Weight loss is one of the most common health goals that individuals patients mention when asked in my family medicine clinic. Messages about weight loss surround us. Whether it is on the cover of magazines, in TV ads or on social media – the message is “You need to lose weight”. The weight loss market in the United States of America is worth $60 Billion. Likewise, fitness programs in the U.S. generated $75 billion of revenue in 2015 according to the International Health, Racquet & Sportsclub Association. But where are we? In 2014, Statistics Canada reported that 54 percent of the Canadian population is overweight or obese.
There are a lot is misconceptions about obesity. Most people feel that obesity can be corrected by just eating less and moving more. Overcoming the chronic disease of obesity is much more than that. The Canadian Obesity Network and a network of international researchers studying obesity have demonstrated that the situation is much more complex. The Canadian Obesity Network has been promoting the 5As approach to obesity. The one of the guiding principles of this approach is to be patient centered and focus on uncovering the root causes of obesity. These root causes include a reduction in metabolic rate, overeating or reduced physical activity secondary to biological, psychological or socio-economic factors.
Being physically active while living with excess weight can be challenging. Every day activities like getting out of bed, getting dressed, doing laundry or empty the dishwasher can be harder for those living with excess weight. State of the art teaching facilities provide medical trainees the opportunity to experience what it is like to participate in activities of daily living while wearing a bariatric simulation suit. This suit does not simulate additional body weight, rather it mimics some common body shapes associated with severe obesity that can restrict range of motion and mobility. Students become more aware of the challenges of doing everyday activities while wearing the suits.
Physical activity trackers have become very popular. All around the world, people are tracking and competing with each other to get 5,000 or the recommended 10,000 steps in each day. I personally have promoted the use these tracking devices to encourage physical activity, reduce sedentary time and promote family fitness. What we often neglect to address is that 10,000 steps for a person without obesity is not the same as 10,000 steps for someone with obesity.
This summer I had the great opportunity to do some hiking in one of Canada’s amazing parks. For three days, I enjoyed the forest, waterfalls and glacial lakes that were along the trail. It was hard work climbing up and down the mountain with all of our gear including food, tent and sleeping bags. Each day, we stopped regularly for breaks to have lunch, a snack or maybe just a drink of water. Every night, when we arrived at our destination, it was relief to take off that back pack for the day.
For individuals living with obesity, they can not just take the weight off. Certainly, it does not mean that people living with obesity cannot be physically active it just means that health professionals like myself need to acknowledge and realize the work patients with obesity are doing every day “Living with Obesity”.
Photo provided by the Canadian Obesity Network