{"id":6646,"date":"2021-10-25T20:29:27","date_gmt":"2021-10-26T02:29:27","guid":{"rendered":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/?page_id=6646"},"modified":"2022-10-26T11:39:13","modified_gmt":"2022-10-26T17:39:13","slug":"clinician-weight-management","status":"publish","type":"page","link":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinician-weight-management\/","title":{"rendered":"Clinician Standards: 6. Weight Management"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#c7c89b&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;||20px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Source Sans Pro|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; text_line_height=&#8221;1em&#8221; header_text_align=&#8221;left&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;||||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]CORE TREATMENT 3: WEIGHT MANAGEMENT[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Source Sans Pro|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;22px&#8221; text_line_height=&#8221;1em&#8221; header_text_align=&#8221;left&#8221; header_text_color=&#8221;#FFFFFF&#8221; header_font_size=&#8221;38px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>STANDARD 6<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;||||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;20px&#8221; text_line_height=&#8221;1.5em&#8221; custom_padding=&#8221;||20px||false|false&#8221; global_colors_info=&#8221;{}&#8221;]When an individual identifies weight management as a priority in their care plan, they should be offered weight management options that are tailored to support their individual needs. Use of shared decision-making techniques will ensure the individual\u2019s priorities, goals, values and preferences are built into their weight management plan.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; disabled_on=&#8221;on|off|off&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#c7c89b&#8221; background_enable_image=&#8221;off&#8221; background_size=&#8221;contain&#8221; background_position=&#8221;center_left&#8221; custom_margin=&#8221;-12px||||false|false&#8221; custom_margin_tablet=&#8221;-12px||||false|false&#8221; custom_margin_phone=&#8221;0px||||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; custom_padding=&#8221;||33px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_image src=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/line-1.png&#8221; title_text=&#8221;line (1)&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; width=&#8221;80%&#8221; max_width=&#8221;80%&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_fullwidth_image][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px||0px||true|false&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; top_divider_color=&#8221;rgba(12,113,195,0.32)&#8221; top_divider_height=&#8221;27px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][lwp_divi_breadcrumbs _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/lwp_divi_breadcrumbs][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#FFFFFF&#8221; custom_padding=&#8221;0px||||false|false&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;0px||0px||true|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_text_color=&#8221;#000000&#8243; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_padding=&#8221;||||false|false&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p class=\"overview\">OVERVIEW<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_2,1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><strong>Key Messages for Weight Management<\/strong><\/p>\n<p>Carrying extra body weight:\u200b<\/p>\n<ol>\n<li>Exerts additional mechanical stress on the lower limb joints; and \u200b<\/li>\n<li>May have a metabolic link to the disease progression\u200b<\/li>\n<\/ol>\n<p>Over time, increased stress on the joints from extra body weight can result in the production of inflammatory mediators from fat tissue, negatively impacting the health of joint cartilage, and causing loss of muscle mass and strength\u200b. Effective weight management explores a wide range of strategies based on the individual\u2019s needs and goals.<\/p>\n<p><strong>Healthy and safe weight management should be considered for all individuals with OA<\/strong>, but reducing\u202fextra body weight may be one goal of those individuals who have obesity\u200b. Obesity is a chronic medical condition characterized by an excessive accumulation of body\u202ffat;\u202fit\u202fis a significant comorbidity in individuals with OA. Effective weight management explores a wide range of strategies based on the individual\u2019s needs and\u202fgoals. Use shared decision-making techniques to build a plan that considers:<\/p>\n<ul>\n<li>Nutritional and\/or weight management services to support\u202flifestyle intervention and behaviour modification\u200b<\/li>\n<li>Coordination with exercise and physical activity plans\u200b<\/li>\n<li>Mental health support\u200b<\/li>\n<li>Referral to appropriate supporting clinicians to assist with:\u200b\n<ul style=\"list-style: circle;\">\n<li>Pharmacological treatments or