We live in an information ecosystem — especially when talking about obesity — that’s full of misinformation, fads and gimmicks, said Ian Patton, director of advocacy and public engagement at Obesity Canada, during a session at Benefits Canada’s 2023 Chronic Disease at Work conference in early February.
In the session, supported by Desjardins Insurance, he noted it can be really difficult to decipher what’s real and what’s valid and evidence-based. “Obesity is more than someone’s weight or size. It’s an upstream condition that has many significant impacts on downstream health.”
Also speaking during the session, Mary Forhan, professor and chair at the University of Toronto’s department of occupational sciences and occupational therapy, defined obesity as a prevalent, complex, progressive and relapsing condition characterized by abnormal or excessive body fat. Body mass index doesn’t measure adiposity (the storage of fat), which is why it’s really important to use more than BMI when defining obesity, she said.
The chronic condition should be managed using evidence-based chronic disease management principles, said Forhan, noting these principles need to validate people’s lived experiences and move beyond the simple approach of “eat less, move more.”
In addition, when it comes to obesity management support, she outlined three key pillars: psychological interventions, which are multi-component and can include behaviour modification, sleep and stress management and forms of evidence-based therapy like cognitive behavioural therapy; pharmacological therapy, which looks at medications and pharmaceutical interventions that can help those living with obesity; and bariatric surgery.
When employers are considering their benefits plans, Forhan suggested they examine whether there are good support and tools for obese employees within these three pillars. It’s important to have a scope of options because, depending on the type of obesity, everyone has their own individual needs, she added. “Psychological makeup is really important and no one treatment will fit all people. We need to personalize and customize treatments for each person in terms of health outcomes and overall quality of life. This will be beneficial in the employee space, as well as chronic disease management as a whole.”
Effective obesity management is also vital to the treatment of other chronic conditions, such as diabetes, hypertension and cardiovascular disease, added Patton, noting it’s important for group benefits plans to include access to obesity-related services that use evidence-based approaches to screening and assessment.
More and more, employees are defining their weight as inappropriate, said Forhan, and these individuals must receive proper guidance to decipher whether obesity treatment is the right fit for them. For those who don’t have an obesity diagnosis, she noted it’s important to have access to services that address wellness, too.
A recent study found employees believe a work environment that’s friendly and free from harassment or discrimination is beneficial in supporting obesity management, she said, suggesting employers provide employees with a wellness fund that has access to physical activities. “For those in the workplace who have chronic conditions or feel as through their weight is inappropriate, these wellness approaches will be beneficial. They will also benefit all of your workforce, not just those living with obesity or [those who] have concerns about their weight.”
In addition, Patton highlighted how a person’s negative feelings about themselves can impact their mental health, well-being or productivity, which he called a product of the oversimplification of obesity. Feelings of hopelessness are often tied to the fact that there are things that can be done, but people simply don’t have the access, he added. “We don’t have enough health professionals trained in obesity management. Wait times for specialized obesity care are dangerously long and access to effective medications or therapies isn’t great.”
People living with obesity experience a great deal of stigma, bias and discrimination, he noted, referring to research that has shown individuals living with obesity are often treated differently in the workplace. This can also have a serious impact on mental health, well-being and productivity. “It’s really important to understand and recognize weight bias and discrimination and to assess your own beliefs and attitudes towards people living with obesity.”
What can employers and benefits providers do? Patton urged employers to understand that obesity is a chronic condition and the stigma attached is very pervasive. Bias hinders progress when it comes to obesity management, as those affected tend to stop accessing health care or avoid it altogether because of how they’re treated, he added.
It’s important to provide coverage for obesity treatments, as well as support that’s evidence-based, he noted. “Successful obesity management is possible if we’re going to address this complex issue and find preventative measures. We need to have a variety of different treatment options and management tools at our disposal.”
Read more coverage of the 2023 Chronic Disease at Work conference.