Pandemic stress drove weight gain in women and youth, with employers urged to rethink coverage gaps
Nearly one in three Canadians lived with obesity in 2023 — a sharp rise driven largely by women and younger adults — as the pandemic intensified caregiving burdens and strained access to treatment, according to research published in the Canadian Medical Association Journal (CMAJ).
The study, based on self-reported BMI data from 746,250 adults between 2009 and 2023, showed obesity rates increased from 25 percent in 2009 to 33 percent in 2023.
According to the study authors, the rate of increase doubled after 2020, from 0.5 to just over one percentage point per year.
Researchers followed World Health Organization obesity definitions, adjusting the threshold for Asian populations.
Severe obesity — a BMI of 40 or higher — nearly doubled during the same period, rising from 2.4 percent to nearly 5 percent.
Laura Anderson of McMaster University, lead author of the CMAJ study, said the findings highlight a shift in population health trends that calls for long-term public-health investment.
“This really quantifies the magnitude of the issue,” she said.
Anderson also noted that lifestyle changes during COVID—such as more sedentary time, mental health strain, and caregiving duties—may have contributed to the weight gain.
Women, in particular, faced growing pressures at home.
Kate Laird, who operates Love Your Body Fitness in Ottawa, told The Globe and Mail that many of her female clients still share how they gained weight during the pandemic and haven't felt like themselves since.
“Moms really bore the brunt of the pandemic,” said Laird. She noted many were isolated with toddlers or supporting children in online school while juggling their jobs. “They worked so hard taking care of everybody else… they put themselves dead last on the list and survived on kids’ sandwich crusts.”
Toronto resident Angela Martin, a nurse who also went through a separation during 2020, said to CBC that she gained significant weight during the pandemic.
“I mean you did the one thing you could do… you were not prevented from cooking so I tried all new recipes and then you couldn't go to the gym,” she said.
Workplace benefit structures may also be influencing outcomes.
As noted in a recent Benefits and Pensions Monitor webinar hosted by Connex Health, Obesity Canada’s director of advocacy Ian Patton said, “Obesity is not self-inflicted. It’s a complex chronic disease influenced by genetics, biology, and environment.”
Patton emphasized that many benefit programs still overlook obesity as a chronic condition and fail to offer adequate support.
According to Patton, coverage gaps exist in access to evidence-based treatments including medications, psychological intervention, and bariatric surgery.
While some medications such as GLP-1 receptor agonists (e.g., Ozempic, Wegovy) have proven effective, they remain out of reach for many due to limited insurance coverage.
“They’re effective lifesaving treatments… but they aren't a magic solution for everyone,” he said, adding that some patients experience side effects or are not good candidates.
Benefits and Pensions Monitor reported that some employers cap obesity drug coverage at $500 annually — enough to fund roughly one month of treatment, while current yearly costs approach $5,000 to $6,000.
GreenShield’s Ned Pojskic noted that generic versions of these medications, expected as early as March, may reduce annual costs to about $1,000.
The economic implications extend beyond the health of individuals. A cost-of-inaction study by Obesity Canada estimates that obesity-related costs total $27bn annually.
These costs include higher disability claims, lost productivity, and absenteeism.
According to Obesity Canada, Type 2 diabetes alone costs employers roughly $1,042 per employee per year due to missed work and $412 per employee from reduced productivity, or presenteeism.
Despite these consequences, Benefits and Pensions Monitor reported that few disability claims explicitly list obesity as a diagnosis, a gap that Cowan Insurance Group’s Lianne Clarke called a “hidden driver in benefits plans costs.”
Clarke added that obesity often remains unrecognized in disability forms even though it underlies many other health issues.
In terms of workplace culture, Patton urged employers to examine how they accommodate and communicate with individuals living with obesity. “Are we thinking about things like weight capacity for chairs or the bathroom spaces?” he asked.
Office culture also matters, as comments about weight or assumptions about fitness can create hostile environments.
Patton said that physical activity remains important, but it cannot replace disease management.
“We can’t treat [gym memberships] as a chronic disease solution,” he said, recommending that plans include access to registered dietitians, cognitive behavioural therapy, medications, and broader awareness initiatives.
Patton concluded that consistent benefit coverage and early intervention could reduce the incidence of downstream conditions such as diabetes, heart disease, and stroke. “If we can treat someone effectively early on… there’s a cost benefit analysis there as well.”
“Obesity is a chronic disease; that’s not something that’s debatable anymore,” Patton said. “Changing how we're talking about that in the workplace is going to make a big, big difference.”
