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:
- Advanced Obesity Management Program (CAD$ 495)
- Canadian Obesity Network: Certified Bariatric Educator Final Exam (CAD$ 295)
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:
- Chaput, J.-P., Ferraro, Z. M., Prud’homme, D., & Sharma, A. M. (2014). Widespread misconceptions about obesity. Canadian Family Physician, 60(11), 973–975.
- An Obesity Manifesto: Debunking the Myths - Medscape - Feb 23, 2017. Retrieved from https://www.medscape.com/viewarticle/875964#vp_1
- Rich P. CMA recognizes obesity as a disease. Oct 9, 2015. Retrieved from www.cma.ca/En/Pages/cmarecognizes-obesity-as-a-disease.aspx2015.