Northwestern Ontario Second-highest Obesity Rate

Sarah Miller is a Registered Dietitian at TBRHSC’s Bariatric Care Centre, which now offers a Medical Management Program.
Sarah Miller is a Registered Dietitian at TBRHSC’s Bariatric Care Centre, which now offers a Medical Management Program.

Sarah Miller is a Registered Dietitian at TBRHSC’s Bariatric Care Centre, which now offers a Medical Management Program.
Sarah Miller is a Registered Dietitian at TBRHSC’s Bariatric Care Centre, which now offers a Medical Management Program.

Obesity Rate in Northwestern Ontario Too High

THUNDER BAY – Healthbeat – Northwestern Ontario has the second-highest obesity rate in Ontario but until this year individuals living with obesity in the region did not have a lot of treatment options.

“There isn’t a lot out there for weight issues that isn’t fee-for-service,” says Sarah Miller, Registered Dietitian at Thunder Bay Regional Health Sciences Centre’s Bariatric Care Centre. “Our patients receive the benefits of an interprofessional model that we pride ourselves on.” Miller is part of an interprofessional team that includes an Endocrinologist, Nurse Practitioner, Registered Nurse, Social Worker, Psychologist, Kinesiologist and two Registered Dietitians.

TBRHSC Helps Fight Obesity

[sws_pullquote_left]“This patient-centred, self-management program is an excellent demonstration of patients receiving the right care in the right place at the right time” – Henderson [/sws_pullquote_left] Since opening in 2010, the Centre has provided pre-surgery assessments and post- surgical follow-up for patients with obesity or morbid obesity.

But as of January this year, the team has been able to offer patients a new Medical Management Program as an alternative to surgery thanks to $300,000 in funding from the Ministry of Health and Long-Term Care.  The program went live in February with its first participants, who are referred to the program by a nurse practitioner or physician.

The Medical Management Programs offer patients two components:  a 12-week cognitive behaviour program and a 26-week program including 12 weeks of meal replacement. Participants receive education and presentations on nutrition, assertiveness, stress, building supports and addressing barriers to a healthy lifestyle. Patients are asked to set goals and to keep a journal in which they record their physical activity, mood, and sleep. The group meets weekly to report progress as well as setbacks and to work together to offer advice and encouragement.

In the meal replacement program, patients who are under medical supervision consume four OPTIFAST shakes a day for 12 weeks. The product is high in protein and potassium and low in carbohydrates. At week 12 they start to gradually transition off the product and back to food. A dietitian regularly meets with the patient during this transition.

Built into the program is 6 months of maintenance support following completion. During this time the patient can drop in to the Centre for lifestyle or medical support.

Dr. Mark Henderson, TBRHSC’s Executive Vice-President, Chronic Disease Prevention and Management, calls the new program a milestone for healthcare providers and patients in Northwestern Ontario. “This patient-centred, self-management program is an excellent demonstration of patients receiving the right care in the right place at the right time,” said Dr. Henderson.

According to the Canadian Obesity Network, an individual is considered obese when his body weight is 20% or more over his desirable weight.

Weight-related health issues include sleep apnea, diabetes, hypertension, osteoarthritis, and joint problems. Many individuals living with obesity also experience bias and discrimination often due to negative stereotypes that persons with obesity are lazy, unmotivated or lacking in self‐discipline.

At the Regional Bariatric Care Centre, obesity is viewed as a chronic health issue. “We think of it as a complex, lifelong disease that requires management,” says Miller. “It’s about more than behaviour. There are a lot of physical and mental, and sometimes hormonal factors that contribute to an individual’s obesity.”

Miller says it feels good to now have a more comprehensive program. “In the past, we felt some patients pursued bariatric surgery because there were no other options. Before this program, we had limited options to suggest to patients. That wasn’t a great feeling because you want to help people. As a clinician, I feel better in terms of job satisfaction now that patients have more options.”

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