Obesity in Canada: Challenges and Opportunities

Yesterday, I applauded the Canadian Obesity Network for being internationally recognised as Canada’s official professional obesity association.

This is important because, although obesity now affects one in four adult Canadians, we are by no means alone with this problem.

Indeed, as noted by the Lancet in 2006,

“No health system is yet meeting the challenges of managing obesity, and no society has developed an effective strategy to prevent it.”

This is both a challenge and an opportunity for Canada. Challenge because our problem cannot be solved by simply importing successful models from elsewhere – there are none!

Opportunity, because we may well be the first to develop promising approaches that could serve as a ‘made in Canada’ solution to others.

Indeed, today I will be speaking at a Caribbean obesity conference in Bridgetown, Barbados, where obesity is rampant and diabetes is endemic. While the health care models that we are adopting in Canada to deal with our own obesity problems may not be easily transferable to Barbados, the same principles will likely hold true.

Public health measures based on the principles of shame, blame, tax, and ban, will prove as unhelpful here as they have proven unsuccessful everywhere else – not surprising as these measures fail to address the psychosocial and biological root causes of the problem.

There is also no doubt that health services approaches that do not embrace the complexity, heterogeneity, and chronicity of obesity, will be doomed to fail – obesity management has to be fully integrated into a chronic disease management framework that includes professional assessment, patient education, and lifelong self-management.

While not everyone with excess body fat needs to lose weight – many do. This will not be achieved by promoting endless cycles of yo-yo dieting with little or no professional help – there may well be far more harm in this than any potential benefit.

The causes of obesity are complex – the solutions cannot be simple.

Doing nothing is clearly not an option but let us at least stop doing things that have already been shown to fail (like simply telling people to eat less and move more).

AMS
Bridgetown, Barbados