Obesity Canada updates the 2020 guidelines with new evidence-based recommendations on nutrition and emerging drug therapies.
Tailor dietary approach to individual cultural and financial situations to promote long-term adherence.
Involve a registered dietitian where available to optimize weight and health outcomes.
The best dietary pattern and food-based approach is one that supports long-term adherence and supports target individualised health goals (i.e., LDL, blood pressure, A1C).
Target 7-15% weight loss in adults with obesity and diabetes for potential remission of type II diabetes.
Including non-diet-based strategies can improve well-being and quality of life.
Consider pharmacotherapy in those with BMI >30 or BMI >27 with obesity related complications.
There are 4 medications approved by Health Canada for obesity: liraglutide 3mg (Saxenda®); naltrexone / bupropion (Contrave®); orlistat (Xenical®); semaglutide 2.4 mg (Wegovy®).
Pharmacotherapy alongside health behavior changes improves obesity related complications including prediabetes, diabetes, obstructive sleep apnea (OSA), and nonalcoholic steatohepatitis (NASH) (terminology was changed since the guideline was published: changed to Metabolic Associated Steatotic Liver Disease).
In patients with psychiatric illness using anti-psychotic medications, consider metformin given metabolic side effects.
Stay tuned for emerging pharmacotherapy options like Tirzepatide (Approved by Health Canada in November 2023 as a treatment for diabetes), Cagrilintide and Setmelanotide (Approved by Health Canada in 2023 as a treatment for certain gene-related severe obesity) on the horizon!
Obesity Canada's updated guidelines focus on personalized nutrition, registered dietitian involvement, and pharmacotherapy for effective obesity management, with promising new treatments on the horizon.
References
Pedersen SD, Manjoo P, Wharton S. Canadian Adult Obesity Clinical Practice Guidelines: Pharmacotherapy for Obesity Management. Version 2, October 21, 2022. Available from: https://obesitycanada.ca/guidelines/pharmacotherapy
Brown J, Clarke C, Johnson Stoklossa C, Sievenpiper J. Canadian Adult Obesity Clinical Practice Guidelines: Medical Nutrition Therapy in Obesity Management. Version 2, October 21, 2022. Available from: https://obesitycanada.ca/guidelines/nutrition