Weight loss

What are overweight and obesity?

Overweight and obesity are both conditions characterized by having a body mass index (BMI) that’s higher than the ‘healthy’ range. Often it’s caused by having excess levels of body fat, but occasionally people with very high levels of muscle mass can have an obese or overweight BMI, too.

Overweight and obesity are both associated with shorter life expectancies, and increase your risk of developing secondary conditions like type 2 diabetes, high blood pressure, and heart disease.^[1][2]

Who is weight loss treatment suitable for?

Weight loss treatments are usually suitable for people with a body mass index (BMI) of 30 or higher. However, they might also be prescribed for people with a BMI of 27 or higher who have other health risk factors, such as type 2 diabetes or high blood pressure.

You can check your BMI using an online calculator. This will help you understand if you are in a healthy weight range and, if not, provide a target for weight loss.

It’s important to know that the health risks associated with BMI can differ across ethnic backgrounds. People of South Asian, Asian, Indigenous, or African descent may face a higher risk of conditions like type 2 diabetes at a lower BMI. For these groups, a BMI of 23 or higher can indicate increased risk, and a BMI of 27.5 or higher is often considered obesity.^[1][2] Some Canadian health tools are starting to incorporate ethnicity to provide more personalized advice based on these risk factors.

If your BMI is between 25 and 30, this is categorized as ‘overweight’. A healthcare provider will usually recommend making adjustments to your diet and increasing the amount of exercise you do. They may advise you to record what you eat in a food diary, which can help identify habits (like adding sugar to your coffee) that you can change under their guidance.

Similarly, keeping an activity diary or using a fitness tracker to monitor your daily steps can help you see how active you are and create a realistic plan to increase your physical activity.

How to get help with weight loss

Because healthcare is provincial, your entry point and coverage will depend on where you live, but the general pathway remains similar across the country.

Your first step should usually be to see your family doctor for a referral from your family doctor. They can often screen for underlying causes (like PCOS or thyroid issues) and look for weight-related complications like sleep apnea or high blood pressure.

The first recommendation is then usually lifestyle changes, such as tailored diet and exercise plans, and psychological support such as counselling and CBT (cognitive behavioral therapy). But if these alone aren’t helping you reach your goal weight, medications or surgery can be recommended.

The cost of medication isn’t usually covered by public health, whereas for eligible patients, surgery can be. It’s worth noting, though, that wait times for surgery can be very long.

Which is the best option for me?

It depends on your individual health needs. For many people, the best option is a sustained focus on a healthy balanced diet and regular exercise. But if you have significant or persistent issues with your weight, medical intervention might be better for you.

Weight loss and diet

For many people who are overweight, changes to diet and regular exercise are enough to reach a healthy weight without medication.

After assessing your habits, you can start setting realistic targets. The British Diabetic Association recommends aiming for a gradual and sustainable weight loss of 0.5kg to 1kg (1-2 lbs) per week.^[1] This is best achieved by managing your daily calorie intake.

Trying to lose weight too quickly by skipping meals is often counterproductive. This can lead to a “yo-yo” effect, where your weight fluctuates up and down, as the natural reaction to drastic under-eating is often over-eating. Drastically cutting calories can also put you at risk of nutrient deficiencies.

In short, focus on eating healthier foods, controlling portion sizes, and exercising regularly. This helps create a calorie deficit (burning more calories than you consume), which is the key to losing weight.

Weight loss and exercise

Exercise helps you burn excess calories and is a critical partner to dietary changes for effective weight loss. It is also great for boosting your motivation and general well-being.

Increasing your activity bit by bit is an effective way to make exercise a regular part of your routine. The Public Health Agency of Canada recommends that adults get at least 150 minutes of moderate-to-vigorous aerobic physical activity per week, in bouts of 10 minutes or more.^[2] Aerobic activities include brisk walking, running, cycling, dancing, and swimming.

It is also beneficial to add muscle-strengthening activities using major muscle groups at least twice a week. A combination of aerobic exercise and strength training (like squats, lunges, and push-ups) can produce excellent results.

It’s important to speak to a healthcare provider before starting a new exercise program, especially if you have been inactive or have underlying health conditions.

Weight loss surgery: is it an option for me?

It may be. Bariatric surgery can be very effective, but it’s a major operation and is typically only considered for people who have not been able to lose weight through diet and exercise.

In Canada, you may be a candidate for surgery if your BMI is 40 or higher, or if your BMI is between 35 and 40 and you have a serious obesity-related health condition. You can discuss this option with your family doctor, who can refer you to a surgical program for assessment.