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Barriers to Obesity Management in Canada. Arya M Sharma, MD/PhD , FRCP(C) Professor of Medicine Research Chair for Obesity Research & Management University of Alberta Medical Co-Director Alberta Obesity Program Edmonton, AB, Canada Summary

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Barriers to obesity management in canada

Barriers to Obesity Management in Canada

Arya M Sharma, MD/PhD, FRCP(C)

Professor of Medicine

Research ChairforObesity Research & Management

University of AlbertaMedicalCo-DirectorAlberta ObesityProgram

Edmonton, AB, Canada

  • Summary

  • Current Obesity Management in Primary Care

  • Key Principles of Obesity Management

  • The 5As of Obesity Management™

Canadians Do Not Look to Their Doctors for Obesity Help

Representative survey of Canadians(IPSOS REID 2010):

  • Within the last 12 months:

  • only 5% had asked their family physician about weight loss

  • only 19% had been advised to lose weight without specifically asking

  • only 14% reported having their waist circumference measured (96% reported having their blood pressure measured, and 56% reported having a test for diabetes)

  • Patient Focus Groups

  • Information from physicians seldom helpful

  • Physicians lack sensitivity in addressing obesity

  • Patients want more support in self-management

  • Patients want specific tailored weight-management strategies

  • Patients want to be directed to reliable resources

Interdisciplinary Weight Management is Effective

  • Individually tailored multi-component long-term interventions are the most effective. However:

  • Current recommendations look at obesity as a homogeneous condition amenable to simply reducing caloric intake and/or increasing activity.

  • No attempt is made to distinguish between different causes or stages of obesity.

  • People seeking weight-loss support often present with a range of barriers, including mental health issues, chronic pain and family or social issues.

Kirk S et al. IJO 2011

Core Principles of Obesity Management

  • Practitioner and Expert Interviews regarding key messages that would assist with obesity management in primary care

  • Primary Practice working group agreed on FIVE Key Principles of Obesity Management

  • Presented at 2011 National Obesity Summit Workshop

5As Framework for Obesity Management

Arya M. Sharma, MD/PhD, FRCPC

Scientific Director & CEOCanadian Obesity Network

5As Framework – Practitioner Responses

  • Canadian Family Medicine Forum, Montreal, Nov 2011

  • Ontario Family Medicine Forum, Toronto, Nov 2012

  • Ontario Nurse Practitioner Conference, Hamilton, Dec 2011

  • Focus Group, Calgary PCN, Dec 2011

  • 126 Respondents

  • 86% (n=107) physicians

  • 10% (n=13) nurses or nurse practitioners

  • 77% provided written feedback

  • The 'five As' provide a useful framework for obesity management in primary care”

  • 99% “Agree” or “Strongly Agree”

    • “Helpful”

    • “Great- it’s about time something like this was available”

  • The sequencing of Ask, Assess, Advise, Agree, Assist is appropriate”

  • 99.2% “Agree” or “Strongly Agree”

    • “It makes sense to ask first. I feel bad bringing it up with patients. Good idea.”

    • “Would be nice to have some sample approaches/dialogues to help open discussion with patients”

  • The extent of information provided on this tool is enough to serve as a quick guide”

  • 86.4 % “Agree” or “Strongly Agree”

    • “Need more mental health information to show patients”

    • “Would like an online course on how to use it”

  • I would use this tool in my practice to discuss weight managements with my patients”

  • 79% “Agree” or “Strongly Agree”

    • “I need more patient resources” (n=28)

    • “Where can I find online resources? I need this electronically or as an EMR” (n=12)

    • “Need more support. I don’t have time to discuss weight with patients. There is no place to refer patients.” (n=14)