Tuesday, November 18, 2014

Obesity Myth: Obese Individuals Are Less Active

sharma-obesity-active-livingThe second most common misconception about obesity, addressed in our article in Canadian Family Physician, is the idea that people living with overweight are any less active than people with “normal” weight:

“It is very common to hear that obese people are lazy and should get off the couch. This discriminatory bias against those with excess weight is not only widespread among the lay public but also among health professionals, even those in regular contact with patients with obesity.

Yet, the most recent data from the Canadian Health Measures Survey, a study of a nationally representative sample that used accelerometers to measure physical activity, suggest otherwise.

Based on objective measures, only 7% of Canadian children and youth8 and 15% of Canadian adults9 meet physical activity guidelines. When split by body mass index categories, obese girls average 11 159 steps per day, while normal-weight girls average 10 224 steps per day. Obese boys average fewer steps (10 256 steps per day) than their normal-weight counterparts (12 584 steps per day), but they have a larger body to carry. Translating this physical activity level into calories expended (kcal per day) would likely show that obese boys actually burn more calories on a daily basis.

Similar findings are observed for Canadian adults. Overall, the message is that there is a physical inactivity crisis in Canada—most people do not meet the recommended amount of physical activity required each day for health benefits—and every Canadian, regardless of body size, would benefit from an increase in physical activity and a decrease in sitting time.

Rather than focusing on burning calories, interventions should aim at reducing sedentary activities and increasing physical activities to improve overall health and general well-being.”

@DrSharma
Auckland, NZ

VN:F [1.9.22_1171]
Rating: 10.0/10 (5 votes cast)
VN:F [1.9.22_1171]
Rating: +4 (from 4 votes)


Monday, November 17, 2014

Obesity Myth: Obesity Is Caused By Simply Eating Too Much And Not Moving Enough

sharma-obesity-caloric-balance1In the latest issue of Canadian Family Physician, my colleagues JP Chaput, Zach Ferraro,Denis Prud’homme and I briefly address common myths about obesity.

Here is what we had to say about the commonly held notion that obesity is just about eating too much and/or not moving enough:

“Unhealthy diet and physical inactivity are the “big 2” on which almost all preventive and therapeutic programs for obesity are focused, thereby neglecting other possible contributors to excess body weight. Although intuitively appealing, clear evidence (eg, individual-level epidemiologic data and randomized experiments) beyond ecological correlations is lacking for the big 2.

Many other putative contributors to the increase in obesity (eg, insufficient sleep, psychological stress, endocrine disruptors, medications, intrauterine and intergenerational effects, etc) have supportive evidence that is as compelling as, if not more compelling than, the evidence for the big 2.

These nontraditional or new determinants of obesity influence energy input and output; overeating and reduced energy expenditure are perceived as “symptoms” and not as the root causes of the excess weight.

On the treatment side, an accumulating body of evidence shows that insufficient sleep can impede weight loss and addressing sleep for weight management has recently been endorsed by the Canadian Obesity Network.

Overall, accumulating evidence suggests that health practitioners and clinicians might need to consider a broader range of influential factors (eg, medications, lack of time, psychological stress, fatigue, chronic pain) to adequately identify and address the key factors responsible for the patient’s obesity, which is likely a clinical sign of chronic caloric “retention” (similar to edema being a clinical sign of fluid “retention”). This will enable health practitioners and clinicians to develop a personalized framework that addresses the root causes of patients’ weight gain.

Physicians must move beyond the simplistic and generally ineffective recommendation to “eat less and move more” by investigating and addressing the determinants of increased energy intake, decreased metabolic rate, and reduced activity.”

@DrSharma
Edmonton, AB

VN:F [1.9.22_1171]
Rating: 10.0/10 (5 votes cast)
VN:F [1.9.22_1171]
Rating: +6 (from 8 votes)


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

VN:F [1.9.22_1171]
Rating: 10.0/10 (2 votes cast)
VN:F [1.9.22_1171]
Rating: +3 (from 3 votes)


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

VN:F [1.9.22_1171]
Rating: 10.0/10 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)


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

VN:F [1.9.22_1171]
Rating: 10.0/10 (3 votes cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)

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

» More news articles...

Publications

  • Subscribe via Email

    Enter your email address:

    Delivered by FeedBurner




  • Arya Mitra Sharma
  • Disclaimer

    Postings on this blog represent the personal views of Dr. Arya M. Sharma. They are not representative of or endorsed by Alberta Health Services or the Weight Wise Program.
  • Archives

     

  • RSS Weighty Matters

  • Click for related posts

  • Disclaimer

    Medical information and privacy
    Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.


  • Meta

  • Obesity Links

  • If you have benefitted from the information on this site, please take a minute to donate to its maintenance.

  • Home | News | KOL | Media | Publications | Trainees | About
    Copyright 2008–2014 Dr. Arya Sharma, All rights reserved.
    Blog Widget by LinkWithin