Surgery\u200b<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;18px&#8221; background_color=&#8221;#f2f2f2&#8243; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; border_radii=&#8221;on|20px|20px|20px|20px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h3 style=\"text-align: left;\"><strong>KEY RESOURCES<\/strong><span style=\"font-size: medium;\"><span style=\"font-size: medium;\"><\/span><\/span><\/h3>\n<ul class=\"fix\">\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/info\/Page7468.aspx\" target=\"_blank\" rel=\"noopener\">Obesity Primary Health Care Resource Centre <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/assets\/info\/hp\/phc\/if-hp-phc-obesity-pt-tip-sheet.pdf\" target=\"_blank\" rel=\"noopener\">Helping Adults with Obesity Who Have Functional Concerns<\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/info\/Page15593.aspx\" target=\"_blank\" rel=\"noopener\">Nutrition Guidelines<\/a>, <a href=\"https:\/\/www.albertahealthservices.ca\/assets\/info\/nutrition\/if-nfs-ng-adult-obesity-care.pdf\" target=\"_blank\" rel=\"noopener\">specifically the \u201cAdult Obesity Care\u201d Guideline <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/scns\/Page7676.aspx\" target=\"_blank\" rel=\"noopener\">Diabetes, Obesity and Nutrition SCN <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/scns\/Page13410.aspx\" target=\"_blank\" rel=\"noopener\">Consider using these modules and resources to support your clinic in becoming more Bariatric Friendly<\/a><br \/>As well as this: <a href=\"https:\/\/www.albertahealthservices.ca\/assets\/info\/hp\/phc\/if-hp-phc-obesity-ee-checklist.pdf\" target=\"_blank\" rel=\"noopener\">Checklist for Creating Inclusivity <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/info\/Page3749.aspx\" target=\"_blank\" rel=\"noopener\">Weight Management Workshops for Clinicians <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\">Referral to Bariatric Specialty Clinics \u2013 Search on <a href=\"https:\/\/albertareferraldirectory.ca\/PublicSearchController?direct=displaySpecialistSearch\" target=\"_blank\" rel=\"noopener\">Alberta Referral Directory <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/obesitycanada.ca\/\" target=\"_blank\" rel=\"noopener\">Obesity Canada<\/a>, specifically the <a href=\"https:\/\/obesitycanada.ca\/guidelines\/chapters\/\" target=\"_blank\" rel=\"noopener\">Clinical Practice Guidelines<\/a> and the <a href=\"https:\/\/obesitycanada.ca\/guidelines\/weightbias\/\" target=\"_blank\" rel=\"noopener\">Reducing Weight Bias Statement <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/assets\/about\/scn\/ahs-scn-bjh-osteoarthritis-and-obesity-white-paper-final.pdf\" target=\"_blank\" rel=\"noopener\">Bone and Joint Health SCN White Paper on Obesity and OA <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"http:\/\/www.drsharma.ca\/wp-content\/uploads\/edmonton-obesity-staging-system-staging-tool.pdf\" target=\"_blank\" rel=\"noopener\">Edmonton Obesity Staging System <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"http:\/\/www.myhealthywaist.org\/index.php?id=90&amp;app=1&amp;cHash=acb4d3c01d\" target=\"_blank\" rel=\"noopener\">Waist Circumference Measurement Guidelines <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/2_SDM-Toolkit.pdf\" target=\"_blank\" rel=\"noopener\">Shared Decision-Making Toolkit <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a target=\"_blank\" rel=\"noopener\" class=\"learn-more learn-more-oa-self-management-toolkit-2\">OA Self Management Toolkit<\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/4_Sample-Resource-Inventory.pdf\" target=\"_blank\" rel=\"noopener\">SAMPLE Resource Inventory<\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/5_Resource-Inventory-TEMPLATE.docx\" target=\"_blank\" rel=\"noopener\">TEMPLATE Resource Inventory <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/6_NEW-FORM-Care-Plan-Documentation.pdf\" target=\"_blank\" rel=\"noopener\">FORM to Document\/Modify a Care Plan for Management of OA <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/7_Tables-of-Examples-for-the-Treatments-Toolbox.pdf\" target=\"_blank\" rel=\"noopener\">Tables of Examples for the Treatment Toolbox <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/www.albertahealthservices.ca\/info\/Page16720.aspx\" target=\"_blank\" rel=\"noopener\">Health Change Methodology <\/a><br \/><\/span><\/li>\n<\/ul>\n<p style=\"margin-top: 20px;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinician-resources\/\" style=\"text-align: left;\"><strong>View All Resources<\/strong><\/a><\/p>\n<p><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinicians-reference-6\/\" style=\"text-align: left;\"><strong>View References<\/strong><\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; module_class=&#8221;desk&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(255,255,255,0.86)&#8221; background_image=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/Pngtree\u2014blue-hexagon-abstract-medical-technology_1298247-e1653654071890.jpg&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_blend=&#8221;overlay&#8221; custom_margin=&#8221;||||false|true&#8221; custom_padding=&#8221;||100px||false|true&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_4,3_4&#8243; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;d55fc8c6-b5de-4b77-a65b-80d125d2b382&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_4&#8243; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;e067a3d0-44a1-4396-9c39-e633c5db2c25&#8243; background_color=&#8221;rgba(255,255,255,0.64)&#8221; z_index=&#8221;1&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;46786535-2f5d-4ee1-8e00-c908da837293&#8243; global_colors_info=&#8221;{}&#8221;]<a