Skip to main content

Advertisement

Log in

Obesity Prevention and Management Strategies in Canada: Shifting Paradigms and Putting People First

  • Obesity Prevention (A Must, Section Editor)
  • Published:
Current Obesity Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this study was to review public and private sector obesity policies in Canada and to make recommendations for future evidence-based obesity prevention and management strategies.

Recent Findings

Synthesis of obesity prevention and management policies and research studies are presented in three primary themes: (1) Increased awareness about the impact of weight bias and obesity stigma in Canada; (2) Inadequate government obesity prevention and management policies and strategies; and (3) Lack of comprehensive private sector obesity prevention and management policies.

Summary

Findings suggest that in Canada, obesity continues to be treated as a self-inflicted risk factor, which affects the type of interventions and approaches that are implemented by governments or covered by private health plans. The lack of recognition of obesity as a chronic disease by Canadian public and private payers, health systems, employers, and the public, has a trickle-down effect on access to evidence-based prevention and treatment. Although there is increasing recognition and awareness about the impact of weight bias and obesity stigma on the health and social well-being of Canadians, interventions are urgently needed in education, healthcare, and public policy sectors. We conclude by making recommendations for the advancement of evidence-based obesity prevention and management policies that can improve the lives of Canadians affected by obesity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Lau DCW, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176(8):S13.

    Google Scholar 

  2. Twells LK, Gregory DM, Reddigan J, Midodzi WK. Current and predicted prevalence of obesity in Canada: a trend analysis. Can Med Assoc J. 2014;2(1):E18.

    Google Scholar 

  3. PHAC. Curbing childhood obesity: a federal, provincial and territorial framework for action to promote healthy weights. Public Health Agency of Canada. 2011. http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/framework-cadre/index-eng.php.

  4. PHAC. Actions taken and future directions 2011: a federal, provincial, and territorial framework for action to promote health weights. Public Health Agency of Canada; 2011.

  5. CMA. Canadian Medical Association recognizes obeisity as a disease. 2015. https://www.cma.ca/En/Pages/cma-recognizes-obesity-as-a-disease.aspx.

  6. Kirk SFL, Price SL, Penney TL, Rehman L, Lyons RF, Piccinini-Vallis H, et al. Blame, shame, and lack of support: a multilevel study on obesity management. Qual Health Res. 2014;18(4):501.

    Google Scholar 

  7. Cameron E. Toward a fat pedagogy: a study of pedagogical approaches aimed at challenging obesity discourse in post-secondary education. Fat Stud. 2015;4(1):28–45.

    Article  Google Scholar 

  8. Puhl RM, Andreyeva T, Brownell KD. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes. 2008;32(6):992–1000. https://doi.org/10.1038/ijo.2008.22.

    Article  CAS  Google Scholar 

  9. Browne N. Weight bias, stigmatization, and bullying of obese youth. Bariatric Nurs Surg Patient Care. 2012;7(3):107–15.

    Article  Google Scholar 

  10. Puhl RM, Latner JD, O'Brien K, Luedicke J, Danielsdottir S, Forhan M. A multinational examination of weight bias: predictors of anti-fat attitudes across four countries. Int J Obes. 2015;7:1166–73. https://doi.org/10.1038/ijo.2015.32.

    Article  Google Scholar 

  11. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity. 2009;17(5):941–64.

    Article  PubMed  Google Scholar 

  12. Gortmaker SL, Must A, Perrin JN, Sobol AM, Dietz WH. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993;14:1008.

    Article  Google Scholar 

  13. Boyd MA. Living with overweight. Perspect Psychiatr Care. 1989;25(3):48–52.

    Article  Google Scholar 

  14. Sutin AR, Stephan Y, Terracciano A. Weight discrimination and risk of mortality. Psychol Sci. 2015;26(11):1803–11. https://doi.org/10.1177/0956797615601103.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jackson SE, Beeken RJ, Wardle J. Obesity, perceived weight discrimination, and psychological well-being in older adults in England. Obesity. 2015;23(5):1111. https://doi.org/10.1002/oby.21052.

    Article  Google Scholar 

  16. •• Ramos Salas X, Fohan M, Caulfield T, Sharma AM Raine K. A critical analysis of obesity prevention policies and strategies. Can J Public Health. 2017;108(5-6):e598–e608. https://doi.org/10.17269/CJPH.108.6044. This study reviews Canadian obesity prevention policies and critically assesses how they contribute to the conceptualization of obesity in Canada. The authors highlight the need to recognize weight bias and obesity stigma as key determinants of health.

  17. CON-RCO. 5As of obesity management framework and resources. Available at: http://www.obesitynetwork.ca/5As. Accessed 9 April 2018.

