Treat obesity with surgery, not exercise: study

Doctors told to disregard weight and instead treat patients as suffering from chronic illness.

Doctors in Canada have been told to treat obese patients differently. Picture: istock

Obesity should be treated with therapy and surgery rather than diet and exercise, according to a pioneering study.

Doctors in Canada are being told to disregard a patient’s weight, size and willpower and instead treat them as suffering from a chronic illness caused by trauma, genetic factors or mental health problems. The national guidelines were written by 62 Canadian experts, who analysed half a million peer-reviewed articles and interviewed obese people.

They were produced by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons and published this week in the Canadian Medical Association Journal.

“Obesity is now clearly defined as being a chronic, relapsing, often progressive disease … not simply as something that you can fix by going on a diet,” Arya Sharma, one of the authors, told The Times.

A quarter of Canadians are obese. Picture: istock

The guidelines replace those from 2007, which have been largely ineffective. In the past 30 years, the rate of obesity has tripled in Canada. Today, a quarter of Canadians are obese.

Instead of reciting the mantra “eat less, move more,” Canadian doctors are now expected to suggest cognitive behavioural therapy, prescribe medication and encourage bariatric surgery, such as a gastric bypass. While they can still use diagnostic criteria, such as body mass index, they should not focus on size, but how excess weight affects long-term health.

“The dominant cultural narrative regarding obesity fuels assumptions about personal irresponsibility and lack of willpower and casts blame and shame upon people living with obesity,” the report claims. As a result, primary health providers in Canada should recognise any bias they might have against overweight patients.

David Lau, another author and a professor at the University of Calgary, said: “The healthcare professional is more like a coach to help the person change.”

The Times