Time for Change Around “Fat Shaming” and “Weight Loss Shaming” in Employee Benefits

By Dan Eisner, Employee Benefits Advisor

Over the past few years, we have noted how consistent our thinking has been around most chronic conditions—until a new category entered the conversation. Would we ever consider shaming a cancer patient for doing chemotherapy or radiation, or taking drugs to help manage their cancer? Do we shame people with Diabetes for using insulin? These types of rhetorical questions could be applied to any number of chronic diseases realistically, but we have thankfully not been prone to asking these types of questions. However, today that has all changed when it comes to employee benefits plans and obesity, and the use of GLP-1 weight loss drugs.

Historically, it has been too easy to blame overweight people for their own problems. It was quite common to observe “fat shaming” and telling them to just eat less and exercise more. However, obesity has already been recognized by the medical community as a chronic disease and not a lifestyle issue. Many factors can lead to an individual being overweight or obese: genetics, life events, poor mental health, mobility issues caused by injuries, lifestyle choices (drinking, smoking), lack of access to both professional and personal support, etc. Unfortunately, obesity and excess weight can also lead to many other chronic diseases and poor mental health.

The relatively recent advent of weight loss medications has been a breakthrough in metabolic health, offering individuals struggling with obesity and related conditions a potentially effective treatment path. Interest in those weight loss drugs has grown exponentially but so has the rhetoric around those drugs. Unfortunately, we have now been seeing the advent of “weight loss shaming” and telling overweight people that their weight loss success does not really count because they were using drugs.

The lingering view of obesity as a lifestyle issue perpetuates bias and stigma, which adversely affects those seeking help. This lingering bias might also be impacting employee benefits plan sponsors as coverage for weight loss drugs is nowhere near where it needs to be to make an impact, even though interest in providing coverage has increased. There is an unfair burden placed on people dealing with obesity to try and prove the cost-effectiveness of drugs treating obesity, when compared to other chronic diseases. Ironically, if the health of overweight and obese individuals declines further, they may ultimately deal with other chronic diseases for which the treatments will not be questioned or shamed.

Broadly as a society and particularly within the employee benefits industry, we need to eliminate the historical practice of lumping obesity into other lifestyle issues. By truly recognizing obesity as a chronic disease, there should not be any doubt, stigma or bias about covering the full range of available treatments, including weight loss drugs.

The good news is that the vast majority of insurers in the industry have now developed “prior authorization” protocols to help manage weight loss drug costs by ensuring the right people “get on” these drugs at the right time, and also that these people “get off” weight loss drugs if they are not doing their part by way of diet and exercise. As well, in 2026 lower cost “generic/biosimilar” versions of Ozempic could change the game in Canada and provide new opportunities for overweight and obese individuals and employee benefits plan sponsors.

Obesity now impacts over a third of Canadians, and those that are overweight account for almost another third of the population. These individuals should not feel shame for the chronic disease they are dealing with, nor for using weight loss drugs to manage their disease. Employee benefits plan sponsors can play a key role in dealing with this stigma and proactively providing coverage for weight loss drugs to their employees. Working with their advisor, plan sponsors can set up this coverage on a sustainable basis to support employee health and wellbeing.

Should you have any questions about the above, please do not hesitate to contact any member of our team.

Most employee benefits advisors come from an insurance background, but Dan Eisner began his career as a CPA and now he has almost 25 years’ experience in the group benefits industry. This unique experience allows him to:

• Challenge the norms and historical practices in the employee benefits industry over the past 20–30 years
• Facilitate better discussions between HR and Finance professionals
• Analyze benefits plans through a financial and risk-management lens
• Support CFOs and Finance teams with cost forecasting and sustainability modeling
• Align employee benefits strategy with long-term corporate goals and HR strategies
• Leverage the most experienced team in the industry at ZLC Employee Benefits Solutions

ZLC Employee Benefits Solutions is one of the fastest growing advisors for employee benefits and group retirement programs in Vancouver and we are fortunate to have the best people, resources, and clients. We provide value by leveraging one of the most skilled benefits teams – collectively almost 500 years of experience within our team of 21 employee benefits specialists. We have been working with businesses ranging from 3 to over 75,000 plan members for over 40 years.