Obesity Canada updates clinical practice guidelines with new info on medical nutrition therapy and pharmacotherapy

Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons have released an update to their Canadian Adult Obesity Clinical Practice Guidelines (CPGs) which were originally launched in August 2020. The updates to the guidelines focus on information on two key paradigms for obesity treatment, namely medical nutrition therapy and pharmacotherapy. “The literature search and evidence synthesis for the guidelines was a labour-intensive and time-consuming task, and so our original date range for assessing peer-reviewed papers was January 2006 to June 2018,” Dr. Mary Forhan, scientific director for Obesity Canada and associate professor and chair of the Department of Occupational Science and Occupational Therapy at the University of Toronto, said in the release. “There is heightened interest in obesity research today, and we felt that there were enough new publications in pharmacotherapy—coinciding with the approval of a fourth obesity medication in Canada—and medical nutrition therapy to warrant updates to these chapters.” While the authors of the medical nutrition therapy chapter did not make changes to the current recommendations, they did update the list of references available on two areas: use of partial meal replacements and intermittent fasting. As for the pharmacotherapy chapter, the authors did update recommendations. The guidelines now include a fourth drug now approved in Canada for obesity management: semaglutide 2.4mg As well, they added new recommendations on using pharmacotherapy combined with health-behaviour changes in certain circumstances. These included treating those with “obstructive sleep apnea and BMI ≥ 30 kg/m2 for weight loss and associated improvement in apnea-hypopnea index and ii) treat people living with non-alcoholic steatohepatitis (NASH) and overweight or obesity for weight loss and improvement of NASH parameters.” Also in the pharmacotherapy chapter, another new recommendation “suggests that metformin and psychological treatment (such as cognitive behavioural therapy) should be considered for prevention of weight gain in people with severe mental illness who are treated with antipsychotic medications associated with weight gain.” The chapter also has new sections on how obesity medications affect cravings and quality of life. It also includes information on medications that are still in their emerging stage, like tirzepatide and setmelanotide.

Obesity Canada updates clinical practice guidelines with new info on medical nutrition therapy and pharmacotherapy

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