Friday, November 14, 2014

Video: Principles of Obesity Management

Arya Sharma Kingston Nov 2014Over the past weeks, I have given a rather large number of talks on obesity management to a variety of health professionals. Now, there is a recording of one of my talks (which I gave a few days ago in Kingston, Ontario) on Youtube.

Although the quality of the recording is perhaps not the best and the talk is rather long (about 100 minutes), for those of you, who would like to have a better grasp of how I think about and approach obesity management, here is the link.

Feedback is very much appreciated.

@DrSharma
Edmonton, AB

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Wednesday, November 12, 2014

5As of Obesity Management in Primary Care

sharma-obesity-5as-booklet-coverThis week I am again touring Ontario to train health professionals in the 5As of Obesity Management (Kingston, Ottawa, St. Catherines).

It is heartening to see the tremendous interest in this topic and how the message about obesity as a chronic disease resonates with health practitioners, few of who have any prior training in obesity management.

It is particularly rewarding to see how well the Canadian Obesity Network’s 5As of Obesity Management framework is received and embraced by those working in the front lines of primary care, as this is exactly the audience for which this framework is intended.

Regular readers may recall that the 5As of Obesity Management framework was developed by the Canadian Obesity Network in an elaborate undertaking involving scores of primary care providers, experts and patients from across Canada. The tools were modelled using the latest in health information design technology and extensively field tested to ensure their applicability and adaptability to primary care practice.

Rather than overloading the tools with intricate algorithms, we opted for a rather general but insightful set of principles and recommendations designed to facilitate professional interactions that seek to identify and address the key drivers and consequence of weight gain as well as help tackle the key barriers to weight management.

Indeed, the 5As of Obesity Management are steeped in a deep understanding of the complex multi-factorial nature of obesity as a chronic (often progressive) disease for which we simply have no cure.

The framework recognizes that health cannot be measured on a scale, BMI is a poor measure of health and that obesity management should be aimed at improving the overall health and well being of those living with obesity rather than simply moving numbers on the scale.

Research on the use of the 5As in primary practice has already shown significant improvements in the likelihood of obesity being addressed in primary practice.

A large prospective randomized trial on the implementation of the 5As of Obesity Management framework in primary care (the 5AsT trial) is currently underway with early results showing promising results.

I, for one, will continue promoting this framework as the basis for obesity counselling and management in primary care – at least until someone comes up with something that is distinctly better.

If you have experience with this approach or have attended one of the many education sessions on the 5As of Obesity Management offered by the Canadian Obesity Network, I’d certainly like to hear about it.

To view an introductory video on the 5As of Obesity Management click here

@DrSharma
Ottawa, ON

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Friday, November 7, 2014

Prevention Vs Treatment Is Not An “Either-Or” Question

sharma-obesity-rod-of-aesclepiosYesterday, at Obesity Week, I attended a debate on whether or not obesity is a disease (really, is anyone still debating this?).

While both sides made the usual arguments and both debaters (one perhaps more so than the other) landed heavily in favour of calling obesity a disease, the audience comments against calling obesity a disease were what you may expect.

While I get the caution against possible stigmatization and the issue that not all people living with obesity are necessarily “diseased” (we desperately need a non-weight based definition of obesity), the counterargument that to me is most irritating and holds the least merit, is the notion that calling obesity a “disease” will somehow distract from or even hinder the efforts at prevention.

This is something I simply do not get.

Indeed, I am not aware of any preventable condition (CVD, Cancer, Diabetes just to name a few) where efforts at prevention are abandoned, diminished or hindered by calling the condition a “disease”.

If anything, you would think that ‘legitimizing” a condition by calling it a (serious) disease, would lead to even more efforts at prevention – especially when we have such poor treatments.

In fact I simply do not get why one would even discuss which is more important: prevention or treatment – both are!

No amount of prevention will treat the people who already have the condition and treatments should never replace prevention.

Funnily enough, I do not believe that I have ever heard anyone who calls for better treatments (of any disease) pooh-pooh the need for prevention – at least not for conditions where prevention actually works.

The opposite, sadly, is not true.

@DrSharma
Boston, MA

 

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Thursday, November 6, 2014

STOP Obesity Alliance Guide to Discussing Health and Weight

STOPObesityAlliance-logoYesterday, at Obesity Week, the Strategies To Overcome and Prevent (STOP) Obesity Alliance released a guide for health professionals seeking to discuss obesity and health with their patients.

As readers are aware, weight is a complex and sensitive issue, and conversations about weight can be challenging, not least because such discussions, when done inappropriately, can promote feelings of failure, shame, and a sense of being judged by the health care provider.

Thus, the discussion tool focuses on skills for building a safe and trusting environment with patients to facilitate open and productive conversations with patients.

In principle, the issues discussed in the tool are very similar to the approach taken in the Canadian Obesity Network’s 5As of Obesity Management.

The tool addresses patient accommodation, building trust, beginning a conversation, adressing readiness, the use of people-first language, as well as goal setting and support.

There is a special mention of how to deal with patients who have experienced trauma as well as a discussion about providers who may have concerns about their own weight.

Finally, the guide also provides a list of links to additional resources that health care practitioners may find helpful in advising and working with their patients.

To visit the STOP Obesity Alliance – click here

@DrSharma
Boston, MA

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Friday, October 31, 2014

German TV Looks At Healthy Obesity

Arya Sharma on bike 3SATRegular readers will be familiar with the fact that not all people with excess weight necessarily have health problems. Now, the 3SAT television channel, which broadcasts in Germany, Austria and Switzerland has produced a 45 minute documentary on the science behind these findings.

Although the film is in German, I thought I would post the link anyway as many of my readers may well be able to grasp the story even if they are not entirely fluent.

To watch the documentary on line click here.

Incidentally, I am featured about 2.5 minutes into the film, discussing the Edmonton Obesity Staging System and related issues.

Appreciate all comments.

@DrSharma
Toronto, ON

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In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

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