fat shaming is officially over

“exercise and diet.” that’s the advice doctors have given patients living with obesity for far too long, says dr. sean wharton, an internist who has authored new clinical guidelines for treating obesity in the canadian medical association journal (cmaj). he says canadians living with obesity have traditionally been viewed as lazy and unmotivated and dismissed by the healthcare system.

and it’s based on over 500,000 published peer-reviewed articles — “not something printed off of google,” says wharton, medical director of the wharton medical clinic in burlington, ont. the new guidelines were developed by obesity canada and the canadian association of bariatric physicians and surgeons , and authored by over 60 medical professionals as well as people living with obesity.

instead, says wharton, obesity needs to be viewed as a neurobiological issue, driven by a variety of hormones which influence people’s eating habits and behaviours. to that end, patients need approaches to managing how those hormones react in their bodies. this can be achieved through bariatric surgery – which reduces the size of the stomach, but also affects hormones and gut bacteria that affect hunger. medications such as glucagon-like peptide 1 (glp-1) agonists can also increase the levels of hormones that make people feel full after eating, while antidepressant/anti-addictive medications can also manage cravings and hunger pangs. cognitive behavioural therapy can also help people retrain the way they think about food.

wharton says the guidelines come at a time when obesity is seen as a major risk factor for diabetes and covid-19. research has shown that the adipose tissue of people who live with obesity can lead to inflammation that complicates these conditions and can lead to more severe symptoms. people with obesity are also less likely to receive treatments for other health issues, as physicians are less motivated to treat them, says wharton.