Canada’s youth face obesity epidemic
June 18, 2011
Sarah Telfer’s dreams are what most 19-year-olds call life.
She wants to shop at cool clothing stores, jump into a friend’s car without worrying the seatbelt won’t fit around her waist, and teeter on dizzying stilettos at strobe-lit nightclubs. Having just reached legal drinking age, she’s eager to test-drive her new adult status.
But at 5-foot-6 and 260 pounds, which means she is morbidly obese with a body mass index of 42, she can’t.
“I don’t really get out that much,” she says. “I love to dance, but I just don’t feel comfortable. I feel like people are looking at me and talking about how fat I am.”
Telfer is part of a growing number of overweight youth who medical experts say are on an inevitable path to become morbidly obese adults.
Unchecked, Telfer will face health complications such as heart disease and diabetes, further reducing her quality of life and straining Ontario’s healthcare system.
The Star is probing obesity in a series that began Saturday. More and more people in Ontario are overweight and the province lacks a coordinated strategy to tackle the problem.
There are 212,000 obese children in Ontario and another 420,000 who are overweight. To fight back, Toronto’s Hospital for Sick Children created the SickKids Team Obesity Management Program (STOMP) a little more than a year ago.
STOMP has enough money to help just 50 kids between the ages of 12 and 17 each year and SickKids doctors have hand-picked Ontario’s most dire cases.
Telfer has felt like that for years. Once active on the soccer field, she began eating more and exercising less as a teen. By 15, she knew she had a problem.
An emotional eater, she fights stress with comfort foods like fried chicken, a grilled cheese sandwich or a late night bag of chips.
High school was tough. Classmates would berate her for being the “bigger twin” in relation to her thinner, blonder identical sister. They would snicker “go home! — it isn’t working!” if they saw her jogging.
Telfer wants to become a nurse and hopes to get on the list for a weight reduction operation. For the summer, she is packaging hot dogs at a Schneider’s plant.
At one point, she spent more than $2,000 on an herbal weight-loss product. That ended in more weight gain.
Telfer recently abandoned a low-calorie diet that prohibited carbohydrates and egg yolks, and allowed some protein, salads and eight grapes a day. It made her light-headed and dizzy.
In the past six months, the Cambridge native has been diagnosed with fatty liver disease, a build-up of too much fat in the liver cells.
Telfer’s back aches. Her knees creak like they belong to a woman four times her age. Doctors think she might have sleep apnea.
Her weight has caused polycystic ovarian syndrome, which can cause infertility and makes it more difficult for her body to relinquish fat.
By the time she is 40, if her problem remains, obesity experts say the weight will wreak havoc on every organ, causing problems like heart and gall bladder diseases, cancer, cataracts, stroke and pancreatitis to name a few. Knees and hips, already aching from the stress of carrying too much weight for too many years, crumble. This is when things get costly.
The price of obesity is difficult to measure. Excess weight can create many problems that are a huge drain on the healthcare system, experts say. Expensive treatments aside, a Queen’s University study in 2009 estimated that an obese woman around Telfer’s age costs OHIP $682 a year in extra doctors’ fees alone. By the time men and women pass middle age, the cost jumps to as much as $1029 per year in doctors’ fees.
Telfer is hoping she will be accepted as a candidate for the OHIP funded bariatric surgery that costs the healthcare system between $16,000 and $18,000.
A few months ago she wrote her family doctor pleading for a referral. “I want to live a long happy life . . . I know gastric bypass surgery can be dangerous, but I am ready to make a change in my lifestyle.”
Telfer is now on a year-long wait list just to find out if she qualifies for the procedure.
There are only seven hospitals in Ontario that offer the operation for adults.
Since the SickKids program began, five Ontario teens have had the surgery.
But bariatric surgery is not a focus of the two-year STOMP program. Changing food behaviour is. In addition to discussing portion size and expounding on the benefits of exercise, STOMP counsellors and kids spend biweekly group sessions trouble-shooting ways to handle real-life food situations, like the dreaded buffet-style family dinner.
One participant’s suggestion: send a parent to fill your plate, quashing the urge to pile it too high.
