Measure waistlines, new obesity guidelines urge doctors

Doctors should use tape measures in addition to stethoscopes and other diagnostic tools to fight the growing problem of obesity in Canada, according to a new report issued Monday.

Measuring and recording waistlines in addition to heights and weights will help health providers aid overweight Canadians in their fight against fat, according to Obesity Canada, which put together the 120-page report, Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children.

The guidelinesare being called the first in Canada to provide a comprehensive, evidence-based framework for health-care professionals and policy-makers to battle obesity and the diseases that arise from it, notably heart disease and Type 2 diabetes.

"We need to talk about the waist circumference measurement as a new 'vital sign,"' said Dr. David Lau, president of Obesity Canada, a non-profit organization dedicated to dramatically reducing the number of overweight and obese Canadians.

Under the guidelines, a waistline of more than 94 centimetres (37 inches) for a man and 80 centimetres (32 inches) for a woman should be considered a risk factor for cardiovascular disease and Type 2 diabetes.

Modest weight loss helps

Almost two-thirds of Canadian adults are overweight and almost one-quarter obese, said Lau, an endocrinologist and a professor of medicine at the University of Calgary. Among children, one in four is overweight and one in 10 obese.

CherylHarvey,who weighs 167 kilograms, told CBC News she welcomed the new guidelines.

"It's been a life-long battle, something I need medical help with," she said.

The payoff in terms of health benefitskick inafter losingfive to seven per cent of weight,studies show.

Doctors are also now seeing obesity occurring in children at an alarming rate, Lau said Monday in Calgary. He noted that endocrinologists are seeing overweight and obese teens with health conditions that at one time were seen primarily in adults, including diabetes, high blood pressure and high cholesterol.

Rising tide of obesity

"We're now seeing Type 2 diabetes, previously a typical disease of the 40s and 50s in men and women, now we're seeing this in teenage girls and as young as six years of age," he said, adding that today's children are facing a life expectancy shorter than their parents' if the rising tide of obesity isn't dealt with now.

"The way I see it is the personal and societal consequences of inaction on obesity can no longer be ignored."

Children may sit in front of TV, computer and video game screens for four hours a day, but the guidelines recommend reducingthe timeto two hours.

Some otherkey recommendations forhealth providersfrom the report include:

• Starting at age 10,overweight or obese Canadians should have theirfasting glucose, cholesteroland blood lipids measured and tracked.
• Screen patients for depression, eating and mood disorders. Assess readiness to change and barriers to weight loss.
• Devise lifestyle modification plan with patient and, when appropriate, family members.

However,one expert expressed some concernabout therecommendations.

"There's an enormous amount of weight prejudice in our society, and my concern about this study is that this will exacerbate that," said Merryl Bear, director of Toronto's National Eating Disorder Information Centre.

Obesity should be seen as a chronic condition that needs a long-term approach not a cosmetic one, agreedDr. Arya Sharma, one of the authors of the report and executive director of theCanadian Obesity Network in Hamilton.