Obesity has long been misunderstood and stigmatized as a lifestyle condition instead of a complex disease, said Rami Halabi, a medical science liaison with Novo Nordisk, during a webinar hosted by Benefits Canada and sponsored by Novo Nordisk in November.
The condition isn’t just a measure of size, but a progressive, relapsing chronic disease characterized by excess body weight, which ultimately impairs an individual’s health. “It’s much more complex than the result of eating more and moving less,” he said, citing factors such as genetics, psychology, environment, social inequalities and medication.
Read: Evidence-based treatments key to effective obesity management
Obesity is associated with a range of comorbidities and complications, including asthma, cancer, cardiovascular disease, incontinence, infertility, knee osteoarthritis, type 2 diabetes and sleep apnea. There’s also a bi-directional relationship between mental health and obesity — for example, someone diagnosed with depression might be predisposed to developing obesity and vice versa.
Reducing weight by just five per cent can lead to improvements in hypertension, while weight loss of more than 15 per cent can lead to improvements in cardiovascular disease, noted Halabi. However, he also said reduced weight can be difficult to maintain due to a phenomenon known as metabolic adaptation, in which the body resists weight loss at a hormonal level. It reduces fullness hormones and increases hunger hormones to promote weight regain.
“Our brains are quite primal in nature and respond to weight loss by trying to prevent starvation and boost weight regain.”
Clinical practice guidelines are a blueprint for medical management of obesity, he said, noting these guidelines address the drivers of obesity and include evidence-informed recommendations, such as medical nutrition therapy, pharmacotherapy, physical activity, psychological interventions and surgery. While lifestyle recommendations related to medical nutrition and physical activity are the cornerstone of obesity management, Halabi noted they can sometimes be insufficient.
Read: Applying chronic disease principles to supporting plan members with obesity