Five advocates shared their thoughts on what they felt was the most important issue facing the obesity community.
by Dave Yasvinski
Obesity has emerged as a global health crisis, with the fastest growth rates in low- and middle-income countries. In 2024, we’re witnessing a transformative shift: the rise of new prescription medications promising to significantly impact obesity and related health issues. This shift is fuelled by patients’ readiness to invest in their health but comes with its challenges, including concerns about healthcare costs and equitable access.
Leading up to World Obesity Day on March 4, Obesity Matters asked five advocates to identify the most important issue that came to mind when talking about obesity. Here’s what they told us.
Obesity and caregiving
Sandra Elia, Board Chair, Director of Education & Patient Advocacy, Obesity Matters
Why did you choose to discuss obesity and caregiving?
When you’re caring for somebody, the most important thing is to look at them through the eyes of love — especially when we’re talking about children who are struggling with their weight or obesity. It’s really important to remember that there’s nothing wrong with them. There’s nothing for us to change. What they’re going through is a real medical condition that requires proper treatment. After that, it’s about helping that person with their own internalized bias. They may feel guilty or shameful. They may have bought into the idea that this is their fault, that this is a lifestyle choice. If you’re caregiving for someone who has those beliefs, it’s going to be hard for them to come forward and be able to say they need to see a doctor. Once we’re able to get somebody in good place — where they’re feeling empowered and aware that their weight or their eating is not a moral issue — then, oftentimes, the caregiver becomes a healthcare advocate.
I have been an advocate for my mother. She lived with obesity and was sick for pretty much my entire life. She was also an immigrant to this country who didn’t speak English. At a very young age, I had to be her translator when we were searching for help around 40 years ago. During those times doctors — and I’m sad to say they still do this — used shame tactics and scare tactics. I can remember being at a doctor’s office as he was going through my mother’s blood work and he was just so frustrated and disgusted with her results and high blood pressure. He told me, ‘Your mother’s going to be dead in two months if she doesn’t stop eating the way she’s eating.’ And I had to translate that to her. I was only eight or nine and so I thought he was telling the truth. I was trying to manage my own fears and then I had to tell her this and just kind of watch her sink into her chair as shame washed over her.
As caregivers, when we take our loved ones to the doctor, we really have to listen for the bias. We have to listen for things like, “You should be eating less and moving more.” That’s not a treatment plan. Full stop. As a doctor, you have a responsibility to offer treatment. Right now, we’re quite lucky: It’s the first time in history that we have clinical practice guidelines put out by Obesity Canada and there’s a template for treating obesity. There are three pillars: Behavioural modification, pharmacotherapy and bariatric surgery. Some people will need all three pillars, some will need two, some will need one. If your doctor is not helping you with these pillars, then they’re really just shaming you.
What does World Obesity Day mean to you
For me, World Obesity Day means that, collectively, we can take a pause. My hope is that we can drop the judgment and look for solutions.
How has this community helped you on your journey?
I need to be tapped into a community that supports me when I fall down and celebrates each and every success. I need community to combat loneliness because at the end of the day, if you’re living in North America, loneliness is a real health risk and I see a link between loneliness and obesity. When we are able to be a part of a supporting community that holds us up, we’ve got a better chance on every level.
Obesity and private payer insurance
Neda Nasseri, advisory board member, Obesity Matters
Why did you choose to discuss obesity and workplace/private payer insurance?
A few years ago, healthy habits in the workplace were all the rage. Employers were embracing wellness accounts, offering gym memberships and encouraging employees to take the stairs instead of the elevator. Then it was all about mental health. Companies put employee assistance programs together to offer coverage for psychologists and similar types of support. Now, everyone is interested in diversity and inclusion initiatives. People are looking at gender, race and sexual orientation but, for some reason, size doesn’t seem to sell. Maybe it’s because one out of four Canadians are living with obesity, so it’s not diverse enough?
Throughout all of these health initiatives, people who live with obesity have been indirectly targeted — not named, but ignored. Invisible, like part of the decor. I want employers to recognize obesity as a chronic disease and I want to ensure that people living with obesity have the same tools to take care of their health as anyone else. I want their uniforms to fit their size, I want their desks and chairs to be comfortable, I want them to have enough coverage to see a dietitian or a physiotherapist if their knees and back hurt. I want them to be able to see a kinesiologist once they are healthy enough to start an exercise program and to be able to turn to medication without being afraid of financial concerns or the judgment of others. I want people living with obesity to belong and to feel welcome.
What does World Obesity Day mean to you?
To me, World Obesity Day is a reminder to the planet that, ‘Hey, we’re important too! Don’t just look at us, SEE us. HEAR us.’ Despite all the effort that has been made to describe obesity as a chronic disease, some employers still don’t feel the need to adapt their environments or provide access to care. No one chose to be living with obesity. No one chose to have to battle against themselves every day — against the body’s hunger signals, against a slow metabolism, against a lack of muscle mass. Actions are so much stronger than words. I want to see more local action, where our leaders will talk about laws against size discrimination.
