How supportive workplaces can improve obesity coverage

Ian Patton has seen firsthand how the obesity narrative has changed over the last decade. The director of advocacy and public engagement at Obesity Canada has witnessed the widespread shift to recognizing obesity as a complex, chronic disease rather than a lifestyle issue.

Now, organizations are learning how to create a workplace that is both supportive and practical for employees living with obesity. Patton simply said being conscious of how we're speaking about obesity and how we're treating people living in larger bodies can go a long way.

“While a lot of times it's unintended, there's a lot of weight bias and stigma that people living with obesity experience,” Patton said, emphasizing that assumptions and pre-conceived notions of how one views and treats someone living with obesity should be addressed in workplace policies.

“How we're communicating with them is really the foundation of making a more accommodating and accessible environment for people to work,” Patton added.

He pointed to the workplace environment as one of the first areas employers should prioritize.

“Is it an environment that's welcoming, inclusive and accessible for people living with obesity? Are we thinking about things like weight capacity for chairs or the bathroom spaces? Do they accommodate larger bodies?” he suggested.

It’s not just about physical space though as Patton asserted office culture also plays a role. Comments about weight or assumptions about a person’s fitness level can contribute to a hostile work environment.

“Thinking about how we’re speaking about weight, obesity or our bodies and not making stigmatizing comments… Simple fixes like that can make a workplace more accommodating,” he said.

He also highlighted that employee benefits have overlooked obesity as a medical condition, leaving many workers without access to evidence-based treatments. That’s something Patton says needs to change.

“The clinical practice guidelines outline three evidence-based pillars to obesity management and treatment. That includes bariatric surgery, the psychological intervention, and then the medications,” he said.

“All those pillars support and enable an individual to manage the behavioural, physical activity and the nutritional side of things more effectively. It becomes this big comprehensive approach to chronic disease management so the benefit programs should be treating obesity like any other chronic disease,” Patton explained.

Yet, many employers still fail to cover obesity medications, despite their effectiveness. Bariatric surgery, while mostly covered by provincial health plans in Canada, isn’t the right fit for everyone, Patton highlighted.

Additionally, despite the efficacy and popularity of GLP-1 receptor agonists being powerful tools to combat obesity, they remain out of reach for many workers. Patton also cautions against treating them as a one-size-fits-all solution.

“There's still not great coverage across the board when it comes to things like the medication,” he said. “They're effective lifesaving treatments and they’re very useful for some people, but they aren't a magic solution for everyone living with obesity.”

Patton noted some employees have reported side effects to the extent that they can’t continue taking the medication.

“It's not like every individual in Canada living with obesity is going to be a good candidate for those medications,” he said. “People living with diabetes have access to lots of options and their benefit programs typically cover those options.”

Whereas for people living with obesity, their chronic disease is not covered in the same way other chronic diseases are, Patton noted.

“What we need to do is look at how we're supporting individuals for other chronic diseases and recognize the value. There's probably a very strong cost effectiveness argument to be made about early intervention and access to effective obesity treatments,” he said.

Because obesity is an upstream condition to “a whole host of downstream conditions,” Patton added, “if we can treat someone effectively early on and make sure they have access to those pillars, they’ll likely prevent or treat those other downstream conditions they’re dealing with. There's a cost benefit analysis there as well.”

As for workplace wellness programs that include gym memberships or fitness incentives, Patton warned against using these as a substitute for real medical support, despite physical activity and exercise being one of the most important things for overall health and wellbeing.   

“The one caution I have with it is if we’re trying to offer a gym membership in lieu of appropriate disease management,” he said. “We should absolutely be making physical activity and exercise more accessible, and if we can do that through health spending accounts, I’m all for that. But we can’t treat that as a chronic disease solution.”

To mark World Obesity Day, Obesity Canada is hosting its Connected Conference for employers to take charge of their workplace policies and benefits surrounding obesity and chronic disease.

“Obesity is a chronic disease; that's not something that's debatable anymore. It needs to be treated like one,” he asserted. “Once we start viewing it in that light and being aware of the stigma and narratives is really important.”

“Changing how we're talking about that in the workplace is going to make a big, big difference,” said Patton.