Multidisciplinary Management
of Obesity and Related Disorders

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Our Mission:

Medical Weight Management Program provides an interdisciplinary, evidence-based, individualized, long-term approach to assess and treat patients with obesity.  Our team works together to improve the health and quality of lives of patients whose physical and/or psychological health is significantly impaired by their weight and where long-term weight management will play a central role in the reduction of cardiometabolic risk, the maintenance of mobility and of psychosocial well being.  

 This is not a cosmetic weight loss program and is only available to patients who require long-term weight management for significant medical and/or psychosocial reasons.

 We do endeavor to make this program universally accessible to patients of all socioeconomic backgrounds who have a clear need for our services. Apart from the patient's diet, which they mostly purchase at grocery stores, there are NO major costs required for participation in this program. Items such as the pedometers, therapeutic exercise bands, healthy eating plates, Living Life to the Full course material, and other items are not essential and may be made available at a cost or for free if these have been provided through our compassion program.  

 We do assess patients for their need and suitability for bariatric surgery and will refer patients to the Metabolic and Bariatric Surgery Centre in Richmond when deemed appropriate. We work closely with the surgical team to assist in the preparation of the surgical candidate and will continue to provide ongoing follow up for the patient after the immediate post operative period.

We do manage each patient’s medical, emotional and psychiatric conditions that have a direct bearing on their obesity and related disorders. In some cases, medications will be changed or adjusted if an appropriate substitute is available that does not interfere with successful weight management. We do assess many of our patients for sleep apnea and will prescribe CPAP or other treatments as appropriate. 

 

To the Family Physician:

We do not bill the Medical Services Plan using the Chronic Disease Management Incentives, Mental Health Incentives or the Complex Care Initiative Codes since each patient’s family physician will remain as the Most Responsible Physician for their patient’s longitudinal care. We do endeavor to communicate any medication changes, therapeutic milestones or diagnostic findings with the patient's family doctor. 

 We do not sell food products or supplements and we do not benefit financially from any referrals that we arrange. We may, from time to time, offer patients free samples of food products, medications or nutritional supplements as they become available and as we deem this to be appropriate. Other items are not essential but may be helpful for a patient, and are available at cost (again we do not benefit financially) such as pedometers, exercise bands, healthy eating plate, and other useful items. Most items are never mandatory and we may provide these items for free for those with financial constraints via our compassion program when appropriate and available. 

We do conduct clinical research and clinical teaching and patients may be given the opportunity to participate in studies from time to time. We only conduct research that has been approved by Health Canada and by UBC’s Clinical Research Ethics Board. Dr. Lyon is a UBC Faculty member and we do have students and medical residents in our facility for assistance in research and for training purposes.   

 

What does our program involve?

The Medical Weight Management program is open to patients whose health is significantly impacted by their weight.  Our clinic assesses and treats patients by physician referral only.  In order to be admitted to our clinic program, a patient's family doctor must determine that their health would significantly benefit from medically supervised, long-term weight management. 

After being referred, patients will be assessed by our medical team to review their medical, nutritional and behavioral background. This team will follow the progress of the patient for as long as the patient continues to come to the clinic. 

Our approach with obesity is based upon the "5-A's of Obesity Management" as described and taught by the Canadian Obesity Network. Our initial assessment of each patient involves determining not just a patient's BMI, but rather, the full impact that their excess weight has on their health, their psychosocial wellbeing and their mobility. Rather than focusing just on weight and BMI, we determine each patient’s stage of obesity based upon the Edmonton Obesity Staging System

This is a long-term, intensive lifestyle modification program with the bulk of visits take the form of in-person group medical visits, and not individual visits alone. 

 

That being said, we do receive referrals from physicians and work alongside patients from all over the province of British Columbia. These circumstances will involve additional costs as out of town patients are often unable to attend in-person group medical visits that are covered by MSP. These costs are there to cover non-MSP services such as dietitian visits, access to videos, and attending group medical visits via webinars.

All new patients to the program start by attending six weekly in-person group medical visits that provide an introduction to the program and lay the foundation of knowledge for the months and years ahead. After the initial, intensive six weeks, patients are invited to attend the regularly scheduled in-person group medical visits which are every second week in the evenings. Altogether, patients may attend a total of up to 30 in-person group medical visits over the course of the first year and it is recommended they remain in the program for long term support and obesity management as deemed appropriate for their needs.

Group medical visits are interactive, physician supervised sessions that are intended to assist patients in carrying out the significant behavioral changes required to successfully impact obesity and its co-morbid conditions. Group sizes vary but certain groups are 50-80 patients and others are less than 30 depending on the session topic.

The costs of attending in-person group medical visits and all other clinic visits are completely covered by the BC Medical Services Plan. Group medical visits provide an effective milieu for often difficult behavioral changes that are essential for the successful management of obesity and related disorders. 

Individual physician visits begin with a very detailed initial consultation and follow up visits are then individualized to the patient’s needs. Each patient's obesity related co-morbidities are carefully addressed, along with their mental health, mobility issues, their diet and lifestyle and an individualized multidisciplinary care plan is carried out.

Clinical Practice Guidelines

The 2013 Canadian Diabetes Association Clinical Practice Guidelines (http://guidelines.diabetes.ca/) recommend an interdisciplinary weight management program for people with obesity, or at risk of, diabetes to prevent weight gain and to achieve and maintain a lower, healthy body weight [Grade A, Level 1A].  Similarly the Canadian Medical Association recommends comprehensive lifestyle interventions for all adults with obesity in their 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity in Adults and Children (www.cmaj.ca/cgi/content/full/176/8/S1/DC1) [Grade A, Level 1]. 

Are there any costs associated with the clinic?

The clinic is funded through medical billings to BC's Medical Services Plan, research grants and philanthropic donations. No required costs are incurred to the patient except for the MWM Program Manual. We want this program to be accessible to every BC resident who needs it regardless of their income.  

Medical consultations, physical examinations, group medical visits and laboratory tests are covered by the British Columbia Medical Services Plan.
 

Living Life to the Full Course: This 8 week program is fully covered by MSP for patients already enrolled in our weight management program. To help us cover the costs to purchase the booklets and handouts that accompany the program, a charge of $30 will be requested from patients.

This 8 week program is for people who are struggling with symptoms of depression or anxiety. This program is done in cooperation with the Canadian Mental Health Association and is facilitated by Dr. Lyon and other trained MWM staff members. It is based on the principles of Cognitive Behavioral Therapy and has been adapted to patients who are using food for comfort when their lives inlclude despair, loneliness, boredom, low self esteem or stress. We also work with many people who have binge eating disorder and /or food addictive tendencies. It is still useful for people currently undergoing psychological counseling or who are on medications such as antidepressants. Participation in this program requires that you have a referral from your family physician and are part of our weight management program.    

 

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Where is the medical weight management program conducted?

Our program is located at 1550 United Boulevard in Coquitlam, British Columbia.  Parking is available at no cost.  We are located near bus stops serviced by the 159 and 791 lines. Note, these buses stop at different stops and come every half an hour.


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