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Canadians Have Virtually No Access To Interdisciplinary Obesity Care



Every single guideline on obesity management emphasises the importance of interdisciplinary obesity management by a team that not only consists of a physician and a dietitian but also includes psychologists, exercise specialists, social workers, and other health professionals as deemed necessary.

As is evident from the evident from the 2017 Report Card on Access To Obesity Treatment For Adults, released last week at the 5th Canadian Obesity Summit, the overwhelming majority of Canadians living with obesity have no access to anything that even comes close.

Thus, the report finds that

Among the health services provided at the primary care level for obesity management, dietitian services are most commonly available.

Access to exercise professionals, such as exercise physiologists and kinesiologists, at the primary care level is limited throughout Canada.

Access to mental health support and cognitive behavioural therapy for obesity management at the primary care level is also limited throughout Canada. bariatric surgery programs often have a psychologist or a social worker that offers mental health support and cognitive behavioural therapy to patients on the bariatric surgery route, but the availability of these supports outside of these programs is scarce.

Centres where bariatric surgery is conducted also have inter- disciplinary teams that work within the bariatric surgical programs and provide support for patients on the surgical route.

Alberta and ontario have provincial programs with dedicated bariatric specialty clinics that offer physician-supervised medical programs with interdisciplinary teams for obesity management.

Interdisciplinary teams for obesity management outside of the bariatric surgical programs are available in one out of five regional health authorities (RHa) in british Columbia, one out of 18 RHas in Québec, one out of two RHas in new brunswick and one out of four RHas in newfoundland and labrador.

Among the territories, only yukon has a program with an interdisciplinary team focusing on obesity management in adults.

I hardly need to remind readers, that this is in stark contrast to the resources and teams available to patients with diabetes, heart disease, lung disease, or any other common chronic disease, that are regularly available in virtually every health jurisdiction across the country (not to say that they are perfect or sufficient – but at least there is some level of service available).

I understand that our current obesity treatments are extremely limited (at least when effectiveness is measured in terms of weight loss). But even if access to these resources could simply help stabilise and prevent further weight gain (progression) and perhaps improve overall health and well-being, surely Canadians living with obesity should deserve no less that people living with any other chronic disease.

There is simply no excuse for treating Canadians living with obesity as second-class citizens in our publicly funded healthcare system.

@DrSharma
Edmonton, AB

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