Supporting employees with obesity starts with recognizing it’s a chronic disease

Six million Canadians are living with obesity and its prevalence is continuing to rise, said David Macklin, medical director of the weight management program at Medcan, during a session at Benefits Canada’s 2019 Chronic Disease at Work conference in Toronto on June 5.

While many may consider obesity to be a matter of will power, simply eating less and moving more, it’s a chronic, progressive, genetically-conferred medical condition, he added. “In fact, 70 to 75 per cent of someone’s risk of struggling with their weight is determined by their genes; it’s powerfully environmentally influenced.”

Read: Employers urged to boost tracking of obesity efforts

Employers should recognize that employees who struggle with obesity are living with a complex medical condition. “Like any other chronic disease, we help people and support them,” said Macklin. “We don’t think about having to treat their multiple sclerosis or ulcerative colitis.”

There are effective, safe and affordable medications that can be accompanied by behavioural modification, he noted. “These medications are mostly thought of in the employer base as lifestyle medications because of the belief that obesity is a lifestyle disease.

“If we recognize this condition is treatable, we can significantly decrease the impact it has on the employee base,” he added, noting obesity in Canada has a high economic cost, at about $7.1 billion in 2006 alone. As obesity rates increase, absenteeism and presenteeism levels rise, he noted. “This is not only because of the state of obesity, but because of the conditions it’s co-morbid with.”

Read: Comorbidity a growing concern as Canadian workforce ages

Depression, which can be a consequence of obesity, has had a significant effect on productivity in the workplace when it comes to absenteeism and presenteeism, said Macklin, noting obesity and depression are bidirectional, so those living with depression are more at risk of developing obesity. “But the other direction is true, too. Those who live with obesity have an increased risk of developing depression.”

The obesity ACTION study in Canada, which was published in 2017 and co-authored by Macklin, found 39 per cent of obese employees said their workplace didn’t have a wellness program, while 99 per cent of employer respondents said they had one.

It also found 35 per cent of obese employees participated in their workplace wellness programs, but those who were taking advantage of the programs actually needed them the least. “These people don’t need treatment — they need support and a path to treatment,” said Macklin.

Read: Employers must consider ‘every dimension’ in tackling obesity, weight management

Three-quarters (76 per cent) of employer respondents to the study said they feel their wellness programs contributed successfully to weight loss, while only 32 per cent of obese employees agreed. Ultimately, perceptions between employers and employees about their wellness offerings are misaligned, said Macklin.

“A change in the workplace environment from the employer to the employee is a forthright recognition of an understanding that what they struggle with is real and complex and biological — not their fault, not a choice. This would be a change in the work environment that would be part of treatment. Addressing internalized bias is a key practice for obesity treatment.”

Read more stories from the 2019 Chronic Disease at Work conference.