Humanistic Burden and Gaps in Care and Treatment Policies of Obesity in Canada: A Systematic Review.

INTRODUCTION: This article aims to describe the results of a systematic literature review of the humanistic impact of obesity in adults in Canada and to identify gaps in obesity care and treatment policies. METHODS: Databases, conference proceedings, and guidelines were searched for recent publications evaluating the humanistic burden of obesity and barriers, guidelines, and treatment policies regarding obesity management worldwide, with results reported here for publications from Canada. RESULTS: Overall, 17,130 publications were identified, of which 22 publications from Canada were included. Of these, four publications reported on humanistic burden, six reported on the barriers towards effective obesity management, and 12 reported on obesity management guidelines and treatment policies. Multimorbidity was associated with poor mental health among people with obesity (PwO), while the communication style adopted by healthcare providers perpetuated the bias and stigma faced by PwO. Barriers to effective treatment included lack of alignment on treatment goals between PwO and physicians, physicians' attitudes toward obesity, inadequate healthcare access, and underutilization of the guideline-recommended pillars of obesity management. INTERPRETATION: The Canada-specific evidence highlighted in this review suggest a negative humanistic impact of obesity, particularly in relation to mental health outcomes and weight stigma. Findings from observational, survey-based, and environmental scan sources also suggest misalignment between guideline-recommended obesity care and real-world access, coverage, or uptake across Canadian jurisdictions. Interpretation of these findings should consider the broad scope and heterogenous nature of the evidence identified.