Asking patients about their performance in daily activities including personal care, mobility and interactions with the built and social environment will provide valuable information about facilitators and barriers to engagement in daily activities, including treatment recommendations. This can help health care practitioners to tailor interventions for obesity treatment and management.
Places and spaces where health care service delivery occurs can be made physically accessible, equipped and respectful for use by persons living with obesity so that patients can access the full range of primary care services including assessment and treatment. Consideration of the accessible features surrounding the clinic space including access to parking, public transit, and door widths to accommodate mobility equipment are also needed.
Injury prevention, which includes falls risk reduction, is possible via the inclusion of exercises to improve postural control, balance, and lower extremity strength. The Falls Efficacy Scale1 is a psychometrically sound measure that determines an individual’s concern about their risk of falling while performing activities of daily living that involve walking or moving about.
Patients who report significant challenges with participation in activities of daily living may benefit from a referral for occupational therapy and/or physiotherapy.
Health care providers should look at the integrity of the patients’ skin and condition of any wounds in order to identify any areas of concern such as; pressure points, skin breakdown or signs of infection.2
We recommend that health care providers ask patients living with obesity if they have concerns about managing self-care activities such as bathing, getting dressed, bowel and/or bladder management, skin and/or wound care, foot care. (Level 3, Grade C)
We recommend that health care providers assess falls risk in people living with obesity as this could interfere with their ability and interest in participating in physical activity. (Level 3, Grade C)
The restricted range of motion, balance and mobility that some individuals living with obesity experience can impact the ability to complete self-care activities such as bathing, getting dressed, bowel and/or bladder management, skin and/or wound care, and foot care. Issues in this area may require adaptation of self-care activities and/or the use of assistive devices such as dressing aids, a long-handled reacher, long-handled sponges, bath benches, grab bars, and mobility aids.3
Some individuals living with obesity experience issues with mobility and are at risk for slips, trips and/or falls. This could interfere with the ability and interest in participating in physical activity. Be sure to let your healthcare practitioner know if you have had a fall or are fearful of falling as you go about your day to day activities.4
Obesity is associated with an increased risk of skin issues that can result in redness, blisters, rashes and open wounds that are resistant to healing. Individuals with obesity should routinely monitor the integrity of their skin and condition of any wounds in order to identify any areas of concern such as; pressure points, skin breakdown or signs of infection. Particular attention to be paid to areas in skin folds.2
Your healthcare practitioners’ offices and clinical care spaces should be physically accessible and equipped so that all patients, including those living with obesity, can access the full range of primary care services including assessment and treatment. Let your healthcare practitioner know if there are barriers that prevent you from fully participating in and accessing care. This includes access to parking or public transit, elevators, stairs, seating, doorways, washroom accessibility, etc. Advocate to have barriers addressed and spaces modified.