Obesity still isn’t a protected characteristic under human rights legislation in any Canadian jurisdiction. You can still get fired just for being too big.
How has this community helped you on your journey?
Working alongside Obesity Matters has been so motivating. Everyone has their own story, but we all work toward the same goals. We all yearn to elevate the conversation around weight and the impact it has on health. We want to bust myths and change the dialogue around obesity and move from blame and shame to empowerment and inclusion. I invite anyone who wants to make a difference to join us on this journey of self-acceptance. The more of us there are, the greater the difference we can make.
Obesity and chronic disease, mental health and access to care
Megha Poddar, medical director of Medical Weight Management Centre of Canada
Why did you choose to discuss obesity and chronic disease, mental health and access to care?
As a physician and healthcare provider, I find that so much of our resources and time are being spent on the complications of obesity and we’re actually missing the forest for the trees when we’re not treating obesity itself. A lot of our healthcare resources are going to diabetes, heart disease, cancer treatment and infertility, when obesity is actually the cause of most of these problems. When we don’t treat obesity, we have to spend more time and resources trying to treat those downstream complications. It’s actually more effective if you treat obesity first.
What does World Obesity Day mean to you?
World Obesity Day sheds light on the fact that this is a growing epidemic. Every single one of us is within one degree of separation of this problem, whether it’s ourselves or a family member or our friends. It touches every single one of us but we haven’t had the opportunity to speak out about it in a scientific, unbiased way. Most of the time, a lot of the shame and blame gets the media attention, but I wanted to highlight that there is safe and effective treatment. There are healthcare providers that want to help and who will advocate for people living with this disease because it affects more people than we think it does.
How has this community helped you on your journey?
This community has been remarkable at giving people with obesity a voice. For so long — at least in my world — this has been a top down conversation from healthcare providers. When you give people living with the disease a platform, the conversation actually changes dramatically and in unexpected ways. This allows for treatment that is truly patient-centred instead of us assuming what people need. In my in my mind, that’s a far more effective conversation. It allows our treatments to be effective because we’re listening to the people living with the disease to understand why they’re struggling.
Obesity and mental health and chronic pain
Jamie Kositsky, advocate and member of the Obesity Matters community
Why did you choose to discuss obesity and mental health and chronic pain?
In my life, these things are very strongly connected to obesity. I’ve been obese for countless years and I’ve struggled with my mental health since I was younger. I’ve noticed that my mental health issues have increased alongside the stress that comes with the medical complications of obesity. Chronic pain is an issue for me because when you carry excess weight it puts pressure on your joints and muscles and makes it easier for you to get injured. This pain just feeds back into my mental health and makes me tired.
It also makes it hard to do the basics, like going to the grocery store and buying healthy food to make proper meals for yourself. By the time I’ve gotten the food, come home, put it all away, done the prep work and made a meal, I just want to sit down. I’m often too tired to even eat it. It becomes really cumbersome — it’s a really big problem in my life.
What does World Obesity Day mean to you?
Hopefully, it will make people more aware and compassionate to the struggles that come with obesity. Maybe it can break down some of the stigma toward people who are overweight and make them feel more included. Sometimes, I’m pretty sure I’m being discriminated against when trying to get a job but it’s hard to do anything about that. Hopefully, people become more aware of the real reasons why people struggle with things like mental health and chronic pain.
How has this community helped you on your journey?
It has helped me so, so much. I’m so grateful because I’ve made so many connections. I’ve connected with a nutritionist, a life coach and a weight management doctor. I had been looking for those things with my social worker for years, but they’re never free and they’re always hard to find. After discovering Obesity Matters on Facebook, a free event came up and that’s where I made connections with people in person. Now, I have accountability buddies that I keep in touch with on a regular basis. These connections are really important for me because I live alone and I don’t have any pets anymore. It really helps to have a sense of community and just people to talk to and lean on.
Obesity and self-love
Brenda Rogers, Obesity Matters wellness participant
Why did you choose to discuss obesity and self-love?
We can’t grow and change through self-hatred of our bodies — I’ve tried and it doesn’t work. So, with the help of coaches and mentors, I’m slowly bringing acceptance and love toward this body that has carried me through so much of life and will be with me for a long time. It’s time to stop the war within and be compassionate with myself.
What does World Obesity Day mean to you?
World Obesity Day gives me hope that more focus and attention will be brought forth to change the approach of healthcare professionals toward those of us who carry extra weight.
How has this community helped you on your journey?
The Obesity Matters Wellness Group has supported and encouraged me throughout this journey and reminded me that I’m not alone. Consistently participating has helped me stay the course and change my mindset to take a more loving and holistic approach to living healthy and well. It has brought light to the dark places we tend to hide and with that light, comes healing. Everything is better together.
Dave Yasvinski is a Toronto-based writer with Healthing.ca.
This article was originally published in Healthing on March 4, 2024