Montreal – The new guidelines developed in partnership with Obesity Canada to supervise the care of young people have been designed to promote dialogue between the various stakeholders, a Montreal scientist who participated in the Canadian press has participated in their development.
The objective, said Doctor Mélanie Henderson, who is a pediatric endocrinologist at the Sainte-Justine CHU, is in particular to ensure that young people and their families have access to the best scientific evidence, in a language that is accessible to them, in order to be able to participate in decision-making with clinicians.
“At each stage, we had clinicians, researchers, but also people who live with obesity or parents of teenagers,” she said. We even had a teenager who participated in various steps. It was very important to us that the patient of the patient and his family was heard. ”
The authors of the guidelines then wanted to know what possible result of this care The main interested parties attacked the most importance, whether mental health or physical health.
They could thus see that the parents want more than anything that their “children grow up, then flourish, then are well in their skin, then are happy,” said Docteure Henderson.
“This is what is most important to them,” she said.
Patients and their parents thus give “critical importance” to several aspects which concern mental health, while they deem at most “important” physical health criteria, such as hypertension or cholesterol levels.
It is therefore essential, continues Dr. Henderson, that there is a stowage between the interventions offered to patients and the results to which they attach the most importance.
Ten recommendations, nine statements
The published guidelines released this Monday by the Canadian Medical Association Journal are therefore made up of ten recommendations and nine statements of good practice.
Five recommendations concern behavioral and psychological interventions, in particular with regard to nutrition and physical activity; three concern pharmacological interventions; And two concern surgical interventions.
“In our meta-analysis, we have found that structured and multiple component behavioral and psychological interventions had a positive effect on the quality of life of patients, with effects ranging from low to important,” write the authors.
In the document, completed Doctor Henderson, “it remains clear (…) that all children who have clinical obesity and who need intervention will benefit from an intervention to modify life habits, work on food, sleep (and) physical activity”.
The statements of good practice rather target clinicians. In particular, they are recommended to use a first -person language and to avoid using a negative or stigmatizing language; to admit that obesity is a complex, chronic and recurring health problem; And to discuss with children and families of their expectations in terms of improving health results.
Doctor Henderson is hopeful of seeing these guidelines come to change the way in which young people’s obesity is taken care of not only in Canada, but also internationally, since she confides that her colleagues and she has been approached by German officials who are interested in adapting their work to their reality.
The most important thing, hammered Doctor Henderson, is to encourage dialogue between nursing staff, patients and their families.
“The document is written in order to promote common decision-making,” she said. It will allow families to name their preferences, which they are ready or not to try. ”
For example, she says, “pharmacotherapy is not for everyone, and it’s correct, but at least we can offer treatment”.
And that will be there, hopes Dr. Henderson, the other usefulness of these new guidelines: allow specialists to put pressure on decision -makers in order to obtain, supporting evidence, the changes they consider necessary.
“We want to be able to plead in favor of our patients,” she said. We want to be able to say to the government, this is what science says. Now, how will we change our health system to allow young people who have clinical obesity can be treated adequately? ”
It thus cites restricted access to pharmacotherapy, which creates a cleavage between patients who are able, for example, to offer molecules which cost several hundred dollars per month and those who do not have the means, since these are not fees that are currently reimbursed by the government.
“Clinicians do their best, but you have to have an infrastructure to be able to welcome these young people and offer them the services they need,” she concluded.
