High Time For Canadian Governments To Recognise Obesity As A Chronic Disease

It has now been almost two years since the Canadian Medical Association declared obesity to be a chronic medical disease.

This declaration was widely praised by people living with obesity as well as healthcare and academic professionals (not least myself), who supported the notion that recognition of obesity as a disease would help precipitate a shift in thinking of obesity as just a lifestyle choice to a medical disease with an obligation to prevent and treat it as other chronic diseases.

Not much has happened since then – at least not as far as Canadian policy makers are concerned.

Thus, it is evident from the 2017 Report Card on Access To Obesity Treatment For Adults, released last week at the 5th Canadian Obesity Summit, that so far, neither the federal government nor any of the provincial/territorial governments in Canada have recognized obesity as a chronic disease. As discussed in the report, this has a significant negative trickle-down effect on access to obesity treatment for the over 6,000,000 Canadians living with this chronic disease, not to mention the millions of Canadians at high risk of developing this disease in the near future.

As a reminder, in preparing the Report Card, the Canadian Obesity Network extensively reviewed all publicly accessible resources and documents for evidence of policies, guidelines and services for obesity treatment and management in each province and territory. In addition, the Canadian Obesity Network tried to identify and speak directly to government officials in each province and territory regarding their take on obesity as a chronic disease.

This was by no means an easy task,

“The search for information on the recognition of obesity as a chronic disease and treatment guidelines or recommendations by provincial/territorial governments and identifying appropriate policy makers in each province/ territory required significant effort. many provinces and territories do not have a person or department dedicated to the bariatric or obesity-treatment portfolio.” 

As the Report Card highlights,

“Since the declaration, none of the provincial or territorial governments have officially recognized obesity as a chronic disease.”

“Health Canada has also not officially recognized obesity as a chronic disease and has continued to consider obesity as a lifestyle risk factor. There is no directive from Health Canada on the treatment and management of obesity in adults.”

It also notes that the 2016 report of the senate standing Committee on social affairs, science and technology titled Obesity in Canada, referred to obesity as a risk factor for several chronic conditions, but that not one of the 21 recommendations calls for better access to obesity management or bariatric care. Moreover, there was no mention of the existing Canadian Clinical Practice Guidelines, which clearly outline both preventive and treatment measures for Canadians.

This has important negative consequences for the millions of Canadians living with this disease. Thus,

“Canadians living with obesity are largely left to navigate a complex landscape of weight-loss products and services, many of which lack scientific rationale and openly promote unrealistic and unsustainable weight-loss goals. Failure rates of over 95% perpetuate a vicious cycle of “yo-yo dieting,” resulting in frustration, depression, poor self-esteem and further weight gain.”

This is not to mention the substantial humanitarian, physical, emotional, and societal costs that are directly related to not managing this chronic disease.

If and when Canadian governments and healthcare systems will step up to the plate and take responsibility for providing access to evidence-based obesity treatments to Canadians living with obesity is anyone’s guess.

Two years after the declaration, the vast majority of Canadians living with obesity are still waiting for respect and services from their publicly funded health services.

Sadly, not much to write home about.

@DrSharma
Edmonton, AB