The recent Position Statement on Obesity from BC’s Northern Health includes a recommendation for a phased approach to obesity management.
Stage 1: Stabilize weight
Explore, identify and address the causal pathways for excess weight. The goal of this stage is to stop weight gain (stabilize weight), rather than reduce weight. Physicians may use tools such as the Canadian Obesity Network’s 5As of Obesity Management to approach patients to discuss their weight. Further, it is important to consider the drivers and consequences of excess weight.
Stage 2: Address excess weight
When weight has stabilized, address, if medically necessary, the excess weight to reduce health risks that are precipitated and exacerbated by the excess weight. For some, this may involve targeted goals and invasive procedures to balance energy intake and energy expenditure. To achieve long-term success in Stage 3, efforts in Stage 2 must be based on individual lifestyle changes. Specifically, these should not lead to a dieting mentality, but rather lifestyle changes supported by the development of eating competence and an increasingly active lifestyle.
Stage 3: Maintain weight loss
Long-term success in addressing health risks of excess weight requires permanent lifestyle changes. While these changes will not happen overnight, it will be necessary for permanent changes to occur in order for the individual to maintain their state of improved health and reduced risks.
The Position Statement also includes recommendations to use the Edmonton Obesity Staging System to determine the need and course of treatment as well as a statement to target best weight as a realistic goal.