Sean Wharton at ECO2022

ECO2022: Putting People First Internationally in Obesity

With the opening of ECO2022 today, a talented team from Canada, Chile, and Ireland set an important theme. For years now, this team has been translating obesity care guidelines internationally to put people first. Not BMI. No more one size fits all.

It starts with Canadian obesity guidelines that emerged in 2020. The concept that drove these guidelines was to put people living with obesity at the center of the process for obesity care. That means that BMI became only one input into the process for diagnosing and describing the disease. Instead, what really matters in this context is the physical and psychological health of the whole person. Every person is different. So care must be tailored for diverse individuals.

The Harm Done by Putting BMI First

On so many levels, outdated ideas about obesity care did great harm by putting BMI first in defining obesity care. People became bound to BMI cutoffs for overweight and obesity that did not line up with the reality of differences in individual health and risk factors. Because different racial and ethnic groups experience health risks at different BMI thresholds, some people began to think that BMI was itself a tool for promoting bias.

Sean Wharton explained the medical rationale behind the Canadian guidelines. BMI is not the primary driver. But it is not absent either. It’s merely a clinical measure that can contribute to understanding a whole person who is living with obesity.

Translating the Guidelines to Diverse Nations

Almost immediately after Obesity Canada published their new guidelines, the innovation in those guidelines drew interest from obesity care professionals all over the world. So Obesity Canada launched a pilot project to help other nations adapt their guidelines to meet the unique needs of other countries. Ireland and Chile became the test beds for this.

Cathy Breen led the project in Ireland. Yudith Preiss described the process she helped to guide in Chile. Naturally, some of the concepts in the Canadian guidelines translated well into these new countries. Others were not so applicable. In each case, teams of people participated in the translation to these new countries.

Generalizations in obesity can indeed cause a lot of trouble. But the beauty of the the Canadian guidelines is that they revolve around the great diversity in lived experiences with obesity. So respect for diversity has turned out to be a key strength for helping with spreading the wisdom in these guidelines across national borders.

So we see a bright future for obesity care applying principles of diverse lived experiences around the world.

Sean Wharton at ECO2022, photograph by Ted Kyle / Conscienhealth

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May 4, 2022