B.C. doctor calls on the province to cover obesity medications

A B.C. doctor is calling on the province to cover weight management medications in order to fix what she calls a "two-tiered system" for obesity care.  

Dr. Ali Zentner, a diabetes and obesity specialist with Vancouver-based Revolution Medical Clinic, has started a petition to demand the inclusion of medications like semaglutide and liraglutide in B.C. PharmaCare. 

They are anti-diabetic and anti-obesity drugs that can cost patients up to $450 per month out of pocket. 

And even more costly is the serious health problems that patients can develop due to obesity and the treatments needed to address them, which Zentner and a patient say add to the case for covering these drugs.

Around 23 per cent of adults in B.C. are obese, according to 2018 data from Statistics Canada.

In her petition, Zentner says obesity is a disease and not the fault of the patient. She added that current obesity treatments, including drugs that Canada has approved, are very effective.

"Gone are the days of just telling patients to just take care of it themselves," she said. "Now we talk [about] true medical treatments and we have impressive outcomes well beyond weight loss."

The doctor adds that the obesity treatments have led to positive outcomes when it comes to other health risks.

In particular, obesity is a risk factor for health issues such as diabetes, heart disease, stroke and sleep apnea, according to Dr. Tom Elliott, medical director of B.C. Diabetes. He said treating them can come with an "astronomical" price tag, so prevention is important 

Zentner told CBC News that the petition has received almost 1,000 signatures, but it has yet to be sent to the government. 

'Not alone in this'

Emily Henry is one of Zentner's patients who has signed the petition.

Henry, a member of the Ochapowace Cree First Nation in Saskatchewan whose traditional name is kihci têpakohp iskotêw iskwêw, remembers growing up without much food.

Born in 1960, she said one of her first memories was lining up for rations with her mother to feed their family of 12. 

"I remember her face and always feeling hungry," she said. 

This lack of food continued as she attended day school, an experience that she said is also common for her family members who went through the residential school system or were in foster care.

So when she was able to access food later in life, Henry said she just couldn't get enough of it — and she then struggled with obesity through much of her adult life. 

"I had this thing where my pantry had to be full, otherwise I felt incomplete," she said. "I developed Type 2 diabetes, as have all my siblings, so I'm not alone in that."

Now, Henry says she has been on Ozempic for over a year. For her, it has been "almost miraculous" to see her blood pressure lowered and her diabetes improved. And because the medication is for diabetes treatment, she said PharmaCare covers it. 

Henry views obesity, fuelled by the trauma of growing up under colonization, as the root cause of her health issues and said she would have wanted to treat it earlier to not develop these other health issues in the first place.

PharmaCare, however, currently doesn't cover her medication for weight management. 

"I really feel if the health-care system can look at that and examine that through that lens, there's a whole new way of looking at it when people are prescribed obesity medication," she said.

Beyond the petition, Zentner said she pitched the idea of the province covering the drugs directly to Premier David Eby in a 2023 meeting, but more remains to be done. 

"The premier thanked me for my time and passed it onto the minister of health, who has passed it onto PharmaCare who is waiting for [Canada's drug agency]," she said. "So it keeps getting kicked down the line."

In a statement to CBC News, the province's Ministry of Health confirmed that Ozempic is only covered for Type 2 diabetes treatment and not weight loss. 

It added that Health Canada has approved semaglutide under the brand name Wegovy for chronic weight management among adult patients. 

But it says Canada's Drug Agency recommended provincial and territorial drug plans like B.C. PharmaCare not cover it because the drug's submission for approval didn't evaluate its prevention of weight-related health risks.

The ministry did note a 2023 study in the New England Journal of Medicine which demonstrates that the drug reduces the risk of major adverse cardiovascular events. But it says the "new evidence needs to be submitted to CDA for evaluation."