A person living with obesity should not have to hope they get the one doctor who understands obesity as a chronic disease. In Canada, that hope is already strained by a primary care system under pressure: more than one in five Canadians, an estimated 6.5 million people, do not have a family doctor or nurse practitioner they see regularly.
But even when primary care is available, respectful, evidence-based obesity care is far from guaranteed.
A new Canadian study led by Dr. Kerri Delaney, 2024 Obesity Canada Fellowship Award Recipient, found that Canadian medical schools are not consistently preparing future doctors to provide respectful, evidence-based obesity care. Students described gaps in teaching, limited focus on obesity as a chronic disease, and ongoing exposure to outdated or stigmatizing ideas in clinical training.
What medical students learn now will shape how people living with obesity are treated for years to come, influencing not just what future doctors know, but the quality, compassion, and respect people experience in care.
Obesity care starts long before entering practice
By the time a doctor enters practice, many habits have already taken shape. Medical school is where future physicians learn what matters, how to speak with patients, and how to think about disease.
When obesity education is shallow, inconsistent, or shaped by bias, it does not stay in the classroom. It flows into appointments, assessments, and treatment decisions for people living with obesity.
The study identified four clear gaps. First, students said teaching often depends on the individual preceptor, and many lack the knowledge or skills to teach obesity care well. Second, obesity is still not treated as a clear priority in the curriculum or in student assessments. Third, students said they felt especially unprepared to provide pediatric obesity care. And fourth, students pointed to the kinds of learning that work best: case-based teaching, clinical exposure, lectures, standardized patients, and learning that includes lived experience.
It’s not just missing information. It’s also stigma.
Leading medical associations, including the Canadian Medical Association and the World Health Organization recognize that obesity is a chronic disease, not a matter of personal failure or lack of willpower. But students said that understanding is still not being reflected in medical education in Canada.
Students reported hearing obesity discussed as a lifestyle issue rather than a multifactorial chronic disease. Others described seeing stigmatizing language and attitudes in training environments. One student described what that sounded like in the classroom:
“... what I learned in classrooms was not necessarily very helpful because I don’t think it’s ever well received by anyone to say, oh, you know, well, like just change your diet and exercise more. … Anyway, I guess what I’m saying is that was what was taught in the classroom.”
Another student described how obesity care was often reduced to simplistic advice:
“I just don’t think we’ve had an effective way to teach this [obesity care] and thus I haven’t really retained anything other than the portion that is constantly taught, which is to counsel people on lifestyle and lecture them to no end about how they don’t eat right or exercise, and then send them on their way.”
In some cases, students described seeing stigma built directly into teaching materials on obesity physiology:
“[The topic of obesity] was framed about let’s talk about the elephant in the room, and it was like okay, in no way is this an appropriate way.”
Weight bias in healthcare is not rare—64% of adults living with obesity have experienced weight bias from a healthcare professional. Weight bias in healthcare can delay care and treatment, damage trust, and make it harder for people living with obesity to feel safe asking for help for any health concern. If future doctors are not taught obesity care early and well, people living with obesity will continue to feel the effects.
What needs to change
This study makes one thing clear: future doctors want stronger, more meaningful education on obesity care.
They want to be taught how to understand and treat obesity as a chronic disease. They want more opportunities to practice real conversations with patients. They want stronger teaching in pediatric obesity care. And they want learning that helps them understand the full picture, including biology, stigma, assessment, and treatment.
Students were also clear about what better teaching could look like. They valued approaches that help them apply what they learn in real settings. One participant said the best approach would be something that “integrated physiology with presentation, with management” through a memorable case that students could work through and discuss. Another said that hearing lived experience directly was “more powerful than… a traditional kind of lecture.”
That kind of training would better prepare future physicians and help create care that is more informed, respectful, and effective for people living with obesity.
We cannot wait to teach obesity care to future doctors
Better obesity care does not begin when a physician enters practice. It begins much earlier, in the cases they discuss, the questions they are tested on, the language they hear from mentors, and whether they are taught to see the person in front of them clearly and without blame.
Medical education is where tomorrow’s care takes shape. Every improvement in training is a chance to build a healthcare system where people living with obesity are met with knowledge, respect, and support from the very first conversation.
If we want respectful, evidence-based obesity care in Canada, we cannot wait until practice to teach it.
We have to start where doctors start.
Learn more
Read the full study: Obesity care education in Canadian medical schools: A multi-site qualitative study
Read more: Transforming the landscape of obesity education – The Canadian obesity education competencies
