On the Road to Wellness

Helping to solve the obesity epidemic

Obesity is reaching epidemic proportions in Canada. A recent Statistics Canada survey revealed that 23% of adults are obese and 36% are overweight. The rate of obesity has doubled in the past 25 years and is expected to continue rising thanks to increased fast-food consumption, larger portion sizes and reduced physical activity.

Obesity is defined as a body mass index (BMI) of 30 or higher. Individuals are considered overweight if they have a BMI of 25 to 29.9. Research shows that as one’s body weight increases, the risk of developing serious chronic illnesses also increases. Obese and overweight employees are more likely to have higher rates of health claims, absenteeism, injuries and premature deaths.

Clinical practice guidelines for managing and preventing obesity make the following recommendations:

Diet and exercise. The guidelines suggest reducing one’s daily calorie intake by 500 to 1,000 calories and exercising for 30 minutes per day, three to five times per week initially, increasing to 60 minutes or more on most days.

Medications. Two medications are approved for short-term use in Canada—one reduces fat absorption and the other enhances satiety.

Bariatric procedures. Gastric procedures are recommended for individuals who are severely obese with serious co-morbidities (e.g. diabetes, hypertension) or morbidly obese. With laparoscopic adjustable gastric banding, an adjustable band is placed around the upper portion of the stomach to restrict the amount of food one can consume, resulting in early satiety and weight loss.

For morbidly obese employees, losing a substantial amount of weight is likely unattainable through diet and exercise alone or even with medications. A bariatric procedure is often needed and the benefits can be substantial.
Employers can take the following initiatives to encourage a healthy workforce:

• Provide educational materials on the health risks of being overweight and how to eat healthier

• Offer wellness classes on nutrition, exercise and weight management such as Weight Watchers

• Post the calories expended for common activities such as walking, swimming, bicycling

• Sponsor or subsidize health club memberships and/or personal trainers

• Offer healthy choices in cafeterias and/or vending machines

• Allow employees enough time for lunch so they can walk or use the gym

• Provide worksite walking paths and bike racks

• Talk with health plan providers about the availability of employee educations materials and disease management programs

• Talk with your benefit consultant regarding coverage for laparoscopic gastric banding

Dr. Monali Misra is assistant professor, department of surgery, and assistant director, Centre for Minimally Invasive Surgery, St. Joseph’s Healthcare, McMaster University.