The Obesity Alphabet Soup And Its Implications

Yesterday, I gave a day-long presentation to Aboriginal nurses and other health care workers from several First Nation reserves in Southern Saskatchewan. The event was organized and hosted by the Onion Lake Health Board with support from Health Canada.

It was not difficult for me to fill the almost seven hours of the meeting with a roundup of the obesity problem – everything from the societal and environmental drivers of obesity, its economic and humanitarian implications, the problem of weight bias and discrimination, to obesity definitions, classification, genetics, biology, and management.

During the talk I realized that some of my work has significantly contributed to what is now turning out to be an ‘alphabet soup’ that goes well beyond just BMI, WC, or WHR.

As regular readers will recall, we have added EOSS (the Edmonton Obesity Staging System), the 4Ms (Mental, Mechanical, Metabolic, and Monetary drivers, complication and barriers), and now, the 5As (Ask, Assess, Advice, Agree, Assist), to the basics of obesity assessment and management. (some may wish to add HAES to this list)

Although this alphabet soup may seem mysterious and perhaps daunting to some readers, it is gradually but steadily developing into a framework, which is beginning to flesh out a lot of what needs to change and happen in obesity management.

This, at least, became quite clear to me during my presentation and the rather positive response of the almost 200 attendees only served to validate that these concepts have largely been missing in our clinical approach to obesity management.

Supplement this alphabet soup with the etiological framework and ‘Best Weight‘, and we have a whole different way of approaching patients affected by excess weight.

As I know that many of the attendees are also avid readers of these pages, I’d certainly appreciate any feedback and thoughts on yesterday’s workshop.

Regina, Saskatchewan

p.s. obviously the obesity alphabet soup has far more letter – I wonder how many readers can decipher and name the following (in no particular order): PCOS, NAFLD, RNY, LABG, OSA, DVT, PCOS, PYY, GLP-1, T2D, OA, LVH, a-MSH, DEXA, ADHD, PTSD, RMR, NEAT, BAT, WAT.