October 3, 2019

Alberta researcher leads team focused on improving healthcare for patients with obesity

For most of his life, 52-year-old Marty Enokson has lived with severe obesity. But it was a three-month hospital stay for weight-loss surgery a decade ago that reminded him of the stigma people with obesity often face in the healthcare system.

Marty Enokson

“I experienced first-hand how people can treat people with obesity with disrespect. There’s often a misunderstanding among people that we did this to ourselves — when in fact obesity is a complex chronic disease,” Enokson says.

In Alberta, nearly six out of 10 people live with obesity. As more and more people with this disease enter hospitals, they often encounter a healthcare system struggling to deal with their needs. To find answers, University of Alberta researcher Dr. Mary Forhan has been conducting world-leading research to improve the quality of hospital care for patients with obesity.

Photo of PRIHS 1 researcher Dr. Mary Forhan
Dr. Mary Forhan

“The problems facing these patients have been on the radar of clinicians for some time. It made sense to use this project to start to tackle these challenges,” says Forhan, department chair and associate professor, Department of Occupational Therapy, in the Faculty of Rehabilitation Medicine.

Support for research

Since 2014, backed by an Alberta Innovates PRIHS grant, Forhan and a team of colleagues from the university and Alberta Health Services (AHS) have examined these challenges in depth.

Starting four years ago, the team surveyed 2,000 AHS employees about their attitudes regarding patients with obesity. In the process, workers revealed concerns over safe patient handling, a lack of training and the scarcity of appropriate-sized equipment in hospitals. To validate the learnings, the survey results were shared with over 100 patients across Canada with past hospital experience, such as Enokson.

“The patients endorsed all of our findings,” Forhan says.

Piecing this information together, Forhan has worked with AHS and others to develop practical solutions, using the Medicine Hat Regional Hospital as a pilot facility. The hospital, for instance, is currently trying a newly launched furniture and equipment labelling system, consisting of color-coded labels, to clearly identify the weight capacity of equipment and furniture. This system provides a quick reference to staff and patients who can determine whether a chair, wheelchair or other equipment is safe for them to use.

On the leading edge

“To our knowledge, no one has ever done this before in hospitals in Canada or elsewhere,” Forhan says of the labelling approach that is being distributed by Obesity Canada to hospitals across the country.  

Earlier this summer, new curriculum, developed in partnership with Obesity Canada and AHS’s Diabetes, Obesity and Nutrition Strategic Clinical Network was also introduced at the hospital to educate staff on how best to meet the needs of patients with bariatric care needs.  Research supported by Alberta Innovates has also contributed to development of provincial and national standards and recommendations to promote quality care for hospitalized patients with these needs.

Dignity and respect

Dr. Mary Forhan talks with patient Marty Enokson
Mary and Marty

Provincial guidelines and resources are now available from AHS and the Diabetes, Obesity and Nutrition Strategic Clinical Network, while national guidelines and resources are available from Obesity Canada.  

“AHS has identified promoting quality care for patients with obesity as a priority, and they’re working with stakeholders to make important changes to practice,” Forhan says.

“AHS has identified promoting quality care for patients with obesity as a priority, and they’re working with stakeholders to make important changes to practice,” Forhan says.

Enokson agrees: “Many wonderful changes are starting to happen with the pilot. We’re recognizing we need to treat people with obesity in the healthcare system like anyone else — with dignity and respect.”