The Stigma of Obesity in the Health Care System

An article recently released in the Canadian Medical Association Journal (CMAJ) shows a disproportionate growth in the number of adults suffering from obesity (about 2 million people) in Canada. Obesity is a complex disorder often driven by genetics, but environmental, metabolic and behavioral factors can also come into play.

Canada’s Mentality

In Canada, health insurance coverage varies greatly, making bariatric surgery and related treatments difficult to access for many. A dangerous mentality is also present that continually leaves the availability of treatments severely restricted and unequal. The article states:

“Indeed, patients living with obesity continue to face widespread stigma and discrimination within the health care system. The “blame and shame” approach to managing obesity continues to find supporters despite evidence pointing to the ineffective and counterproductive effects of this strategy, which serves only to threaten health, generate health disparities and interfere with effective intervention efforts.”

The article goes on to suggest that that even with an increase in funding for bariatric surgery, there is a significant lack of infrastructure and trained health care professionals who are equipped to perform the surgeries and related tasks.

What Canada Needs to Do

The health care system in Canada needs to offer help on a primary level. Rather than having specialized centers, measures need to be put into place such as a triage system to assess those who are in the greatest need of bariatric surgery. This will ensure that those who need help the most will receive the right treatment first.

The Edmonton Obesity Staging System acts as a response to this issue and sets a good example that should be followed by the rest of Canada. It ranks the mental, medical and functional health of patients with obesity on a five-point scale.

This system:

Is a better way of sensing mortality in advance

Allows us to not ignore the situation – the immediate need for surgery will be prominent

Will reduce and limit weight gain to start rehabilitation

Establish chronic disease management practices such as patient education and self-management

Increase follow-up and support – an important aspect of any road to recovery

Integration of these issues into every level of health education – from physicians to allied health professionals

It’s time for Canada to see that obesity is on a similar spectrum as addiction – where there are significant physical and behavioral components involved beyond the idea of self-control. Rather than blame victims of obesity, we should seek to help them. Increasing infrastructure and providing adequate coverage in Canada will encourage people to get the proper help they need.

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