Every year, March 4 marks World Obesity Day - an international initiative aimed at transforming the way society perceives and treats this condition. For despite the scientific advances of recent decades, obesity is still too often perceived as a matter of willpower rather than what it really is: a complex chronic disease, influenced by genetics, biology, hormones, the environment and psychosocial factors.
In Quebec, around 26 % of adults live with obesity - defined as a body mass index (BMI) over 30 - and over 60 % are overweight. These figures are not a reflection of individual failure: they reflect a biological and environmental reality that deserves a serious medical response. Clinique Omicron accompanies patients on their weight management journey at several of its branches in Quebec.
Obesity: a chronic disease, not a choice
Modern medicine has recognized obesity as a chronic disease in its own right for several decades. It is associated with over 200 medical complications, including type 2 diabetes, cardiovascular disease, hypertension, sleep apnea, certain cancers, joint disease and fatty liver. Its impact on mental health is also considerable: depression, anxiety, social isolation and stigmatization are frequently reported.
Body weight maintenance is regulated by complex biological mechanisms involving numerous hormones - including insulin, leptin, ghrelin and GLP-1 - as well as the central nervous system. When someone loses weight, their body reacts by increasing hunger and reducing basal metabolism to regain the original weight - a phenomenon known as metabolic resistance. This is why approaches based on caloric restriction alone so often fail in the long term without appropriate medical support.
Medical assessment: the essential starting point
Effective management of obesity always begins with a thorough medical evaluation. This helps identify secondary causes of obesity - such as hypothyroidism, Cushing's syndrome or polycystic ovary syndrome - which require specific treatment. It also makes it possible to quantify complications already present, assess cardiovascular and metabolic risk factors, and personalize the treatment plan.
Le bilan inclut typiquement la mesure de l’IMC et du tour de taille, un bilan sanguin complet avec glycémie à jeun, hémoglobine glyquée, bilan lipidique, bilan thyroïdien et bilan hépatique, ainsi qu’une mesure de la tension artérielle. Cette évaluation globale est disponible lors d’une consultation médicale dans plusieurs de nos succursales au Québec, sans nécessiter de référence préalable.
The pillars of obesity management
Medical management of obesity is based on a multimodal approach. Lifestyle modifications - a balanced diet with a moderate calorie deficit, progressive physical activity and work on eating habits - form the basis of all treatment. The support of a nutritionist or dietician is invaluable in personalizing dietary recommendations and avoiding counter-productive restrictive diets. Cognitive-behavioral therapy can help identify and modify emotional eating patterns.
When lifestyle modifications are insufficient to achieve clinically significant weight loss - generally defined as 5 to 10 % of initial weight - pharmacotherapy may be considered as a complement, never as a replacement.
New GLP-1 drugs: a therapeutic revolution
The arrival of GLP-1 receptor agonists - a class of drugs that includes semaglutide (marketed under the names Ozempic and Wegovy) and tirzepatide (Mounjaro) - has profoundly transformed the medical treatment of obesity. These molecules mimic the action of a natural intestinal hormone that reduces appetite, slows gastric emptying and acts on the brain's satiety centers. Clinical studies show average weight losses of 15 to 22 % of body weight over one year - unprecedented results for a pharmacological treatment.
These drugs are subcutaneous injections, administered once a week. They are indicated for patients with a BMI greater than 30, or greater than 27 in the presence of weight-related comorbidity. They are not reimbursed by the RAMQ for obesity in Quebec - except under certain conditions for type 2 diabetes - but may be partially covered by some private insurers. Their monthly cost in Quebec ranges from $250 to $500, depending on molecule and dosage.
Frequently asked questions about obesity management in Quebec
Is bariatric surgery the only effective long-term solution to obesity?
No. Although bariatric surgery - notably sleeve gastrectomy and gastric bypass - is the most effective intervention for severe obesity (BMI over 40), the new GLP-1 drugs offer comparable results for a significant proportion of patients, without the surgical risks. For the majority of people with a BMI between 30 and 40, an approach combining lifestyle modifications, nutritional support and pharmacotherapy today represents a credible alternative to surgery.
Do drugs like Ozempic work without changing lifestyle habits?
GLP-1 drugs are most effective when combined with dietary changes and physical activity. Used alone, they still produce significant weight loss in the majority of patients, but the best results - and especially long-term maintenance - are achieved as part of a medically supervised, comprehensive approach. What's more, stopping the medication without modifying lifestyle habits often leads to weight regain, as the underlying biological mechanisms are not permanently corrected.
Can I see a doctor at Clinique Omicron for weight management without a referral?
Yes, at many of our Quebec locations, you can make an appointment directly with a physician to discuss your weight and health goals. The consultation includes a complete medical evaluation, a blood test if indicated, and a discussion of available options - including prescribing medication if appropriate. No prescription or referral from another professional is necessary.
Is obesity genetic? Can we really do anything about it?
Genetics play an important role in predisposition to obesity - certain genetic variations influence basal metabolism, appetite regulation and the way the body stores fat. However, genetics are not inevitable: environment, diet, physical activity and medical treatment can significantly modulate the expression of these predispositions. The medical management of obesity is effective even for people with a strong genetic component, provided a sustained and personalized approach is adopted.
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