Canadians face a significant gap in access to coverage for obesity-related treatments, a new report suggests.

In a survey of Canadians with private drug insurance, only 8.8 per cent reported having access to anti-obesity medications, according to a new report from the Canadian Obesity Network. It also found public and private plans don’t tend to cover the cost of meal replacements as part of weight-management programs.

“There doesn’t seem to be a long-term chronic disease management strategy for obesity as there seems to be for other chronic diseases,” says Dr. Arya Sharma, scientific director at the Canadian Obesity Network.

Read: Healthy Outcomes: Cheat days ‘problematic,’ says obesity expert

The study also noted many Canadians who have benefits plans can’t use their health spending accounts to submit claims for obesity-related products or file the treatment as a medical expense on their income tax. And while Health Canada has approved two obesity medications, Orlistat and Liraglutide, most plan sponsors don’t include them on their drug formularies. At a cost of roughly $150 to $400 per month, the drugs are comparable in price with those for chronic conditions like diabetes and hypertension, says Sharma.

Given the report’s findings, Sharma urges public and private payers to prioritize obesity as a chronic disease and look at boosting the treatment options available for patients by providing them with access to specialists and interdisciplinary teams, medically supervised weight-management programs with meal replacements, anti-obesity medications and bariatric surgery.

Read: Addressing obesity in the workplace

While some plans do cover the medications, most employers prefer to focus on the root causes of obesity because the drugs often come with side-effects, says Joseph Chan, a benefits consultant and vice-president at advisory firm Stem Capital Inc. “Treatment is good, but you want to look at what’s causing the condition.”

While health spending accounts don’t cover medically supervised weight-management programs with meal replacements, a wellness account may offer some coverage, says Chan.

Most employers, he adds, choose to address the issue through prevention and wellness programs that encourage people to eat better and exercise more. Chan notes some organizations have focused on other ways to tackle obesity, whether by addressing mental-health issues that may play a role in overeating and weight gain or providing resources such as subsidies for healthy meals or access to a dietitian or nutritionist.

But those approaches aren’t sufficient, notes Sharma, adding that society still sees obesity as a lifestyle problem, as it did with diabetes and high blood pressure in the past. While someone with those two chronic diseases will get referrals to medical treatment, people dealing with obesity are expected to fix the problem on their own by changing their lifestyle or following commercial programs, says Sharma. And dealing with the problem by themselves is a major challenge, he adds.

Read: The growing costs of treating chronic illnesses

“Let’s say you get to 250 pounds, doesn’t matter how you get to 250 pounds, but once you get to [that weight], you’re there for a while,” he says. “It’s like your body resets and just says that 250 pounds is where you need to be, and as you start trying to lose weight, whether through exercise or diet, your body is always going to try to get you back to 250 pounds because that’s how our bodies work.”

Science supports the fact that obesity is a chronic disease, yet many organizations don’t recognize it as such, according to Sharma. And measures that focus on preventing obesity with information and wellness programs aren’t enough, he adds. “Nobody talks about the seven million people who already have the problem and where they go for help and what’s being offered to them in terms of access to treatment for obesity.”

Read: The economic burden of smoking, obesity and inactivity

Employers, in particular, should address the lack of treatment options because they have a stake in the matter, says Sharma, citing the links to issues such as absenteeism, presenteeism and benefits costs. “There’s a very substantial cost to employers, so they definitely need to worry about it.”

And while efforts to promote healthy behaviour in the workplace may be effective for the general population, they don’t necessarily work people dealing with obesity, says Sharma. “People fall into the trap of saying, ‘Let’s provide wellness, maybe improve food in the cafeteria, provide access to a gym or treadmill and the problem will go away.’ But there’s actually very little evidence those things work. For most people, they’re not going to have a significant impact on their body weight in the long term.”

Read: Chronic diseases connected to mental health issues

Copyright © 2018 Transcontinental Media G.P. Originally published on benefitscanada.com

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