news & trends

Tag Archives: weight

Body Weight Words Matter! Reflecting on the New Canadian Adult Obesity Clinical Practice Guidelines

Posted on
Reply

For most people their body weight is a personal issue. However people living in larger bodies face hurtful stigma including language surrounding obesity and overweight.  Developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, the new Canadian Adult Obesity Clinical Practice Guidelines represent the first comprehensive update in Canadian obesity guidelines since 2007.[1]

Decades of research in behavioral and nutrition science suggest that it’s time to update our clinical approach and recognize that some patterns of communication about body weight are more helpful than others. Registered dietitians are deeply involved in this discussion and here are some of the topline messages from leading experts that stood out to us:

  1. Body Mass Index (BMI) is NOT an accurate tool for identifying obesity related complications [2]
    BMI is a widely used tool for screening and classifying body weight but it’s been controversial for decades.  A person’s BMI number is generated by considering their height in relation to their weight and it tells us about the size of the person’s body.  Experts now agree that more information than BMI is needed to determine whether a person is sick or healthy.
  2. Patient-centered, weight-inclusive care focuses on health outcomes rather than weight loss 1,2
    Remember to ask permission before discussing body weight and respect the person’s answer. Health issues are measured by lab data and clinical signs. These can include blood pressure, blood sugar or reduced mobility. Shift the focus toward addressing impairments to health rather than weight loss alone.
  3. Obesity is NOT simply a matter of self-control and the ‘eat less, move more’ advice is insufficient1
    The effects of a dieting lifestyle are burdensome. Evidence-based advice must move beyond simplistic approaches of ‘eat less and move more’. For example, in recent years researchers gained a better understanding of clinical evidence and body weight biology. These include the amount of food energy absorbed through the gut, the brain’s role in appetite regulation and the thermic effect of eating.[3] Environmental factors such as where people live, work and food availably also have an influence on body weight.
  4. People of higher weights should have access to evidence informed interventions, including medical nutrition therapy
    There is a lot of misinformation about body weight so evidence-based health management is key. One of the recommended interventions is to include personalized counselling by a registered dietitian with a focus on healthy food choices and evidence-based nutrition therapy.
  5. Recognize and address weight bias and stigma
    People with excess body weight experience weight bias and stigma. Weight bias is defined as negative weight–related attitudes, beliefs and judgements toward people who are of higher weight. This thinking can result in stigma which is acting on weight-based beliefs such as teasing, bullying, macroaggressions, social rejection and discrimination towards people living in larger bodies. People may also internalize weight stigma and criticize themselves or others based on body weight.
    Experts consider that changes to language can alleviate the stigma of obesity within the health-care system and support improved outcomes for both people living in a larger body and for the health-care system. 3,[4],[5],[6]

In our Body Weight Words Matter! chart below we provide several examples of communication interventions to help assess your attitude and reduce body weight bias. Body Weight Words Matter INFOGRAPHIC N4N (Click here to download your copy of the PDF Body Weight Words Matter INFOGRAPHIC N4NN ) Body Weight Words Matter

References:

[1] Obesity Canada (2020) Canadian Adult Obesity Clinical Practice Guidelines (CPGs) https://obesitycanada.ca/guidelines/

[2] Obesity Canada (2020) CMAJ Obesity in adults: a clinical practice guideline https://www.cmaj.ca/content/cmaj/192/31/E875.full.pdf

[3]   Rubino et al. (2020) Joint international consensus statement for ending stigma of obesity. Nature Medicine  www.nature.com/medicine

[4] Obesity UK (2020) Language Matters: Obesity https://cdn.easo.org/wp-content/uploads/2020/07/31073423/Obesity-Language-Matters-_FINAL.pdf

[5] Puhl, R. et.al (2016) Cross-national perspectives about weight-based bullying in youth: nature, extent and remedies. Pediatric Obesity,

[6] Puhl R., Peterson J. L., Luedicke J. (2013). Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. Int. J. Obes.  https://www.nature.com/articles/ijo2012110

Healthy Diets & Weight – Highlights from the Canadian Nutrition Society Conference

Posted on
Reply

Highway Signpost Image with Health related wording

With the start of the new year, there’s always a buzz about diets and weight.
But what is really fact and what’s fiction? At the annual thematic conference of the Canadian Nutrition Society, researchers, physicians and dietitians shared their perspectives to deepen our understanding of this complex topic. Here is just a snapshot of our top takeaways from the event.

