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Open Access Highly Accessed Research article

Weight management in Canada: an environmental scan of health services for adults with obesity

Marie-Michèle Rosa Fortin1, Christine Brown1, Geoff DC Ball2, Jean-Pierre Chanoine3 and Marie-France Langlois14*

Author Affiliations

1 Centre de recherche clinique Étienne-Le Bel, Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada

2 Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada

3 Endocrinology and Diabetes Unit, British Columbia Children’s Hospital and University of British Columbia, British Columbia, Canada

4 Department of Medicine, Division of Endocrinology, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada

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BMC Health Services Research 2014, 14:69  doi:10.1186/1472-6963-14-69

Published: 12 February 2014

Abstract

Background

Obesity in Canada is a growing concern, but little is known about the available services for managing obesity in adults. Our objectives were to (a) survey and describe programs dedicated to weight management and (b) evaluate program adherence to established recommendations for care.

Methods

We conducted an online environmental scan in 2011 to identify adult weight management services throughout Canada. We examined the degree to which programs adhered to the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (CCPGO) and the analysis criteria developed by the Association pour la Santé Publique du Québec (ASPQ).

Results

A total of 83 non-surgical (34 community-based, 42 primary care-based, 7 hospital-based) and 33 surgical programs were identified. All programs encouraged patient self-management. However, few non-surgical programs adhered to the CCPGO recommendations for assessment and intervention, and there was a general lack of screening for eating disorders, depression and other psychiatric diseases across all programs. Concordance with the ASPQ criteria was best among primary care-based programs, but less common in other settings with deficits most frequently revealed in multidisciplinary health assessment/management and physical activity counselling.

Conclusions

With more than 60% of Canadians overweight or obese, our findings highlight that availability of weight management services is far outstripped by need. Our observation that evidence-based recommendations are applied inconsistently across the country validates the need for knowledge translation of effective health services for managing obesity in adults.

Keywords:
Obesity; Weight management; Bariatric surgery; Multidisciplinary team; Primary care