Wishing All My Readers A Happy, Healthy, and Prosperous 2016

Slide1Thank you for your support – back with more posts in 2016

@DrSharma
Edmonton, AB

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Going Slow

Northern-LightsAs 2015 is rapidly coming to an end, I will be taking the next couple of weeks a bit slower. This means fewer posts till we get to 2016.

I’d like to take this opportunity to wish all my readers a happy holiday season and thank for your ongoing enthusiastic support.

If you do need your daily Dr. Sharma “fix”, please feel free to roam the archives of this blog – many posts are as relevant today as they were when I first wrote them.

@DrSharma
Montreal, QC

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The Lancet Commission On Obesity – A Global Approach To Globesity?

global-burden-disease2Obesity is a global problem – no country appears immune – the global direct and indirect costs in human and social costs are in the trillions.

Thus, The Lancet should no doubt be commended on partnering with the World Obesity Federation to constitute an international panel of 22 experts under the leadership of Boyd Swinburn (New Zealand) and William Dietz (USA) to

…stimulate action on obesity and strengthen accountability systems for the implementation of agreed recommendations to reduce obesity and its related inequalities and to develop new understandings of the underlying systems that are driving obesity in order to develop innovative approaches towards making those systems less obesogenic.

While (perhaps to my surprise) I have previously heard of only one of the panelists (Shiriki Kumanyika, Emeritus Professor of Biostatistics and Epidemiology, University of Pennsylvania), I am sure that all of the panelists bring a wide range of expertise to the table.

The overall mandate of the Commission is rather ambitious, with the following declared goals:

First, the Commission will stimulate action and strengthen accountability systems for the implementation of agreed recommendations to reduce obesity and its related inequalities at global and national levels.

Second, it will develop new understandings of the underlying systems that are driving obesity and also devise innovative approaches to reorient those systems in a sustainable and scalable way to encourage healthy weight.

Third, it will also establish mechanisms for regular, independent reporting on progress towards national and global obesity targets, implementation of recommended policies and actions, and specific systems analyses of obesity drivers and solutions.

Clearly, the Commission has its work cut out for it, as their goal is to address all underlying systems that are driving obesity, including nutrition, physical activity, urban planning, food systems, agriculture, climate change, economics, governance and politics, law, business, marketing and communication, trade and investment, human rights, equity, systems science, consumer advocacy, monitoring and evaluation, Indigenous health, epidemiology, medicine, and health care.

The Commission will have its inaugural meeting in February, 2016, in Washington DC, USA, to determine its work plans.

I guess we should stay tuned to see exactly what that plan will look like.

@DrSharma
Edmonton, AB

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It Is Time Canadian Benefits Plans Begin Considering Obesity A Disease

Screen Shot 2015-12-11 at 1.30.00 PMThe recent declaration by the Canadian Medical Association that obesity is a chronic disease not only sends a strong signal to medical doctors to take this issue seriously but also has important consequences for Canadian benefits plans.

As international readers may not be aware, while the Canadian publicly funded health care system covers all in-hospital costs and visits to doctors, it does not generally cover cost for medications or consultations with dietitians, psychologists or other allied health professionals in the community.

These healthcare costs can be covered by private benefits plans, often paid or co-payed for by employers (plan sponsors).

Thus, while consultations in hospital based clinics or primary care units are generally covered, whether or not patients have coverage for medications and other treatments depends on whether or not they have benefit plans.

Unfortunately, when it comes to obesity, Canadian drug benefits plans generally do not cover treatments, as these plans consider obesity a “lifestyle” problem rather than a disease (e.g. unlike type 2 diabetes, which although as much a “lifestyle” issue, is covered as a disease).

Thus, it will be interesting to see how the declaration of obesity as a chronic disease by the Canadian Medical Association, will change how obesity treatments are covered by Canadian benefits plans.

Now a white paper sponsored by Novo Nordisk, the maker of Saxenda, a GLP-1 analogue recently approved for obesity treatment in Canada, outlines why reclassifying obesity as a disease would be of advantage to Canadian employers (who usually decide what is covered in the plans they buy for their employees).

The paper summarizes finding from a series of meetings with obesity experts, patients, plan sponsors, benefits providers and advisors, and calls for a rethinking of obesity as a medical condition that can benefit from individualised and ongoing management.

While it is obvious why Novo Nordisk would have an interest in better coverage for its anti-obesity drug, it is important to note that the white paper outlines the benefits of treating obesity like every other chronic disease that go well beyond just coverage for obesity drugs – rather it argues how this shift in thinking will benefit all Canadians affected by obesity irrespective of what treatment they chose.

The full white paper is available on the Benefits Canada website and can be downloaded here.

@DrSharma
Edmonton, AB

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Will Low Oil Prices Lead To An Obesity Spike In Alberta?

Oil-Barrels-with-Red-Arrow-740There is no doubt that the low oil price is pummelling the Alberta economy.

According to the Alberta economic dashboard, in October 2015, Alberta’s seasonally adjusted unemployment rate was 6.6%, up from the 4.4% rate a year earlier and from last month’s 6.5% rate. The youth unemployment rate was 11.6%, up from last year’s 9.0% rate, while male unemployment increased precipitously from 3.6% last October to 7.3% this year.

As no one seems to be expecting a rosier future for this industry, it may well be that many who lost their jobs in the wake of mass oil patch layoffs, will find the coming months (not to mention the festive season) both economically and emotionally challenging.

According to this report, suicide rates from January to June in Alberta this year are up 30% compared to the same period in 2014.

One challenge that may escape notice is the fact that this situation may also lead to significant weight gain in those affected.

Depression, anxiety, food insecurity, insomnia and simply being unable to afford healthy food are all important risk factors for weight gain.

Indeed it is hard to imagine how going from a high-paying job to being unemployed with little immediate hope of recovery will affect families.

Maintaining a positive spirit – necessary for eating healthy, engaging in physical activity and healthy sleep – will clearly be a challenge.

So while it may take some time for “official” statistics regarding overweight and obesity to change, I would not be surprised to see numbers go up.

Unfortunately, when this happens, people putting on the extra pounds will likely face the same blame and shame for “making poor choices” as everyone else who is struggling with this problem faces everyday.

As medical professionals, we need to acknowledge that unemployment and the worries that come with it can make our patients more susceptible to weight gain – let us not miss the opportunity for prevention.

If you’ve been affected by the economic downturn and this is affecting your health, please feel free to leave a comment.

@DrSharma
Edmonton, AB

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