Canadian Arthritis Report Targets Obesity



Yesterday, the Arthritis Alliance of Canada together with the Canadian Arthritis Network released The Impact of Arthritis in Canada: Today and Over the Next 30 Years, a 50-page report that provides a detailed look at the impact of arthritis in Canada and offers solutions on how to mitigate and manage the situation.

According to this report, there are currently more than 4.4 million people living with osteoarthritis (OA) in Canada. In 30 years, more than 10 million or one in four Canadians is expected to have OA. Within a generation (in 30 years), there will be a new diagnosis of OA every 60 seconds.

Currently OA drives about $10 billion in direct health care costs and about $17 billion in indirect costs (lost wages, lost taxes, etc.) – together with other forms of arthritis (especially rheumatoid arthritis) the total cost of arthritis amounts to an estimated $33 billion annually. These numbers will on only grow.

Recognising that excess weight is one of the prime (modifiable) drivers of the OA epidemic, the report suggests that targeting obesity should be a priority (along with better access to joint replacements and adequate pain management) in reducing the burden of arthritis on Canadians.

As the report points out:

If a prevention program was available to reduce obesity rates by 50% in the Canadian population over the next 10 years:

• 45,000 new cases of OA could be avoided over 10 years and over 200,000 cases of OA could be avoided over 30 years;

• 25,000 workers could avoid OA over 10 years and over 136,000 cases of OA in the labour force could be avoided over 30 years;

• $3.8 billion could be saved in cumulative direct health care costs over 10 years and $48.3 billion over 30 years (2010 dollars); and

• $14.0 billion could be saved in cumulative productivity losses over 10 years and $163.7 billion saved over 30 years (2010 dollars).

(Limitation: Costs attributable to obesity-reduction interventions were unavailable and, therefore, not considered in the model.)

While this conclusion stresses the importance of obesity as a key driver of arthritis costs, this assumption of course is rather optimistic.

To my knowledge, there is no known prevention strategy that comes even close to reducing obesity prevalence by 50% in 10 years. Indeed, for those at the highest risk of OA, namely, those who are already obese, ‘prevention’ strategies come too late – you would actually have to look at ‘treatment’ strategies.

The authors are certainly aware of this as they concede that:

“Further research is needed to improve on current strategies for preventing and treating obesity.”

Fortunately, we’re already on it.

AMS
Edmonton, Alberta