AN­GE­LO JE­DIDI­AH

Re­porter

an­ge­lo.je­didi­ah@guardian.co.tt

For many peo­ple, the num­bers on the scale mat­ter more than any­thing - so much so that they’ve built their en­tire self-im­age around a spe­cif­ic weight. How­ev­er, obe­si­ty and weight man­age­ment spe­cial­ist Dr Bri­an Chadee is chal­leng­ing that mind­set by re­plac­ing shame with per­son­alised care, ex­er­cise, and a deep­er look at the per­son be­hind the weight.

The cen­turies-old ad­vice for los­ing weight has sound­ed al­most (painful­ly) sim­ple: “Eat less, ex­er­cise more, lose weight.”

Of­ten­times, for those strug­gling with their weight, this ad­vice comes wrapped in even harsh­er lan­guage. The the­o­ry be­hind ‘fat-sham­ing’ (crit­i­cis­ing or ha­rass­ing some­one about their body weight, size, or eat­ing habits) has been used as a crude method to in­crease the nec­es­sary willpow­er to lose weight.

Dr Chadee be­lieves this ap­proach is en­tire­ly wrong. Be­hind the strug­gle, he ex­plains, is of­ten a per­son deal­ing with com­plex un­der­ly­ing is­sues.

“This is not your fault. There are many fac­tors such as your ge­net­ics, your en­vi­ron­ment, and child­hood trau­ma. All these things that could es­sen­tial­ly in­flu­ence your weight, and you have no con­trol over,” Dr Chadee told Guardian Me­dia.

Com­bined with dai­ly life stress and fi­nan­cial pres­sures, these fac­tors can lead to a dif­fi­cult re­la­tion­ship with food and poor lifestyle choic­es, not be­cause some­one is “lazy” or “lack­ing dis­ci­pline.”

As a med­ical doc­tor, Dr Chadee has worked across sev­er­al ar­eas of the pub­lic health sec­tor, in­clud­ing emer­gency and in­ter­nal med­i­cine, car­ing for pa­tients at fa­cil­i­ties across the coun­try. But at 33, his grow­ing in­ter­est in obe­si­ty care has tak­en his med­ical ca­reer in a new di­rec­tion.

The Gym Clin­ic

Dr Chadee fur­thered his med­ical spe­cial­i­sa­tion in obe­si­ty, meta­bol­ic health and weight man­age­ment, earn­ing cer­ti­fi­ca­tion in obe­si­ty care from the World Obe­si­ty Fed­er­a­tion (SCOPE) - the pre­mier in­ter­na­tion­al cer­ti­fi­ca­tion pro­gramme for obe­si­ty man­age­ment.

But as a fit­ness en­thu­si­ast him­self, he re­alised T&T did not need an­oth­er iso­lat­ed doc­tor’s of­fice or com­mer­cial gym. To­geth­er with his wife, Jenelle Chadee, they found­ed the Gym Clin­ic, lo­cat­ed in Palmiste, to of­fer a mul­ti­dis­ci­pli­nary ap­proach to weight man­age­ment. A mes­sage they share across so­cial me­dia.

“I want­ed to com­bine fit­ness and ex­er­cise pre­scrip­tion with med­i­cine, my pro­fes­sion. So hence the name.”

Work­ing along­side ex­perts in lifestyle med­i­cine, nu­tri­tion, per­son­al train­ing, and phys­io­ther­a­py, Dr Chadee says he pro­vides ev­i­dence-based care for pa­tients liv­ing with over­weight and obe­si­ty.

“Obe­si­ty is so com­plex. It’s mul­ti­fac­to­r­i­al. And there are so many caus­es and stig­ma around obe­si­ty.”

Con­fronting obe­si­ty

For Dr Chadee, the ini­tial con­sul­ta­tion is key. It is not just about record­ing a pa­tient’s weight, but un­der­stand­ing why they came, what their goals are, and what bar­ri­ers stand in their way.

“When they come say­ing, ‘Doc, I want to im­prove my health’ I smile. Be­cause usu­al­ly, if they come and say ‘You know, I want to drop ten, fif­teen pounds’, I know that al­right, I have to do some coun­selling here,” Dr Chadee ex­plained.

