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9 TH LEARNING RETREATPRINCIPLESAND PRACTICE OFINTERDISCIPLINARYOBESITYMANAGEMENTFOR DIETITIANSON THEThursday, October 25th toFriday, October 26th, 2018Oakham House, Ryerson Student Centre, Thomas LoungeADDRESS: 55 Gould StreetToronto ON M5B 1E9Details at: www.dietitians.ca/www.obesitycanada.caAn intensive educational experience with a strong emphasis on the practical aspects ofobesity management and the role of the dietitian in inter-professional bariatric care.This certification will build knowledge in the areas of: 5As of Obesity Management EOSS Your role(s) as part of the interdisciplinary obesity management team Clinical assessment and medical management of obesityPRESENTED BY:

9 TH LEARNING RETREATPRINCIPLESAND PRACTICE OFINTERDISCIPLINARYOBESITYMANAGEMENTFOR DIETITIANSON THEprogramoverview3Learning Objectives4Learning Retreat Daily Schedule7Speakers9General Information10 Retreat Pre-readings12 Map – Parking at Ryerson2018 Learning Retreat on Interdisciplinary Obesity Management 2

learningobjectivesAT THE CONCLUSION OF THE WORKSHOP, PARTICIPANTS WILL BE ABLE TO: Discuss relevance of epidemiology and causes in management of obesity. Recognize environmental factors that influence obesity, both in obesity prevention and obesitymanagement, particularly as related to public health approaches to obesity management. Develop an awareness of potential professional weight bias/stigma (of all health care providers) as abarrier to the management of obesity. Facilitate effective client-centred conversations with patients who have obesity or are at risk. Develop skills to counsel patients on complications of obesity. Distinguish differences and advantages between common forms of behavioural & pharmacotherapies. Develop skills to counsel on lifestyle and management strategies that patients can realisticallyincorporate based on their individual needs. Meets the certification criteria for the Canadian Bariatric Educator (CBE) Program.Obesity Canada-Obésité CanadaObesity Canada is a broad Network of over 15,000 individuals and organizations who are committedto stemming the tide of obesity in Canada and reducing the mental, physical and economic burden ofobesity on Canadians. The mission of Obesity Canada is to act as a catalyst for addressing obesity inCanada and to foster knowledge translation, capacity building, and partnerships among stakeholders sothat researchers, health professionals, policy makers and other stakeholders may develop effectivesolutions to treat, and to prevent, obesity. Obesity Canada’s three strategic goals are to 1) Address thesocial stigma associated with obesity; 2) Change the way professionals think about obesity andinteract with obese individuals; and 3) Improve access to obesity prevention, treatment and management. Since 2006, Obesity Canada has trained more than 8,000 health professionals on key issues relatedto obesity. In 2016, Obesity Canada expanded to include the public and has a website that is a one-stopresource for support to remove the stigma from obesity and bring positivity and respect to those who areaffected by it; credible and evidence-based information and tools designed to change how we perceiveand discuss obesity; and a conduit for connecting to the community of researchers, health professionalsand policy makers who want to make a difference in the lives of those living with obesity management,launched two widely used literature alerting services, published and award winning magazine (CONDUIT),organized Canada’s only recurring scientific conference dedicated to obesity. Obesity Canada is anon-profit organization hosted by the University of Alberta and Alberta Health Services in Edmonton,Alberta. Find out more at www.obesitycanada.ca.Dietitians of Canada – Les diététistes du Canada (DC)DC is the national professional association for dietitians, representing 6,000 members at the local,provincial, national and international levels. As the recognized leaders of dietetic practice, DC advanceshealth through food and nutrition, providing trusted information to Canadians and advising governmentsat the federal and provincial/ territorial levels on best practices in nutrition. DC supports its membersthrough a broad portfolio of professional development activities, accreditation of academic programs, andsupports research as a founding partner of the Canadian Foundation for Dietetic Research. We promotedietitians as valuable members of the health team providing cost-effective health promotion, diseaseprevention, treatment and supportive care. DC is one of the largest organization of dietetics professionalsin the world, and actively facilitates the global advancement of dietetics.2018 Learning Retreat on Interdisciplinary Obesity Management 3

