Canada’s healthcare system overlooks a key piece of chronic disease care
Millions of Canadians live with more than one chronic disease—conditions like obesity, diabetes, heart disease, high blood pressure, and depression often overlap. Yet most patient care plans don’t reflect that reality.
A national study co-authored by Obesity Canada, published in BMC Public Health in 2023, found that although obesity directly affects how people manage other chronic conditions, it remains largely overlooked in chronic disease management programs. Despite growing recognition of obesity as a chronic disease, most patients report receiving little or no support in managing it alongside their other health concerns.
The research highlights a major gap between what’s recommended in the Canadian Adult Obesity Clinical Practice Guideline and what’s happening in real-world care—a gap patients feel everyday as they navigate multiple health conditions without coordinated support.
What the research reveals about gaps in care
The study’s findings reveal how this disconnect plays out for patients across Canada. Most people living with obesity navigating multiple health conditions aren’t receiving support for their obesity, even when it’s making their other conditions harder to manage.
This study focused on obesity as defined by BMI and self-reported diagnosis, but it’s important to recognize that obesity as a disease is not always synonymous with body size or weight alone. The research did not differentiate between these definitions, but the same inequities persist for people in larger bodies or those living with higher body weight — who often face the same barriers to care, stigma, and exclusion within the healthcare system.
While all respondents indicated they were living with obesity, had a BMI that classified them as having obesity, or had undergone obesity treatment:
- Only 26% reported ever receiving a formal diagnosis of obesity.
- Fewer than 10% had accessed medically supervised obesity treatment.
- More than half (55%) said obesity made managing their other chronic diseases more difficult.
- 39% believed their other conditions worsened because obesity was left untreated.
And despite recognizing obesity as a chronic disease, 78% still felt managing it was solely their personal responsibility.
“Most people are still left to manage obesity alone — even when it’s making their other health problems worse.”
Unequal access to obesity care and treatment
For Canadians managing obesity alongside other chronic diseases, there was a clear divide between how obesity is treated and how other chronic diseases are managed. People with cancer and cardiovascular disease are 70% more likely to receive coordinated care through multidisciplinary teams, those living with obesity and other chronic conditions rarely do.
The Canadian Adult Obesity Clinical Practice Guidelines outline effective, comprehensive approaches to treatment — including behavioural therapy, pharmacotherapy, and bariatric surgery. Less than half of participants said their healthcare provider discussed any of these options with them.
Referrals to interdisciplinary team members like registered dietitians and kinesiologists were made 15% and 6%, respectively while mental health support were made in fewer than 9% of cases, and referrals to specialists or bariatric surgery were reported by only 5–6% of participants.
“Evidence-based treatments exist — but too few Canadians are being offered them.”
How weight bias and stigma shapes healthcare in Canada
One in five participants in the study said they had delayed or avoided healthcare because they feared being judged or dismissed because of their weight.
When that happens, other health concerns can go untreated, or are overshadowed by assumptions about weight. Over time, this erodes trust, discourages follow-up care, and contributes to poorer health outcomes.
When obesity is viewed as a personal failure instead of a chronic disease, it limits access to the same kind of evidence-based care routinely offered for other conditions.
Why these findings matter
These findings confirm what many Canadians living with obesity already know: when care is fragmented, people are left to manage complex health challenges on their own. Treating obesity separately from other chronic diseases doesn’t reflect how these conditions overlap, or how patients experience them in real life.
Embedding obesity care into chronic disease management isn’t just good medicine — it’s smart policy.
The research points to three clear gaps. Access to evidence-based obesity treatment remains limited, even as other chronic diseases benefit from coordinated care. Outdated measures like BMI still delay or deny treatment. And the link between obesity and mental health — especially anxiety and depression — is too often ignored.
A call for change in Canada’s healthcare system
It is clear that Canada’s health system must evolve to see obesity as part of chronic disease care, not apart from it. That means better training and resources, more integrated care models, and system-level support to deliver evidence-based care without stigma or bias.
Failing to integrate obesity care into chronic disease management is costing Canadians $27 billion per year, and has a significant impact on Canadians’ quality of life.
→ Read more: The Cost of Inaction in Treating Obesity in Canada
Obesity Canada will continue to advocate for a system where every person — regardless of body size — can access coordinated, compassionate, and evidence-informed treatment.
Read the full study: Patient perceptions about obesity management in the context of concomitant care for other chronic diseases
