Obesity usually negatively affects a persons health and wellbeing for life -the only exception being a successful bariatric operation (gastric bypass, sleeve gastrectomy); however bariatric patients also need life long health check-ups.
This puts extensive demands on the health care of an obese patient, you need to assess the whole person and have a potentially life long perspective when doing it.
Our health care systems are often too subdivided and fragmentized for this to work; an obese person may be in contact with family physician, obesity unit, diabetes care unit, sleep apnea unit, perhaps bariatric clinic. You may end up attending several of these in parallell. Rarely do the different units communicate with each other in an effective manner, a lot of responsibility is placed on the individuals themselves.
Medical Weight Management Centre
Last spring I got a tip from a friend about a clinic that treats obesity with a more holistic approach to the problem -Medical Weight Management Centre (MWM) in Coquitlam/Vancouver, B.C., Canada. The centre is led by Dr Michael Lyon. Mid December 2017 I made a very interesting study visit:
The clinic services the entire British Columbia (pop. 4,5 million) and accepts referrals from family physicians, currently they have approx. 3000 patients enlisted in the different programs. The first year as a patient is intense. You attend physician appointments every three months. Here your entire obesity-related health situation is addressed -it may mean keeping a food diary, being put on modern weight loss medications, optimizing blood pressure, diabetes or sleep apnea with CPAP. Parallell to this you follow the clinic’s group session program -on average one evening group session weekly 40 of the first 52 weeks. During my visit one session topic was “Handling the Holidays”, with the food challenges of Christmas and New Year’s on the horizon.
The group sessions cover everything from nutrition, physical exercise and weight physiology to daily life cognitive behavioural therapy (Living Life To The Full, developed by Dr Chris Williams, Glasgow, Scotland). Patients considered suitable for obesity surgery will after 3-6 months in the general program start to attend specific bariatric surgery focused group sessions. When deemed ready, the patients are then transferred to a cooperating bariatric clinic in nearby Richmond. After surgery and the initial 6 months of postoperative check-ups, the patient comes back to MWM and continues their care there -for life.
Reach your best weight!
The goal of all patients -regardless of having surgery or medical treatment -is the reach their Best Weight. What is this then? It is the weight you reach while living the healthiest lifestyle you can truly enjoy.
For some, best weight will mean not gaining any more weight (often only diet and exercise regimes), for others a moderate (diet plus weight loss medication) or pronounced weight loss (bariatric surgery). Focus is on how you feel and live, the weight is only measured if and when you ask for it yourself. After the intensive first year you are then welcome to continue attending sessions and check-ups for as long as you wish.
Utopia? Yes, apart from the fact that this centre already exists and is up and running! We will try to keep in touch with MWM (and I also introduced our app BariBuddy to their staff, so hopefully we can benefit from our experiences both ways), follow us via this blog.