Latest / Morning Medical with Dr. Chow / Cannabis & Dementia, Singh's Healthcare Plans, and Childhood Obesity Guidelines

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Cannabis & Dementia, Singh's Healthcare Plans, and Childhood Obesity Guidelines · Morning Medical with Dr. Chow

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  Welcome to Morning Medical with Dr.
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  Chow.
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  I'm Dr.
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  Chi-Ming Chow, and today we're diving into a fascinating study that's raising some eyebrows
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  in the medical community.
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  We're talking about the potential link between cannabis use and dementia, a topic that's
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  gaining attention as cannabis becomes more widely used and accepted in various parts of
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  the world.
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  A Canadian study, published in JAMA Neurology, has shed light on a concerning association
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  between emergency care for cannabis use and an increased risk of dementia.
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  This analysis was conducted on a massive scale, involving over six million people in Ontario,
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  Canada, who were 45 years and older and had no history of dementia when they joined the cohort
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  between 2008 and 2021.
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  The study found that individuals who required emergency department visits or hospitalizations
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  due to cannabis use had a 23 percent higher risk of developing dementia within five years
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  compared to those who had acute care for other reasons.
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  Even more striking, the risk of being diagnosed with a new case of dementia was 72 percent
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  higher than the general population within that same timeframe.
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  To put it in perspective, among those who needed acute care due to cannabis use, the
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  absolute risk of developing dementia was 5 percent, compared to 3.6 percent for those with
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  all-cause acute care.
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  This risk was even more pronounced when compared to the general population, where the
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  absolute risk stood at 1.3 percent.
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  The researchers, led by Dr.
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  Daniel Myran from the University of Ottawa, adjusted for various factors such as
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  sociodemographic variables and chronic health conditions.
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  Despite these adjustments, the heightened risk remained significant, highlighting a potential
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  link that warrants further investigation.
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  Interestingly, the study also noted that the risk of dementia associated with cannabis use
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  was lower than that linked to alcohol use, yet it still poses significant concerns.
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  Dr.
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  Colleen Webber, a co-author of the study, pointed out that regular cannabis use might
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  lead to changes in brain structure or increase the risk of other dementia-related factors like
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  high blood pressure, head trauma, and social isolation.
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  It's important to note, however, that the study does not claim cannabis use directly causes
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  dementia.
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  There are limitations, as the study did not examine patterns of cannabis use that did not
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  result in acute medical care, and factors like residual confounding and reverse causation
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  might have influenced the results.
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  Despite these limitations, this study is significant because it represents the largest
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  analysis to date on the association between cannabis-related emergency care and dementia.
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  With the liberalization and legalization of cannabis in Canada, particularly since 2014,
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  these findings highlight the need for further research into the long-term effects of cannabis
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  use.
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  NDP Leader Jagmeet Singh has made a significant pledge in the run-up to the Canadian federal
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  election, promising to hire thirty-five thousand nurses by the year two thousand
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  thirty.
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  This announcement comes amidst growing concerns about the state of Canada’s healthcare system,
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  which has been under pressure due to underfunding and staffing shortages.
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  During a recent election event in Toronto, Singh outlined his commitment to not only
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  increase the number of nurses but also to ensure safe working conditions for them.
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  He emphasized the importance of maintaining an appropriate ratio between nurses and patients,
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  although he did not specify what that ratio should be.
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  Instead, he mentioned that an NDP government would collaborate with provincial and
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  territorial governments to determine the best approach.
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  Singh criticized the use of private nursing agencies by provincial governments, arguing
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  that they contribute to a two-tier healthcare system.
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  He pledged better compensation for nurses working within the public system as part of his
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  strategy to strengthen Canada’s healthcare infrastructure.
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  Although healthcare staffing is primarily a provincial responsibility, Singh stated that
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  his party would link new federal health transfers to specific hiring and retention
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  strategies.
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  This approach aims to ensure that provinces and territories have the resources needed to
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  bolster their healthcare workforce.
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  The Canadian Nurses Association has also been vocal in the lead-up to the election, calling
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  on all parties to establish a national licensing framework.
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  Such a framework would provide nurses with the flexibility to work in regions where they are
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  most needed, addressing disparities in healthcare access across the country.
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  Polling conducted by Ipsos for Global News indicates that healthcare ranks third among
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  voter priorities, following affordability and cost of living, as well as the economy.
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  This highlights the significance of Singh’s promise and its potential impact on voters who
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  are concerned about the future of healthcare in Canada.
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  The relationship between technology use and cognitive health is a topic that has intrigued
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  many, especially as the first generation widely exposed to technology reaches older age.
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  A new meta-analysis study by researchers from two Texas universities, published in Nature
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  Human Behavior, sheds light on this very issue.
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  The study examined the hypothesis known as "digital dementia," which suggests that
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  reliance on technology might weaken cognitive abilities over time.
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  However, the findings challenge this hypothesis.
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  The researchers analyzed fifty-seven studies involving over four hundred thousand older
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  adults and discovered that technology use was associated with a forty-two percent lower risk
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  of cognitive impairment.
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  Cognitive impairment, in this context, included diagnoses of mild cognitive impairment or
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  dementia, as well as subpar performance on cognitive tests.
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  The types of technology examined included computers, smartphones, internet, email, and
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  social media.
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  Interestingly, the study found that these effects persisted even after adjusting for
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  factors such as education, income, and other lifestyle elements, indicating that the
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  protective effect of technology use might not be solely due to other brain health factors.
