from stigma to science: how canada's physicians are redefining obesity care
canada’s understanding of obesity is evolving, but there’s still a long way to go for access to care
published mar 04, 2026
6 minute read
6 minute read
dr. sean wharton, an internal medicine physician with a focus on obesity medicine practising at the wharton medical clinic and the university of toronto. supplied
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world obesity day, on march 4, offers a moment to reflect honestly and openly about obesity: what it is, how it impacts canadians, and how the way it’s understood shapes patient care.
across the country, four of canada’s leading obesity health-care providers are seeing the same urgent reality through different regional lenses: canada has made important strides in obesity science and clinical guidance, but access to care remains inconsistent.
as a result, canadians living with obesity still face barriers to accessing the care they need, with ripple effects for individuals, the economy, and the health-care system.
leading the way
as canada seeks to set a world-leading standard of compassionate care for obesity, there is an opportunity to confront stigmas and misconceptions about obesity, understand the evolving science, and explore how our health-care system can offer more effective, consistent care across the country.
dr. ali zentner, a specialist in internal medicine and obesity at revolution medical clinic in vancouver, was drawn to the field because it intersects with almost every aspect of health.
“it was a space in medicine that touched many subspecialties: neurology, nephrology, diabetes, endocrinology, hypertension, cardiology, even mental health. and yet there wasn’t anyone who was championing its treatment,” she says.
dr. marie-philippe morin, a specialist in internal medicine with a fellowship in bariatric medicine at the quebec heart and lung institute (iucpq), sees the downstream consequences daily.
“obesity is the cause of several chronic health problems,” she says. “we treat each of these conditions separately, but no one treats the initial problem.”
that disconnect explains why patients can experience varying levels of support depending on where they live, what services are available, and how obesity is understood within local health systems.
dr. marie-philippe morin, a specialist in internal medicine with a fellowship in bariatric medicine at the quebec heart and lung institute (iucpq) francis vachon
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confronting stigma and redefining obesity
obesity is commonly classified as having a body mass index (bmi) of 30 and over. however, science is revealing that it is more complex.
“obesity is a chronic disease,” says dr. morin. “for many people who are living with obesity, it becomes a vicious circle that’s difficult to break. it’s a myth that eating less and exercising more alone will solve the problem.”
dr. tasneem sajwani, medical director at the edmonton weight management centre, points to the different forces that shape how obesity develops and persists.
“there are environmental, psychosocial, and biological factors that influence how obesity presents. therefore, we need to start treating it like every other chronic disease,” she says.
“it’s a misconception that these are lazy people who have no willpower or discipline,” says dr. morin. “it’s dangerous to have that kind of discourse. because of this stigma, some people will receive less care. these prejudices also become somewhat internalized by the patient, which prevents them from seeking help because they think it’s entirely their fault.”
an ipsos study released on world obesity day 2026 shows that despite the fact that canadians living with obesity demonstrate high awareness of the associated health risks, few have consulted with a doctor about their weight.
the global perceptions of obesity study, spanning 14 countries, found that those living with obesity in canada are highly aware of the disease’s links to type 2 diabetes (72 per cent), and to heart disease (76 per cent) – far exceeding the 14-country average (53 per cent and 52 per cent, respectively).
yet, only one in five (21 per cent) had consulted a doctor about their weight in the past year.
dr. sean wharton, an internal medicine physician with a focus on obesity medicine practising at the wharton medical clinic in ontario, says, “the science has helped to drive the message that obesity is a biological disease and not the result of a lack of willpower.”
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for dr. zentner, a science-based framing also changes what patients feel they can ask for, and what clinicians feel equipped to offer.
“when you have legitimate, evidence-based treatments that are effective, you stop blaming patients,” she says.
dr. ali zentner, a specialist in internal medicine and obesity at the revolution medical clinic in vancouver. ethan cairns
recognition across canada varies
the formal recognition of obesity as a chronic disease matters because it influences canadians’ access to care. currently, only one province, alberta, has officially declared obesity a chronic disease.
“in alberta, we might be a bit ahead of the game,” says dr. sajwani. “my colleagues and i, alongside obesity canada, worked to have alberta recognize obesity as a chronic disease. but when it comes down to real-world care, there are still barriers. and if there’s inconsistency around the understanding that obesity is a chronic disease, then operationally, how are we going to manage that nationwide? care ends up being fragmented.”
dr. zentner points to the gap between broad acknowledgement and what patients experience day to day.
“the canadian medical association has acknowledged that obesity is a chronic disease. we have treatment options. so, why aren’t we able to provide the quality of care that exists?” she says.
provincial approaches to obesity care
across the regions, the clinicians describe many of the same ingredients for effective obesity care: multidisciplinary support, shared decision-making, and treatment plans tailored to the individual. what differs is how consistently those ingredients are available and how easy it is for patients to find a clear path to care.
dr. wharton is the lead author of obesity in adults: a clinical practice guideline, which places bias and stigma front and centre. “the biggest challenges in practising obesity care in ontario are bias, stigma, and discrimination,” he says.
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dr. wharton explains that this widespread bias affects funding models. comprehensive care would include “appropriate nutrition education, psychological intervention, and pharmacological intervention,” and this requires corresponding funding.
in alberta, we get a glimpse of what the recognition of obesity as a chronic disease can look like in practice: multidisciplinary care, shared decision-making, and a compassionate approach. however, as dr. sajwani notes, barriers remain.
“access to clinics that provide multidisciplinary care may be financially inaccessible to patients,” she says. “coverage of obesity care is limited. this creates a discrepancy between those who can and cannot afford it.”
navigating access
dr. zentner has become adept at navigating the system’s limitations. “the biggest challenge we face in b.c. is twofold,” she says. “one is access to medications. two is access to surgery. many patients could benefit from these care options, but access is limited.”
“it’s a two-tier system here in quebec when it comes to obesity,” says dr. morin. “people with private insurance are able to see psychologists, nutritionists, physiotherapists, join a gym, pay for medication, have bariatric surgery, and so on. when you have a higher socioeconomic status, everything is much easier.”
building on canada’s leadership
while the practitioners driving stronger obesity care in canada note that we’re already leaders in the space from a clinical guidelines perspective, there’s still work to be done. we need consistent standards of care across all provinces and territories, better training and education, better access, and more coordinated care pathways — better national alignment, essentially.
canada succeeds by rejecting shame and blame, says dr. wharton, and by believing that patients are worthy of care. we need to ensure this approach is embraced from coast to coast to coast.
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canada has the expertise, strong clinicians, research leadership, and clinical guidelines to truly elevate obesity care nationally and globally. a standardized approach to care and a shared language would help us to build on this leadership further.
dr. tasneem sajwani, medical director at the edmonton weight management centre. amber bracken
looking ahead with hope
this world obesity day is a call to action to standardize recognition of obesity as a complex, chronic disease and to expand compassionate, evidence-based care that is coordinated and accessible.
“canada is leading the world in what ideal obesity care should look like: compassionate, multimodal, evidence-based, and individualized,” says dr. sajwani. “my ultimate vision is that anyone who struggles with obesity can walk into a clinic and expect compassionate, evidence-based, multidisciplinary care that puts quality of life at the centre.”
dr. zentner shares that vision and hopes for a system where time is spent delivering care rather than navigating obstacles.
“i look forward to a time when i don’t spend 80 per cent of my day trying to figure out how to get a patient access to the care that will make the biggest difference in their life and in their health,” she says.
this story was created by healthing content works, healthing.ca’s commercial content division, on behalf of eli lilly canada.
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