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The cost of skinny

Pinch an inch
Pinch an inch - 123RF Stock Photo

In the battle to lose weight and regain health, the bank account can take one of the hardest hits

Stricken with a rare blood disorder, then-24-year-old Samantha Davenport was put on medication to save her life.

But it came with a terrible side effect that would prove to be almost as dangerous.


"It made me starving all the time, so I did nothing but eat," the Fredericton resident said.

In a little over a decade, the five-foot, nine-inch Davenport's weight soared to 550 lbs. As she got heavier and bigger, many everyday things became impossible.

"I couldn't walk a telephone pole length. Getting in the car was hard because my stomach touched the steering wheel. I couldn't bend over to tie my shoes," she said.

That, though, was then.

“You'd think that if you eat less that you'd save money. Healthy food costs more.” — Dr. Sara Kirk, a professor at Dalhousie University's School of Health and Human Performance

After losing 353 lbs. with the aid of bariatric surgery, proper eating, exercise and the support of friends at weekly Take Off Pounds Sensibly meetings, Davenport is now down to 197 lbs. She can walk four kilometres and goes horseback riding with her daughter.

"She can't keep up with me," said Davenport. "It drives her crazy."

Her struggle with weight – although perhaps more extreme than that of many people – is certainly not unique.

In Atlantic Canada – as in much of North America – obesity is endemic.

Statistics Canada figures for the most recent year for which data is available show that more than a third of Atlantic Canadian adults admit to being not only overweight but obese.

Although many of these Canadians are perfectly healthy, obesity has been linked to a greater likelihood of developing many serious health problems. These include heart attacks, strokes, arthritis, some cancers, diabetes and sleep apnea. And yet, there is relatively little by way of dedicated medical resources to help these people, says Dr. Arya Sharma, the scientific director of the Canadian Obesity Network.

"For most Canadians, you're going to have a lot of difficulty getting access to treatment," said the University of Alberta professor. "There is not a lot of acceptance for treating obesity (as a chronic disease) by the public and not because of the costs but because of the stigma."

With politicians not green lighting publicly funded obesity treatments, those suffering are left with limited options and higher costs.

Bariatric surgery
Bariatric surgery

Take bariatric surgery.

Although it is a major surgery – which can involve a variety of procedures, including a reduction of the size of the stomach or removal and re-routing of parts of the gastrointestinal tract – it has been shown to have a high rate of success. This, in turn, has helped people recover from diabetes, improve cardiovascular health, and resulted in many of these patients enjoying longer and healthier lives.

"It's drastic. It's a major operation. But if you look at the long-term data, it seems to have the best outcome for obesity," said Sharma.

Despite the hope that bariatric surgery offers, the country has relatively few surgeons to perform these medical procedures, according to the Obesity Network.

Nova Scotia has the fewest bariatric surgeons for the number of people who could benefit from these procedures compared to the rest of Canada. There is only one bariatric surgeon for every 1,312 Nova Scotians, making the wait time between eight or nine years, said Sharma.

In Quebec, by comparison, there is a bariatric surgeon available for every 90 people who qualify for the procedure. In Newfoundland and Labrador there is only one bariatric surgeon for every 390 residents who could use those procedures. In Prince Edward Island, the surgery is not offered but is covered under the provincial Medicare program.

Faced with delays of years, many Canadians instead head south to Mexico and pay for their own bariatric surgeries in private medical establishments.

The costs are formidable – and the follow-up health care is often lacking.

"You're looking at somewhere between $10,000 and $15,000 for the surgery itself," said Sharma.

Still, there are significant costs for those Canadians who choose to lose weight by going the bariatric surgery route. Ahead of the surgery, these patients are asked to lose a significant amount of weight on their own, usually using meal replacement drinks that can cost up to $2,000 per year.

There are two other medical treatments which are considered to be effective at treating obesity. And both involve taking medication for the rest of the patient's life.

They're also not cheap.

Orlistat, sold under the brand name Xenical, is a pill that slows down the body's digestion of fat, letting it pass with the stool, and reducing the number of calories from fat a person can access. The downsides are that it can cause diarrhea and a typical prescription costs about $205 per month. Even with a good health care plan, the patient usually still has to pay about $37 per month, or about $440 per year.

The other choice is a hormone, commonly referred to as GLT1, which suppresses a person's appetite.

"It's a hormone so you would have to inject it once a day," said Sharma. "In Canada, it would cost you $400 a month and you would have to do that for life.

"Medical plans typically do not cover it," he said.

Then there is the diet.

Tough as it is to face daily hunger pangs, get rid of bad habits and start eating well, those struggling to attain their ideal weight and be healthy also face an additional and often-ignored hurdle.

The size of their grocery bill.

 "You'd think that if you eat less that you'd save money," said Dr. Sara Kirk, a professor at Dalhousie University's School of Health and Human Performance, in an interview.

"Healthy food costs more. Milk is a classic example. (In 2014), you could get two litres of Coke or Pepsi for $1 … Two litres of milk was then priced at $2.19."

That high cost for healthy food isn't just a Canadian problem. A scientific analysis of 27 studies from 10 countries published in 2013, the cost of eating healthier foods then came out to about $550 US per person.

On the other side, the study estimated poor eating habits to then be responsible for $1,200 US per American in extra health care costs.

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