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Why The 500% Increase in Severe Obesity Should Concern Us All



sharma-obesity-waiting-timeAs someone working in a tertiary care bariatric clinic, I have often been accused of just seeing the tip of the iceberg.

Unfortunately, it is this “tip” that is growing the fastest, when it comes to the increase in obesity rates across Canada.

Thus, a paper by Laurie Twells and colleagues from Memorial University, St John’s, Newfoundland, published in CMAJ Open, not only predicts that overall obesity rates in Canada will continue to grow well into 2019, but also shows that between 1985 and 2011, the rates of Canadian adults with a BMI greater than 40 have increased from 0.3 to 1.6%.

Over the same time period, rates of Canadians with Class I and  Class II obesity have increased from from 5.1% to 13.1%, from 0.8% to 3.6%.

So, while the efforts in obesity prevention may or may not eventually lead to fewer people getting obese in the first place, our strategies are miserably failing those, who already have the problem.

This should come as no surprise, as Canada has yet to come up with a coherent strategy to address adult obesity.

As the authors note, there is indeed a wide variability between provinces when it comes to access to obesity treatments, irrespective of whether this is bariatric surgery or behavioural programs in primary care.

There also continues to be a significant deficit in training and education of health professionals in best-practices in the prevention of weight gain and obesity treatments.

Unfortunately, the impact of this lack of access and resources affects those the most, who already have the problem. They neither have the time to wait for prevention measures to kick-in nor do I expect measures aimed at prevention to lessen their health burden – they need treatments.

It would of course help if we actually had better treatments. Given a 95% failure rate of “Eat-Less-Move-More” approaches to obesity management, there is no doubt that the sooner we find more effective treatments, even if they only help prevent progression in those who already have the problem, the better for everyone.

After all we are talking about our families, friends, colleagues, neighbours – people, whose struggles with this condition should concern us all.

@DrSharma
Edmonton, AB

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