National obesity congress: questioning weight loss at all costs

April 28, 2011 – From April 28 to 1^er May, more than 600 Canadian experts will converge on Montreal, where the 2^e National Congress on Obesity. This will be an opportunity for clinicians to take stock of the most promising approaches to combat what is now considered a global epidemic.

“The scientific community is increasingly turning its back on dieting and weight loss at all costs,” says Dr.^r Arya Sharma, Professor of Medicine at the University of Alberta and President of the Canadian Obesity Network.

D^r Arya sharma

Indeed, the repeated failures of their patients have led clinicians to question the dogmas of the past. “To lose 2 or 5 kilos, making a few changes to your diet and exercising is enough,” continues the specialist. But when you have 15 or 25 kilos to lose, it’s a different story. It takes huge efforts to lose the excess weight, and you have to maintain those same efforts for the rest of your life if you don’t want to gain it back. Unless you become and stay a marathoner, that’s just not realistic! “

Lyne Mongeau, coordinator of the government action plan to promote healthy lifestyles and prevent weight-related problems, agrees with Dr.^r Sharma. Draconian diets cause imbalances not only physically, but also behaviorally (it is enough to deprive yourself of chocolate to feel an irrational desire to eat it) and moral (repeated failures lead to a feeling of helplessness. ). “The talk about healthy weights is more of a dream than reality,” she says.

Is it necessary to lose weight?

The good news: More and more scientific studies are showing that making reasonable adjustments to your diet and doing light exercise leads to a host of health benefits, even when these new habits do not lead to weight loss. or only modest weight loss.

“By moving and eating better, by adopting a Mediterranean-type diet for example, we increase our body’s sensitivity to insulin, which reduces the risk of diabetes”, explains Simone Lemieux, professor at the Department of Human Sciences. food and nutrition at Laval University. “We also manage to lower bad cholesterol levels in the blood and lower blood pressure, thereby reducing the risk of suffering from cardiovascular disease. In addition, sleep is improved. “

Obesity, a chronic disease

For the D^r Sharma, obesity should be treated like any chronic disease. Patients should be followed up every 3 or 6 months because the battle is never won. “There are several elements that contribute to obesity: genetics, lack of education about the benefits of diet, lack of time that encourages people to turn to the fast food, lack of cooking skills, depression, taking certain medications … You have to take the time to examine all of these factors and offer each patient a tailor-made approach. Everyone should be encouraged to make small changes in their lifestyle, realistically and very gradually. “

According to Lyne Mongeau, Quebec would have a head start in this area. The Quebec Action Plan that it coordinates favors a biopsychosocial approach to the treatment of obesity.

For Simone Lemieux, however, the game is far from over. “The prejudices surrounding overweight and obesity are very widespread and they do not spare clinicians”, says the professor who, on May 19, will offer a videoconference entitled Treating Obesity: Why Has Success So Mixed?. “Many healthcare professionals still feel that if a person has extra pounds it’s their fault and that the only measure of success is weight loss. Taking medications to treat complications of obesity is sometimes seen as a failure resulting from an inability to lose weight. However, hypercholesterolemia is treated very vigorously, with statins, while healthier lifestyles would improve the health record of patients in many cases. The social norm is quite different. “

No one denies that losing weight in obese people is beneficial for their health. “But, weight loss should not be the only target of treatment and we should not only define success in kilograms lost”, summarizes Simone Lemieux. “When it comes to the treatment of obesity, the time has come for clinicians to redefine what they mean by the word ‘success’. “

Dominique Forget – PasseportSanté.net