UAlberta researcher Mary Forhan at the bariatric symposium she organized. (Photo: Jeannine Guérette)
(Edmonton) Mary Forhan opens the discussion about treatment practices and persistent stigmatization around obesity in Canadian hospitals. Some of the leading obesity experts across Canada, who like Forhan are steeped in the challenges facing health-care professionals and patients, met on April 23 at the University of Alberta to confront the issues and share their knowledge and experiences in treating patients with severe obesity.
Hospital stays are twice as long for patients with severe obesity as the rest of the population. This problem, among many others, is one of the barriers Forhan and her colleagues hope to help solve.
"We want to develop a group that's committed to coming together to address some of the important challenges in bariatric care and rehabilitation for patients with severe obesity and to share ideas about safer patient care, better training for staff who work with patients who have severe obesity, and helping patients move through the health-care system more efficiently," said Forhan, an assistant professor of occupational therapy with the Faculty of Rehabilitation Medicine.
"We want to develop a group that's committed to coming together to address some of the important challenges in bariatric care and rehabilitation for patients with severe obesity." - Mary Forhan, Faculty of Rehabilitation Medicine
Equipment is another issue. Patients who have severe obesity and who are recovering from surgery with limited mobility need specialized wheelchairs, lifts and even toilets, not to mention hospital beds.
Symposium participants shared several stories related to bariatric care-stories of patients being transported to the hospital while riding on the ambulance's floor, patients being prevented from showering because the safety bar would not support their weight, or denial of surgery because of weight bias from surgeons.
"Weight bias is a real problem around people's perception about living with obesity, that people aren't motivated or are lazy," Forhan said.
"A lot of these stereotypes compromise a patient's safety. One of our goals with this group is to educate health-care professionals about the causes and consequences of obesity so that they can understand it as a complex health condition and not as a moral failure or lack of control for the patient."
At the U of A, Forhan and her colleague, Arya Sharma, chair of obesity research and management with the Faculty of Medicine & Dentistry, teach the only Canadian bariatric certification workshop in Canada. The workshop runs only when they receive enough participants, yet has accredited over 90 health-care professionals.
But what should patients know to ensure they have the best care possible, to be their own advocates?
"Ask the questions that health-care professionals aren't asking. Raise the issues that the health professional isn't raising," Forhan advised. "They may be looking for permission from patients that it's okay to talk about their condition. It's really important that patients are their own advocates in raising these issues."
Forhan said it's also important to have a fair amount of patience with health-care providers.
"A lot of times they are doing the best they can with the training and equipment they have."
The 20 health experts Forhan assembled for the bariatric symposium plan to develop a compendium of guidelines and resources to improve the quality of care and rehabilitation for patients with obesity throughout the health-care system.
The collaboration identified four key areas that require action: equipment and design, health system enablers, ongoing professional education and a continuum of care.
Forhan hopes focusing on these areas will help not only Edmonton-area hospitals, but also national health professionals provide better and more efficient care for patients with severe obesity.
"We will continue to work as a Canadian group to develop this resource and will expand our network as needed or as interest in our work grows."