He em­pha­sis­es that un­der­stand­ing why some­one wants to lose weight is cru­cial. If their mo­ti­va­tion stems from the be­lief that weight loss alone will bring hap­pi­ness, he en­cour­ages them to look be­yond the scale.

When peo­ple fo­cus sole­ly on body weight, the goal­posts con­tin­u­al­ly move, leav­ing ex­pect­ed hap­pi­ness out of reach.

Dr Chadee urges pa­tients to fo­cus on over­all health rather than mak­ing weight loss the sole met­ric of suc­cess.

When men­tal and emo­tion­al bur­dens are sig­nif­i­cant, he refers pa­tients to be­hav­iour­al health pro­fes­sion­als.

Dr Chadee stress­es that fat-sham­ing does not just hurt feel­ings - it caus­es re­al dam­age.

“Re­search ac­tu­al­ly shows that stig­ma and bias and sham­ing about weight, it ac­tu­al­ly does the op­po­site. It de­creas­es phys­i­cal ac­tiv­i­ty. It de­creas­es the chances of some­body who is over­weight, their chances of go­ing and seek­ing med­ical at­ten­tion,” he said.

In many cas­es, that stig­ma orig­i­nates with­in the health­care sys­tem it­self.

“The first thing the doc­tor may say is, ‘you just need to lose weight.’ They gone for back pain. They gone for headache, the doc­tor says you have to lose weight. So you know, all those things they in­ter­nalise and they just don’t go by the doc­tor, re­duc­ing doc­tor vis­its and be­com­ing a dri­ver it­self of obe­si­ty.”

Ad­dress­ing

the is­sue

Dr Chadee is work­ing to break that cy­cle. Pa­tients who vis­it The Gym Clin­ic are not sim­ply placed on a tread­mill. While “ex­er­cise is med­i­cine” re­mains his core mantra, he clar­i­fies that ex­er­cise alone is not a com­plete treat­ment for obe­si­ty.

The same ap­plies to di­et­ing, as many peo­ple mis­tak­en­ly be­lieve that sim­ply “eat­ing healthy” is a full cure.

“Di­et and ex­er­cise are re­al­ly good for your health. Im­prov­ing your blood sug­ar, your cho­les­terol, your men­tal health, all these things. But in gen­er­al, treat­ing obe­si­ty as a stand­alone [is­sue] is not enough.”

“There are some pa­tients who need med­ica­tion. If they need it, I would say, ‘hey, we have this med­ica­tion’ and ed­u­cate them on it with all the re­search. Maybe they might need to go see a ther­a­pist for binge eat­ing. Some­times I will need to guide them through a nu­tri­tion plan. Every pa­tient is dif­fer­ent.”

The clin­ic is not strict­ly for weight loss. Shift work­ers, teenagers, and adults of all ages con­sult with Dr Chadee to build strength for dai­ly tasks, work, or sports. Care plans (nu­tri­tion and ex­er­cise pre­scrip­tions) are tai­lored to in­di­vid­ual needs, ad­dress­ing spe­cif­ic phys­i­cal or med­ical lim­i­ta­tions and ex­ter­nal bar­ri­ers.

“Let’s say they have a shoul­der is­sue, or they can’t do too much ex­er­cise be­cause of a heart con­di­tion, I give them that ex­er­cise pre­scrip­tion. I lit­er­al­ly walk them out the door and I hand them off to a per­son­al train­er, where they have that pri­vate train­ing and some­thing that is de­vel­oped specif­i­cal­ly for them.

“I com­mu­ni­cate with the train­er, the per­son­al train­er, and he com­mu­ni­cates with me, and we go back and forth. That’s how we use ex­er­cise it­self as a pre­scrip­tion.”

And while spread­ing the mes­sage that shame has no place in health, Dr Chadee al­so re­minds pa­tients that they do not need to wage war on food. He ad­vo­cates for flex­i­ble, in­tu­itive eat­ing over la­belling foods as “good” or “bad.”

“Your over­all di­etary needs could be bal­anced for you. It must be bal­anced for you. Not your neigh­bour, not your par­ents, but for you.”