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Why you should offer obesity management coverage

By: Benefits by Design | Tuesday April 30, 2024

Updated : Monday April 29, 2024

text: Why you should offer obesity management coverage.. Image: woman jogging with symbols of a stop watch, water bottle, dumbbell, scale, heart monitor and fruits and veggies floating around her.

Obesity management is about giving employees access to useful, individualized support. It means working towards healthier outcomes and personal confidence, not towards a number on the scale. And there are more people than you think that need this support. In fact, 60% of Canadian adults are considered obese or overweight.

Rethinking Obesity and Its Impacts on Canadians and Their Benefits Plans

The hard facts: Why obesity management is needed

Chronic obesity is a complex disease that hasn’t been fully recognized by all medical professionals. Too often, obese or overweight people face judgement by peers and medical professionals alike and are seen as lazy or lacking in willpower.

“But like all chronic diseases, the root causes of obesity run much deeper. They can be genetic, psychological, sociocultural, economic and environmental.” – The Root of Obesity by World Obesity

Obesity rates

More than a quarter of adult Canadians are considered obese. Over the past 15 years, the rate of men with obesity has hovered between 24% and 27%. Women have seen a much more turbulent obesity rate. Sometimes as high as 27%, and other times dipping down to 22%, where they are currently.

Of more concern, however, is the fact that the rate of obese and overweight Canadian children has increased to almost a third. This troubling trend shows a need for obesity management awareness and support, since obesity is often carried through to adulthood.

Cost of obesity in Canada

The economic impact of obesity in Canada cannot be understated. Data from the Government of Canada suggested that in 2010, obesity cost Canadians between CAD$4.6 billion to CAD$7.1 billion dollars. “In this study, the economic burden of obesity was defined as both the direct costs to the health care system (i.e., hospital care, pharmaceuticals, physician care and institutional care) and indirect costs to productivity (i.e., the value of economic output lost as a result of premature death and short- and long-term disability).”

In Ontario, another study found that physician costs increased by 14.7% and 18.2% respectively for men and women with obesity, compared to those of healthy weight.

Finally, in 2021 it was found that almost CAD$12,000 million per year is lost in taxes alone, both from direct taxes due to lost income, and indirect taxes due to lowered consumption of goods and services.

Health risks of obesity

Obesity itself can lead to chronic pain and fatigue, as well as depression or other mental health issues. Additionally, obese individuals may be at higher risk for a variety of diseases or conditions, including:

hypertension or high blood pressure;
coronary heart disease;
Type 2 diabetes;
stroke;
gallbladder disease;
osteoarthritis;
sleep apnea and other breathing problems; and
some cancers such as breast, colon and endometrial cancer;

How obesity management coverage can help

Many people living with chronic obesity have been prescribed medication to help with obesity management.

Average monthly obesity medication cost per 1,000 covered lives: 2019: $433 2020: $504 2021: $702 2022: $786 This is the equivalent to $0.79 per covered life, per month. That's less than $10 per covered life, per year. The cost of covering obesity medication is not significant in comparison to the cost of illness from obesity associated comorbidities. Source: Obesity toolkit - Novo Nordisk

Yet while the personal cost has nearly doubled since 2019, it is not a large expense to cover under a group insurance plan. Considering the cost per covered life is less than $10 annually (see image above), the cost of comorbidities, illness, or injury is far more significant.

For context, an employee with diabetes costs employers almost $1,500 per year in lost productivity and missed days.

While not all mental health issues are related to obesity, the reality is that some of them are, and these costs also add to the overall price tag of obesity on business. Chronic pain can also be caused by obesity in some cases, which can exacerbate mental health conditions.

Overall health and comorbidities

Obesity can also lead to other chronic diseases. In fact, obesity is the biggest risk factor for Type 2 diabetes, with one study concluding just a 13% reduction in weight can reduce the risk of Type 2 diabetes by up to 41%!

Proof that obesity directly affects other aspects of our health is further shown in the 2023 Benefits Canda Healthcare Survey (BCHS). Individuals with obesity are almost 7x more likely to have poor overall health, and 3x more likely to have poor mental health than those with no chronic condition. (see image below)

In order to combat obesity, many people take a multi-pronged approach. This includes medication, along with counselling, coaching or therapy, and a concerted effort to eat healthy and follow physical activity guidelines.

The latter is not an easy feat. In fact, “only around 15% meet the national guidelines for being active.”

What obesity management coverage is in your employee benefits plan?

The following list outlines each benefit line, and the type of coverage within that can help with obesity management in some form. *Many plans do not cover obesity medication. You can stand out as an employer by providing this much needed, often overlooked benefit.

Health care coverage and/or a health care spending account (HCSA):

Prescription drug coverage – obesity medication*;
Paramedical services – psychologist, nutritionist, registered dietician, therapist, and/or kinesiologist;
Self-guided psychological assistance – internet-based cognitive behavioural therapy (iCBT) apps or services.
Lifestyle rewards programs – BestLife Rewarded and Change4Life rewards members for making positive changes and healthy choices.
Bariatric surgery coverage – only covered if medically necessary as determined by a physician.

Group Health Insurance 101: What is Extended Health Care (EHC)?

Personal/wellness spending account (PSA/WSA):

Exercise equipment
Exercise gear (shoes, garments, duffle bag)
Gym pass/season pass

What is a Personal Spending Account (PSA) and How Does it Work?

Disability coverage:

Mental health leave coverage along with adequate disability management.
Physical injury or bariatric surgery leave coverage along with adequate disability management and return to work accommodations.

Disability Insurance – Short-Term vs. Long-Term

Many of the coverages needed to help with obesity management are already found within a fully insured employee benefits plan. The addition of obesity medication, along with a PSA can significantly increase the ability for employees to effectively manage their obesity using their employer sponsored benefits.