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updated obesity treatment guidelines emphasize understanding and access to care
"we need to focus on reducing barriers to treatment and focus on safe treatment for patients and not just having access to care, but access to comprehensive, safe, holistic care"
5 minute read
access to care for obesity hasn’t always been an option, as up until recently, society and even people in the medical community didn’t treat it or classify it as a chronic medical condition.
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over 30 per cent of the canadian population now lives with obesity, a complex and multifactorial disease that can affect a person’s overall health. that number has grown significantly in recent years, as well. in 2009, only eight per cent of people were affected.
due to research and advancements in the area of obesity medicine, the incorrect and widely-accepted narrative that it was a personal failure as opposed to a chronic disease is slowly being phased out.
that, along with the introduction of viable and valuable medications that can be added to the toolkit of therapy for people living with obesity, has led to an update to the current pharmacotherapy guidelines that will change the way people look at obesity medicine and what proper care looks like for each unique individual who develops obesity. the updated guidelines were published in the canadian medical association journal in august 2025.
updating guidelines to reflect the truth about obesity
dr. andrea rowe, obesity medicine specialist and assistant medical director with felix, a fully integrated healthcare platform, notes that the guidelines are constantly “evolving” with the science regarding obesity.
“when it is felt that there are significant changes in our understanding or our treatment of obesity, the guidelines are updated,” she said. “the medication treatment section of the guidelines was recently updated and so that is important because for so many years, obesity treatment was only lifestyle management. we didn’t have a lot of pharmacotherapy options available to us.”
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because many people believed that obesity wasn’t a chronic disease, but rather the result of poor lifestyle choices, medication wasn’t available. that said, “the understanding of obesity and how that works in our body and the consequences have evolved over time,” leading to a collection of different medications, such as glp-1 receptor agonists, dual gip and glp-1 receptor agonists, and fat-digestion blockers.
it’s not just medications that are changing regarding treatment. it’s also the understanding of individuals and how medications can and should be used for those who have obesity, which can cause other health consequences.
dr. rowe notes that the old guidelines looked at body mass index, more commonly known as bmi, as the main factor to determine whether a person would be approved to access obesity medications. but the disease is so complex, as is each case.
“the recommendation is to make sure that we’re taking into consideration gender and ethnicity-specific indications for treatment because we have found that people with different ethnicities and different genders have those medical complications of obesity at different sizes,” she said.
other factors that have gone into consideration to update the guidelines focus on not body size overall, but what the risk of complications is for each person living with obesity. for example, someone who lives with obesity but in a smaller body than someone else who has the disease may be more at risk of severe complications, even though they’re in a smaller body.
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“different body composition is associated with other medical complications,” said dr. rowe. “if you have a different body structure where you hold more of your adiposity or fat tissues around your abdomen, it’s more likely that you are going to have fat tissues around your internal organs, which causes more medical complications.”
today, treating obesity isn’t about following a chart and handing out medications based on a number, but rather creating a comprehensive treatment plan that takes into account an individual’s size, overall health, body composition and risk of complications. by creating this unique approach, people who were previously denied obesity medications may finally be able to access them without having to put up a fight.
improving access to care and reducing barriers in the obesity landscape
access to care for obesity hasn’t always been an option, as up until recently, society and even people in the medical community didn’t treat it or classify it as a chronic medical condition.
that, in and of itself, had been a significant barrier to care that amplified the stigma that people living with obesity were at fault, all while leaving them vulnerable to harmful comorbidities and health consequences.
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“we now understand that there are so many things that affect your body size, your energy balance, your appetite control, things like that,” said dr. rowe. “and for so many people, when that (lifestyle changes) wasn’t sufficient, we thought, what’s their problem? what’s wrong with the patient? why are they not doing this? and a lot of shame and blame and judgement, not just external but also internal. the patients were blaming themselves.”
dr. rowe notes that obesity should be treated no differently than heart disease, high blood pressure, or any other condition that emphasizes both lifestyle changes and medication for management. accessing care and adequate treatment requires medical providers who offer both pharmacological and lifestyle interventions.
“healthy eating, physical activity is important for everybody’s health, regardless of your body size and regardless if you have obesity,” she said. “with treatment of high cholesterol, some patients are able to manage that medical condition with those healthy lifestyle choices alone, and many are not, and that’s the same with obesity. not everybody requires medications for treatment, but many do, and we need to have patients be able to have access to a proper evaluation and assessment to be able to determine that.”
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because of the stigma associated with obesity, many patients have suffered in silence for years, only to now be able to reach out for help with their chronic disease.
dr. kelly anderson, family physician and medical director at felix, notes that at felix, 75 per cent of patients who inquire about care for obesity are doing so for the first time, which can play into the stigma that’s slowly lessening, as well as a lack of viable therapy options in the past.
however, now that obesity is being recognized for its complex nature, accessing care through programs like the one at felix or consulting with obesity medicine specialists is crucial. dr. anderson notes that it can extend far beyond family practice because that role is often inadequate for managing obesity.
“if they (patients) do have a family doctor, it can be very tricky to access them for non-acute medical concerns, because a lot of times, family medicine is just trying to address acute health concerns and more chronic concerns become less pressing, and that may be difficult to bring up something like this with your family doctor,” she said. “we see thousands and thousands more patients access our care for obesity. we’re making sure that all of our practitioners are extensively trained in the guidelines.”
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this isn’t to say that family physicians cannot help people living with obesity. according to dr. rowe, they are “in general becoming more and more comfortable with treating obesity,” but time and resource restrictions make it difficult for them to provide the multi-faceted approach that a specific care plan can offer.
“this is an exciting time in that we are finally at a stage where the science and treatments are evolving hand-in-hand, and in the past we were really starting to recognize it as a medical condition, but couldn’t really do much about it,” said dr. rowe. “now, patients have treatment options available to them, and we need to focus on reducing barriers to treatment and focus on safe treatment for patients and not just having access to care, but access to comprehensive, safe, holistic care.”
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