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Letters

Many hands lighten the obesity load

Aric Sudicky and Christopher Mackie
CMAJ September 22, 2015 187 (13) 997; DOI: https://doi.org/10.1503/cmaj.1150061
Aric Sudicky
Cumming School of Medicine, (Sudicky) University of Calgary, Calgary, Alta.; Middlesex–London Health Unit, London, Ont.
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Christopher Mackie
Cumming School of Medicine, (Sudicky) University of Calgary, Calgary, Alta.; Middlesex–London Health Unit, London, Ont.
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Fletcher and Patrick1 make an excellent case for population-level measures to curb obesity rates, but fail to highlight opportunities for improvement in primary care and medical education.2,3

In the average family practice, about 4.4 hours per day would be required to provide only A-level preventive screening to adults over 25 years of age.4 It is not surprising then that only 23% of obese individuals have a documented care plan.5

Innovative tools exist to make obesity prevention quicker, easier and more effective. Simply adding a signed prescription with clear instructions can increase patient adherence to exercise and diet advice.6

Modifications to physician education are also required. Most medical curricula in Canada do not offer formal education in obesity prevention.1 Canadian medical graduates report dissatisfaction with current nutrition education and their ability to provide nutrition counselling to patients.7 To that end, an enhanced medical education curriculum is being developed and piloted in Canada.2

The past 50 years of battling Big Tobacco has shown that physicians can offer leadership in both clinical innovation and healthy public policy8,9

We are proposing a multilevel approach to obesity prevention, integrating physicians with allied health, public health and community incentives. This is the foundation of our multiclinic pilot study, Prevention Rx, which is currently under evaluation.

Letters to the editor

Letters have been abbreviated for print. See www.cmaj.ca for full versions and competing interests.

References

  1. ↵
    1. Fletcher J,
    2. Patrick K
    . A political prescription is needed to treat obesity. CMAJ 2014;186:1275.
    OpenUrlFREE Full Text
  2. ↵
    1. Cardinal BJ,
    2. Park EA,
    3. Kim M,
    4. et al
    . If exercise is medicine, where is exercise in medicine? Review of US medical education curricula for physical activity-related content. J Phys Act Health 2014 Dec. 2. [Epub ahead of print].
  3. ↵
    1. Kovacs Burns K,
    2. Gramlich L,
    3. Bistritz L,
    4. et al
    . Piloting online WellnessRx learning modules: demonstration of developmental evaluation. Eval Program Plann 2015;49:76–85.
    OpenUrlCrossRefPubMed
  4. ↵
    1. Flegal KM,
    2. Carroll MD,
    3. Ogden CL,
    4. et al
    . Prevalence and trends in obesity among US adults, 1999–2008. JAMA 2010;303:235–41.
    OpenUrlCrossRefPubMed
  5. ↵
    1. Yarnall KC,
    2. Pollak KI,
    3. Østbye T,
    4. et al
    . Primary care: Is there enough time for prevention? Am J Public Health 2003;93:635–41.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Swinburn BA,
    2. Walter LG,
    3. Arroll B,
    4. et al
    . The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners. Am J Public Health 1998;88:288–91.
    OpenUrlCrossRefPubMed
  7. ↵
    1. Gramlich LM,
    2. Olstad D,
    3. Nasser R,
    4. et al
    . Medical students’ perceptions of nutrition education in Canadian universities. Appl Physiol Nutr Metab 2010;3:336–43.
    OpenUrl
  8. ↵
    1. Rosser WW
    . Physicians for a smoke-free Canada. CMAJ 1985;133:1115–6.
    OpenUrlPubMed
  9. ↵
    1. Rafuse J
    . New program helps physicians guide patients to a smoke-free future. CMAJ 1994;150:261–2.
    OpenUrlPubMed
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Canadian Medical Association Journal: 187 (13)
CMAJ
Vol. 187, Issue 13
22 Sep 2015
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Many hands lighten the obesity load
Aric Sudicky, Christopher Mackie
CMAJ Sep 2015, 187 (13) 997; DOI: 10.1503/cmaj.1150061

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Many hands lighten the obesity load
Aric Sudicky, Christopher Mackie
CMAJ Sep 2015, 187 (13) 997; DOI: 10.1503/cmaj.1150061
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