There has been a dramatic increase in the number of Canadians living with obesity over the past few decades and it is often cited as a risk factor for other chronic health conditions including type 2 diabetes, hypertension, cardiovascular disease and some forms of cancer. This means that obesity is frequently a hot topic in the news. But media stories often miss the mark when it comes to informing Canadians about the complex factors that lead to obesity.
What we know is that obesity is both a chronic and often progressive condition. Research has identified a number of factors associated with obesity including: physical activity, diet, socioeconomic status, ethnicity, immigration and environmental factors, which all interconnect in complex ways and patterns. This means that while the root cause of weight gain may be a reduction in metabolic rate, overeating or a reduction in physical activity, secondary factors such as biological (e.g., genetics), psychological (e.g., depression) and/or socioeconomic (e.g., poverty) may also pose significant barriers to weight management.
So the short term, 'quick-fix' solutions often espoused by shows like The Biggest Loser -- focusing on maximum weight loss in a minimum amount of time -- are generally unsustainable in the long term and associated with high rates of weight regain. Experts point to the fact that successful obesity management requires realistic and sustainable treatment strategies.
Here's what everyone should know:
1. The prevalence and severity of obesity in Canada has increased dramatically in the past three decades while fitness levels are decreasing. Research shows that one in four Canadian adults and one in 10 children are clinically obese. Obesity rates have roughly doubled in the past 30 years among both males and females in most age groups in both adult and youth categories. Since the late 1970s, increases in the prevalence of obesity have been proportionately greater for the heaviest weight classes. On top of this, evidence demonstrates a trend toward decreased fitness for children, youth and adults.
2. Obesity is a costly epidemic. It has been estimated that obesity costs the Canadian economy approximately $4.6 billion in 2008, up $735 million or 19% from $3.9 billion in 2000.
3. Measurement of obesity is not straightforward. The Body Mass Index (BMI) should be considered a rough guide for predicting health risk in individuals. The distribution and amount of body fat are also crucial determinants of some obesity-related health risks. For example, fat around the abdominal region has a stronger association with type 2 diabetes and cardiovascular disease than BMI. Hence measuring waist circumference alone provides a more complete picture of overall obesity-related health risk than BMI.
4. Experts are looking to government regulations and food industry. Similar to smoking and problems with alcohol use, obesity is not simply the result of individuals making bad decisions, but is strongly influenced by the social and commercial environments that puts some individuals at higher risk for certain behaviours. Some risk factors include: the promotion and availability of high-calorie food, limited access to healthy foods, lack of time for meal preparation and barriers to physical activity.
Experts point to promising government regulatory approaches such as: discouraging higher calorie consumption by enforcing serving sizes, banning food and beverage advertisements targeting children, zoning laws prohibiting fast food sales near schools, regulating nutrition claim packaging, tax credits for fitness activities, more affordable recreational activities and better walking paths.
5. Weight bias is associated with significant discrimination against people living with obesity in employment, health, health care and education and is often caused by widespread untrue negative stereotypes that persons with obesity are lazy, unmotivated and lacking willpower and self-discipline.
Carolyn Shimmin is a Knowledge Translation Coordinator with EvidenceNetwork.ca and the George and Fay Yee Centre for Healthcare Innovation.
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