How do we help people who struggle with excessive weight without fat-shaming?

We are constantly bombarded with conflicting messages about our weight.

In an image-obsessed, finger-wagging culture where yoga pants don’t come in plus sizes, being overweight is seen as a sign of laziness or being undisciplined.

Even if we don’t want to have perfectly crafted abs or run a marathon, every advice column about living a long life reminds us that we need to exercise and follow a healthy diet. The message is that our destiny is our own responsibility.

A third cultural narrative is that we should embrace our bodies, no matter how much we weigh. Performers such as Lizzo are justifiably celebrated for their love-me-as-I-am message of affirmation and self-acceptance. To talk otherwise is to risk accusations of fat-shaming.

Dr. Michael Lyon says it’s time for a new approach — identify the barriers to living our best lives and take a scientific approach to overcoming them. Being “skinny” is not the goal. It’s about being healthier.

“The worst thing about obesity is the bigotry, bias and stigma,” says the medical director of the Medical Weight Management Program. “That needs to be done away with. People need to say this is no longer acceptable.

“But,” he adds, “we also have this obesity epidemic that’s catastrophic for people personally and for our healthcare system. We need to look at obesity as a disease and develop a disease model. We need government resources for accepted treatments because this is not something people can fix on their own.”

The Coquitlam clinic creates a safe, non-judgemental environment. There’s no pressure to reach certain milestones. Instead, the medical, nutrition, exercise and mental health professionals help patients understand what’s really holding them back from making positive changes. It might be a medical or metabolic problem, or challenging issues such as sexual abuse, mental illness or food addiction.

“Everyone is an individual. We start by listening to their story,” Lyon says. “The old-fashioned idea that you can somehow do a medically supervised diet and that’s enough is no longer considered scientifically valid. It’s an overly simplistic approach.”

Multiple factors can lead to obesity. It could be childhood trauma, depression, an anxiety disorder or an inability to cope with stress. People might not have had exposure to healthy food choices and rely on packaged or restaurant foods.

“If you start by really evaluating a person thoroughly and understand the complexity of their problem, you can help them through a multi-disciplinary approach,” Lyon says.

Lyon’s story is that he was born overweight and started life as a heavy kid in an era when this was quite unusual. His mother, who died early as a result of complications from diabetes, was a gourmet chef who owned a catering company and loved sharing food.

“I was the only heavy kid in school,” he says. “I was teased a lot and excluded from most things. It was not a very happy childhood in many ways and I became very introverted and solitary. Then, when I was a teenager I got really sick and lost a lot of weight. When I went back to school, I was treated like a normal person for the first time in my life.

“I went into medicine because I want to help people who are prisoners in the same situation that I was. I was fortunate enough to escape but it’s a way of life that you keep working on every day. Weight loss alone doesn’t fix a serious weight problem.”

Sometimes patients choose bariatric surgery. “People have the idea that this is the easy way out but that’s not at all the case. Our patients undergo extensive preparation before we refer them for government-funded surgery and the surgical program accepts them with a minimal wait time because they know that our patients are ready to get the maximum benefit from the procedure.”  

At the Medical Weight Management Program, patients become part of a community of change.

“Our primary objective is to try to teach people to fall in love with the healthiest lifestyle possible. Through that they’re going to be able to embrace a healthier diet, a better relationship with food, better mental health and self-esteem regardless of their weight,” Lyon says.

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