href=\"#introduction\">Introduction<\/a>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;46786535-2f5d-4ee1-8e00-c908da837293&#8243; global_colors_info=&#8221;{}&#8221;]<a href=\"#collaborating\">Collaborating on weight management<\/a>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;46786535-2f5d-4ee1-8e00-c908da837293&#8243; global_colors_info=&#8221;{}&#8221;]<a href=\"#continuing\">Continuing education<\/a>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;3_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<div id=\"introduction\" class=\"background1\">\n<h1 class=\"heading\">INTRODUCTION<\/h1>\n<p>A higher body weight and excess body fat have been linked with the development and progression of osteoarthritis (OA). This is due to additional mechanical stresses on the lower limb joints with higher body weight, and a metabolic and inflammatory relationship between body fat and OA disease progression<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Godziuk K, Kania-Richmond A, Hart D. Obesity: Implications for patients with osteoarthritis.<\/span><\/span>. Therefore, weight maintenance, or prevention of weight gain, is a foundational strategy in OA management. This is particularly important due to the risks of weight gain associated with both aging and inactivity.<\/p>\n<p>Weight reduction may also be beneficial for reducing OA symptoms and slowing disease progression.<\/p>\n<div class=\"info-box\">\n<div class=\"col-icon\"><span style=\"font-size: 30px;\" class=\"et-pb-icon\">r<\/span><\/div>\n<div>\n<div class=\"tooltip-wrapper\" data-tooltip-wrapper=\"\">\n<p>Studies have shown that losing 5-10% of body weight can reduce joint forces\/stresses and improve OA-related pain, physical function, and quality of life. Behaviour-based weight management approaches (using nutrition, activity and behavioural control strategies) usually result in sustained weight loss of 3-5% of body weight, however this could still be effective to improve symptoms.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>For individuals who are overweight or obese, weight reduction may also be beneficial for reducing OA symptoms and slowing disease progression.<\/p>\n<p>Although sustained weight loss might support reduction of symptoms, the body has mechanisms to defend against weight loss, and most individuals experience weight gain. Therefore, strategies and recommendations around weight management should focus on improvements in overall health, OA symptoms, and physical function rather than weight lost or numbers on a scale.\u202fChanging body composition (decreasing body fat without weight change) may also be beneficial.<\/p>\n<p>Body Mass Index (BMI) is a screening tool used to classify normal, overweight and obesity in adults. It is calculated by dividing weight in kilograms by height in metres squared (kg\/m<sup style=\"color: #666;\">2<\/sup>). BMI only provides information about body size. It is not useful to identify the health status of an individual. When used in combination with waist circumference, it can indicate risk for obesity related illness such as diabetes, hypertension and cardiovascular disease. Another tool is the Edmonton Obesity Staging System<span class=\"tooltips\"><sup>3<\/sup><span class=\"tooltiptext\"><sup>3<\/sup>Sharma AM, Kushner RF. A proposed clinical staging system for obesity. International Journal of Obesity. 2009;33(3):289-95. <\/span><\/span> (EOSS). The EOSS is a classification system which takes into account the <span class=\"tooltips\">comorbid<span class=\"tooltiptext\">Rueda-Clausen CF, Poddar M, Lear SA, Poirier P, Sharma AM. Canadian Adult Obesity Clinical Practice Guidelines: Assessment of People Living with Obesity. <\/span><\/span> and functional impact obesity has on an individual\u2019s health to determine their stage of obesity (stage 0-4) and guide treatment options.<span class=\"tooltips\"><sup>3<\/sup><span class=\"tooltiptext\"><sup>3<\/sup>Sharma AM, Kushner RF. A proposed clinical staging system for obesity. International Journal of Obesity. 2009;33(3):289-95. <\/span><\/span><\/p>\n<\/div>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#000000&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;20px||||false|false&#8221; custom_padding=&#8221;20px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<div id=\"collaborating\" class=\"background2\">\n<h1 class=\"heading\">COLLABORATING ON WEIGHT MANAGEMENT<\/h1>\n<p>Weight bias is the negative attitudes, beliefs and assumptions towards individuals with obesity. One of the most important strategies to reduce weight bias is self-awareness. Clinicians should identify and address their own personal assumptions and attitudes about weight. Several resources are available including the Canadian Adult Obesity Clinical Practice Guidelines: <a href=\"https:\/\/obesitycanada.ca\/guidelines\/weightbias\/\" target=\"_blank\" rel=\"noopener\">Reducing Weight bias in Obesity Management Practice and Policy<\/a>.