“Most programs are just about teaching people what to eat, what to limit,” says STOMP director Dr. Jill Hamilton. “They don’t often deal with the underlying reasons for why it’s hard.”
STOMP’s approach is attracting a lot of attention and the eight month weight list is growing.
Chelsea, 15, a program patient, said she is thriving because it offers her
Something else it does: Connect her with peers who understand exactly what it’s like to go through life plus-sized and a target of what obesity experts call society’s last acceptable prejudice.
Chelsea, who asked that her name not be usedss, has plump arms that curve alongside a rolling waist, and almond-shaped blue eyes inset above wide cheeks. She doesn’t know exactly how much she weighs, she says, and wouldn’t tell anyway. It’s a sore spot.
Because of her weight, she lived in fear of being shoved down the stairs at her elementary school. “Oh my god,” her tormentors would yell, “the world just shook.” The group of boys succeeded in toppling her over more than 10 times between Grades 6 and 8. Each time they stood by laughing.
Humiliated, Chelsea would pluck herself off the steps, fix her eyes on the floor and sprint home. “I was the only one they picked on,” she said. “I was the chubby girl.”
Crippled by anxiety, she dropped out last year to be home-schooled. It is hard for her to go out in public alone without the shielding presence of her mother.
She is grappling with big issues that started when she was little.
As a youngster, Chelsea, like many children of working parents, would find herself at home alone after school peering into kitchen cupboards. Hungry, she would eat a granola bar and, unable to stop herself, pick away at more until she devoured the entire box. “I didn’t realize I shouldn’t eat so much,” she says.
Her mother, Donna, who has also spent a lifetime struggling with her weight, would hide junk food in the basement and sneak it to her older, thinner son when she thought her daughter wasn’t looking.
STOMP is helping Chelsea embrace her physique emotionally while physically trying to improve it. Already she has lost 40 pounds and dropped two dress sizes. But it’s a constant challenge. Part of the solution has been setting a realistic weight-loss goal: to become a size 16, which would mean she’d be free of health complications and able to wear cute clothes.
The cost of fat
At 52, Leonard Labelle has already forgone about $1.5 million in wages, depriving the province of some $50,000 in taxes since he stopped working almost three decades ago.
His life as an adult shows how expensive weight is to a person and society.
Labelle busted both knees lifting a 54-kilogram load as a 23-year-old labourer. Since then depression and inactivity have caused his weight to swell. Always barrel-chested and burly, but once active as a runner and swimmer, he now weighs 400 pounds and is unable to do anything that involves too much moving or standing.
His knees buckle after only a few minutes upright. Sweat drips from his forehead, and his breathing becomes shallow and rapid after he walks fewer than 20 steps. He chain-smokes and has diabetes.
In the past seven years he has visited the doctor about 150 times and had his blood analyzed 58 times, costing OHIP $4,053.
Qualified to receive money from Ontario’s disability pension plan, he says, he has opted not to take the money. It would mean a clawback to his wife Kathleen’s income. She works from home, coordinating orders for Pizza Pizza.
Like many obese people, who he keeps himself hidden, spending his days and most of his nights in the dark basement of his Scarborough bungalow. His black swivel chair bears permanent indents in the shapes of his buttocks and thighs. In front of him is a movie-sized TV screen hooked up to his computer and a camera that watches over his driveway. It helps him screen visitors because he can’t easily “get up in case someone knocks at the front door.”
He receives a $300 monthly pension from Ontario’s Worker Safety and Insurance Board. He recently asked the WSIB for more money for his injuries, but his request and appeal were both denied, in part, because his “obesity... more likely than not prevented the worker from returning to any form of work,” the ruling states.
The medical expenses are growing.
Labelle’s blood pressure and cholesterol levels are high and he is at extremely high risk for heart disease and stroke. A coronary bypass costs hospitals $23,800, according to hospital data and that doesn’t include cardiologist or surgeon’s fees, which could add another $1,000. If he suffers heart failure, hospitals bill OHIP $9,700. Stroke: $26,300. And if he has complications like pneumonia, it will cost a hospital $8,100 to treat him.
“It's very hard. I feel like I'm useless and helpless. And I wish I could lose weight. I'm trying. I'll keep trying,” Labelle said.