Links Between Mental Health and Obesity: from Biology to Behaviour
– Valerie Taylor, MD, PhD, FPCP, Professor & Chair of Department of Psychiatry, University of Calgary

  • Mental illness such as bipolar and depression is linked with a 25-45% higher chance of obesity.
  • Late night sleeping leads to short sleep duration, which is associated with obesity. Reducing sleep by 2 hours lowers the levels of leptin (the hormone which makes us feel full). At the same time, levels of ghrelin increase (the hormone which makes us feel hungry).
  • Sleep loss is a new risk factor for insulin resistance and type 2 diabetes.

Diets and Body Weight Management: Trying to Make Sense of it All
– Eric Doucet, PhD, Professor, Faculty of Health Sciences, University of Ottawa

  • Calories still count in weight loss. Either you manipulate the macronutrients or restrict the caloric intake.
  • It’s very challenging to keep the weight off. Very often, most if not more of the weight lost is gained back over time.
  • Doucet’s research found that for every kg of weight loss, a person’s appetite increased by 100 calories per day.

Weight Loss and Client Centred Care: Perspectives in Nutrition Counselling
– Andrea Miller, MHSc, RD, Consulting Dietitian

  • When it comes to weight loss, most people are looking for a simple solution to a very complex problem.
  • Practice nutrition counselling without blame or judgement. Even dieting can sometimes improve a person’s nutrition and mindful eating behaviours.
  • Understand and listen to your client’s story about their weight and their relationship with food.

Turning the Tide with Health at Every Size – Time for Change
– Maria Ricupero, RD, Certified Diabetes Educator, Toronto General Hospital

  • Weight stigma includes: negative weight-related attitudes/beliefs/ assumptions/attitudes; unequal/unfair treatment of people due to their weight; social stereotypes and misconceptions about obesity.
  • Health at Every Size (HAES) is about: weight inclusivity, size acceptance, self-acceptance, body respect, well-being and healthy day-to-day behaviours whether weight changes or not.
  • Change the culture around weight rather than change our bodies. There can be health benefits without weight loss.

Kids on Diets: How the Culture of Fad Diets Influences Parental Feeding and Children’s Eating Behaviours
– Jess Haines, PhD, MHSc, RD, Associate Professor of Applied Nutrition, University of Guelph

  • Parents feel stigma when they have a child with overweight or obesity. 75% of these parents say that other family members make comments to them about their child’s weight. And 89% of these parents report negative feelings about themselves such as “I feel less of a mom.”
  • Focus on healthy behaviours for kids, not their weight as an outcome.
  • Healthy habits for kids include: Eat more meals together as a family, with the TV off; Set a bedtime routine aiming for 11 hours of sleep; Remove the TV from the room where your child sleeps; Limit TV time to less than 2 hours per day.

Written by: Sue Mah, MHSc, RD, PHEc, and Lucia Weiler, BSc, RD, PHEc
– Co-Founders of Nutrition for NON-Nutritionists, nutrition experts and trailblazing dietitians who love food!

Questions, Comments? Contact Us

Intermittent Fasting – the new weight loss trend?

Posted on
Reply

Clock made of spoon and fork, isolated on white background

Fasting has been practiced for centuries around the world, typically for religious reasons. Now, intermittent fasting is becoming a trendy way to lose weight. But does it really work and should you try it?

