Weight management

Understanding body weight and diabetes

Measure weight & risk Management options Weight loss medications

Losing weight and maintaining that loss long-term is challenging. Weight management is more complex than just diet and physical activity.

Obesity is a chronic (long term), progressive health condition with ups and downs. It’s considered a chronic disease because it changes over time and requires lifelong management.

Many factors—such as genetics, physical and emotional health, sleep, medications, and other medical conditions—can affect your weight. It’s best to speak with a healthcare provider to determine the best approach for you.

Ways to measure weight and risk

There are several ways to assess weight and its link to health. While the most accurate methods aren’t widely available, Body Mass Index (BMI) and Waist Circumference (WC) are commonly used as starting points. These tools offer a basic picture of your weight and risk for chronic conditions but should be part of a broader conversation about your overall health, health goals and lifestyle with your health care team.

Body Mass Index (BMI)

BMI is a ratio of weight to height [BMI=kg/m2]. When your BMI is calculated, the number is then compared to ranges on a BMI chart that outlines your risk for obesity.

While widely used, BMI isn’t the most accurate tool. It doesn’t consider genetics, biological sex or gender, or other individual health factors. It also does not consider the amount of muscle vs. fat tissue your body has or the way these tissues are found within your body. It’s a starting point but should not be used alone to assess health risks.

Note: BMI is not applicable to pregnant/lactating women, long-distance endurance athletes, very muscular adults, adults with physical disabilities, or those with a very lean build. BMI classification values are not appropriate for use with people under 18 years of age, and do not account for biological sex or gender. BMI values may not be accurate for specific ethnicities.

Waist Circumference (WC)

WC measures the area around your waist. Extra fat around the waist is linked to increased health risks. WC targets vary by ethnic background and biological sex. Generally, you are considered at lower risk if your WC is:

Less than 40 inches (102 cm) for most men
Less than 35 inches (88 cm) for most women

These numbers may differ based on your cultural background or overall health.

Weight management options

If weight affects your health or how you feel, there are different options available. Your plan should be made to suit your goals and needs. In addition to healthy eating, physical activity, stress management, and sleep, Obesity Canada outlines three main approaches:

1. Behavioural and Psychological Interventions
These address personal challenges with weight maintenance and support long-term lifestyle changes to improve quality of life. They may include:

Cognitive Behavioural Therapy (CBT) for emotional eating and healthy habit-building.
Medical Nutrition Therapy (MNT) for personalized nutrition guidance.
Regular physical activity to boost energy and reduce stress.

2. Pharmacological Treatments
Some medications support weight loss and improve blood sugar levels. Health Canada has approved several that regulate appetite, metabolism, and cravings. These are often combined with behavioural strategies for long-term success.

3. Bariatric Surgery
For complex cases or serious health risks, bariatric surgery can be effective. It’s typically considered when behavioural and medication approaches haven’t met desired goals or when medications aren’t tolerated.

Weight loss medications

Common weight loss medications, such as GLP-1 agonists and dual GIP/GLP-1s, act on the brain to help you feel more satisfied, reduce hunger, and control cravings. They help with weight loss by:

Lowering appetite,
Helping you feel full sooner, and
Slowing down digestion.

Some medications like GLP-1 agonists and dual GIP/GLP-1s have been approved for weight loss in Canada. There are also medications approved for use in type 2 diabetes that can result in weight loss or be prescribed ‘off-label’ for weight loss. Talk to your health care team to determine the best option for you.

While effective for many people, these medications can be expensive, are not always covered by benefits providers and may cause side effects such as nausea, vomiting, diarrhea and/or constipation, reduced appetite, and abdominal pain.

These side effects may lead to:

Increased fullness and reduced nutrient intake,
Nutrient loss due to gastrointestinal symptoms,
Lower fibre and protein intake, and/or
Dehydration.

It is important to work with your health care team and consider all of these factors to find the best medication that will work for you.

Healthy Eating Tips While Taking Weight Loss Medications

Because these medications reduce food intake, you may not get all the nutrients your body needs. To support your health:

Eat small, frequent meals if your hunger is low.
Include a protein source in each meal to maintain your muscle mass.
Choose balanced meals that contain nutrient rich foods like vegetables and fruit, grains, protein and healthy fats.
Consider a multivitamin (ask your healthcare provider).
Stay hydrated by drinking water.
Avoid skipping meals – even a small snack helps.

If possible, talk to a dietitian to help build a healthy eating plan that works for you.

Who can help?

There are many health-care providers (e.g. dietitian, doctor, diabetes educator, pharmacist) who can support you with your weight management and health goals. Check with them before starting any new routines or making changes to medications, eating patterns or exercise.

Keep in mind that many things can make managing weight a challenge, including access to healthy food, safe environments for exercise, stress, some medical conditions and certain medications, including insulin.

Be kind to yourself, start slowly and remember that making changes takes time. Set goals that help you achieve better health whether they are weight-related or not.