Shahebina Walji, MD, CCFP

Diplomate,

American Board of Obesity Medicine

Medical Director,

Calgary Weight Management Centre

Clinical Assistant Professor,

University of Calgary

bh in Brief

Dr. Shahebina Walji has been Medical Director of the Calgary Weight Management Centre since 2008. She is also Clinical Assistant Professor in the Department of Family Medicine at the University of Calgary. She received her MD from McMaster University in Hamilton and a Family Medicine specialty from the University of Toronto. Dr. Walji is currently an obesity-focused preceptor and lecturer at the University of Calgary. She has spoken internationally and in 2017 was co-author of the Clinical Practice Guidelines on the Management of Overweight and Obesity in Adults. Perhaps most rewarding is what patients say in describing her as “compassionate, caring and knowledgeable in helping to develop healthy and sustainable habits and overseeing the transition from obesity to normal weight” 

www.obesitycanada.ca

“Obesity is a chronic and relentless condition …”

1. Why do people gain weight?

Many people believe that body weight is determined only by how many calories are eaten and how many calories are burned, and that weight gain occurs when a person is eating too much and moving too little.  While it is true that what and how much we eat, as well as our level of activity, are important, this explanation of body weight and weight gain is far too simple. The reality is that weight and weight gain leading to obesity are the result of a very complex interplay between many different factors, including genetic, environmental, biological, medical, and behavioural influences. 

2. What is obesity?

According to the World Health Organization, “overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health.” Obesity is associated with a myriad of health problems, and it has the potential to affect every system in the body in some capacity. In 2015, the Canadian Medical Association declared obesity to be “a chronic disease requiring enhanced research, treatment and prevention efforts.” 

 3. Can obesity be successfully managed?

Obesity is a chronic and relentless condition, which does not seem to ever go away.  This is because in order to survive, our bodies are programmed to defend against change.  Just as it protects us from changes in blood pressure, body temperature and blood sugar levels, our body is also programmed to defend against changes in weight.  When we try to lose weight, our body’s biological (both hormonal and metabolic) defences favour weight regain.  While obesity cannot be cured, it can be managed like most other chronic diseases in accordance with chronic care principles. Successful management requires a multifaceted approach and lifelong attention.  Quick fix diets are not effective and, typically, only result in a discouraging pattern of weight cycling.

4. What factors in the workplace contribute to obesity?

There are many factors in the workplace that can contribute to obesity. These include things such as high availability of unhealthy food options, sedentary work environments requiring long periods of sitting, long work hours or shift work, and high levels of stress associated with occupational responsibilities. 

5. What can employers do? 

Because obesity management is multifactorial, it is important for employers to consider multidimensional opportunities to intervene. These could include:

• Assessing needs, with sensitivity, to identify what employees living with obesity will find beneficial.
• Evaluating interventions in terms of their effect on weight and other factors such as quality of life, workplace satisfaction, and levels of absenteeism and presenteeism. 
• Examining the workplace environment to see if it is comfortable, helps reduce stress, and promotes healthy behaviours through, for example, access to nutritious foods, recreation facilities and opportunities to consult with physicians, dietitians and psychologists who are knowledgeable about weight management. 
• Considering individualized or group behavioural interventions, like a “lunch and learn,” provided with help from health professionals with expertise in weight management.  
• Ensuring employee benefits cover the services of allied health professionals and medications shown to be effective adjuncts to behavioural efforts to decrease weight, reduce health risks and improve quality of life.  

There is much that employers can do to provide interventions that are appropriate for their workplace and meet the needs of employees struggling with weight management. bh