The Canadian Medical Association defines obesity by health and not just weight.

The updated clinical practice guidelines for obesity from the Canadian Medical Association takes a more wholistic approach to health than the previous version from 2006. While still using the BMI (Body Mass Index) and waist circumference, it acknowledges their limitations and says doctors should focus on how weight affects a person’s health and on patient-centred outcomes rather than the number on the scales. It also hits out strongly at weight-related stigma and the blame and shame this directs toward people living with obesity, and the way weight bias impacts how health professionals treat obese people including outright discrimination.

The new guidelines recommend a patient-centred approach of compassion and empathy rather than care based on the belief that a person has no willpower or personal responsibility. This change is in response to scientific progress in the understanding of biology and physiology of obesity. Instead of giving the simple advice to ‘eat less and move more’, the guidelines recommend an individualised approach to improve eating habits and increase physical activity as well as other supports such as psychological therapy, and medication and bariatric surgery.

They recommend individual medical nutrition therapy with a dietitian, and a non-dieting approach to improve quality of life, psychological outcomes, cardiovascular outcomes, body weight, physical activity, cognitive restraint and eating behaviours.