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Obesity and Overweight in Canada

Obesity levels are rising in Canada and disproportionately impacting historically marginalized and rural communities, resulting in a variety of obesity targeted interventions.

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November 14, 2023

Global Guide to Obesity
Obesity rates are rising across the world. This guide explores country-specific challenges as well as ways global employers can support their workforce.
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In recent decades, Canada, like many other countries across the globe, is grappling with an increasing population of people living with obesity and overweight. Though obesity trends in Canada are not as high as levels seen in the U.S. and across much of Central and South America, Canada nonetheless has a prevalence of obesity that is greater than many other comparable developed and wealthy countries.1 According to the Canadian Risk Factor Atlas (CRFA), 26.7% of adults in Canada have obesity and 35.9% are overweight.2 Globally, Canada ranks 20th among adult males with obesity (30.47%) and 54th among adult females (30.44%).

Future projections indicate an ongoing increase in obesity rates in Canada.4 In fact, the 2023 World Obesity Atlas estimates that by 2035, nearly half (49%) of adults in Canada will have obesity; an annual increase in prevalence of 2.3% is expected between 2020 and 2035.4 Furthermore, the prevalence of obesity is projected to increase among both adults and children living in Canada (Figure 1.1).

Projected Trends in the Prevalence of Obesity. the 2023 World Obesity Atlas estimates that by 2035, nearly half (49%) of adults in Canada will have obesity; an annual increase in prevalence of 2.3% is expected between 2020 and 2035.4 Furthermore, the prevalence of obesity is projected to increase among both adults and children living in Canada (Figure 1.1). 
Figure 1.1: Projected Trends in the Prevalence of Obesity

Source: World Obesity Federation: World Obesity Atlas 2023

Employer Opportunity

The rising percentage of people who are living with obesity or overweight in Canada has significant, lasting repercussions for both the workplace and broader society. For employers in Canada, it is important to understand the overarching implications of obesity on their bottom line, including lost employee productivity and correlated increased health care costs.


Similar to how health inequities proliferate around the world, existing disparities in the prevalence of individuals living with obesity or who are overweight in Canada are driven by a multitude of factors, including differences in socioeconomic status, geographical location and/or belonging to a historically marginalized population. For example, Indigenous people in Canada (i.e., First Nations,Métis and Inuit) are disproportionately affected by the burden of obesity and are some of the most socioeconomically marginalized.5


Employer Opportunity

Results from Business Group on Health’s Global Weight Management Survey reveal only two employer respondents rated the quality of weight management services as either very good or good.18 However, half of responding employers rate it merely as fair, highlighting an opportunity for employers to take proactive actions to improve quality and safeguard equitable access to available weight management services. As such, one area for employer consideration is assessing weight management programs from an equity-based lens and incorporating obesity and overweight into ongoing diversity, equity, inclusion and belonging (DEIB) practices. In addition, employers with sufficient land/space may consider creating walkable spaces for employees to take breaks, have lunch during meetings, and enjoy the outdoors.


Cost and Impact of Overweight and Obesity

In the absence of mitigative actions to address the looming economic and societal impacts tied to increasing populations of people who are experiencing obesity in Canada, employers can expect these costs to continue to skyrocket to potentially unmanageable numbers. From a health care cost perspective, the total impact of overweight in Canada is estimated to increase from $15.24 billion in 2020 to over $23 billion by 2035 (Table 1.1).