<\/p>\n<p>Understanding the individual\u2019s health priorities, goals, values and preferences is the starting point for having a discussion around weight management for OA. This includes asking the individual for permission to discuss body weight, assessing their weight history, previous and current behaviour management strategies, and interest in additional strategies or supports. Caution and supervision around weight management may be needed in individuals who are at-risk for conditions such as malnutrition or sarcopenia.<\/p>\n<div class=\"info-box\">\n<div class=\"col-icon\"><span style=\"font-size: 30px;\" class=\"et-pb-icon\">r<\/span><\/div>\n<div>\n<div class=\"tooltip-wrapper\" data-tooltip-wrapper=\"\">\n<p>Malnutrition and sarcopenic obesity would significantly complicate the person\u2019s efforts to participate in their OA treatment, and therefore these treatments should be addressed first.<span class=\"tooltips\"><sup>6<\/sup><span class=\"tooltiptext\"><sup>6<\/sup>Godziuk K, Prado CM, Woodhouse LJ, Forhan M. The impact of sarcopenic obesity on knee and hip osteoarthritis: A scoping review. BMC Musculoskeletal Disorders. 2018;19(1):1-10. <\/span><\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>All people, regardless of body size, are equally as susceptible to malnutrition and sarcopenia<span class=\"tooltips\"><sup>4, 5<\/sup><span class=\"tooltiptext\"><sup>4<\/sup>Lee S, Kim TN, Kim SH. Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: A cross\u2010sectional study. Arthritis &amp; Rheumatism. 2012;64(12):3947-54.<br \/>\n<sup>5<\/sup>Jin WS, Choi EJ, Lee SY, Bae EJ, Lee T-H, Park J. Relationships among obesity, sarcopenia, and osteoarthritis in the elderly. Journal of Obesity &amp; Metabolic Syndrome. 2017;26(1):36\u201344.<\/span><\/span>.<\/p>\n<p>There are a range of strategies available to support weight management in OA based on the individual\u2019s needs. Use <a href=\"#\" class=\"learn-more learn-more-shared-decision-making\">shared decision-making<\/a> techniques to create a plan that is tailored to the individual\u2019s goals, values and preferences. This may incorporate:<span class=\"tooltips\"><sup>7, 8<\/sup><span class=\"tooltiptext\"><sup>7<\/sup>Kahan S. Overweight and obesity management strategies. The American Journal of Managed Care. 2016;22(7):S186-S96.<br \/>\n<sup>8<\/sup>Obesity Canada. Canadian Adult Obesity Clinical Practice Guidelines (CPGs) Edmonton, Alberta: Obesity Canada; 2020 [Available from: https:\/\/obesitycanada.ca\/guidelines\/chapters\/. <span><\/span>:<\/span><\/span><\/p>\n<ul class=\"nest\">\n<li>Weight management services to support lifestyle intervention and behaviour interventions (nutrition, physical activity, sleep, stress reduction), to help the individual reach their health goal.\n<ul style=\"list-style: circle;\">\n<li>Examples provided in the Health Resource Matrix, in the Treatment Menu and on the Tables of Examples for the OA Treatments Toolbox.<\/li>\n<\/ul>\n<\/li>\n<li>Coordination and complementation with the individual\u2019s exercise and physical activity care plan (<span><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinician-exercise\/?et_fb=1&amp;PageSpeed=off\" class=\"in-text\">Standard 5<\/a><\/span>).<\/li>\n<li>Referral to supports for mental health or psychotherapy, which may assist with managing sleep, stress, and chronic pain as well as eating behaviours such as emotional eating.<\/li>\n<li>Referral to <a href=\"#\" class=\" learn-more learn-more-referral-between-clinicians\">appropriate supporting clinicians<\/a>\n<ul style=\"list-style: circle;\">\n<li>Possibly including referral to specialized multidisciplinary care for individuals with obesity.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#000000&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;20px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div id=\"continuing\" class=\"background1\">\n<h1 class=\"heading\">CONTINUING EDUCATION<\/h1>\n<p>For some <span>clinician<\/span>s the skills required for offering the support described in this standard may be an evolving skill set. There are a number of resources provided <span>in the <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/HealthResourcesCLINICIANS.pdf\" target=\"_blank\" rel=\"noopener\">Health Resources Matrix<\/a><\/span><span> to explore continuing education.<\/span><\/p>\n<\/div>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; module_class=&#8221;mob&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_accordion _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;7edfcb3f-f900-45e5-aca9-ee6492dc7b76&#8243; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_accordion_item open=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_css_main_element=&#8221;display:none;&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_accordion_item][et_pb_accordion_item title=&#8221;INTRODUCTION&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; open=&#8221;off&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p>A higher body weight and excess body fat have been linked with the development and progression of osteoarthritis (OA). This is due to additional mechanical stresses on the lower limb joints with higher body weight, and a metabolic and inflammatory relationship between body fat and OA disease progression<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Godziuk K, Kania-Richmond A, Hart D. Obesity: Implications for patients with osteoarthritis.