About one-third of Canadians live with obesity, yet many health care professionals and policymakers lack a comprehensive understanding of what causes it, the challenges faced by people who live with it and the broader economic implications of doing nothing about it.
Most of the problems stem from the broad misconception that obesity is a lifestyle issue caused by a lack of discipline around food and exercise.
“Many people still believe that people with obesity just need to eat less, move more and have more willpower,” says Sanjeev Sockalingam, scientific director of Obesity Canada, a registered charity that aims to address the social stigma associated with obesity.
“But we know that obesity is impacted by many factors like genetics, neurobiology, environment and socio-demographic variables like people’s ability to have enough income to access good nutrition, housing and health care,” Dr. Sockalingam adds.
The Canadian Medical Association and the World Health Organization (WHO) consider obesity as a progressive chronic disease that requires treatment and prevention alongside other chronic diseases.
Obesity Canada says an estimated one in 10 premature deaths among Canadian adults are directly attributable to obesity. And, a recent Obesity Canada report shows the cost of inaction in treating obesity in Canada has reached a “staggering” $27.6-billion, which includes $5.9-billion in the health care system and $21.7-billion from increased absenteeism and presenteeism, reduced productivity and lower workforce participation, among other causes.
“If we don’t treat obesity, look at the costs that we as Canadians are enduring. And, most importantly, look at the disability impact and the risk of mortality that Canadians are facing,” Dr. Sockalingam says.
Obesity and its health impacts
Obesity is defined as an abnormal or excessive accumulation of fat that can be detrimental to your health. According to Obesity Canada, it results from complex interactions between genetic, environmental, behavioural and social factors. And while obesity can’t be cured, it can be controlled, like other chronic diseases such as diabetes or high blood pressure.
While the WHO defines obesity as a body mass index (BMI) greater than or equal to 30, experts say that measurement has limitations. For example, it doesn’t differentiate between lean mass and body fat, which means buff athletes like football players and weightlifters could be falsely classified as having or living with obesity by using this measure. BMI also doesn’t indicate how fat is distributed.
A commission of international medical experts recently proposed expanded diagnostic criteria to include factors like waist circumference, waist-to-hip ratio, and waist-to-height ratio.
Obesity has been linked to several life-altering medical conditions, such as Type 2 diabetes, various types of cancer, depression and dementia, says Abhinav Sharma, a cardiologist and clinician-scientist at McGill University.
He says there’s also a strong correlation between obesity and diabetes, high blood pressure, sleep apnea and liver disease – all of which are risk factors for cardiovascular disease.
“One in five individuals with obesity will suffer a heart attack; these are striking numbers,” Dr. Sharma says.
He says each of these medical conditions requires their own set of treatments, visits to specialists and lifestyle modifications, not to mention time away from work and family and managing the stress of knowing you’re living with serious diseases.
“When you start to add them all up, it produces a tremendous burden on individuals,” Dr. Sharma says.
The obesity stigma
People living with obesity face weight bias, stigma, discrimination, and not just from family, friends and co-workers but within the health care industry.
“People may have tried reaching out to multiple health care providers but faced comments like ‘you’re not working hard enough; you just need to control your eating and exercise,” Dr. Sockalingam says. “We don’t say things like that to people who are dealing with cancer.”
Patients living with obesity who feel shamed or judged at the doctor’s office are less likely to consult their physician to learn about all the options available to them for treating obesity, Dr. Sockalingam says. He believes health care workers should treat patients living with obesity with the same respect and compassion given to other chronic diseases.
To help reduce the stigma, Obesity Canada has created an obesity curriculum for health care workers. It’s designed to help them reflect on their attitudes and beliefs around the disease and ensure they’re not shaming people who need treatment.
“We need to make sure the next generation of care providers is equipped with the skills and knowledge that can really meet our patients and engage them with care, especially given how much they’ve had to endure in terms of stigma and weight bias over the course of their lifetime,” Dr. Sockalingam says.
He also believes there’s a need for policy change and a larger investment in obesity care, including more accessibility to psychological, pharmacological and surgical treatments for those in need.
Health care company Novo Nordisk Canada, which specializes in diabetes and obesity treatments, is also funding research, education and prevention initiatives in a multi-pronged approach to the obesity crisis.
For example, Novo Nordisk Canada recently partnered with the Nova Scotia government to create the Nova Scotia Lighthouse project to address childhood obesity and chronic disease in the province.
Novo Nordisk Canada also joined forces with the University of Toronto – each investing $20-million – to establish a network supporting health in urban communities. This investment will strengthen partnerships in health care, fund community outreach and support new and existing research.
“Beyond treatment, we’re looking at better ways to prevent, detect and manage obesity because, for society as a whole, this is a big burden to deal with,” says Vince Lamanna, president of Novo Nordisk Canada. “Maybe we can also discover and find cures here to defeat chronic diseases, like obesity.”
For that to happen, he says will require a more integrative approach to health care.
“It’s not just about you and your doctor. It’s also about your nurse, social worker and nutritionist coming together as a team because coordinated care delivers better results,” Mr. Lamanna says.
Advertising feature produced by Globe Content Studio with Novo Nordisk. The Globe’s editorial department was not involved.
link