Table 1.1: Impact of Overweight

Health care impact of BMI ≥ 25kb/m2, US$ million

Total economic impact of BMI ≥ 25kb/m2, US$ million

Estimated GDP US$ billion

Impact of BMI ≥ 25kb/m2 on GDP

2020

15,240

41,480

1,651

2.5%

2025

17,527

48,763

1,907

2.6%

2030

20,095

57,604

2,117

2.7%

2035

23,003

68,586

2,386

2.9%

Source: World Obesity Federation: World Obesity Atlas 2023

It is important to keep in mind that such expected increases extend far beyond just the direct cost of health care. These estimates also indicate that the economic impact of overweight in Canada contributes to increasing trends in premature death, absenteeism and presenteeism (Figure 1.2). Moreover, in 2019, the total estimated economic impact of obesity and overweight in Canada is $40.34 billion; but by 2060 the direct and indirect costs are expected to increase fourfold, to $162.35 billion.8

Figure 1.2: Projected Economic Impact of Overweight. in 2019, the total estimated economic impact of obesity and overweight in Canada is $40.34 billion; but by 2060 the direct and indirect costs are expected to increase fourfold, to $162.35 billion. 
Figure 1.2: Projected Economic Impact of Overweight

Source: World Obesity Federation: World Obesity Atlas 2023

Regional Differences

Rural areas tend to have a higher prevalence of obesity; for example, the rural regions of Newfoundland and Labrador, along with Prince Edward Island and New Brunswick, represent areas in Canada with the greatest proportion of residents living with obesity.6 The level of walkability of neighborhoods–or how well spaces support physical activity and access to services–is another factor driving regional disparities in obesity.7 Not surprisingly, rural neighborhoods tend to score lower in terms of walkability compared to suburban and urban areas. Amongst Canadian adults ages 18-59 years old, there was a 50% lower share of individuals with a body mass index (BMI) in the overweight or obesity range in the most walkable neighborhoods compared to the least.7

Employer Opportunity

In light of the compelling evidence regarding the influence of the workplace on employee health and well-being, along with the heightened evaluation of workplace environments in Canada, it is advisable for employers to reassess policies that may contribute to a sedentary lifestyle. This may involve, for example, conscientiously designing the workplace infrastructure to encourage spontaneous walking opportunities and enhancing flexible working arrangements.


Addressing Rising Rates of Obesity and Overweight: Trends in Employer Coverage, Policy Developments and Interventional Approaches

In recent years there have been notable discussions and gradual changes in thinking about eligibility and coverage criteria used by Canada’s public health system. Still, for the most part, obesity is determined solely by an individual’s BMI. According to Canadian guidelines, an individual has obesity if they have a BMI of greater than or equal to 30, while overweight is categorized as having a BMI of 25 to 29.9.9 Eligibility for weight loss surgery has traditionally been limited to individuals with a BMI above a certain threshold, typically 35 or 40, in combination with obesity-related health conditions, such as diabetes or hypertension.10 However, there have been ongoing shifts towards consideration of additional factors, such as the impact of obesity on mental health, weight stigma, quality of life and the presence of other obesity-related comorbidities such as type 2 diabetes.11

Employer Opportunity

People living with obesity experience significant stigma and bias that contributes to heightened levels of mortality and morbidity independent of weight or BMI.12 According to Business Group on Health’s Global Weight Management Survey, a third of employer respondents state that there is moderate weight stigma, while a majority of employers (58%) think that severity of weight stigma is mild (n=19).18 Nonetheless, employers should look at metrics that go beyond BMI and consider issues such as the presence and severity of weight stigma when looking at programs to address growing trends in obesity and overweight employee populations.


Survey Findings: Employer-sponsored Support and Offerings

Business Group survey findings, five employer respondents note that weight management is covered under their health plan in Canada, while six employers report that they either don’t cover weight management in Canada or don’t know. Moreover, employers with employees in Canada noted that coverage for weight management under their supplemental health plans include outpatient services/nutritional counseling as well as prescription drugs to treat obesity and overweight. Survey participants also reportedly offer the following weight management programs in Canada:

phone app

Digital (app-based) weight management

phone

Telephonic weight management

clinic

Weight management program through an on-site clinic

group of people

Group-based weight management

doctor

Medically supervised weight management such as a specialty clinic

For those employers who are not offering weight management support in Canada, the top reasons cited include coverage already provided by the national health plan, lack of demand, lack of support from senior management, and costs of services. Additionally, a mindset that obesity is a lifestyle issue creates both a gap and an opportunity for employers.