<\/span><\/span>. Therefore, weight maintenance, or prevention of weight gain, is a foundational strategy in OA management. This is particularly important due to the risks of weight gain associated with both aging and inactivity.<\/p>\n<p>Weight reduction may also be beneficial for reducing OA symptoms and slowing disease progression.<\/p>\n<div class=\"info-box\">\n<div class=\"col-icon\"><span style=\"font-size: 30px;\" class=\"et-pb-icon\">r<\/span><\/div>\n<div>\n<div class=\"tooltip-wrapper\" data-tooltip-wrapper=\"\">\n<p>Studies have shown that losing 5-10% of body weight can reduce joint forces\/stresses and improve OA-related pain, physical function, and quality of life. Behaviour-based weight management approaches (using nutrition, activity and behavioural control strategies) usually result in sustained weight loss of 3-5% of body weight, however this could still be effective to improve symptoms.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>For individuals who are overweight or obese, weight reduction may also be beneficial for reducing OA symptoms and slowing disease progression.<\/p>\n<p>Although sustained weight loss might support reduction of symptoms, the body has mechanisms to defend against weight loss, and most individuals experience weight gain. Therefore, strategies and recommendations around weight management should focus on improvements in overall health, OA symptoms, and physical function rather than weight lost or numbers on a scale.\u202fChanging body composition (decreasing body fat without weight change) may also be beneficial.<\/p>\n<p>Body Mass Index (BMI) is a screening tool used to classify normal, overweight and obesity in adults. It is calculated by dividing weight in kilograms by height in metres squared (kg\/m<sup style=\"color: #666;\">2<\/sup>). BMI only provides information about body size. It is not useful to identify the health status of an individual. When used in combination with waist circumference, it can indicate risk for obesity related illness such as diabetes, hypertension and cardiovascular disease. Another tool is the Edmonton Obesity Staging System<span class=\"tooltips\"><sup>3<\/sup><span class=\"tooltiptext\"><sup>3<\/sup>Sharma AM, Kushner RF. A proposed clinical staging system for obesity. International Journal of Obesity. 2009;33(3):289-95. <\/span><\/span> (EOSS). The EOSS is a classification system which takes into account the <span class=\"tooltips\">comorbid<span class=\"tooltiptext\">Rueda-Clausen CF, Poddar M, Lear SA, Poirier P, Sharma AM. Canadian Adult Obesity Clinical Practice Guidelines: Assessment of People Living with Obesity. <\/span><\/span> and functional impact obesity has on an individual\u2019s health to determine their stage of obesity (stage 0-4) and guide treatment options.<span class=\"tooltips\"><sup>3<\/sup><span class=\"tooltiptext\"><sup>3<\/sup>Sharma AM, Kushner RF. A proposed clinical staging system for obesity. International Journal of Obesity. 2009;33(3):289-95. <\/span><\/span><\/p>\n<p>[\/et_pb_accordion_item][et_pb_accordion_item title=&#8221;COLLABORATING ON WEIGHT MANAGEMENT&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; open=&#8221;off&#8221; sticky_enabled=&#8221;0&#8243;]Weight bias is the negative attitudes, beliefs and assumptions towards individuals with obesity. One of the most important strategies to reduce weight bias is self-awareness. Clinicians should identify and address their own personal assumptions and attitudes about weight. Several resources are available including the Canadian Adult Obesity Clinical Practice Guidelines: <a href=\"https:\/\/obesitycanada.ca\/guidelines\/weightbias\/\" target=\"_blank\" rel=\"noopener\">Reducing Weight bias in Obesity Management Practice and Policy<\/a>.<\/p>\n<p>Understanding the individual\u2019s health priorities, goals, values and preferences is the starting point for having a discussion around weight management for OA. This includes asking the individual for permission to discuss body weight, assessing their weight history, previous and current behaviour management strategies, and interest in additional strategies or supports. Caution and supervision around weight management may be needed in individuals who are at-risk for conditions such as malnutrition or sarcopenia.<\/p>\n<div class=\"info-box\">\n<div class=\"col-icon\"><span style=\"font-size: 30px;\" class=\"et-pb-icon\">r<\/span><\/div>\n<div>\n<div class=\"tooltip-wrapper\" data-tooltip-wrapper=\"\">\n<p>Malnutrition and sarcopenic obesity would significantly complicate the person\u2019s efforts to participate in their OA treatment, and therefore these treatments should be addressed first.<span class=\"tooltips\"><sup>6<\/sup><span class=\"tooltiptext\"><sup>6<\/sup>Godziuk K, Prado CM, Woodhouse LJ, Forhan M. The impact of sarcopenic obesity on knee and hip osteoarthritis: A scoping review. BMC Musculoskeletal Disorders. 