada recognize that personalized counseling from a registered dietitian-nutritionist (RDN) is critical!  It’s evidence-based but individually focused.   
  • Exercise: 30-60 minutes of “vigorous” activity on most days. No worries here – remember everything is individualized.
  • Use all appropriate tools: medication, if needed, referrals for cognitive behavioral therapy, even psychotherapy if needed, and bariatric surgery as a last resort.

It’s “Best Weight” Not “Ideal Weight”

“Ideal weight” may be an unrealistic goal for many, especially if they’ve been overweight for years.  That’s OK.  The goal should be better HEALTH first, and whatever weight you are when you’re doing healthy behaviors – whatever weight that is. 

Silver lining: Even losing 3-5% of initial body weight reduces your health risks.  Just do what you can. 

  QUALITY of life is everything!

Cut-To-The-Chase Takeaway

These CPGs don’t give permission to disregard the pursuit of healthy behaviors and lifestyles.  They focus on YOUR best health.  That means striking that sweet spot between doing what you need to do and not leaving out what you most enjoy.  It’s not the same for everyone, so have a chat with your doctor.   The goal is better health, and better QUALITY OF LIFE.  Obsession with the scale isn’t healthy! 

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