Bariatric Medicine: Struggles and Lessons Learned in the New World of COVID-19

Protecting Individuals Living with Overweight and Obesity: Attitudes and Concerns Towards COVID-19 Vaccination in Canada 

Stephen A. Glazer, MD, FRCPC, FCCP
Internal Medicine, Critical Care Medicine
Diplomat of the American Board of Obesity Medicine
President of the Canadian Association of Bariatric Physicians and Surgeons
Medical Director Bariatric Surgical Program, Humber River Regional Hospital
Assistant Professor, Department of Medicine, Queen's University
Lecturer, Department of Internal Medicine, University of Toronto
Toronto, ON

Dr. Stephen Glazer holds certification in Internal Medicine and Intensive Care Medicine from the University of Toronto in Ontario. He is also certified as a specialist in Sleep Medicine through the College of Physicians and Surgeons of Ontario. He has a strong interest in perioperative risk assessment. 

Dr. Glazer is both a provincial and a national leader in Bariatric Medicine. In 2010, Dr. Glazer became the Medical Director for both the Bariatric Surgical and Medical Program at Humber River Hospital, a dedicated center of excellence for the management of Obesity in Ontario. He is an active board member of the Ontario Bariatric Network, sitting on numerous subcommittees, including being the Vice-Chair of the OBN Medical Program Task Force. He is involved in establishing the standards of care for patients in Ontario participating in both surgical and medical approaches for weight loss. In 2012, he was among one of the first Canadian physicians who successfully completed the American Board of Obesity Medicine (ABOM) Certification examination and is a diplomat of the ABOM. 

In 2019, Dr. Glazer became the President of the  Canadian Association of Bariatric Physicians and Surgeons (CABPS), an national organization representing  Canadian specialists interested in the treatment of obesity for the purposes of  maintenance and improvement for the standards of Bariatric care in Canada, supporting both primary and continuing educational programs, knowledge, research and developing policies and new ideas in the areas of clinical care, education, and research in Bariatric Medicine and Surgery. 

Dr. Glazer participates in multiple clinical research projects and publications. He is the author of the Pre-Operative Management for Bariatric Surgery chapter for the 2020 Canadian Obesity Clinical Practice Guidelines. His greatest enjoyment is teaching and interreacting with other health care providers via lecturing at conferences or other educational venues. His enthusiasm and passion for the field of Obesity Medicine and the care of patients living with obesity is blatantly obvious and he hopes infectious to others.

Presentation Overview:

In an attempt to understand the psychosocial and behavioural impact of the COVID-19 pandemic on individuals living with overweight and obesity in Canada, we recently completed a survey-based study called the EPOCH study: Evaluation of the Pandemic on Obesity Care and Health.

The EPOCH survey included over 2000 Canadians living with overweight and obesity. It was one of Canada's largest obesity related surveys and was  a broad assessment of the impact of the COVID-19 pandemic on behaviour, emotions, and psychosocial functioning of those living with overweight and obesity.  Obesity is a risk factor for hospitalization, ICU admission and mortality from COVID-19.  

Vaccines have been developed to combat COVID-19 but are dependent on acceptance by the population; hence vaccine attitudes and fear play a strong role in achieving herd immunity.  The first of four articles to be published was on vaccine hesitancy. 

New finding in this manuscript: Approximately 40% of those living with obesity were not comfortable receiving a COVID-19 vaccination; and in the context of significant fear of COVID-19, especially for those in higher weight categories, confidence in vaccination programs is very low, especially in those pursuing obesity management. Impact of the findings on clinical practice in light of significant ambivalence concerning COVID-19 vaccination amongst those living with obesity, significant attention should be placed in communication skills promoting shared decision making to reduce ambivalence and build trust in medical recommendations.

The next paper will be the main results of the study submitted in the next several weeks. The results are fascinating and worrisome. It will speak to weight gain through this pandemic, patient preference and experience with medical treatment both in person and virtually, patient experience with weight bias and stigma, exercise sleep and substance abuse, psychiatric conditions, and an overall assessment of the drivers of weight gain during this pandemic