2018;19(1):1-10. <\/span><\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>All people, regardless of body size, are equally as susceptible to malnutrition and sarcopenia<span class=\"tooltips\"><sup>4, 5<\/sup><span class=\"tooltiptext\"><sup>4<\/sup>Lee S, Kim TN, Kim SH. Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: A cross\u2010sectional study. Arthritis &amp; Rheumatism. 2012;64(12):3947-54.<br \/>\n<sup>5<\/sup>Jin WS, Choi EJ, Lee SY, Bae EJ, Lee T-H, Park J. Relationships among obesity, sarcopenia, and osteoarthritis in the elderly. Journal of Obesity &amp; Metabolic Syndrome. 2017;26(1):36\u201344.<\/span><\/span>.<\/p>\n<p>There are a range of strategies available to support weight management in OA based on the individual\u2019s needs. Use <a href=\"#\" class=\"learn-more learn-more-shared-decision-making\">shared decision-making<\/a> techniques to create a plan that is tailored to the individual\u2019s goals, values and preferences. This may incorporate:<span class=\"tooltips\"><sup>7, 8<\/sup><span class=\"tooltiptext\"><sup>7<\/sup>Kahan S. Overweight and obesity management strategies. The American Journal of Managed Care. 2016;22(7):S186-S96.<br \/>\n<sup>8<\/sup>Obesity Canada. Canadian Adult Obesity Clinical Practice Guidelines (CPGs) Edmonton, Alberta: Obesity Canada; 2020 [Available from: https:\/\/obesitycanada.ca\/guidelines\/chapters\/. <span><\/span>:<\/span><\/span><\/p>\n<ul class=\"nest\">\n<li>Weight management services to support lifestyle intervention and behaviour interventions (nutrition, physical activity, sleep, stress reduction), to help the individual reach their health goal.\n<ul style=\"list-style: circle;\">\n<li>Examples provided in the Health Resource Matrix, in the Treatment Menu and on the Tables of Examples for the OA Treatments Toolbox.<\/li>\n<\/ul>\n<\/li>\n<li>Coordination and complementation with the individual\u2019s exercise and physical activity care plan (<span><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinician-exercise\/?et_fb=1&amp;PageSpeed=off\" class=\"in-text\">Standard 5<\/a><\/span>).<\/li>\n<li>Referral to supports for mental health or psychotherapy, which may assist with managing sleep, stress, and chronic pain as well as eating behaviours such as emotional eating.<\/li>\n<li>Referral to <a href=\"#\" class=\" learn-more learn-more-referral-between-clinicians\">appropriate supporting clinicians<\/a>\n<ul style=\"list-style: circle;\">\n<li>Possibly including referral to specialized multidisciplinary care for individuals with obesity.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>[\/et_pb_accordion_item][et_pb_accordion_item title=&#8221;CONTINUING EDUCATION&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221; open=&#8221;off&#8221;]<\/p>\n<p>For some <span>clinician<\/span>s the skills required for offering the support described in this standard may be an evolving skill set. There are a number of resources provided <span>in the <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/HealthResourcesCLINICIANS.pdf\" target=\"_blank\" rel=\"noopener\">Health Resources Matrix<\/a><\/span><span> to explore continuing education.<\/span><\/p>\n<p>[\/et_pb_accordion_item][\/et_pb_accordion][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px||0px||true|false&#8221; custom_padding=&#8221;0px|0px|0px|0px|true|true&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px||0px||true|false&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<a class=\"et_pb_button et_pb_button_0 stickyMenu floating et_pb_bg_layout_light\" href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinician-adjunct\/\" data-icon=\"=\"><span>VIEW NEXT<\/span><\/a>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"bookmark\">\n<div id=\"ribbon\"><span id=\"content\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/0-clinician-toolkit-introduction\/\">CLINICIANS<\/a><\/span><\/div>\n<\/div>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px|0px|0px|0px|false|false&#8221; custom_padding=&#8221;0px|0px|0px|0px|false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#FFFFFF&#8221; width=&#8221;100%&#8221; max_width=&#8221;2560px&#8221; custom_margin=&#8221;0px||0px||true|false&#8221; custom_padding=&#8221;0px|0px|0px|0px|true|true&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][el_modal_popup modal_id=&#8221;learn-more-shared-decision-making&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;learn-more-shared-decision-making&#8221; close_on_esc=&#8221;on&#8221; modal_title=&#8221;Shared Decision Making&#8221; show_footer=&#8221;off&#8221; disable_website_scroll=&#8221;off&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;0e4bb1fa-d312-42c0-b873-269eda7f61b5&#8243; modal_title_text_font_size=&#8221;23px&#8221; modal_title_text_letter_spacing=&#8221;1px&#8221; modal_title_text_line_height=&#8221;1em&#8221; modal_width_tablet=&#8221;&#8221; modal_width_phone=&#8221;&#8221; modal_width_last_edited=&#8221;on|desktop&#8221; border_radii_modal=&#8221;on|3px|3px|3px|3px&#8221; border_width_all_modal=&#8221;2px&#8221; border_color_all_modal=&#8221;#515151&#8243; box_shadow_style_trigger_element=&#8221;preset4&#8243; global_module=&#8221;6834&#8243; saved_tabs=&#8221;all&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; max_width__hover_enabled=&#8221;on|desktop&#8221;]<\/p>\n<div class=\"modal-container\"><div id=\"attachment_4837\" style=\"width: 310px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4837\" class=\"wp-image-4837 size-medium\" src=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/shared-decision-making-300x168.png\" alt=\"Shared decision making\" width=\"300\" height=\"168\" \/><p id=\"caption-attachment-4837\" class=\"wp-caption-text\">The inter-twining principles that ground the Comprehensive Quality Care Standards for Osteoarthritis of the Hip and Knee.