Breaking down the stigma: What employers need to know about obesity
May 23, 2017
Posted by: CPHR Manitoba
As featured in the Spring 2017 issue of HRmatters
Authored by: Dr. Sean Wharton
Dr. Sean Wharton is an Internal Medical Specialist and Medical Director of the Wharton Medical Clinic in Burlington, Ontario, a community-based internal medicine weight management clinic which adopts a comprehensive, multidisciplinary approach in the long-term treatment of obesity.
Many Canadian employees, to some degree, struggle with their weight. According to self-reported data collected by the Canadian Community Health Survey, 62 per cent of Canadian adults are overweight or living with obesity. Increased weight can cause or worsen other serious health conditions including high blood pressure, high cholesterol, depression, osteoarthritis, sleep apnea, cancer, back pain, heart disease, stroke, and diabetes.
The Science behind Obesity
People living with obesity have been consistently ridiculed for making poor lifestyle choices, and often branded as “overeaters who don’t exercise enough.” These pre-conceived notions have left people thinking that the simple solution to losing weight and keeping it off is to promote a healthy lifestyle consisting of more exercise and reduced caloric intake. However, by understanding the science behind obesity, we now understand that in the long-run, such an approach may not produce the desired results of decreased weight. Research has shown that more than 90 per cent of people who are successful at losing weight through calorie-reduced diets eventually gain most, if not all of this weight back within five years. Another study found that while people with obesity initially lost an average of 14 per cent of their body weight through diet and exercise, after five years, the average loss had declined three per cent. However, it is important to note that any increase in activity and improved eating habits will improve an individual’s overall health, but may not result in decreased weight.
Ultimately, the human body’s central regulatory system is designed to defend an individual’s highest weight point and will therefore try to regain any lost weight, regardless of whether or not that particular weight point is healthy. In 2011, groundbreaking research found that individuals who dieted to lose weight triggered significant changes in their bodies’ hormone levels, resulting in an increased appetite and feelings of hunger. One year after the period of initial weight loss, their hormone levels had not reduced to the levels observed before dieting, meaning that their bodies were still encouraging weight regain.
Scientific evidence confirms that obesity is in fact, a chronic medical condition and recognizing it as such is the first step in supporting employees in the workplace and encouraging effective treatment approaches. People living with obesity carry a heavy stigma, or “weight bias”, leaving the impression that personal willpower is the only thing that is needed to lose weight, and failure to do so is indicative of personal weakness. For the majority of people, this is not the case.
Obesity in the Workplace
Weight bias represents a significant barrier to identifying the most effective ways of addressing obesity, including in the workplace. According to many health experts, it is also a root cause of the health system’s inability to take responsibility for and ensure access to evidence-based obesity treatments. The stigma surrounding obesity and a fear of public failure prevents many people living with obesity from participating in workplace challenges, weight loss programs or using on-site gyms.6 For the majority, weight loss challenges in the workplace often fail because they do not acknowledge how hard it is to control the hormones that regulate appetite and energy. In fact, these challenges can make matters worse because people will often do anything to win a competition, including excessive exercise, starving themselves or even taking laxatives.6 Ultimately, such actions make treating obesity more difficult because they are predicated upon doing things that in the long run, are either unhealthy or unsustainable.
Simple dialogue between employers and colleagues, tailoring support to the needs of a particular individual and offering a variety of support systems are all important initial steps employers can take to breaking down existing stigmas. Employers can create positive spaces through forums, of evidence-based information, for people to discuss obesity and the challenges they face in addressing this condition. Furthermore, offering life coaches, nutrition coaches and specially trained healthcare professionals can help an employee with obesity determine a daily treatment program that can be realistically maintained for the long term. By playing a supportive role in eliminating the stigma surrounding obesity, offering comprehensive support and facilitating greater access to evidence-based treatments for obesity, employers can begin to play a positive role in improving health outcomes for Canadian employees who are living with obesity.
Benefits of Offering Evidence-Based Treatments
Given obesity’s high prevalence and causative link to other costly chronic conditions, a proactive approach on obesity can reduce spending on other chronic conditions (high blood pressure, high cholesterol, depression, osteoarthritis, cancer, back pain, heart disease and diabetes). For instance, a five to 10 per cent weight reduction, no matter the starting weight, can produce significant health benefits.6 For an employer, this means less money devoted to providing treatment for heart disease and diabetes as well as the devices needed to support those with sleep apnea.
By effectively treating obesity, employers can also help boost labour force participation and productivity. A 2014 study found that obesity is an independent risk factor for reduced work productivity and is associated with elevated rates of absenteeism. Furthermore, this direct approach will help mitigate the losses in productivity and days of work missed due to other previously mentioned chronic conditions. By improving health outcomes for their employees, organizations and benefits providers can help foster a more productive work force and thereby improve business competitiveness.
According to the World Health Organization, “obesity is one of today’s most blatantly visible — yet most neglected — public health problems.” Scientific evidence confirms that obesity is a chronic disease — one that can cause or aggravate other serious chronic conditions. By mitigating the spread of misinformation about the causes of obesity and facilitating access to evidence-based treatments, employers can play a positive role in reducing associated health risks, reducing the cost burdens of private health benefits plans and achieving gains in labour productivity.
For more information on how employers can take meaningful strides to reduce the health risks associated with obesity, consult Obesity is a chronic disease: Why this fact changes everything when it comes to health and the evolution of benefits plans, a White Paper for plan sponsors, benefits providers and advisors.
This article was written in collaboration with Novo Nordisk Canada Inc.
 Statistics Canada. Body composition of adults, 2012 to 2013. Health Fact Sheets, Statistics Canada, 82-625-X.
 Safer DJ. Diet, behavior modification, and exercise: a review of obesity treatments from a long-term perspective. South Med J, 1991; 84(12): 1470-4
 Anderson, J. W., Konz, E. C., Frederich, R. C., & Wood, C. L. (2001, November). Long-term weight-loss maintenance: A meta-analysis of US studies. Retrieved November, 2016, from https://www.ncbi.nlm.nih.gov/pubmed/11684524
 Sumithran P, Prendergrast L, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011; 365: 1597-604
 Sanchez Bustillos A, Vargas III KG, Gomero-Cuadra R. Work Productivity among adults with varied Body Mass Index: Results from a Canadian population-based survey. J Epidemiol Glob Health. 2015 June; 5(2): 191-9