Medical Program

The Bariatric Medical Program provides comprehensive medical care led by an interdisciplinary team. The focus of this program is the non-surgical treatment of obesity and obesity-related health conditions, safe weight management, and healthy lifestyle changes.

In order to be referred to the Medical Program, patients will require a physician's referral. 

Patients who meet the eligibility criteria are assigned to a Bariatric Centre of Excellence (BCoE) or Regional Assessment and Treatment Centre (RATC).

Eligible patients will be contacted directly by their assigned bariatric centre to attend an orientation session, followed by comprehensive screening and assessment by the interdisciplinary bariatric team to assess their appropriateness for a treatment plan. Intensive education and nutritional counselling is provided. Following the completion of the medical treatment plan, patients are monitored and scheduled for routine follow-ups for a period of up to 2 years.

Medical Program Eligibility

Eligibility:

  • 18 years of age and older (allow referrals at age >=17.5 years)
  • BMI greater than, or equal to 35
  • BMI greater than or equal to 30, but less than 35. With at least one of the following comorbidities (as determined by your physician):
    • Complicated Type II diabetes mellitus
    • Idiopathic intracranial hypertension
    • Poorly controlled hypertension

Ineligibility (not limited to):

  • Current drug or alcohol dependency (within 6 months of referral)
  • Recent major cancer (life threatening, within last 2 years) with active treatment where caloric restriction might exacerbate the condition
  • Untreated or inadequately treated psychiatric illness
Types of Medical Programs

There are three types of Medical Programs that may be offered to patients through the OBN. For all Medical Programs, the focus is to help patients achieve medically acceptable weight loss in order to improve their co-morbidities and quality of life. The programs focus on helping patients achieve a healthier state of wellness by providing knowledge and life skills to change their eating and coping behaviours, and develop alternative lifestyles that promote healthy eating, physical activity, and healthy living.

The appropriate treatment option for the patient is determined by the interdisciplinary team of bariatric experts at each centre. Program duration varies depending on the treatment plan, and centres follow patients for a period up to 2 years.

Bariatric Medical Program is comprised of: 

  • Meal Replacement/Behavioral Modification Program
  • One to One Program

 

 

Medical Program Features

The OBN has established standardized care paths based on current evidence and best practice that outline the minimal tests/assessments required for all Medical Program bariatric patients in Ontario. Assessments, appointments and treatment plans may vary from person to person, depending on the individual and their health care needs.

  • Program Orientation (Group Session) 
  • Interdisciplinary Bariatric Team Assessments
  • Routine blood work and additional diagnostic testing based on patients' individual medical needs
  • Behavioural modification/education classes (up to 24 people) are closed groups for patients only and are facilitated by the clinic’s social worker, registered dietitian, psychologists and kinesiologist; as appropriate
  • Patients may be on a low calorie meal replacement at patients own expense for 6 to 12 weeks depending on BMI, after which time, patients are slowly reintegrated back onto food
  • Your treatment plan could also include one-on-one intervention, based on individual needs
  • Weight is measured each week
  • Attendance is mandatory
  • Follow up assessments at the following time intervals
    • 6 months 
    • 1 year
    • 2 years
  • The program will incorporate use of telemedicine as appropriate
FAQ

What is the definition of obesity?

Overweight: 10% to 20% above the person's "desirable" body weight

Obesity: 20% or more than the person’s "desirable” body weight. It is an increase in body weight beyond the limitation of skeletal and physical requirements, as the result of excessive accumulation of body fat.

Super Obesity: 
40% or more than the person’s "desirable” body weight. It is an excess of body fat, or weight of 45.4 kilograms (100 pounds) over ideal body weight, that increases the risk of developing cardiac and endocrine disturbances, including coronary artery disease and diabetes mellitus, as well as some kinds of cancer.

What is Body Mass Index (BMI)?

Body Mass Index (BMI) is a measurement of weight in relation to height. BMI is calculated by dividing your weight in kilograms by the square of your height in meters.

Excess Body Weight (EBW) is a measurement of current weight in relation to the ideal weight which is based on age and height. The amount of weight in excess of one's ideal body weight is the calculated EBW.

Is attendance to classes / appointments mandatory?

Patients are informed at Orientation that attendance is mandatory.

If a patient misses a scheduled intervention or group class due to illness, planned vacation, or extenuating circumstances, patients are encouraged to arrange a follow-up session with their bariatric clinic to review missed content. 

What is the focus of the Medical Program?

For all Medical Programs, the focus is to help patients achieve medically acceptable weight loss in order to improve their co-morbitities and quality of life. The programs focus on helping patients achieve a healthier state of wellness by providing knowledge and life skills to change their eating and coping behaviours, and develop alternative lifestyles that promote healthy eating, physical activity, and healthy living.

 

Can I repeat the Medical Program?

Patients cannot repeat the Medical Program. The program is a one-time only MOHLTC funded program per patient, providing intervention for 2 years. Patients are then transitioned back to the community to their Primary Care Provider. 

 

What is the length of the program?

The Medical Program is a 2 year commitment for patients.

Patients are enrolled for 6 months of active treatment, followed by 6 months of maintenance and 12 months of monitoring (between years 1 and 2).