learningretreat dailyscheduleTHURSDAY, OCTOBER 25, 20187:30 am – 8:00 amRegistration Desk OpensLight refreshments served.8:00 am – 8:20 amWelcome and Opening RemarksSean Wharton, MD, PharmD, FRCP(C), InternalMedicine Specialist Adjunct Professor YorkUniversity, Dept. Kinesiology and Health SciencesObesity is a complex disease that requires lifelongtreatment. The opening will cover: epidemiology of obesity in Canada trends across the lifespan specific trends in special populations(e.g. ethnic, children, adolescents, First Nations)An overview of the complexity of the causes ofobesity will be reviewed (biological, behavioural,and environmental).8:20 am – 9:10 amLiving with Obesity: A Patient’s ExperienceIan Patton, PhD, Patient Engagement Coordinator,Obesity Canada9:10 am – 9:30 amHealth Break9:30 am – 12:00 pmSetting the Stage: Biology of Obesity & Weight LossEric Doucet, PhD, Professor, School of HumanKinetics, University of OttawaDr. Doucet will review the importance of some ofthe biological processes associated with obesity tobetter understand this disease. This talk will cover: Energy balance Basal Metabolic Rate Physical Activity Overview of central nervous system aspects:- Role of neuropeptides (and how these varywith bariatric surgery or weight loss)- Role of brain, gut, adipocyte interactions (roleof key hormones and how these interact tocontribute to obesity) Body Composition and its relation to theregulation of energy intake and expenditure.12:00 pm – 1:00 pmLunch1:00 pm – 2:00 pmNutrition Guidelines for Pre- and Post-BariatricSurgery Part one-ScienceJennifer Brown, Registered Dietitian with theOttawa Hospital Weight Management Clinic andBariatric Centre of ExcellenceBariatric surgery is increasingly being used as anintervention for obesity management. Dietitiansplay a key role in the pre and post-operativemanagement of patients considering or have hadbariatric surgery. This presentation will cover thefollowing components to help support dietitians atany level of experience in bariatric surgery. Review surgical operations and nutrition-relatedimplications Hormonal changes after bariatric surgery –connection between hedonic hunger, appetitemeasures and peptide hormones post-bariatricsurgery Weight regain after bariatric surgery – review ofpossibilities and how dietitians can help2:00 pm – 2:15 pmHealth Break2:15 pm – 3:30 pmNutrition Guidelines for Pre- and Post-BariatricSurgery Part two-PracticalJennifer Brown, Registered Dietitian with theOttawa Hospital Weight Management Clinic andBariatric Centre of Excellence Incorporating a HAES-approach to bariatricsurgery treatment Pre-op assessment/preparation Post-op nutrition requirements Using a nutrition-focused physical assessment(NFPA) in post-bariatric patients – assessingmicronutrient deficiencies Post-op cases (the good, bad and ugly) Weight regain after bariatric surgery – review ofpossibilities and how dietitians can help2018 Learning Retreat on Interdisciplinary Obesity Management 4

learningretreat dailyschedule3:30 pm – 4:30 pmPharmacotherapySean Wharton, MD, PharmD, FRCP(C), InternalMedicine Specialist Adjunct Professor YorkUniversity, Dept. Kinesiology and Health Sciences Current Canadian options: orlistat, liraglutide Options in the US: Phentermine, Topiramate/phentermine, Lorcaserin,naltrexone/bupropion Alternative therapy Summary of current evidence4:30 pmSummary & Closing remarksJennifer Brown, Registered Dietitian with theOttawa Hospital Weight Management Clinic andBariatric Centre of ExcellenceEric Doucet, PhD, Professor, School of HumanKinetics, University of OttawaSean Wharton, MD, PharmD, FRCP(C), InternalMedicine Specialist Adjunct Professor YorkUniversity, Dept. Kinesiology and Health SciencesFRIDAY, OCTOBER 26, 20187:30 am – 8:00 amRegistration Desk OpensLight refreshments served.8:00 am – 8:15 amWelcome to Day 2 and Opening RemarksSean Wharton, MD, PharmD, FRCP(C), InternalMedicine Specialist Adjunct Professor YorkUniversity, Dept. Kinesiology and Health Sciences8:15 am – 9:15 amObesity Medicine: Perspectives from PrimaryCare – Current Challenges and Hope for theFuture and Food Addiction: Everything inModeration for Everyone?Angie Hong, MD, CCFP, FCFP, ABOM diplomateDiscovery Weight Clinic, Toronto To discuss the four main challenges faced byprimary care physicians when managing obesityas a disease. To share information regarding new initiativesand opportunities for involvement. To open a conversation about the concept offood addiction and treatment.9:15 am – 9:30 amHealth Break9:30 am – 12:00 pmWeight Bias & Behavioural TherapyT. Michael Vallis, PhD, Associate Professor,Department of Psychology, Dalhousie UniversityIndividuals living with obesity are highly stigmatizedand face multiple forms of prejudice and discrimination because of their weight, often due to widespreadnegative stereotypes. How can practitioners recognizethe impact of stigmatization in the context of subtleand at times unconscious psychological behaviors?Participants will receive an overview of the conceptof stigma and weight bias. How can health providershelp obese individuals overcome difficulties in changing their eating habits and maintaining these changes?The goal of this session is to help participants engagepatients in ways to ensure the emotional factors associated with eating become the starting point for clinical interventions. The presentation will include skillsand strategies for motivational enhancement, behaviour modification and emotion management.2018 Learning Retreat on Interdisciplinary Obesity Management 5