The most common employer initiatives include stress management, healthy nutrition and fitness (either offered at on-site facilities or through gym membership subsidies). Other employer efforts include healthy sleep programming and biometric screening/weight management advice during health checks.


Recent trends in employer-sponsored support seem to fall in line conceptually with an increasing emphasis from Canada’s government on the importance of comprehensive pre-operative assessments in determining coverage for weight loss surgery. These assessments are considered a better way to evaluate an individual’s physical and mental health, their readiness for surgery and their understanding of the long-term commitment that comes post-surgery, such as nutrition and lifestyle changes. Similarly, with an increasing recognition that weight loss surgery is merely one aspect of a patient’s overall treatment journey, health care systems within Canada are placing greater importance on providing long-term follow-up care, including regular monitoring, nutritional counseling, decreasing periods of sedentary activity as well as access to pharmaceutical therapies and multidisciplinary care teams that can appropriately address the diverse needs of all patients, especially historically marginalized subpopulations.

Listed below are some of the ongoing government policy interventions that aim to address the growing prevalence of obesity and overweight populations in Canada:

  • Movement-based policy interventions: Let’s Get Moving is a national policy document guided by five interdependent principles that serve as a collective way forward to direct the country toward increasing physical activity and reducing sedentary living.13 In addition, the Canadian 24-hour Movement Guidelines for adults established in 2020 offer evidence-based recommendations to promote a more active lifestyle for Canadians of all ages.14,15 To increase access to green spaces, there are numerous efforts to advance the development of urban outdoor fitness parks.16
  • Evidence-based clinical guidelines: The Canadian Adult Obesity Clinical Practice Guidelines (CPGs) offer a crucial evidence-based framework for health care professionals, patients and decision makers. They are the first comprehensive update to Canadian obesity guidelines since 2007 and represent the most extensive global review of obesity evidence ever conducted.17 The CPGs, developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons covers various clinical and scientific issues. A frequently updated, public summary of these recommendations is published in the Canadian Medical Association Journal.
  • Nutritional policies: As part of ongoing efforts to curb the rising prevalence overweight and obesity, in 2018 Canada implemented a mandatory nationwide ban on the use of trans-fats or use of partially hydrogenated oil (PHO) in all foods.18 Another government-directed nutritional policy requires a front-of-package nutrition symbol labelling for all foods high in at least one of the following nutrients: Sodium, sugars and/or saturated fat. While this policy was first established in 2022, the Canadian government has given industry stakeholders until January 1, 2026, to implement this policy change.19
  • Pharmacological policies: Along with an increasing focus on societal, nutritional and environmental-based policy approaches, evidence-based pharmacotherapy is recommended for long-term weight management in individuals with a BMI of 30 kg/m² or higher, or a BMI of 27 kg/m² or higher with associated health conditions like type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea.20 There are four medications approved by Health Canada for long-term obesity management: liraglutide 3.0 mg (Saxenda®), naltrexone/bupropion in a combina­tion tablet (Contrave®), orlistat (Xenical®) and semaglutide 2.4 mg (Wegovy®). Health Canada has set forth specific criteria that must be met for a pharmacotherapeutic agent to obtain regulatory approval for long-term weight management. There is also recognition that in Canada there is off-label use of other available medications for obesity manage­ment.20

The growing population of individuals living with obesity or overweight in Canada carries substantial consequences both within the workplace and for broader society. By taking into consideration and leveraging the frameworks, government policies and interventional approaches already being implemented, employers can also help to mitigate this increasing population. Employers are well-positioned to help proactively address rising rates of overweight and obesity.

Overweight and Obesity in Canada

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TABLE OF CONTENTS

  1. Cost and Impact of Overweight and Obesity
  2. Regional Differences
  3. Addressing Rising Rates of Obesity and Overweight: Trends in Employer Coverage, Policy Developments and Interventional Approaches