Canadian Adult Obesity Guidelines Take the World Stage

— Brad Hussey
Obesity Canada pilot project will adapt ground-breaking CPGs for use in Chile and Ireland in 2021, with more countries on board in 2022

Canada’s sweeping new clinical practice guidelines (CPGs) for treating obesity in adults may soon become the foundation for evidence-based patient care globally, thanks to a new international adaptation program launched by Obesity Canada. 

Developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons and launched in August 2020, the Canadian Adult Obesity Clinical Practice Guidelines were compiled by over 60 Canadian health professionals, researchers and individuals living with obesity. More than 500,000 published peer-reviewed articles were assessed to identify 80 key recommendations in what became the Canadian Medical Association Journal’s top-read article for 2020. Nineteen supplemental chapters on the Obesity Canada website delve into greater detail on topics ranging from weight bias to behavioural interventions, medical nutrition therapy, Indigenous health and more. 

The CPG process required extensive resources and several years’ worth of work, putting similar exercises out of reach for many countries, according to Dr. Mary Forhan, Obesity Canada’s scientific director and Chair/Graduate Chair, Department of Occupational Science and Occupational Therapy, University of Toronto. 

“The Canadian CPGs authors performed a monumental task and created the most thoroughly researched obesity guidelines in the world to date, and the first to be truly patient-centred,” Dr. Forhan says. “We saw a strong response from organizations and individuals working outside of Canada who asked how they could use the CPGs to improve obesity care in their own country. This pilot adaptation program was our response to that demand.” 

A call for applications was launched in 2021 to identify one European and one Latin American nation, represented by national or regional organizations responsible for obesity, to adapt the CPGs. Ireland and Chile were selected based on strong demonstrations of the need to improve obesity care, and the ability to organize and support the adaptation process and disseminate the guidelines to stakeholders. Each nation will use the same framework as the Canadian CPGs to assess country-specific evidence, while adjusting for differences in healthcare delivery models, availability of specific treatments and supports, and unique socio-cultural factors so the adapted CPGs are relevant. Obesity Canada will support the adaptation processes in both countries. 

“This is a great opportunity to leverage Canadian expertise and allow other jurisdictions to benefit from Obesity Canada’s leadership,” Dr. Forhan concludes. “In a sense, we are collectively working to create a defacto international guideline that puts patients first, while dismantling pervasive weight bias and unscientific approaches to obesity care. As a highly multicultural nation, Canada will benefit from the insights we will gain from how other cultures implement the CPGs, and so we look forward to rolling the program out to more countries in 2022.”

Statements from participating organizations:

Chilean Society of Bariatric and Metabolic Surgery:

“In Chile, we have seen a steady increase in the prevalence of obesity and related diseases over the last 30 years. Although recent governments have implemented various strategies at the public health level to address this situation, no changes have been observed in this trend.

“We need to change our approach to obesity. We need the authorities to understand that obesity is a complex and multifactorial disease.  It is for this reason that, during 2020, we began a process of updating local clinical guidelines, in conjunction with other related Chilean scientific societies.  When we learned about the possibility of applying to participate as a pilot country for the adaptation of the Canadian clinical practice guidelines, we decided to give it a try. The level of excellence in their content and their patient-centered approach was for us a model to follow, on which we were drawing inspiration for our own update. That is why we are deeply grateful for this opportunity and hope that through this work, people living with obesity in our country will be able to access better quality healthcare without being stigmatized.”

Association for the Study of Obesity Ireland:

“We are delighted to have been selected to take part in the pilot process of adaptation and implementation of the Obesity Canada Clinical Practice Guidelines for Ireland. This is excellent timing for us nationally, as the Model of Care for Management of Obesity in Ireland has just been launched, and developing high quality guidelines is an important next step to improve access and delivery of care.

“The OC CPGs place a strong emphasis on reducing obesity bias and stigma in healthcare settings and society in general, and ASOI believes that this is critical for improving the lives of people living with obesity.  We are looking forward to working with our colleagues in Canada and Chile on this exciting project.”

Learn more about the Canadian Adult Obesity Clinical Practice Guidelines: www.obesitycanada.ca/guidelines

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