Obesity should be defined by a person's health—not just their weight, says a new Canadian clinical guideline. It also advises doctors to go beyond simply recommending diet and exercise. Instead, they should focus on the root causes of weight gain and take a holistic(整体的) approach to health.
Ximena Ramos-Salas, one of the guideline's authors, said research shows many doctors discriminate(歧视) against obese patients, and that can lead to worse health outcomes regardless of their weight. "The weight bias(偏见)is not just about believing the wrong thing about obesity, " she told the BBC. "The weight bias actually has an effect on the behaviour of healthcare doctors. "
Although the latest advice still recommends using diagnostic(诊断的)criteria like the body mass index (BMI) and waist circumference, it admits their clinical limitations and says doctors should focus more on how weight affects a person's health. Small reductions in weight, of about 3%-5%, can lead to health improvements and an obese person's "best weight" might not be their "ideal weight" according to the BMI, the guideline says.
It emphasizes that obesity is a complex, chronic condition that needs lifelong management. "For a long time we've associated obesity as a lifestyle behaviour. It's been a lot of shame and blame before, " Ms Ramos-Salas says. "People living with obesity need support like people living with any other chronic diseases. " But instead of simply advising patients to "eat less, move more", the guideline encourages doctors to provide supports along the lines of psychological therapy(治疗), medication and bariatric surgery like gastric bypass surgery(胃分流手术).
The guideline doesn't completely give up standard weight-loss advice. "All individuals, regardless of body size or composition, would benefit from adopting a healthy, well-balanced eating pattern and engaging in regular physical activity, " it says.
