Clinicians need long-term support for the management of obesity
References
1. Sean Wharton, David C.W. Lau, Michael Vallis, et al. Obesity in adults: a clinical practice guideline. CMAJ 2020;192:E875-E891.
2. Lindeman C, et al. Body mass index and waist circumference documentation in Canadian primary care electronic medical records. Research Square 14 Jul, 2020. https://assets.researchsquare.com/files/rs-41280/v1/7fdfdc99-bc4a-4d9a-9046-661841aea57e.pdf
3. Butsch WS, et al. Low priority of obesity education leads to lack of medical students' preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study. BMC Med Educ 2020;20:23.
4. Mastrocola MR, Roque SS, Benning LV, Stanford FC. Obesity education in medical schools, residencies, and fellowships throughout the world: a systematic review. Int J Obes (Lond) 2020;44:269-79.
5. Crowley J, Ball L, Hiddink GJ. Nutrition in medical education: a systematic review. Lancet Planet Health 2019;3:e379-89.
Congratulations Wharton and colleagues for the comprehensive practice guideline on obesity management [1]. I agree that many multicausal and multidimensional interacting factors influencing obesity and their consequences. There are two 'physician' aspects worth mentioning.
First, obesity affected 27.7% or 7.6 million Canadian adults in 2019. The authors are right with the regularly assessment step "Direct measurement of height, weight and waist circumference and calculation of body mass index (BMI) should be included in routine physical examination for all adults.“ [1] A current data analysis of the Canadian primary care electronic medical records with 707,819 patients aged 40 or older showed that 58.6% had at least one BMI recording but only 11.5% had at least one waist circumference (WC) documentation. However, in 81% of Canadian patients there was no simultaneous monitoring of BMI and WC by primary care clinicians [2].
Second, obesity education currently has a very low priority in medical school curricula, with an average of just 10 hours over four years [3]. Medical students are by no means sufficiently prepared to manage patients with obesity - especially nutrition competencies are enormously deficient across the globe [4, 5]. In addition to this helpful practice guideline, primary care clinicians need urgent long-term support for the management of obese patients.