FIGHTING OBESITY IS MORE COMPLEX THAN ‘CALORIES IN; CALORIES OUT’
Obesity canbe conquered with the right support
Dr. Kristin Terenzi has made it a mission to help patients overcome the stigma and the challenges of dealing with chronic obesity.
The Woodbridge- based family doctor takes the obesity challenge personally. “I struggled with weight gain for over 20 years,” she says. “I would try to lose weight and then it would all come back and then some. It was so discouraging.”
Like many women, losing weight became an even bigger challenge after going through menopause. “I was constantly on diets and tried every kind you could name. I realized after gaining even more weight during menopause that I couldn’t do it that way anymore.”
She also tended to avoid social occasions when her weight increased. “The thought of having to dress up to go out ate away at my self- confidence. In a perfect world we wouldn’t attach self- esteem to weight. But that’s certainly not the case.”
Obesity is more than a social or self- esteem issue. It can put one’s health at risk. Excess weight has been associated with a number of other conditions, including osteoarthritis, diabetes, heart disease, high blood pressure, depression, and even cancer.
Obesity was affecting her own health, Dr. Terenzi says. “I have pretty significant arthritis in my knees. I love to shop, but wasn’t able to get through the mall without having to stop. Then my back started to hurt.”
Contrary to what many might think, maintaining a healthy weight is far more complicated than eating less and exercising more, she stresses. Another challenge is that people tend to blame themselves for the issue.
A recent Obesity Canada study shows that 74% of people living with obesity think the management of their condition is their sole responsibility. “They don’t believe doctors have any responsibility, but the reality is there are a lot of things they can do,” Dr. Terenzi says.
Available treatments fall into three categories, she explains. The first is combining dieting and exercising with cognitive behavioral therapy. “The therapy helps patients deal with the ‘ knee jerk’ desires for food, and retrains their way of thinking.”
Another option is pharmaceuticals in the form of medications that, when combined with a reduced calorie diet & increased physical activity can either help block the absorption of fat or regulate appetite and/or food intake.
Bariatric surgery is a third alternative for that may be considered for severely obese patients when behavioral therapy is not sufficient.
It’s also important to understand that there is no one treatment that fits all people, she notes. “Treatments can be different for every patient. For some, only diet and exercise will work, for others, a prescription may be added to help get them on track. In extreme cases surgerymay be the answer.”
Dr. Terenzi herself opted to use a combination of medications with cognitive behavioural therapy techniques – a method she now provides to the patients that need it. “I began to realize how much that supported approach changed my life. It was the first time I was able to get to a healthy weight that I have been able to maintain for more than three years. It turns out I just needed that extra help.”
Cognitive behavioral therapy is not as complicated as it sounds, she explains. “It’s finding out what your thoughts are around food and changing them. For example, when you go to eat something, learn to
ask yourself first if you are truly hungry or just want to eat that. If you are hungry, the next question is, is what you are choosing the best choice to stay healthy? If the answer is no, what can you eat that’s better for you?”
Her biggest frustration these days is the lack of awareness around obesity. Not everyone realizes that obesity is a chronic disease that is an epidemic in Canada and should be treated as such.
According to a 2017 study by the Public Health Agency of Canada, 27% of Canadian
adults are currently living with obesity, but according to the 2019 Report Card on Access to Obesity Treatments for Adults in Canada less than 20% of Canadians’ benefit plans covered anti- obesity medications.
One of the most significant hurdles is the fact that patients won’t discuss their obesity concerns with their doctors, she says. “They won’t talk about it because they feel ashamed and that their weight problem is all their fault. But obesity can be attributed to a number of
reasons - hormones, psychological issues, stress, long-established eating habits, or genetic factors to name a few.”
Having gone through the obesity struggle herself and finding light at the end of the tunnel, Dr. Terenzi now draws onher ownexperiences to treat others. “As a chronic disease, obesity is something you have to manage your whole life. There will be ups and downs, but a good doctor can be with you for the journey. A good first step is starting that conversation.”