The Canadian Obesity Guidelines define obesity as follows: *****************************************************************************************************<\/p>\n ****************************************************************************************************<\/p>\n Managing obesity is important as it is associated with significant health problems as it causes: In Part 2 I will cover the holistic approach to obesity treatment.<\/p>\n<\/div><\/div><\/div>
\nObesity is a prevalent, complex, progressive and relapsing chronic disease, characterized by abnormal or excessive body fat (adiposity), that impairs health.<\/b><\/span>
\nLet me break down that definition:
\nPrevalent <\/b><\/span>\u2013 common in the world; the World Health Organization says that 43% of adults are living with overweight and 16% living with obesity. It is estimated that 20 million South Africans are living with overweight or obesity.
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\nComplex<\/span><\/b> \u2013 there are many causes (genetic, lifestyle, stress, etc) and obesity causes significant complications such as Type 2 diabetes sleep apnoea, osteoarthritis.
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\nProgressive<\/span><\/b> \u2013 weight gain is more common as we age
\nRelapsing \u2013 this reflects the difficulty in keeping the weight off
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\nChronic<\/span><\/b> \u2013 life-long in nature
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\nDisease<\/span><\/b> \u2013 not a normal state of health
\nIt is important for any healthcare provider (HCP) treating people living with obesity (PWO) to establish what is important for that person. An accepted approach to do this is to follow the 5 A questions:
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\nASK<\/span><\/b> \u2013 ask permission to talk about obesity.
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\nASSESS<\/span><\/b> \u2013 by measuring height, weight, BMI, waist circumference a diagnosis of obesity can be made. The HCP will take a full history to establish what the drivers of obesity are: genetics, medical conditions, medications, lifestyle, psychological.
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\nADVISE<\/span><\/b> \u2013 the HCP will explain the complications of obesity and the benefits of weight loss.
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\nAGREE<\/span><\/b> \u2013 here realistic goals are set and an approach on how to achieve this.
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\nASSIST<\/span><\/b> \u2013 a multidisciplinary approach is extremely important, and the dietician is the key member of the team. If needed, the biokineticist or exercise trainer, psychologist and practice nurse may be involved too.
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\nIn my experience, PWO are often looking for the answer to WHY? Why am I overweight, especially when they are actively trying to lose weight. It may help to recap the causes of obesity:<\/p>\n\n\n
\n NON-MODIFIABLE<\/span><\/u><\/b><\/td>\n MODIFIABLE<\/u><\/b><\/td>\n<\/tr>\n \n Genetics<\/td>\n Excess calories in diet<\/td>\n<\/tr>\n \n Age<\/td>\n Low physical activity<\/td>\n<\/tr>\n \n Hormonal changes e.g. menopause<\/td>\n Mental health, especially stress<\/td>\n<\/tr>\n \n <\/td>\n Poor sleep, including sleep apnoea<\/td>\n<\/tr>\n \n <\/td>\n Some chronic medications<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n87% of type 2 diabetes
\n68% of hypertension
\n61% of endometrial cancer
\n45% of ischemic stroke
\n38% of ischemic heart disease
\n31% of kidney cancer
\n24% of osteoarthritis
\n17% of colorectal cancer
\n13% of postmenopausal breast cancer<\/p>\n<\/i> Services<\/h4><\/div>
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