Canada Needs a National Strategy to Tackle Obesities

Faithful readers may recall previous posts in which I described obesity as a complex heterogeneous disorder of multiple etiologies and called for a far more sophisticated classification of obesity in terms of its diagnosis, its complications, and perhaps most importantly, its diverse etiologies.

The fact that obesity is not a single syndrome or homogeneous entity is indirectly reflected in the language that Health Canada uses to describe the determinants of “healthy weight”:

“Healthy weight is influenced by a number of things, including your lifestyle, environment, metabolism (how quickly you transform food into energy), height, age, and family history/genetics.”

An even clearer recognition that obesity is simply a term used to describe a wide range of heterogeneous conditions (all of which result in excess weight) was perhaps evident in the recent UK Foresight Report, which preferred to use the term “obesities” rather than “obesity”.

The potential implications of speaking of “obesities” rather than “obesity” are profound and are vital to a meaningful public discourse on this issue.

Indeed, the term “obesities” not only implies that there are many causes and forms of obesity but also that no single prevention strategy or treatment will ever eradicate all forms of excess weight.

Some obesities may well be tackled with “social engineering” while other obesities may require highly specialised psychological, medical, or even surgical treatments.

People with some obesities may better manage their weight with education on healthy eating and activity, people with other obesities, who may already be eating healthy and physically active, will require completely different lines of treatment.

This is not unlike the situation with cancer, which most experts often refer to as “cancers”, because although all cancers are characterized by malignancy, there are countless types of cancers, each requiring its own specialised diagnosis and treatment.

Thus, when we speak of cancer prevention – we are actually speaking about preventing cancers. Some prevention strategies may well prevent some forms of cancer (e.g. smoking cessation for lung cancer), while the same strategy may have little or no impact on other cancers.

So let us make the national dialogue on obesity a national dialogue on obesities – what we need is a national strategy to address obesities – not just obesity.

Of course we are not about to rename the “Canadian Obesity Network” the “Canadian Obesities Network” or rename these pages “Dr. Sharma’s Obesities Notes” but perhaps, over time, we can all learn to automatically interpret the word “obesity” as really meaning “obesities”.

Lake Louise, Alberta