Monday, February 5, 2018

5 Misconceptions Every Pharmacy Student Probably Has About Obesity

Obesity is in some ways like trying to fix a pipe leak – we think we know how to do it, yet 5 minutes into an overflowing washroom, we’re calling the plumber.  

That is exactly how I felt when I was completing the Advanced Obesity Management Program (AOMP) on Advancing Practice, I thought I understood obesity but in fact I had a lot to learn. As a 4th year pharmacy student on the cusp of becoming a licensed pharmacist, I was shocked at how little I knew about obesity as a disease and its management. Even though the prevalence of obesity is widespread, there is still a large knowledge gap among many healthcare professionals; especially pharmacists in my opinion.

Here are the 5 greatest misconceptions I feel pharmacy students have on obesity, which I have also experienced:

Misconception #1: Obesity is solely caused by excessive eating and/or lack of physical activity
From the AOMP, I have learned that obesity is much more complex than just “energy in” versus “energy out”. Important contributors such as genetic pre-disposition, insufficient sleep, psychological stress, hormonal imbalance and medications, have compelling supporting evidence in the development of obesity.1

Misconception #2: Obesity is a risk factor for disease, it is not a chronic disease itself
Obesity is in fact both a risk factor and chronic disease itself, similarly to hypertension. Although pharmacists are well aware that obesity can increase the risk of other diseases (e.g. type 2 diabetes, obstructive sleep apnea, hypertension etc.), it is also important to acknowledge obesity as a chronic disease. This would allow us to change how we manage obesity as well as help reduce the stigma surrounding it.2

Misconception #3: Patients’ willpower and self-control determines their ability to lose weight and keep it off
A patient may be successful in losing weight but the maintenance of weight loss is hard. Despite putting in more effort into a weight loss program, it does not always result in additional weight loss. When I learned that our bodies had an inherent compensatory to maintain our “highest weight”, I had a deeper appreciation for the fight patients had to go through.1 This explains the difficulty of maintaining and further achieving weight loss.

Misconception #4: Body Mass Index (BMI) can be used to define obesity 
For a very long time, I believed BMI was a number that determined if a patient had obesity or not. However, the Canadian Medical Association recommends using clinical measures of health rather than diagnosing obesity with BMI values as it measures body size.2-3 Although BMI can be a useful tool to glean insight into a patient’s health status, it should not be the sole measure of obesity.

Misconception #5: Pharmacists do not have a role in obesity management 
I have been guilty of providing the oversimplified “Eat less, move more” response to patients seeking weight loss advice in the pharmacy and often, would redirect patients to dieticians or family physicians. However, as frontline healthcare workers, we are in the perfect position to initiate conversations about obesity, arrange follow-up monitoring, and provide patient support and encouragement. Most pertinent to our practice is preventing weight gain caused by certain medications dispensed regularly by providing weight management strategies beforehand.

It is definitely a difficult feat to manage obesity, especially when the individuals that patients turn to for help already have misconceptions about the disease and/or patient. Hopefully, as healthcare professionals, we can further educate ourselves on obesity and try to move away from our own biases to help make a significant impact on this disease. To learn more about obesity, click below to discover Advancing Practice’s continuing education program and become certified as a Bariatric Educator:



If you are itching to delve into the obesity conversation, look out for my 3-part interview series where various experts weigh in on the subject of obesity, no pun intended!

Cheerio,
Aveline

References:
  1.  Chaput, J.-P., Ferraro, Z. M., Prud’homme, D., & Sharma, A. M. (2014). Widespread misconceptions about obesity. Canadian Family Physician60(11), 973–975.
  2.  An Obesity Manifesto: Debunking the Myths - Medscape - Feb 23, 2017. Retrieved from https://www.medscape.com/viewarticle/875964#vp_1
  3. Rich P. CMA recognizes obesity as a disease. Oct 9, 2015. Retrieved from www.cma.ca/En/Pages/cmarecognizes-obesity-as-a-disease.aspx2015.