Brenndon Goodman was nine years old when a doctor told him that he would be dead at age 30 if he could not control his weight.
“You are going through all the problems that a nine -year -old normal child goes. In addition to that, they also tell you that you are overweight, you are an aberration. For me, I felt it was a failure,” said Goodman, 30, who lives in Thornhill, Ontario.
He said he remembers infinite, useless quotes, in weight loss programs that were equivalent to diet plans and shame of cookie cutter. What finally worked was when a team of doctors, dietitians, specialists and psychologists at the Toronto Children’s Hospital began to tell him about the psychological and genetic aspects of obesity.
This type of collaborative and inclusive approach should be what all doctors and nurses take when treating children who fight with obesity, say the authors of New Canadian Clinical Practice Guidelines Published Monday at Canadian Medical Association Journal.
The authors say that doctors should ensure that patients and families are well informed and included in any decision making.
They also say that health workers must provide psychological treatments such as advice for behavior change, together with strategies such as improving nutrition and physical activity.
“In terms of, you know, the ‘Eating less, moving more’ movement, we know that only a treatment for obesity does not provide sustained success,” said Dr. Sanjeev Sockalingam, professor of the Department of Psychiatry at the University of Toronto and scientific director of the obesity of Canada without profit, which co-codified the new guidelines.
In some cases, the authors say, families must also have the opportunity to consider medications, such as LPG-1, sold under marks such as Ozempic or Mounjaro, which mimic the natural hormone to help regulate the levels of appetite and blood sugar, and are widely used for type 2 diabetes or weight loss. The guidelines also say that some children fighting with weight control could be considered for weight loss surgery, under certain conditions.
It is the first time that the guidelines are updated since 2007, and they are very late, some experts say.
“Much has changed how we drive children, and there is also a lot of new literature,” said Dr. Jill Hamilton, head of the Endocrinology Division of the Hospital of Sick Children and one of the co -authors of the guidelines.
“For so long, we focus on only weight or [body mass index] As a result, “he said.
“Other results are so important or more important than for families. Things such as improving the quality of life related to health,” such as high blood pressure, musculoskeletal pain, anxiety or bullying.
New Objective Stigma Guidelines
The new guidelines also talk about the stigma associated with obesity.
It is a great change of the Guidelines published in 2007where the word “stigma” is not mentioned.
“We have had a long -standing story in the care and management of obesity, where people have attributed it as something to do with willpower,” Sockalingam said.
“All this stigma only perpetuates all negative experiences, especially the experience of children and young people day by day.”
On the other hand, the new guidelines define childhood obesity as a chronic, stigmatized and progressive disease, characterized by the presence of excess body fat that could affect the health or well -being of a patient.
“It is a complex chronic disease and, like other chronic diseases, we need more tools in the toolbox to treat it,” Sockalingam said.
Encourage medical care providers to recognize obesity as such, he said, could encourage more research that could help scientists obtain the best markers to define and treat the condition.
But others say that new guidelines do not get far enough to break the stigma associated with childhood obesity.
Vincci Tsui, a dietitian registered in Calgary and the founder of weight inclusion dietitians in Canada, said that although it is good that the guidelines emphasize the importance of addressing the stigma of weight, a greater body weight should not be treated as a disease in itself.
“The problem is when pathologies a body size or pathologies This idea of ’excess body fat’, which in itself also increases stigma,” he said.
The main medical groups are proposing a change in how doctors diagnose obesity, moving away from the body mass index or BMI. The new definition intends to get away from the stigma of weight and, instead, focus on treatment.
Bariatric medication and surgery
TSUI said that medical care suppliers must take into account that guidelines recommend stronger interventions, such as taking GLP-1 medications or undergo bariatric surgery, only in certain conditions, such as after a risk-benefit analysis.
He also warned that there is not a lot of evidence on the side effects of drugs such as LPG-1 for children, something that Hamilton, one of the co-authors.
“It is currently recommended for over 12 years, and obviously more research is needed because these are relatively new medications,” said Hamilton.
“More work is needed in this area in all age groups, but also especially in pediatrics.”
Ultimately, Hamilton said, medical care providers should respect the opinions and desires of families, even when it comes to more invasive interventions such as surgery, especially for children who have significant health conditions associated with obesity, such as the obstructive apnea of sleep or insulin resistance.
For some children, such as Brenndon Goodman, weight loss surgery can really make a positive difference.
“It is a choice that would do again a hundred times,” he said, because he could think about that carefully and felt supported by a good team long after the procedure.
Goodman said he hopes that young people and families also have the opportunity to make that decision, if that is what they want and need.
As Canada prepares to publish new guidelines to treat childhood obesity, some experts criticize new guidelines in the United States that recommend more aggressive treatments such as medicines and surgery for children up to 12 and 13 years.
