Report Card on Access to Obesity Treatment for Adults in Canada 2017: Recommendations
Based on the failing access to obesity care for the overwhelming majority of the 6,000,000 Canadians living with obesity in our publicly funded healthcare systems, the 2017 Report Card on Access To Obesity Treatment For Adults, released the 5th Canadian Obesity Summit, has the following 7 recommendations for Canadian policy makers: Provincial and territorial governments, employers and the health insurance industry should officially adopt the position of the Canadian Medical Association that obesity is a chronic disease and orient their approach/resources accordingly. Provincial and territorial governments should recognize that weight bias and stigma are barriers to helping people with obesity and enshrine rights in provincial/territorial human rights codes, workplace regulations, healthcare systems and education. Employers should recognize and treat obesity as a chronic disease and provide coverage for evidence-based obesity programs and products for their employees through health benefit plans. Provincial and territorial governments should increase training for health professionals on obesity management. Provincial and territorial governments and health authorities should increase the availability of interdisciplinary teams and increase their capacity to provide evidence- based obesity management. Provincial and territorial governments should include anti-obesity medications, weight-management programs with meal replacement and other evidence-based products and programs in their provincial drug benefit plans. Existing Canadian Clinical practice Guidelines for the management and treatment of obesity in adults should be updated to reflect advances in obesity management and treatment in order to support the development of programs and policies of federal, provincial and territorial governments, employers and the health insurance industry. If and when any of the stakeholders adopt these recommendations is anyone’s guess. However, I am certain that since the release of the Report Cards, the relevant governments and other stakeholders are probably taking a closer look at what obesity management resources are currently being provided within their jurisdictions. Given that things can’t really get any worse, there is hope that eventually Canadians living with obesity will have the same access to healthcare for their chronic disease as Canadians living with any other illness. @DrSharma Edmonton, AB
Canadians Have Virtually No Access To Interdisciplinary Obesity Care
Every single guideline on obesity management emphasises the importance of interdisciplinary obesity management by a team that not only consists of a physician and a dietitian but also includes psychologists, exercise specialists, social workers, and other health professionals as deemed necessary. As is evident from the evident from the 2017 Report Card on Access To Obesity Treatment For Adults, released last week at the 5th Canadian Obesity Summit, the overwhelming majority of Canadians living with obesity have no access to anything that even comes close. Thus, the report finds that Among the health services provided at the primary care level for obesity management, dietitian services are most commonly available. Access to exercise professionals, such as exercise physiologists and kinesiologists, at the primary care level is limited throughout Canada. Access to mental health support and cognitive behavioural therapy for obesity management at the primary care level is also limited throughout Canada. bariatric surgery programs often have a psychologist or a social worker that offers mental health support and cognitive behavioural therapy to patients on the bariatric surgery route, but the availability of these supports outside of these programs is scarce. Centres where bariatric surgery is conducted also have inter- disciplinary teams that work within the bariatric surgical programs and provide support for patients on the surgical route. Alberta and ontario have provincial programs with dedicated bariatric specialty clinics that offer physician-supervised medical programs with interdisciplinary teams for obesity management. Interdisciplinary teams for obesity management outside of the bariatric surgical programs are available in one out of five regional health authorities (RHa) in british Columbia, one out of 18 RHas in Québec, one out of two RHas in new brunswick and one out of four RHas in newfoundland and labrador. Among the territories, only yukon has a program with an interdisciplinary team focusing on obesity management in adults. I hardly need to remind readers, that this is in stark contrast to the resources and teams available to patients with diabetes, heart disease, lung disease, or any other common chronic disease, that are regularly available in virtually every health jurisdiction across the country (not to say that they are perfect or sufficient – but at least there is some level of service available). I understand that our current obesity treatments are extremely limited (at least when effectiveness is measured in terms of weight loss). But even if access to these resources could simply help stabilise and… Read More »
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… Read More »
Another Canadian Obesity Summit Exceeds Expectations
Wow, what a week! Just back from the 5th Canadian Obesity Summit, there is no doubt that this summit will live long in the minds (and hearts) of the over 500 attendees from across Canada and beyond. As anyone would have appreciated, the future of obesity research, prevention and practice is alive and kicking in Canada. The over 50 plenary review lectures as well as the over 200 original presentations spanning basic cellular and animal research to health policy and obesity management displayed the gamut and extent of cutting-edge obesity research in Canada. But, the conference also saw the release of the 2017 Report Card on Access to Obesity Treatment for Adults, which paints a dire picture of treatment access for the over 6,000,000 Canadians living with this chronic disease. The Report Card highlights the virtually non-existant access to multidisciplinary obesity care, medically supervised diets, or prescription drugs for the vast majority of Canadians. Moreover, the Report Card reveals the shocking inequalities in access to bariatric surgery between provinces. Merely crossing the border from Alberta to Saskatchewan and your chances of bariatric surgery drops from 1 in 300 to 1 in 800 per year (for eligible patients). Sadly, numbers in both provinces are a far cry from access in Quebec (1 in 90), the only province to not get an F in the access to bariatric surgery category. The presence of patient champions representing the Canadian Obesity Network’s Public Engagement Committee, who bravely told their stories to a spell-bound audience (often moved to tears) at the beginning of each plenary session provided a wake up call to all involved that we are talking about the real lives of real people, who are as deserving of respectful and effective medical care for their chronic disease as Canadians living with any other chronic disease. Indeed, the clear and virtually unanimous acceptance of obesity as a chronic medical disease at the Summit likely bodes well for Canadians, who can now perhaps hope for better access to obesity care in the foreseeable future. Thanks again to the Canadian Obesity Network for hosting such a spectacular event (in spectacular settings). More on some of the topics discussed at the Summit in coming posts. For an overview of the Summit Program click here @DrSharma Edmonton, AB
Public Engagement For Obesity
This week, the Canadian Obesity Network will host its 5th National Obesity Summit in Banff, Alberta. While the formal program begins on the evening of the 26th with the delivery of Award lectures, there are plenty of pre-conference workshops to chose from. One such workshop is the strategy meeting of the Network’s Public Engagement Committee, which will meet in person to discuss the Network’s public engagement strategy. As reader may know, this committee was formed two years ago at the last Canadian Obesity Summit in Toronto (image) and has been extremely active since in helping plan and provide direction for the Network’s activities to tie in and meet the interests and needs of the nearly 7,000,000 Canadians living with obesity. It is fair to say, that their voice has been largely ignored in the policy discussions around obesity prevention and management and there is little evidence that Canadians living up with obesity are speaking up for themselves. This is a crying shame, as who should know more about the realities and challenges that Canadians living with obesity face everyday in settings including education, workplace, and society in general? Unfortunately, the challenges also extend to health care – as will become evident from the Report Card on Access to Obesity Treatments in Canada, which will be released at the Summit later this week. With this work, the Network is following closely in the footsteps of the Obesity Action Coalition and the EASO Patient Council to provide a voice at the table for Canadians living with this chronic disease. I look forward to a most exciting and informative week. @DrSharma Banff, AB
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