“The rates of obesity are increasing across the provinces and territories,” says Ximena Ramos Salas of the Canadian Obesity Network. “What we are seeing more of is severe obesity increasing at an even faster rate. We usually measure obesity using the body mass index (BMI), and looking at BMI levels of 30, which is obesity, we are seeing BMI levels of 35, 40 and 45 increasing at a faster rate.”
Earlier this year the Canadian Obesity Network released a report card on obesity treatment in every province and territory. It didn’t make for happy reading, with most jurisdictions found lacking in terms of medical weight management, registered dietitians, obesity medications and bariatric surgery.
Such treatment is used either to prevent the disease from occurring, or eliminating it when it does. According to Salas, it is an illness that isn’t considered like other chronic diseases, which goes some way to explaining the lack of care.
“It is a chronic disease like diabetes, like cancer, like heart disease,” she says. “In our report we found that none of the governments in Canada or the insurance companies treat obesity as a chronic disease. They consider it a lifestyle risk factor, and that is the fundamental barrier we have in increasing access to treatment.”
Such views, especially at an institutional or government level, is highly damaging, believes Salas. Obesity is a growing problem in Canada, and needs to be recognized as such by those with the power to make a difference, she adds.
“Telling people to eat less, move more, and just lose weight on their own is as helpful as telling somebody with depression to smile and be happy,” says Salas. “There are a lot of biological and physiological issues that prevent someone from managing their weight. There needs to be access to interdisciplinary support for people that have obesity.”
Salas believes that support should come from both government and employer-sponsored health plans, which will require a significant shift in position regarding obesity and its causes.
“No province provides access to the anti-obesity medications that have been accepted by Health Canada,” says Salas. “Our survey also found that in a sample of 45% of Canadians who have private drug insurance, only 8.8% had access to anti-obesity medications through their drug insurance plans.”
She adds: “When people try to access treatment through their health plans, they are told obesity is a lifestyle risk factor. The programs that are available in that category are not in the clinical practice guidelines for obesity. Moving obesity out of the lifestyle box and into chronic disease will be a big step for the insurance industry.”
Canadians' health under threat from spiralling obesity rates
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Stigma of obesity is holding back treatment of the disease, with government bodies and insurance companies among the biggest culprits. That’s the view of the Canadian Obesity Network, a non-profit organization dedicated to creating awareness and changing policy on this issue. Obesity has been identified by the World Health Organisation as a global threat, as prevalence rates have almost tripled since 1975. That increase means 39% of adults were overweight in 2016, and 13% were deemed obese. It is a number predicted to get worse in the short term, which is why groups like the Canadian Obesity Network are calling for urgent action.