Course aims to better educate doctors about obesity

· The Pulse

A new course spearheaded by the Edmonton-based Obesity Canada aims to help doctors and other healthcare professionals better understand what obesity is and how best to treat it.

The program, called Calibre (for Canadian Advanced Learning in Bariatric Care), was launched at the end of September by Obesity Canada, which is based at the Li Ka Shing Centre for Health Research Innovation at the University of Alberta. Its partners in the project are the Canadian Society of Endocrinology and Metabolism and the European Association for the Study of Obesity.

"Healthcare practitioners in Canada and globally typically receive little to no education or training in obesity management, and so professional education is a core activity for Obesity Canada," said Dr. Sanjeev Sockalingam, Calibre's course director.

Calibre provides knowledge and tools for clinicians in a streamlined way designed to build confidence in treating obesity in collaboration with their patients. Roughly half of the material is available in self-directed readings and video formats, with additional live online workshops to give participants the benefit of learning from peers and experts.

"While obesity is a chronic disease, it is not a heterogenous one — how it develops and how it can be successfully managed are not the same for everyone who lives with it," said Sockalingam, who is also a professor and vice-chair of education for the department of psychiatry at the University of Toronto.

"Calibre reinforces the new definition of obesity, where excess or abnormal fat accumulation affects one's health; it's not about size, BMI, or a number on the scale, but about objective health measures. In other words, you don't have obesity just because you live in a larger body – it's only when weight affects health, such as having high blood pressure, diabetes, et cetera, that one can be diagnosed with obesity."

The program builds off of the Canadian Adult Obesity Clinical Practice Guidelines (CPGs) previously developed by Obesity Canada and Canadian Association of Bariatric Physicians and Surgeons, with additional expertise from faculty to underpin practical advice for healthcare workers.

The CPGs grew out of the work of Dr. Arya Sharma, the past scientific director of Obesity Canada. He came up with what came to be known as the Edmonton Obesity Staging System as a way to get away from body-mass index to understand someone's health needs.

A smiling Dr. Sanjeev Sockalingam on a city street

Dr. Sanjeev Sockalingam is the course director for Calibre, a program to enhance healthcare professionals' knowledge in obesity management. (University of Toronto)

Dr. Yoni Freedhoff of the University of Ottawa spoke to On the Media in July about the superiority of the Edmonton Obesity Staging System and the degree to which our obsession with body mass results in inferior healthcare for people in larger bodies.

"Society has been trained to believe that weight automatically carries risk," he told the WNYC podcast. "Society has not been trained to believe that there is systematic bias in the treatment of patients with obesity."

Using BMI as a measure, Statistics Canada reported that 7.3 million Canadian adults were classified as obese in 2018. The proportion of adult residents deemed to be obese in Alberta was 28.8%, slightly higher than the national average of 26.8%.

But numbers don't really tell the story, Sockalingam suggested. The experience of obesity varies greatly within the affected population, and Calibre reflects a more nuanced approach to successful treatment.

"The message in Calibre is the message in the CPGs — treatment for obesity is not solely about weight loss, but rather on improving health measures and quality of life so that patients can live their best life."

People living with obesity were included in every step of the program's development, Sockalingam said. Seven were directly involved in developing Calibre, reviewing all content and presentations and providing feedback on patient resources included in the modules.

"Individuals living with obesity also provided videos that are included in each module, so that the content is centred on real-life lived experiences," Sockalingam explained.

The first Calibre cohort will begin live training on Nov. 15, with more groups to follow as registration increases.