The Ontario Bariatric Network (OBN) was established in 2009 as part of the Ontario Bariatric Services Strategy through the Ministry of Health and Long Term Care (MOHLTC). The provincial bariatric program was developed to make treatment more accessible for people suffering from obesity and to improve patient navigation through the system.
Five regional bariatric surgery centres were funded across Ontario to provide bariatric surgery services. Guelph General Hospital Bariatric Centre of Excellence opened in August 2009 and offers a Medical Bariatric program as well as a Bariatric Surgery program.
Medical Bariatric Program
This program is a non-surgical, medically supervised outpatient program. The goal is to help people regain control over their health and weight.
- candidates not wanting or ready for surgery
- individuals deemed too high risk for surgery
Candidates are evaluated individually prior to being enrolled in the program. A team of experts help individuals build and practice skills needed to maintain healthy habits.
Individuals must commit to the full program of weekly meetings for 26 weeks.
Surgical Bariatiric Program
This program consists of a thorough evaluation, extensive education, bariatric surgery and a follow-up program after surgery.
- individuals who are morbidly obese (Obese Class III)
- well informed, motivated individuals
- candidates not at high risk for surgery
Candidates are individually evaluated prior to being enrolled in the program. Individuals must commit to attend all pre-op visits, tests and a follow-up program after surgery.
Health Canada classifies BMI for adults according to the associated risk of developing health problems:
|Less than 18.5
|18.5 to 24.9
|25.0 to 29.9
|30.0 to 34.9
||Obese class I
|35.0 to 39.9
||Obese class II
|40 or higher
||Obese class III
*The above classification does not apply to people younger than 18 years of age, pregnant women, or breast-feeding women. For people 65 years and older, the "normal" range is higher, beginning slightly above 18.5 and extending into the "overweight" range.
To calculate your BMI, click here
Prerequisites for Bariatric Surgery
- Smoking cessation for a minimum of 6 months before surgery
- Stable mental health
- No current substance abuse problems with drugs or alcohol
- Cancer free for 2 years
- Previous weight loss attempt for 6 months or longer, preferably with a registered dietitian
- Adequate molars for chewing
- Optimized glucose control with an A1C ideally less than 8.5%
- Sleep study if BMI over 50 or if indicated
- H-pylori blood test and treatment if positive and symptomatic. If treated for H-pylori, will need a recheck with a nuclear breath test
- Other lab tests to be done within 2 weeks of first individual appointment
- Commitment to program
- A family doctor or nurse practitioner must refer all patients to the clinic by completing a referral form through the Ontario Bariatric Registry click here
- Once the clinic receives the referral from the registry, the patient is mailed a date to attend a mandatory two-hour orientation session at the clinic.
- A package of information and a list of required tests are also mailed to the patient.
- Patients will be assessed by a registered nurse, registered dietitian and registered social worker on their first clinic visit after the orientation session.
- Each patient will return to the clinic for a number of follow-up appointments or classes based on the initial and ongoing assessments of the team.
- If the surgical treatment option is indicated, a meeting with a surgeon will be scheduled.
- If the interdisciplinary team feels the patient is a good candidate for bariatric surgery and has completed all of the necessary requirements, the patient will be booked for bariatric surgery.
To learn more about bariatric surgery and the Ontario Bariatric Network, click here