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  Dr.
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  Jared Benge, a co-lead study author, highlighted that this finding is encouraging,
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  as it suggests that technology use may offer some net positive benefits to brain health.
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  Despite the positive findings, the study's authors caution against assuming that all
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  technology use is beneficial.
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  Dr.
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  Michael Scullin, another co-lead author, emphasized that the study does not endorse
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  mindless scrolling or excessive use.
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  Instead, it suggests that the generation that introduced us to the internet has found ways to
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  derive cognitive benefits from these tools.
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  There are still uncertainties about how different aspects of technology use impact
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  brain health.
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  The study did not delve into specific details about how participants used these technologies
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  or how much time they spent on them, which leaves open questions about what types of use
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  are most beneficial and whether there is a threshold for potential harm.
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  The findings support the cognitive reserve theory, which argues that engaging in complex
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  mental activities can lead to better cognitive well-being in older age, despite age-related
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  brain changes.
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  Dr.
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  Amit Sachdev noted that technology might help reduce the risk of cognitive decline by keeping
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  us neurologically active, and it can also promote social connections, which are essential
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  for brain health.
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  Experts advise that moderation is key when it comes to technology use.
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  Engaging in activities that bring joy, genuine connection, creativity, and intellectual
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  stimulation is beneficial.
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  Dr.
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  Sachdev pointed out that too much of anything can be detrimental, and it is important to
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  identify the purpose and duration of technology use to maintain a healthy balance.
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  For older adults hesitant about using technology, it is worth noting that even those
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  with mild dementia can learn to use these tools.
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  While it can be frustrating at times, this challenge reflects the mental stimulation that
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  comes with learning something new, which can be beneficial for cognitive health.
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  Today, we're going to explore a significant update in the field of childhood obesity care
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  in Canada.
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  For the first time in nearly two decades, the national clinical guidelines for managing
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  childhood and adolescent obesity have been overhauled, and they're shifting away from
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  focusing solely on numbers on a scale.
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  This change is driven by a recognition of the complexities of obesity as a disease,
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  emphasizing quality of life and mental health as pivotal aspects of treatment.
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  These new guidelines, published in the Canadian Medical Association Journal, were developed
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  with Obesity Canada and include ten recommendations and nine good practice
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  statements.
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  Importantly, they suggest the use of medications like glucagon-like peptide-1
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  receptor agonists, such as Ozempic and Wegovy, for adolescents aged twelve and up who have
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  obesity and have not been successful with weight loss through diet and exercise alone.
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  However, these medications are not approved for younger children.
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  Lisa Schaffer, the executive director of Obesity Canada, highlighted the shift in
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  understanding obesity as more of a disease of the brain, necessitating early recognition and
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  intervention.
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  This new perspective aims to address obesity's true complexities as a chronic disease and
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  emphasizes the necessity of updating clinical practice guidelines for pediatric obesity.
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  The guidelines recognize obesity as a complex, chronic, and highly stigmatized disease that
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  poses a risk for over two hundred health conditions.
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  Alarmingly, rates of obesity are on the rise, with around twenty-five percent of children
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  aged four to eleven and thirty-three percent of those aged twelve to seventeen having a body
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  mass index that may indicate they are overweight or obese.
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  The guidelines emphasize that more than fifty percent of children aged seven to eleven living
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  with obesity will continue to do so into adolescence, and roughly eighty percent of
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  teens aged twelve to eighteen will carry the condition into adulthood.
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  The updated guidelines emphasize evidence-based options for managing obesity, focusing on
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  shared decision-making between children, their families, and healthcare providers.
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  While weight loss might be part of the journey, it's no longer the sole measure of success.
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  Instead, multicomponent interventions that include physical activity, nutrition, and
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  psychological support are recommended as the foundation of care.
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  Where appropriate, medications or surgery may also play a role.
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  The guidelines cautiously recommend glucagon-like peptide-1 medications for
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  managing pediatric obesity, acknowledging that while these drugs can aid in weight loss and
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  improve certain health markers, the long-term benefits and side effects remain unclear, and
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  results can vary among individuals.
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  Additionally, under specific conditions, the guidelines suggest that weight-loss surgeries,
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  such as laparoscopic sleeve gastrectomy and gastric bypass, might be beneficial for
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  adolescents aged thirteen and over.
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  These surgeries work by limiting the stomach's capacity or altering digestion, leading to
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  weight loss and health improvements when combined with behavioral and psychological
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  support.
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  However, they do come with risks, including mild side effects like nausea and, in rare
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  cases, more serious complications.
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  Dr.
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  Sanjeev Sockalingam, the scientific director of Obesity Canada, noted the lack of equitable and
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  affordable access to treatments in Canada, with only two surgical centers and a fragmented
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  system of multidisciplinary obesity management clinics.
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  He emphasized the importance of these guidelines as a foundation for advocating and
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  educating towards establishing a new standard of obesity care for children and adolescents,
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  ensuring they have access to evidence-based care to improve their health and wellbeing.
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  These updates to the guidelines are a crucial step forward in addressing the complexities of
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  childhood obesity, providing a holistic approach that considers the physical,
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  psychological, and social dimensions of health.
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  That's it for today's episode of Morning Medical with Dr.
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  Chow.
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  I hope you found the discussions enlightening and informative.
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  Remember, health is a journey, not a destination, and staying informed is key to
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  navigating it.
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  Until next time, stay healthy and take care.