learningretreat dailyschedule12:00 pm – 1:00 pmLunch1:00 pm – 2:30 pm Weight Bias & BehaviouralTherapyT. Michael Vallis, PhD, Associate Professor,Department of Psychology, Dalhousie University Behavioural modification Motivational interviewing (MI): differenttechniques with examples Techniques and tips: Strategies to approach thepatient (advanced) Weight bias/stigma Evidence of Mindfulness? Health at Every Size- Patient history, current lifestyle, physicalassessment (EOSS), testing, Goal settingwith patients3:30 pm – 4:00 pmComplex Case StudiesJennifer Brown, Registered Dietitian with theOttawa Hospital Weight Management Clinic andBariatric Centre of Excellence.Sean Wharton, MD, PharmD, FRCP(C), InternalMedicine Specialist Adjunct Professor York University,Dept. Kinesiology and Health Sciences4:00 pm – 4:30 pmClosing remarks & Evaluation2:30 pm – 2:45 pmHealth Break2:45 pm – 3:30 pmUnderstanding clinical assessment using theEOSS classification systemSean Wharton, MD, PharmD, FRCP(C), InternalMedicine Specialist Adjunct Professor York University,Dept. Kinesiology and Health SciencesProper assessment of a patient with obesity is acrucial component of developing a managementstrategy. This session will guide dietitans throughthe assessment of a patient with obesity. He willhighlight the Edmonton Obesity Staging System(EOSS), a 5-point ordinal classification system forobesity that considers co-morbidity and functionalstatus, has been validated against nationally representative US samples and is superior to BMI, WC ormetabolic syndrome in predicting mortality. EOSScan also guide clinical management and may allowbetter triaging of resources in health care systemsto patients who stand to benefit the most. Mortality, CVD, Diabetes and metabolic syndrome,Cancer, Hepatic, Mental health, Lung function(including sleep apnea) Musculoskeletal disorders Other consequences to touch on:- Intertrigo, pannus, deep vein thrombosis,hypertension, fertility (PCOS)- Strategies to approach the patient (basic)2018 Learning Retreat on Interdisciplinary Obesity Management 6

speakersJENNIFER BROWN MSc., RDRegistered Dietitian, The Ottawa Hospital Weight Management Clinic & BariatricCentre of ExcellenceJennifer Brown is a registered dietitian with the Ottawa Hospital WeightManagement Clinic and Bariatric Centre of Excellence and is the provincial leadfor eConsult in bariatric nutrition. She is an expert member of the AmericanAcademy of Nutrition and Dietetics Evidence Analysis Workgroup on BariatricSurgery (systematic review project), co-chair of the Ontario Bariatric NetworkDietitian Task Force and an executive member of the bariatric surgery subgroup ofthe Dietitians of Canada – DOC network. She received a BSc. from St. FrancisXavier University in Human Nutrition and a MSc. from the University of Ottawain Human Kinetics exploring the relationship between appetite, olfaction, foodreward and peripheral hormone changes in weight regain after Roux-en-Ygastric bypass surgery. Jennifer has been invited to speak at numerousnutrition, obesity and surgery conferences across North America and hopesto standardize bariatric nutrition care through collaborative research acrossCanada and internationally.ÉRIC DOUCET PhDProfessor at University of Ottawa, Faculty of Health Sciences, School of HumanKineticsEric Doucet is an expert in the study and treatment of obesity and its associatedcomplications. He is full professor at the School of Human Kinetics at theUniversity of Ottawa. He obtained his Ph.D. in Physiology and Endocrinologyat Université Laval in Québec City