Hello everyone.
Today,
we will be discussing obesity,
officially a disease.
We would like you to know that the creators of this
video
are not healthcare professionals.
And that the purpose of the video is just to
discuss non-individualized information regarding obesity.
Self-diagnosis should not be made based on the information in
this video and a healthcare professional,
should be consulted instead.
Obesity is a chronic and sometimes progressive condition that can
negatively affect the quality of our physical,
and mental health,
and can reduce some individuals' life.
span. Obesity,
is when an individual has an excess or an accumulation
of fat cells. As of 2020,
The National Institute of Health, Canadian Medical Association, and the
World Health Organization
recognize obesity
as a chronic disease, where healthcare
providers must assess obesity on a similar level to that of the
other
chronic conditions such as type 2 diabetes.
Obesity is typically diagnosed based on the measures of body
height and weight that are used to calculate the body
mass index or BMI. The BMI helps Physicians indicate which
weight category people fall under. The use of waist
circumference gives an indication of visceral fat,
which is the fat that accumulates around the organs in
the abdomen.
It is a critical part of diagnosis because it is
the only fast storage location that's directly associated with cardiovascular
disease and death.
Oftentimes,
people associate obesity with being lazy,
unhygienic, and unattractive.
thus adding to weight bias,
which promotes eating disorders and depression in obese
individuals. These were exacerbated by previous
2006 guidelines
that emphasized the importance of weight reduction and based diagnosis
solely on the numerical values of BMI and waist
circumference, without considering that obesity is multifactorial and therefore
based on environmental, biological, and social factors as well.
However,
recent 2020 guidelines take these factors into consideration when treating
and diagnosing obese
individuals.
When seeing obesity diagnosis in this new light,
we recognize that obesity is a modifiable disease
that is influenced by factors
that can either improve or worsen outcome.
It has been established
that would having a greater BMI
there is an increased risk of complications and death,
however,
the risk at any given BMI can be altered. For
example,
if someone smokes, consumes a poor diet, has reduced fitness,
and greater visceral fat,
then they will have higher risk than an average person
at that given BMI.
On the other hand,
if someone has better fitness, follows a healthy diet, and
has lower levels of visceral fat, than they have lower
risk than an average person with the same BMI.
For example,
research has found that physical fitness is a great predictor
of health,
regardless of obesity status.
Let's break that down.
It has been found that people who are physically fit
and obese actually have less risk of complications
and death than normal weighted people who are sedentary. Thus,
it is true that the number on the scale is
not the sole predictor of health outcomes.
Diagnosis and treatment plans for obesity in Canada
are now based on new criteria that physicians consider. In
the past,
clinicians would only assess BMI and waist circumference,
however,
they now look at biological factors such as genetics,
hormone changes, and associated
chronic diseases,
as well as social determinants such as cultural practices and
beliefs, life and childhood experiences,
psychological factors, and medication.
These new recommendations are based on understanding and taking a
detailed historical exam to identify potential
root causes and different barriers that may stunt positive progress.
Obesity itself is initially not the problem,
however,
it is considered a chronic disease due to increased risk
of development of other obesity-related conditions and complications.
Some conditions that have been found to be linked to
obesity are hypertension–
which is high blood pressure–,type 2 diabetes,
cardiovascular disease,
certain types of cancer, and osteoarthritis. Therefore,
preventing the development of these conditions and preserving and
improving quality of life
are the main target of a obesity management and treatments.
Beyond BMI and waist circumference,
the Edmonton Obesity Staging System, or EOSS,
is one of the tools utilized during clinical assessments
for obesity. The EOSS
is composed of stages.
zero to fourth. Each stage,
measures the severity of obesity-related risk factors,
including the metabolic, physical,
and mental implications.
The EOSS allows healthcare providers to categorize patients with obesity
into a stage, depending on the health
implications they may be experiencing
Stage
zero is when the patient demonstrates
no
obesity-related risk factor.
This means that at stage zero
a patient has normal blood pressure and fasting glucose and
there is no impediment to their physical metabolic and mental
well-being.
Stage one is associated with mild obesity-related
symptoms.
This includes borderline hypertension,
fatigue,
body,
aches and pain.
Stage two is when the patient displays chronic obesity-related
comorbidities. Some of these factors include hypertension sleep,
apnea,
type 2
diabetes, anxiety, and cystic ovary syndrome.
Patients with stage 3
obesity manifest irreversible
organ damage, also called and organ damage.
This leads to heart failure,
diabetic complications, and other significant consequences to their well-being.
Lastly stage four is associated with life-threatening or severe
obesity-related
comorbidities.
This includes severe heart disease,
severe diabetic complications, and other critical or end-stage obesity-related
chronic conditions.
The new treatment plans for obesity considers root causes and are
based on individualized,
long-term care plans.
They provide nutritional, physical activity, and therapy plans
based on the individual's,
current state, background,
and contributors to their diagnosis.
Plans may also include psychological pharmacological and or surgical interventions.
It is now emphasized that healthcare providers should focus
on realistic and practical goals that promote healthy living and
positive changes for the individuals' obesity management,
while minimizing the stigma that surrounds obesity,
Although there are improvements in treatment interventions for obesity management,
there are some barriers patients my face. Social stigma around
obesity
may also deter individuals from seeking guidance from healthcare
professionals
due to the fear of being judged.
There may also be a lack of general obesity programs
or intervention specific programs available close by,
as well as limited access to healthcare providers with obesity
expertise or training.
There also may be very long wait times for referrals
and surgery which is discouraging for many. Furthermore,
some treatment plans are very high in cost and
not affordable at all.
Currently,
in Canada,
none of the anti-obesity medications are covered by benefits or
care programs,
making it even less accessible for some individuals.
Thanks for watching,
if you enjoyed this topic, watch our YouTube short titled,
"The Reality of Obesity:
ObI's story" to follow oBI through his diagnosis of obesity.
Don't forget to subscribe to the Demystifying Medicine
McMaster YouTube channel
for more videos like this.