Nothing New in Guidelines from Canada
Image: William Warby on Unsplash. Image description: Two silver rulers and a yellow measuring tape are partially shown, one coming up from the bottom of the image and two coming down from the top.
Earlier this year a group of Canadian doctors published Obesity in adults: a clinical practice guideline, "intended to improve the standard of, and access to, care for individuals with obesity in all regions of Canada". The National Association to Advance Fat Acceptance (NAAFA) believes that, upon close examination, these guidelines present no new information and perpetuate the myth that fat bodies are diseased simply because they are fat.
These guidelines hinge on the premise that excess fat is a disease. Against the recommendation of their own scientific advisors, the American Medical Association declared "obesity" a disease in 2013. Now Canada is going down the same precarious path. Many experts believe this will further damage the already fragile relationship between physician and fat client.
"I don't think these people are aware of the utter disconnect between what they are doing and what would be helpful to us. I don't think they would be happy knowing how this situation undermines the power of the therapeutic alliance, our respect for them, and their chances of achieving their intention to actually support health. For us, it is profoundly troubling to have to rely on people who are defining simply aging in our bodies as evidence of our bodies being diseased," stated Dr. Deb Burgard, Psychologist and Fellow of the Academy for Eating Disorders, and NAAFA Advisory Board Member.
Some medical providers are beginning to accept the fact that diets don't work. Much of the public has also realized that their individual experiences of losing then regaining weight are not personal failures, but rather a feature of the weight cycling industry's business model. As the public wises up, the faltering weight cycling industry has had to convince doctors to be their marketing arm, propping up interventions that do not create lasting health or weight change in the long run for most people. By arbitrarily declaring a body size a disease, the money can keep pouring in because insurers are compelled to pay for "treatment," even though in this case it is generally ineffective.
The Canadian guidelines are an attempt to rebrand the same old thing with a dash of politeness. It is not supportive to health to keep prescribing failed treatments and then blame people for the health disparities that result. Real progress will come only when the medical profession turns its scrutiny on its own ghastly history of harm toward higher weight people and resolves to start over to do better, this time by actually listening to fat people.
NAAFA offers strategies to help healthcare providers offer the best possible care for their fat clients and help reduce health inequities created by weight stigma in our brochure, NAAFA Guidelines for Healthcare Providers with Fat Clients. Share it with your provider today!