  18. Forhan M. 1st Canadian summit on weight Bias and discrimination—final report. Edmonton: Canadian Obesity Network; 2011.

    Google Scholar 

  19. CIHR-INMD. INMD-CON bariatric care research—workshop report. http://www.cihr.ca/e/43557.html: CIHR Institute of Nutrition, Metabolism and Diabetes; 2011.

  20. Ramos Salas X, Forhan M, Sharma AM. Diffusing obesity myths. Clin Obes. 2014;3:189. https://doi.org/10.1111/cob.12059/abstract.

    Article  Google Scholar 

  21. CON-RCO. Toronto charter for obesity and mental health. http://www.obesitynetwork.ca/files/Toronto_Charter_on_Obesity_&_Mental_Health_Jul052012_DH.pdf: Canadian Obesity Network, World Obesity Federation (International Association for the Study on Obesity), Centre for Addictions Mental Health 2012.

  22. Alberga AS, Russell-Mayhew S, von Ranson KM, McLaren L, Ramos Salas X, Sharma AM. Future research in weight bias: what next? Obesity. 2016;24(6):1207–9.

    Article  PubMed  Google Scholar 

  23. CON-RCO. EveryBODY matters collaborative. Canadian Obesity Network- Réseau canadien en obésité (CON-RCO), http://www.obesitynetwork.ca/pg.aspx?pg=452. 2016. http://www.obesitynetwork.ca/pg.aspx?pg=452. 2017.

  24. Lee M, Ata RN, Brannick MT. Review article: malleability of weight-biased attitudes and beliefs: a meta-analysis of weight bias reduction interventions. Body Image. 2014;11:251–9. https://doi.org/10.1016/j.bodyim.2014.03.003.

    Article  PubMed  Google Scholar 

  25. • Alberga AS, Pickering BJ, Alix Hayden K, Ball GC, Edwards A, Jelinski S, et al. Weight bias reduction in health professionals: a systematic review. Clin Obes. 2016;6(3):175–88. https://doi.org/10.1111/cob.12147. This systematic reviews provides a comprehensive synthesis of weight bias reduction interventions for health professionals. The review highlights the need for more interventions in this area.

  26. Daníelsdóttir S, O'Brien KS, Ciao A. Anti-fat prejudice reduction: a review of published studies. Obes Facts. 2010;3(1):47–58. https://doi.org/10.1159/000277067.

    Article  PubMed  Google Scholar 

  27. •• Ramos Salas X, Alberga A, Cameron E, Estey L, Forhan M, Kirk SFL, et al. Addressing weight bias and discrimination: moving beyond raising awareness to creating change. Obes Rev. 2017;11:1323–35. https://doi.org/10.1111/obr.12592. This paper provides a comprehensive synthesis of weight bias reduction interventions and outlines a consensus on weight bias reduction key messages and strategies for healthcare, education, and public policy sectors. The paper highlights the role of patient engagement in weight bias reduction interventions .

  28. •• CON-RCO. Report card on access to obesity treatment for adults in Canada 2017. Available at: http://www.obesitynetwork.ca/reportcard. Accessed 10 April 2018. This report provides an overview of the current state of Canadian obesity management policies and programs in Canada. The report highlights the lack of public and private policies and interventions for obesity management .

  29. Senate SCoSA, Science and Technology. Obesity in Canada: a whole-of-society approach for a healthier Canada. Ottawa: Senate of Canada2016 March 2016.

  30. Government oC. Government’s role in addressing childhood obesity. Health Canada, Ottawa. 2016. https://www.canada.ca/en/public-health/services/childhood-obesity/government-role-addressing-childhood-obesity.html. Accessed January 4 2018.

  31. Government oC. Revision process for Canada’s Food Guide. Health Canada, Ottawa, ON. 2016. https://www.canada.ca/en/health-canada/services/canada-food-guides/revision-process.html. Accessed January 4 2018.

  32. Ramos Salas X. The ineffectiveness and unintended consequences of the public health war on obesity. Can J Public Health = Revue Canadienne De Sante Publique. 2015;106(2):e79–e81. https://doi.org/10.17269/CJPH.106.4757.

  33. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100(6):1019–28. https://doi.org/10.2105/AJPH.2009.159491.

    Article  PubMed  PubMed Central  Google Scholar 

  34. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Switzerland: World Health Organization2000. Report No.: 0512-3054.

  35. Katzmarzyk PTA, C.I. Overweight and obesity mortality trends in Canada, 1985-2000. Can J Public Health. 2004;1:16.

    Google Scholar 

  36. • Hatzenbuehler ML, Phelan JC, Link BG. Stigma as a fundamental cause of population health inequalities. Am J Public Health. 2013;103(5):813–21. https://doi.org/10.2105/AJPH.2012.301069. This paper provides a model for conceptualizing the impact of stigma on population health outcomes.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. Nutr J. 2011;10(1):9. https://doi.org/10.1186/1475-2891-10-9.