There are a few variations of intermittent fasting:

Alternate day fasting was researched by Dr. Krista Varady who is an Associate Professor of Nutrition at the University of Illinois in Chicago. The idea is to alternate back and forth between eating about 500 calories one day and then eating a moderate high-fat diet the next day. In her research trials, she found that adults lost an average of 11 pounds in 12 weeks. Plus, the alternate day fasting lowered the participants’ levels of the “bad” LDL (Low Density Lipoprotein) cholesterol which helps to lower their overall risk for heart disease.

The 5:2 fasting diet is a modified version of the alternate day fasting diet. The general idea here, according to proponent Dr. Mark Mattson, is to eat no more than 500 calories on two non-consecutive days each week. On the other five days of the week, you can eat your usual diet. Mattson is a Professor of Neuroscience at the John Hopkins University. In his research, overweight and obese women who followed the 5:2 diet for six months lost just slightly more weight than women who were following a low calorie diet. Mattson is now exploring whether this diet can help improve brain health in seniors.

Time-restricted eating is another type of intermittent fasting where you only eat during a small window of time. This includes ideas such as a longer nighttime fast (for example, not eating from 7 pm to 6 am) or eating just one big meal a day instead of three typical meals. Animals who fast in these ways do lose weight, but there are hardly any scientific studies with people.

Here’s our advice:

1. Intermittent fasting is not easy. In fact, 10 to 20% of participants who try intermittent fasting find it too difficult and quickly stopped. Those who stick with the diets admit that it is very challenging for at least the first few weeks.
2. Intermittent fasting isn’t a miracle weight loss cure. The studies show that you can lose about the same amount of weight whether you fast intermittently or just cut back on calories every day.
3. Intermittent fasting is NOT for everyone. For example, if you are pregnant, underweight or have type 2 diabetes, then intermittent fasting is not suitable and can be dangerous for you.
4. The best “diet” is the one you can stick with for the rest of your life. Healthy eating is about enjoyment, not deprivation. If you’re interested in trying intermittent fasting, perhaps start with the least extreme option of extending your nighttime fast. Think of the motto “Done after dinner.” Eat your dinner and then skip any bedtime snack. Refuel with a good breakfast in the morning.
5. Talk to a registered dietitian for safe and expert advice on diets and weight loss.

“Eat Less, Eat Better”…is it that simple? Rethinking our message about healthy eating and obesity

Posted on
Reply

 

Will we solve the obesity crisis by simply telling people to “eat less and eat better”? A one-day health professional forum was held in Toronto on April 28th to rethink our messages about food and obesity. The event featured key leaders in obesity research/treatment and health communications:

  • Dr. Ayra Sharma (Chair for Obesity Research and Management, University of Alberta)
  • Ted Kyle (Founder, ConscienHealth)
  • Sue Mah (President, Nutrition Solutions and Co-Founder, Nutrition for NON-Nutritionists)

Here’s what these experts were saying…

 

Dr. Ayra Sharma
Chair for Obesity Research and Management, University of Alberta

  • Obesity is a complex chronic disease.
  • Simplistic messages about obesity are misleading, can promote unhealthy weight obsession and promote bias and discrimination.
  • Prevention and intervention strategies should focus on improving health behaviours rather than on just changing body weight.

Ted Kyle
Founder, ConscienHealth

  • Use respectful, people-first language that is free of bias and stigma – e.g. “unhealthy weight” or “high BMI” instead of “fat” or “morbidly obese”.
  • “Obese” is a harmful label. “Obesity” is a disease.
  • Shift the conversation from “being obese” towards health.

 

Sue Mah
President, Nutrition Solutions and Co-Founder, Nutrition for NON-Nutritionists

  • “Eating better” means cooking, eating together and enjoying food.
  • Consumers are bombarded with food/nutrition messages that simply don’t “have the scientific muster to present as fact” (quoting Dr. Oz here!)
  • Health and nutrition communications needs to be creative to capture consumers’ attention.
  • From celebrities and chefs to dietitians and politicians, everyone has a role in being a champion for change.