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Obesity specialist Arya Sharma hears the argument all the time: Why should the public health system pay for treatments for people who have essentially “done it to themselves?”

In fact, the public system pays for very little of that sort of treatment now, and a Senate report last year on Canada’s obesity epidemic was virtually silent on improving access to care.

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In a new report, Sharma and colleagues are calling on Canadian governments to recognize obesity as a chronic disease in and of itself, like diabetes or cancer, and improve public coverage for anti-obesity drugs, weight-loss surgery and other interventions.

According to the report by the Canadian Obesity Network, bariatric surgery is available to only one in 183, or 0.54 per cent of adult Canadians who may be eligible for it; wait times between referral to surgery and consultation with a surgical team stretches up to five years; anti-obesity drugs aren’t covered by any provincial or territorial drug formulary; and fewer than 20 per cent of the Canadian population with private drug-benefit plans have access to prescription obesity meds.