<\/p><\/div><\/p>\n<p>Shared decision-making (SDM) techniques and processes are emphasized throughout these standards. The use of SDM is essential to achieving \u2018family and patient-centric\u2019 care. SDM is evidence-based and proven to improve outcomes for the individual such as satisfaction with and adherence to care plans.<\/p>\n<p><a class=\"in-text\" href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/clinician-care-plan\/\">Standard 2<\/a> describes how sharing the decision making is important for building a care plan. <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/2_SDM-Toolkit-3.pdf\" target=\"_blank\" rel=\"noopener\">This toolkit<\/a> <a class=\"in-text\" href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/3_OA-Self-Management-Toolkit.pdf\" target=\"_blank\" rel=\"noopener\">This toolkit<\/a> provides more detail on the 3-talk model that can be used to practice SDM in everyday practice.<\/p>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;learn-more-alberta-referral-directory&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;learn-more-alberta-referral-directory&#8221; close_on_esc=&#8221;on&#8221; modal_title=&#8221;Alberta Referral Directory&#8221; show_footer=&#8221;off&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;0e4bb1fa-d312-42c0-b873-269eda7f61b5&#8243; global_module=&#8221;9824&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<p><a href=\"https:\/\/albertareferraldirectory.ca\/PublicSearchController?direct=displaySpecialistSearch\" target=\"_blank\" rel=\"noopener\">Alberta Referral Directory<\/a> to assist with:\u00a0<\/p>\n<ul class=\"fix\">\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\">Identifying diagnostic imaging locations<br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\">Orthopaedic surgery referral requirements to the Alberta Hip and Knee Program (if appropriate)<br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\">Designing a local Resource Inventory and keeping it up to date<br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\">Referral to other clinicians<br \/><\/span><\/li>\n<\/ul>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;learn-more-resource-inventory-notes&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;learn-more-resource-inventory-notes&#8221; close_on_esc=&#8221;on&#8221; modal_title=&#8221;Resource Inventory Notes&#8221; show_footer=&#8221;off&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; global_module=&#8221;9835&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Resource Inventory Notes:<\/p>\n<ul class=\"fix\">\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a target=\"_blank\" rel=\"noopener\">Form clinic partnerships to create a common Resource Inventory for your local region <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a target=\"_blank\" rel=\"noopener\">Assign one person to review and update the Resource Inventory regularly <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a target=\"_blank\" rel=\"noopener\">Build relationships with the services listed on your Resource Inventory to make transition between care as smooth as possible for the individual with OA <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a target=\"_blank\" rel=\"noopener\">Keep accurate records of cost and wait times for local services to assist individuals wherever possible <\/a><br \/><\/span><\/li>\n<\/ul>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;learn-more-oa-self-management-toolkit-2&#8243; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;learn-more-oa-self-management-toolkit-2&#8243; close_on_esc=&#8221;on&#8221; modal_title=&#8221;OA Self Management Toolkit&#8221; show_footer=&#8221;off&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;default&#8221; global_module=&#8221;9827&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<p><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/3b_OA-Self-Management-Toolkit-Treatment-Menu.pdf\" target=\"_blank\" rel=\"noopener\">OA Self Management Toolkit<\/a>, Includes:<br \/><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/3_OA-Self-Management-Toolkit-3.pdf\" target=\"_blank\" rel=\"noopener\">OA Self Management Toolkit<\/a>, Includes:<\/p>\n<ul class=\"fix\">\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/3a_OA-Self-Management-Toolkit-Report-Card.pdf\" target=\"_blank\" rel=\"noopener\">Report Card <\/a><br \/><\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"font-size: