About 27% of Canadian adults are considered obese, and the prevalence surpasses 30% for those aged 40 to 69 years, according to a new report.
Obesity rates are higher among men, older adults, and in certain locations. Prevalence is highest in Newfoundland and Labrador; it is lowest in British Columbia.
“We are now in the midst of the obesity pandemic worldwide,” Ellina Lytvyak, MD, PhD, one of the study authors and a physician resident of public health and preventive medicine at the University of Alberta, told Medscape Medical News.
“Understanding obesity trends in Canada over time and, more specifically, appreciating age- and sex-specific patterns of obesity along with geographical aspects will help to tailor current and future interventions,” she said.
The study was published online May 24 in the Canadian Medical Association Journal Open.
The researchers conducted a consecutive, cross-sectional study by analyzing data from seven sequential Canadian Community Health Survey cycles from 2005 to 2018. They included data from Canadian adults who participated in at least one of the seven cycles. The data included body mass index (BMI) values, which were based on self-reported weight and height.
Obesity was defined as a BMI ≥30. The research team included data from 746,408 survey participants.
The prevalence of obesity increased significantly across Canada between 2005 and 2018, gradually rising over time from 22.2% to 27.2%.
The prevalence of obesity increased across genders. In 2005, about 24% of men and 20.4% of women were obese. In 2018, the rate continued to be higher among men , at 28.9%, than among women, at 25.4%.
Obesity also increased across all age groups. The highest rates were observed among those aged 50–69 years, followed by those aged 40–49 years. Between 2005 and 2018, the largest increase occurred among persons aged 40–49 years. By 2018, the prevalence of obesity among those aged 60–69 years was 32.3%, followed by those aged 50–59 years, at 31.4%, and 40–49 years, at 30.9%.
Obesity increased across all Canadian provinces and territories as well. In 2005, prevalence was lowest in British Columbia and Quebec, at 19.2% and 20.1%, respectively. It was highest in Newfoundland and Labrador, New Brunswick, and Prince Edward Island: all were above 30%. By 2018, Newfoundland and Labrador reported the highest prevalence, at 39.4%, and British Columbia reported the lowest prevalence, at 22.8%. During that time, the largest relative increases in obesity were in Alberta and Quebec.
“Analyzing obesity trends over time illustrates that this issue is becoming more and more urgent,” Sebastian Straube, BM BCh, DPhil, one of the study authors and director of the preventive medicine division at the University of Alberta, told Medscape Medical News.
“The trend towards more people becoming obese and people becoming more severely obese has been observed for decades,” he said. “But now a very significant proportion of the population is experiencing levels of obesity that are associated with a number of serious medical conditions. This will add a strain on the healthcare system.”
Treatment Without Stigmatization
The findings call for urgent action to identify, implement, and evaluate solutions for obesity prevention and management across all Canadian provinces and territories, the study authors write.
Importantly, they add, these initiatives should treat obesity as a chronic disease that should be managed at both an individual and the population level without stigmatization. The research team is now analyzing trends of severe obesity across Canada and plans to present the findings at an upcoming international meeting.
“Additionally, we know that obesity is a risk factor for severe disease and death in other pandemics, like COVID-19, so knowing the trends is also an important part of planning for these infectious disease pandemics currently and in the future,” Karen Lee, MD, one of the study authors and an associate professor of preventive medicine at the University of Alberta, told Medscape Medical News.
As much as 12% of Canadian health expenditures are attributed to obesity, the study authors write. Aggregated annual costs exceed $11 billion.
Globally, obesity rates have increased in every region and across all socioeconomic classes, according to the World Health Organization. It affects more than 13% of adults worldwide.
In multiple studies across the world, obesity has been identified as a major risk factor for type 2 diabetes, cardiovascular disease, chronic kidney disease, nonalcoholic fatty liver disease, chronic back pain, osteoarthritis, and several types of cancer.
“BMI as an indicator of health on an individual level is flawed, but BMI trends in population research are helpful to shape public policy to increase access to effective interventions for weight management,” Sean Wharton, MD, medical director of the Wharton Medical Clinic, a community-based internal medicine weight management and diabetes clinic near Toronto, Ontario, told Medscape Medical News.
Wharton, who wasn’t involved with this study, has previously studied obesity trends in Canada and is the co–lead author of the Canadian obesity guidelines. Although few interventions have been proven to be effective in preventing obesity, he said, increasing access to treatments for people living with obesity could help. These include psychological options, pharmacotherapy, and bariatric surgery.
With respect to public health initiatives, consideration should be given to the determinants of obesity, including physical, economic, social, and cultural factors.
“Bias, stigma, and discrimination against people living with obesity drives most of the challenges for people living with obesity to gain access to effective treatment,” he said. “Without dealing with this bias, effective obesity management will be blunted, and the upward trends will continue.”
The study was funded in part by Lee’s research funds through the University of Alberta Faculty of Medicine and Dentistry. Lytvyak, Straube, and Wharton have disclosed no relevant financial relationships.
CMAJ Open. Published online May 24, 2022. Full text
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