Thursday, Oct. 19
14:30 – 16:30 (2 hrs)
Meeting Room: Junior Ballroom AB (3rd floor – North Tower)
Sri Mahavir Agarwal*, MBBS, MD, PhD; Sanjeev Sockalingam, MD, MHPE, FRCPC; Stephanie Cassin, C.Psych.; Raed Hawa, MSc MD FRCPC DABSM
Supported by the Psychosomatic Medicine Section

CanMEDS Roles:

1. Medical Expert
2. Scholar
3. Health Advocate

At the end of this session, participants will be able to: 1) Review the prevalence, pathophysiology, and approach to the assessment of obesity in mental health; 2) Understand the pillars of obesity treatment, including the role of behavioural interventions, pharmacotherapy, and surgery; and 3) Appreciate how a data-driven algorithmic approach can inform and improve the mamagement of obesity in mental illness.

Obesity is a growing public health concern in Canada. Obesity and mental health have a complex relationship, and mental health professionals are increasingly faced with challenges in treating psychiatric illness that are complicated by obesity and related metabolic health concerns. Importantly, metabolic dysfunction can compromise adherence with treatment, leading to poor mental health outcomes. In spite of the clear importance of metabolic health, rates of treatment for metabolic comorbidities remain low. This course will therefore discuss the relation between obesity and mental health and provide an in-depth review of clinical tools available to clinicians to address this complex problem.
Presenter one will discuss the prevalence of obesity in mental health and provide an overview of the pillars of obesity treatment, including behavioural and nutritional interventions, pharmacotherapy-based approaches, and the role of surgery. Presenter two will focus on the clinical assessment of obesity and comorbid respiratory and non-respiratory sleep disorders. Presenter three will provide an overview of evidence-based cognitive-behavioural therapy (CBT) interventions for obesity, including psychoeducation, goal setting, self-monitoring, adopting a routine of regular eating, problem solving, and challenging maladaptive thoughts and will discuss the effect of CBT interventions on improving disordered eating and psychological distress. We will discuss the application of data-driven algorithmic pharmacological approaches to managing obesity in people with severe mental illness. Finally, we will review the role of bariatric surgery for obesity management in people with mental illness. Guideline-related resources, including Obesity Canada toolkits and additional resources developed by the presenters will be shared.

References:

1. Wharton S, Lau DCW, Vallis M, et al. Obesity in adults: a clinical practice guideline. CMAJ 2020;192(31):E875–E891.
2. Taylor H, Hensel J. Multimorbidity: a review of the complexity of mental health issues in bariatric surgery candidates informed by Canadian data. Can J Diabetes 2017;41(4):448–452.