medium;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/1b_OA-Self-Management-Toolkit-Treatment-Menu.pdf\" target=\"_blank\" rel=\"noopener\">Treatment Menu<\/a><br \/><\/span><\/li>\n<\/ul>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;learn-more-referral-between-clinicians&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;learn-more-referral-between-clinicians&#8221; modal_title=&#8221;Referral Between Clinicians &#8221; show_footer=&#8221;off&#8221; _builder_version=&#8221;4.18.0&#8243; _module_preset=&#8221;0e4bb1fa-d312-42c0-b873-269eda7f61b5&#8243; modal_width=&#8221;100%&#8221; global_module=&#8221;10005&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<p>The following matrix is provided to guide clinicians on referrals and building a multi-disciplinary team of support for an individual with osteoarthritis (OA). Some supporting clinicians will work in a dedicated team at the same centre as a Primary Clinician, other supporting clinicians will work at separate organizations in the community.<\/p>\n<table>\n<tbody>\n<tr>\n<th style=\"background-color: #fff;\">\u00a0<\/th>\n<th colspan=\"9\">Category of OA Treatments<\/th>\n<\/tr>\n<tr>\n<th>Discipline that may offer the treatment<\/th>\n<th>Education<\/th>\n<th>Exercise and Physical Activity<\/th>\n<th>Weight Management<\/th>\n<th>Supports (Walking and Environmental<\/th>\n<th>Cognitive Behavioural Therapy<\/th>\n<th>Inter-disciplinary Self-Management Programs<\/th>\n<th>Non-prescription Pharma Treatments<\/th>\n<th>Prescription Pharma Treatments<\/th>\n<th>Intra-articular Injections<\/th>\n<\/tr>\n<tr>\n<td>Family Physicians<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X*<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<\/tr>\n<tr>\n<td>Nurses<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<\/tr>\n<tr>\n<td>Physiotherapists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>Restricted<\/td>\n<\/tr>\n<tr>\n<td>Occupational Therapists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Kinesiologists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Exercise Physiologists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Sport and Exercise Medicine Physicians<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Radiologists<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Rheumatologists<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Physiatrists<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Chiropractors<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Orthopaedic Surgeons<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Pharmacist<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Registered Dietitians<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Counsellors<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Psychiatrists<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Psychologists\/Mental Health Therapists<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<tr>\n<td>Podiatrists<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Pedorthists<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>X<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<td>\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Note: The method of delivery of conservative OA treatments can vary between disciplines, between practices and between communities. Clinicians should talk with their individual with OA to make sure the referral will be the right fit for the individual.*Note: Clinicians can offer these services with the applicable training.<\/p>\n<\/div>\n<p>[\/el_modal_popup][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>CORE TREATMENT 3: WEIGHT MANAGEMENTSTANDARD 6When an individual identifies weight management as a priority in their care plan, they should be offered weight management options that are tailored to support their individual needs. Use of shared decision-making techniques will ensure the individual\u2019s priorities, goals, values and preferences are built into their weight management plan.<div class=\"et_pb_module lwp_divi_breadcrumbs lwp_divi_breadcrumbs_0\">\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t<div class=\"et_pb_module_inner\">\n\t\t\t\t\t<div class=\"lwp-breadcrumbs\"> <span class=\"before\"><\/span> <span vocab=\"https:\/\/schema.org\/\" typeof=\"BreadcrumbList\"><span property=\"itemListElement\" typeof=\"ListItem\"><a property=\"item\" typeof=\"WebPage\" href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/\" class=\"home\"><span property=\"name\">Home<\/span><\/a><meta property=\"position\" content=\"1\"><\/span> <span class=\"separator et-pb-icon\">&#x39;<\/span> <\/span><\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div><\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"class_list":["post-6646","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/pages\/6646","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/comments?post=6646"}],"version-history":[{"count":56,"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/pages\/6646\/revisions"}],"predecessor-version":[{"id":10156,"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/pages\/6646\/revisions\/10156"}],"wp:attachment":[{"href":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-json\/wp\/v2\/media?parent=6646"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}