How Preventive Care Funding for Obesity will Decrease Health Care Expenditure in Canada

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The rising rate of obesity cost the global economy an estimated $2 trillion expenditure annually. In Canada, one in four obese people spend as high as $7 billion in related health care costs and is expected to increase in $9 billion by 2021. Dr. Arma Sharma states that expenditure in treating obesity will be lessened if the healthcare system focuses on preventing its occurrence rather than curing the conditions that arise from it. Access to treatment of obesity in the country is difficult due to unapproved territorial/ provincial health plans for medications, long years of bariatric surgery wait times and few and inaccessible medically supported weight loss clinics. Hospitals can’t also provide optimal care due to deficiency in equipment and rehabilitation facilities to accommodate bigger body sizes. The federal government has little direction with the issue of investing economically in preventing and treating people with obesity.

Introduction

Obesity is a progressive chronic disease characterized by excessive fat accumulation that may impair health. Based on population surveillance studies, the prevalence of obesity in Canada significantly increased over the past three decades. Over 5 million adults have obesity as noted by the 2014 Canadian Community Health Survey and 30% or more than one in three obese people require medical support to manage their disease based on 2015 Canadian Health Measures Survey. The prevalence of obesity in Canadian adults is also projected to increase over the next two decades.

Current Status

Canada spends roughly 11 percent of total health expenditure on treating complications of obesity such as diabetes, cardiovascular disease, and cancers. Obese patients with high-risk complications stay longer in hospitals than usual which contribute to an increase in health care cost.

Discussions

Obesity and overweight cases in all ages continually increases every year. Two-thirds of Canadian adults and one-third of Canadian children and youth are overweight or obese. Figure 1 gives information about the overweight and obese cases in Canada based on age. Anti-obesity medications are not covered by provincial and territorial health plans. Canadians can’t use their health spending accounts to submit claims for obesity-related products which causes treatment hesitancy. In 9.6 million Canadians with private drug benefit plans, only 10.4% have plans that include anti-obesity medications. Figure 2 shows the analysis of coverage rates between provinces and territories.

Patients need to wait for up to eight years to undergo bariatric surgeries. In order to qualify for weight loss surgery in Canada, an individual need to have 27 or higher body mass index (BMI). Failure to determine who is at risk of developing obesity or related conditions on early stage. People come for treatment for complications severe enough for surgery and longer stays in hospitals.

Weight loss clinics are minimal and not accessible. There are only 67 American Board of Medicine (ABOM) Certified health professional and 80 Certified Bariatric Educators (CBE) across Canada and not all province has one. Figure 3 shows the distribution of ABOM and CBE among Canadian provinces.

Hospitals have limited equipment and services to accommodate obese people. X-ray machines can’t accommodate bigger body sizes and rehabilitation facilities lack proper equipment contributing longer hospital stays. Obesity programs are not available in all provinces. Yukon is the only territory with a multidisciplinary team on obesity management.

Recommendations

The federal and provincial government should recognize obesity as a chronic disease in order to access health services and interventions.
Development of policy to include anti-obesity medications through public or private health plans to ensure medication compliance.
Reduce bariatric surgery waiting times by minimizing referral period to 6 months.
Introduction of obesity management through behavioral modification technique, activity enhancement and dietary counseling to increase lifestyle optimism.
Increasing the number of health professionals to continue medical education to develop their skills in counseling patients with healthy weight management.
Developing public or private sector support to health professionals who wanted to gain certification for ABOM or CBE.
Increase funding of hospitals or clinics for equipment and facilities to accommodate obese or overweight patients for optimal care.
Production of pan-Canadian obesity management programs to inform people about the risk and prevention of obesity.

Conclusion

Obesity is a growing health concern as the leading cause of preventable morbidity and mortality. The government is spending a lot of health care cost in treating complications of the disease. Obesity should be considered a chronic disease than a lifestyle choice, therefore funding and policies should be developed to support patients to have optimal care. The federal government must take a leadership role in implementing a long-term, multi-pronged, multi-sectoral campaign to help patients who are at risk of obesity.

REFERENCES

Landekic/Postmedia, L. (2019, November 1). It costs Canada $9B to treat obesity when barely any money is put into preventative care. Retrieved from https://vancouversun.com/health/it-costs-canada-9b-to-treat-obesity-when-barely-any-money-is-put-into-preventative-care/wcm/a7c5e38f-4ea3-41d7-9eb4-886649638b45.
Cobourn, C. (2019, February 6). Weight Loss Surgery Canada – Wait Times, Insurance & Surgeon List. Retrieved from https://www.bariatric-surgery-source.com/bariatric-surgery-canada.html.
Obesity Canada-Obésité Canada. Report Card on Access to Obesity Treatment for Adults in Canada 2019. Edmonton, AB: 2019, April. Retrieved from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310037301.

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How Preventive Care Funding for Obesity will Decrease Health Care Expenditure in Canada

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