Today, attendees at the 4th Canadian Obesity Summit will face the tough task of choosing between a variety of workshops dealing with topics ranging from harnessing public-private partnership to promote healthy food in retail stores to patient centredness and ensuring the physical and mental well-being of individuals living with obesity (for a full list of workshops – click here)
A workshop that I particularly look forward to is one on the determinants of the intergenerational transmission of obesity.
As the organisers of this workshop tell us,
“Studies in both animals and humans, including epidemiologic, clinical, and experimental data, have provided strong evidence implicating the intrauterine environment in downstream obesity. In recent years, significant advancements have been made regarding underlying molecular pathways and population level interventions and their effects on fetal programming of obesity.”
Thus, this workshop will provide an update on the topic and focus on the interplay between obesity, gestational weight gain (GWG), lifestyle behaviours, and early life factors (parenting) that exacerbate fetal/child growth and perpetuate the intergenerational obesity cycle.
Epigenetic and clinical evidence will be presented that demonstrates how perturbations during pregnancy affect fetal/infant phenotype and how early postpartum health (of mom and baby) predicts chronic disease risk later in life. The latest evidence from pregnancy and postpartum‐related intervention trials will be presented to identify avenues for clinical management and future research.
For more information on this workshop – click here.
The prevalence of overweight and obesity in children with physical disabilities (CWPD) is 2-3 times that of their non-disabled peers, threatening the increased life expectancy made possible by other medical advances.
Many clinicians report substantial challenges in assessing, discussing and managing the weight of CWPD and there appears to be a tension between a desire to address weight-management, attending to children’s other (sometimes considerable) medical and psychosocial needs, and fear of causing harm.
This is the topic of a half-day workshop on Wednesday, April 29th, 2015, at the Canadian Obesity Summit, which will provide an overview of current research on the identification, management and prevention of obesity in CWPD.
The impact of obesity on service utilization and outcomes will be examined, as well as key weight-related issues faced by clinicians working with CWPD.
Research detailing the self-identified needs of children and their parents will be presented, grounding the workshop in the patient voice. The presenters and their research teams represent leading multi-disciplinary researchers, who are also members of a newly formed network of Canadian researchers working in health promotion and childhood disability.
This network is one outcome of a CIHR- funded, international consensus-building workshop, aiming to build knowledge-generating capacity within Canada around weight-related issues for CWPD.
This workshop therefore offers a critical opportunity to share knowledge, raise awareness and build capacity in this vastly under-researched area.
For more information on this workshop at the Canadian Obesity Summit click here
As part of the 4th Canadian Obesity Summit, EPODE Canada presents its first Canadian Regional Forum. This one-day workshop is designed for program managers, local community coordinators or program advisors of childhood obesity prevention programs, and to share knowledge and practical advice between EPODE and Canadian programs.
Senior members of the EPODE global team including program managers from programs in Belgium and the Netherlands will share their practical experience on program design, social marketing actions, private public partnerships and program evaluation. Canadian program managers will report on their experience and learnings and discuss barriers and levers to working in the Canadian context. A special workshop on program evaluation, chaired by Dr. Emile Levy of Hospital St. Justine in Montreal will discuss practical approaches to evaluating process and outcomes. A special luncheon presentation on kids and nutrition will be given by the founders of Real Foods for Real Kids. A networking event will be held afterwards for more informal discussion or questions. By attending this landmark event you will find ideas that can help you improve the efficiency and effectiveness of your childhood obesity prevention program.
The cost of the full day workshop includes lunch and the networking event. Attendees can choose to attend only the EPODE Canada workshop or to continue on with the full Summit program and presentations. Program members of the EPODE International Network may attend at a significantly reduced rate.
Through these presentations and workshops, participants will learn to improve the efficiency and effectiveness of a community-based childhood obesity prevention program by learning:
- The 23 year evolution of the EPODE methodology and its critical success factors. e.g. the four pillars.
- Best practices from community-based programs around the world in program design, social marketing actions, private public partnershipsand program evaluation methodologies.
- Valuable insights into barriers and opportunities in the Canadian context via experts in the field presenting their findings and experience.
- Participants will share knowledge with other similar programs, and become part of a Canada-wide network of childhood obesity prevention programs.
Who should attend:
Anyone interested in improving the efficiency and effectiveness of implementing a childhood obesity prevention programs. This includes:
- program managers
- local community coordinators
- program advisors (academics, health care professionals) of childhood obesity prevention programs
See a full list of topics in our schedule (as of January 19th 2015).
Registration (ends April 28, 2015)
General – $350
EPODE Network members- $225
Registration is now open!
However, whether or not Canadian hospitals are ready to look after these patients with in the right setting with the right equipment and whether healthcare providers are aware of and sensitive to the special needs of these patients is not clear.
This is why, Mary Forhan and her team at the University of Alberta is currently conducting a qualitative and quantitative assessment of exactly what problems patients with severe obesity face in healthcare settings.
The study, funded by Alberta Innovates Health Solution (AIHS) will look at the special challenges that these patients present in a range for settings – acute care, cancer, cardiology and rehabilitation.
A substudy will also examine the issues faced by kids and adolescent with severe obesity in healthcare settings.
Together, this project should lead to a better understanding on how healthcare systems better prepare themselves to deliver compassionate and professional care to adults and children living with severe obesity in Alberta. The learnings will likely also inform healthcare systems elsewhere.
For more on this study visit the AIHS website.
If you are someone living with severe obesity, who has experienced issues in your healthcare that could have been prevented or addressed with appropriate equipment and/or training, I’d love to hear your story.
Conflict: I am a co-investigator on this project.
The recently released Canadian Practice Guidelines on the prevention and management of overweight and obesity in children and youth released by the Canadian Task Force on Preventive Health Care (CMAJ 2015), rightly recommended that surgery not be routinely offered to children or youth who are overweight or obese.
Nevertheless, there is increasing evidence that some of these kids, especially those with severe obesity, may well require rather drastic treatments that go well beyond the current clinical practice of doing almost nothing.
Just how ill kids can be before they are generally considered potential candidates for bariatric surgery is evident from a study by Marc Michalsky and colleagues, who just published the baseline characteristics of participants in the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study, a prospective cohort study following patients undergoing bariatric surgery at five adolescent weight-loss surgery centers in the United States (JAMA Pediatrics).
While the mean age of participants was 17 with a median body mass index of 50, the prevalence of cardiovascular risk factors was remarkable: fasting hyperinsulinemia (74%), elevated hsCRP (75%), dyslipidemia (50%), elevated blood pressure (49%), impaired fasting glucose levels (26%), and diabetes mellitus (14%).
Not reported in this paper are the many non-cardiovascular problems raging from psychiatric issues to sleep apnea and muskuloskeletal problems, that often dramatically affect the life of these kids.
While surgery certainly appears rather drastic, the fact that these kids are undergoing surgery is merely an indicator of the fact that we don’t have effective medical treatments for this patient population, which would likely require a combination of behavioural interventions and polypharmacy to achieve anything close to the current weight-loss success of bariatric surgery.
That this cannot be the ultimate answer to obesity management (whether for kids or adults), is evident from the rising number of kids and adults presenting with ever-higher BMI’s and related comorbidity – not all of these can or will want surgery.
Thus, while current anti-obesity medications cannot compete with the magnitude of weight-loss generally seen with surgery, medications together with behavioural interventions may well play a role in helping prevent progressive weight gain in earlier stages of the disease.
Unfortunately, I am not aware of any studies that have explored the use of medications in kids to stabilize weight in order to avoid surgery. This would, in my opinion, be a very worthwhile use of such medications.