By Dr. Sanjeev Sockalingam, Scientific Director, Obesity Canada
For many people living with obesity, although evidence-based treatment options exist, access is still out of reach.
They may know there are medications that could be part of their care. Their healthcare professional may know it too. But then come the barriers: limited insurance coverage, high out-of-pocket costs, long waits for metabolic surgery, uncertainty about where to turn, and the lasting effects of stigma in places where care should feel safe.
Health Canada’s approval of generic semaglutide changes part of that landscape. Canada is now the first G7 country to approve a generic version of semaglutide, with additional generic submissions under review as of writing on April 28, 2026.
The significance of this approval goes beyond one product, one manufacturer, or one treatment pathway. It raises a larger question: can people living with obesity access evidence-based care when it is clinically appropriate?
Cost has kept obesity treatment out of reach for many Canadians. Some people pay out of pocket. Some rely on limited private coverage. Some never get the chance to consider medication as part of their care because the cost makes that option unrealistic from the start.
Lower-cost, Health Canada-approved options may help reduce one of the most persistent barriers in obesity care. This moment should also prompt governments, insurers, and employers to reconsider how obesity treatment is covered within these systems.
Obesity care begins with assessment, not a prescription
Obesity is a chronic disease. It is shaped by biology, genetics, environment, mental health, medications, social conditions, and the systems people live in. It is not a personal failure, and it cannot be reduced to appearance, willpower, or a number on a scale.
How we understand obesity affects the care people receive.
Medication can be an important tool for some people living with obesity, but it is not the whole care plan. Pharmacotherapy should only be considered after a full clinical assessment by a healthcare professional competent in evidence-based obesity care. Treatment decisions should reflect a person’s health status, goals, values, preferences, circumstances, and obesity-related complications.
The Canadian Adult Obesity Clinical Practice Guidelines outline comprehensive, evidence-based obesity care. This may include behavioural and psychological support, pharmacotherapy, and metabolic and bariatric surgery, depending on the person’s needs and goals. The goal of obesity care is to improve health, functioning, quality of life, and long-term well-being, not simply to reduce weight.
A lower-cost medication may improve access to one aspect of treatment for some people. It does not replace the need for diagnosis, assessment, shared decision-making, ongoing follow-up, and care that sees the whole person.
Approved generics are regulated medications
As new treatment options become available, people need clear information.
Health Canada-approved generic medications are regulated and reviewed for safety, effectiveness, and quality. That review process gives patients, healthcare professionals, pharmacists, payers, and policymakers a common foundation for decision-making.
People living with obesity deserve access to safe, evidence-based care. They also deserve to have their questions answered without judgment. If someone is currently taking semaglutide or wondering whether it may be appropriate for them, that conversation should happen with a healthcare professional competent in evidence-based obesity care.
Obesity Canada does not endorse specific medications, brands, or manufacturers. Our focus is on ensuring people living with obesity have access to comprehensive, evidence-based care, including Health Canada-approved medications when they are clinically appropriate.
Lower-cost options should change the coverage conversation
Generic semaglutide may help reduce costs for some Canadians, especially those paying out of pocket or navigating limited insurance coverage. But affordability should not depend on whether someone can find a lower-cost product.
Obesity medications remain out of reach for many people because of limited public and private coverage. Fewer than 20 per cent of Canadians with private drug benefit plans have access to Health Canada-approved obesity treatment medications.
If lower-cost approved options become available, governments, insurers, and employers should revisit how obesity care is covered.
People living with obesity should not have to pay out of pocket for evidence-based treatment for a chronic disease when similar treatment pathways are covered for other chronic conditions. We would not accept that standard for diabetes, hypertension, arthritis, or heart disease. We should not accept it for obesity.
The cost of untreated obesity is felt across Canada
The impact of better obesity care reaches beyond individual health. It matters for Canada’s healthcare system, economy, workplaces, families, and communities.
Obesity is an upstream contributor to many other health conditions, including type 2 diabetes, cardiovascular disease, sleep apnea, osteoarthritis, and some cancers. When obesity is not treated, the impact shows up in health system use, workplace productivity, disability, premature mortality, and quality of life.
Estimates show that untreated obesity cost Canada $27.6 billion in 2023, including direct healthcare costs and broader productivity losses.
Those costs are already being paid. The choice is whether Canada continues to absorb the cost of untreated obesity or invests in providing care that can improve health and reduce or prevent complications over time.
Canada’s leadership should be measured in access
Canada has helped shape the global conversation on obesity care through the Canadian Adult Obesity Clinical Practice Guidelines, which have been adapted or adopted in multiple countries such as Ireland, Chile, Greece, and South Africa. As the first G7 country to approve generic semaglutide, Canada now has an opportunity to connect regulatory progress with meaningful access to care.
Leadership means people living with obesity can receive care that is safe, respectful, evidence-based, and appropriate for their needs. It means healthcare professionals have the tools and training to provide obesity care without stigma. It means coverage decisions reflect the science of obesity as a chronic disease and the effectiveness of treatments in obesity care.
Generic semaglutide may recalibrate cost versus benefit discussions in Canada. The work ahead is making sure evidence-based obesity care is not treated as optional, exceptional, or out of reach.
People living with obesity deserve comprehensive care without shame, stigma, or unnecessary barriers. Canada has taken an important step. Now coverage, systems, and policy need to follow.
Add your voice to help improve access to evidence-based obesity care.