    Article  PubMed  PubMed Central  Google Scholar 

  38. WHO. Global plan of action on social determinants of health. World Health Organization, Geneva, Switzerland. 2017. http://www.who.int/social_determinants/action_sdh/en/. Accessed June 2, 2017 2017.

  39. WHO. HEALTH21: the health for all policy framework for the WHO European Region. World Health Organization, Copenhagen, Denmark. 1999. http://www.euro.who.int/en/publications/abstracts/health21-the-health-for-all-policy-framework-for-the-who-european-region. Accessed June 2 2017.

  40. Brauer P, Connor Gorber S, Shaw E, Singh H, Bell N, Shane AR, et al. Canadian Task Force on Preventive Health Care. Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. CMAJ. 2015 Feb 17;187(3):184–95. https://doi.org/10.1503/cmaj.140887.

  41. Block JP, DeSalvo KB, Fisher WP. Are physicians equipped to address the obesity epidemic? Knowledge and attitudes of internal medicine residents. Prev Med. 2003;36(6):669–75.

    Article  PubMed  Google Scholar 

  42. Janke EA, Ramirez ML, Haltzman B, Fritz M, Kozak AT. Patient’s experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity. Prim Health Care Res Dev. 2016;17(1):33–41. https://doi.org/10.1017/S1463423615000171.

    Article  PubMed  Google Scholar 

  43. Greener J, Douglas F, van Teijlingen E. More of the same? Conflicting perspectives of obesity causation and intervention amongst overweight people, health professionals and policy makers. Soc Sci Med. 2010;70:1042–9. https://doi.org/10.1016/j.socscimed.2009.11.017.

    Article  PubMed  Google Scholar 

  44. Tytus R. Weight loss practices of adults in Canada. 1st Canadian obesity summit. Kananaskis: Canadian Obesity Network; 2009.

    Google Scholar 

  45. Freedhoff Y, Sharma AM. “Lose 40 pounds in 4 weeks”: regulating commercial weight-loss programs. Can Med Assoc J. 2009;180:367–8. https://doi.org/10.1503/cmaj.090071.

    Article  Google Scholar 

  46. Sharma AM. M, M, M & M: a mnemonic for assessing obesity. Obes Rev. 2010;11:808–9. https://doi.org/10.1111/j.1467-789X.2010.00766.x.

    Article  PubMed  CAS  Google Scholar 

  47. Sharma AM, Kushner RF. A proposed clinical staging system for obesity. Int J Obes. 2009;33(3):289–95. https://doi.org/10.1038/ijo.2009.2; 10.1038/ijo.2009.2.

  48. Dietz W, Solomon L, Pronk N, Ziegenhorn S, Standish M, Longjohn M, et al. An integrated framework for the prevention and treatment of obesity and its related chronic diseases. Health Aff. 2015;34(9):1456-63. https://doi.org/10.1377/hlthaff.2015.0371.

  49. Torti J, Luig T, Borowitz M, Johnson JA, Sharma AM, Campbell-Scherer DL. The 5As team patient study: patient perspectives on the role of primary care in obesity management. BMC Fam Pract. 2017;18(1):19. https://doi.org/10.1186/s12875-017-0596-2.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Wharton S. Review: current perspectives on long-term obesity pharmacotherapy. Can J Diabetes. 2016;40:184–91. https://doi.org/10.1016/j.jcjd.2015.07.005.

    Article  PubMed  Google Scholar 

  51. Wharton S, Lee J, Christensen RA. Weight loss medications in Canada—a new frontier or a repeat of past mistakes? Diabetes Metab Syndr Obes Targets Ther. 2017;10:413–7. https://doi.org/10.2147/DMSO.S141571.

    Article  Google Scholar 

  52. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Endocr Pract. 2013;19(2):337–72. https://doi.org/10.4158/EP12437.GL.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Law MR, Kratzer J, Dhalia IA. The increasing inefficiency of private health insurance in Canada. Can Med Assoc J. 2014;186(12):E470–4.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ximena Ramos Salas.

Ethics declarations

Conflict of Interest

Arya M. Sharma has received compensation from Novo Nordisk and Valeant for service on advisory boards, and has received compensation from Novo Nordisk and Merck for service on speakers’ bureaus, as well as travel reimbursement from both.

Ximena Ramos Salas declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Obesity Prevention

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharma, A.M., Ramos Salas, X. Obesity Prevention and Management Strategies in Canada: Shifting Paradigms and Putting People First. Curr Obes Rep 7, 89–96 (2018). https://doi.org/10.1007/s13679-018-0309-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13679-018-0309-8

Keywords

Navigation